The Venice specimen of Ouranosaurus nigeriensis (Dinosauria, Ornithopoda)

PubMed Central

2017-01-01

Ouranosaurus nigeriensis is an iconic African dinosaur taxon that has been described on the basis of two nearly complete skeletons from the Lower Cretaceous Gadoufaoua locality of the Ténéré desert in Niger. The entire holotype and a few bones attributed to the paratype formed the basis of the original description by Taquet (1976). A mounted skeleton that appears to correspond to O. nigeriensis has been on public display since 1975, exhibited at the Natural History Museum of Venice. It was never explicitly reported whether the Venice specimen represents a paratype and therefore, the second nearly complete skeleton reported in literature or a third unreported skeleton. The purpose of this paper is to disentangle the complex history of the various skeletal remains that have been attributed to Ouranosaurus nigeriensis (aided by an unpublished field map of the paratype) and to describe in detail the osteology of the Venice skeleton. The latter includes the paratype material (found in 1970 and collected in 1972), with the exception of the left femur, the right coracoid and one manus ungual phalanx I, which were replaced with plaster copies, and (possibly) other manus phalanges. Some other elements (e.g., the first two chevrons, the right femur, the right tibia, two dorsal vertebrae and some pelvic bones) were likely added from other individual/s. The vertebral column of the paratype was articulated and provides a better reference for the vertebral count of this taxon than the holotype. Several anatomical differences are observed between the holotype and the Venice specimen. Most of them can be ascribed to intraspecific variability (individual or ontogenetic), but some are probably caused by mistakes in the preparation or assemblage of the skeletal elements in both specimens. The body length of the Venice skeleton is about 90% the linear size of the holotype. Osteohistological analysis (the first for this taxon) of some long bones, a rib and a dorsal neural spine

The 1966 Flooding of Venice: What Time Taught Us for the Future

NASA Astrophysics Data System (ADS)

Trincardi, Fabio; Barbanti, Andrea; Bastianini, Mauro; Benetazzo, Alvise; Chiggiato, Jacopo; Papa, Alvise; Pomaro, Angela; Sclavo, Mauro; Tosi, Luigi; Umgiesser, Georg

2017-04-01

Upon this fiftieth anniversary of the storm that flooded the historical Italian centers of Venice and Florence, we review the event from the perspective of today's scientific knowledge. In particular, we discuss the components of relative sea level rise in Venice that contribute to flooding, the monitoring networks and forecast capabilities that are currently in place, and the engineering actions adopted since the 1966 flood to safeguard the Venice lagoon and the city. Focusing on the meteo-oceanographic aspects, we also show how sheer luck at the time avoided a much worse disaster in Venice. Reference Trincardi, F., A. Barbanti, M. Bastianini, A. Benetazzo, L. Cavaleri, J. Chiggiato, A. Papa, A. Pomaro, M. Sclavo, L. Tosi, and G. Umgiesser. 2016. The 1966 flooding of Venice: What time taught us for the future. Oceanography 29(4), https://doi.org/10.5670/ oceanog.2016.87.

Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease.

PubMed

Labombarda, Fabien; Hamilton, Robert; Shohoudi, Azadeh; Aboulhosn, Jamil; Broberg, Craig S; Chaix, Marie A; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Macle, Laurent; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Khairy, Paul

2017-08-15

Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers. Qualifying arrhythmias were classified by a blinded adjudicating committee. The most common presenting arrhythmia was intra-atrial re-entrant tachycardia (IART) (61.6%), followed by atrial fibrillation (28.8%), and focal atrial tachycardia (9.5%). The proportion of arrhythmias due to IART increased with congenital heart disease complexity from 47.2% to 62.1% to 67.0% in patients with simple, moderate, and complex defects, respectively (p = 0.0013). Atrial fibrillation increased with age to surpass IART as the most common arrhythmia in those ≥50 years of age (51.2% vs. 44.2%; p < 0.0001). Older age (odds ratio [OR]: 1.024 per year; 95% confidence interval [CI]: 1.010 to 1.039; p = 0.001) and hypertension (OR: 2.00; 95% CI: 1.08 to 3.71; p = 0.029) were independently associated with atrial fibrillation. During a mean follow-up of 11.3 ± 9.4 years, the predominant arrhythmia pattern was paroxysmal in 62.3%, persistent in 28.2%, and permanent in 9.5%. Permanent atrial arrhythmias increased with age from 3.1% to 22.6% in patients <20 years to ≥50 years, respectively (p < 0.0001). IART is the most common presenting atrial arrhythmia in patients with congenital heart disease, with a predominantly paroxysmal pattern. However, atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A new hydrogeologic model to predict anthropogenic uplift of Venice

NASA Astrophysics Data System (ADS)

Teatini, P.; Castelletto, N.; Ferronato, M.; Gambolati, G.; Tosi, L.

2011-12-01

Recent numerical studies based on a simplified lithostratigraphy of the Venice subsurface suggest that the city may be raised by pumping seawater into deep aquifers through 12 wells located on a 10 km diameter circle. Using an updated 3-D reconstruction of the Quaternary deposits, developed very recently from about 1050 km of multichannel seismic profiles and eight exploration wells, along with a more accurate representation of the injection boreholes, novel finite-element predictions are performed. The new model simulates the lithostratigraphy of the lagoon subsurface and allows for a reliable assessment of the water volumes injected into the geologic formations based on the actual bottom hole overpressure that can vary both in space and time. Pumping occurs into two Pleistocene sequences that are originated from the Alps and Apennine sedimentation and terminate just south and north of Venice, respectively, and the shelf portion of a Pliocene sequence that is rather continuous below the central lagoon with arenite layers to depths as much as 1000 m below mean sea level. With a proper tuning of the injection pressure the new hydrogeologic model allows for a prediction of a quite uniform 25-30 cm uplift over 10 years after the inception of injection. The gradient of the vertical displacement ξz does not exceed 5 × 10-5 and 1 × 10-5 in the whole lagoon and Venice, respectively, i.e., well below the most conservative bound recommended for the safety of the structures. If ad hoc calibrated injection overpressures are implemented in each single well, ξz may be reduced to as much as 0.1 × 10-5 throughout the city.

About Arrhythmia

MedlinePlus

... may shut down or be damaged. View an animation of arrhythmia . Types of Arrhythmias Atrial Fibrillation = upper ... learn about: S tructure of the heart Watch an animation of heart valve anatomy The heart: four chambers, ...

Trends in Reporting Methadone-Associated Cardiac Arrhythmia, 1997–2011

PubMed Central

Kao, David; Bartelson, Becki Bucher; Khatri, Vaishali; Dart, Richard; Mehler, Philip S.; Katz, David; Krantz, Mori J.

2013-01-01

Background: Long-acting opioids are a leading cause of accidental death in the United States, and methadone is associated with greater mortality rates. Whether this increase is related to the proarrhythmic properties of methadone is unclear. Objective: To describe methadone-associated arrhythmia events reported in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS). Design: Description of national adverse event registry data before and after publication of a 2002 report describing an association between methadone and arrhythmia. Setting: FAERS, November 1997 and June 2011. Patients: Adults with QTc prolongation or torsade de pointes and ventricular arrhythmia or cardiac arrest. Measurements: FAERS reports before and after the 2002 report. Results: 1646 cases of ventricular arrhythmia or cardiac arrest and 379 cases of QTc prolongation or torsade de pointes were associated with methadone. Monthly reports of QTc prolongation or torsade de pointes increased from a mean of 0.3 (95% CI, 0.1 to 0.5) before the 2002 publication to a mean of 3.5 (CI, 2.5 to 4.8) after it. After 2000, methadone was the second-most common primary suspect in cases of QTc prolongation or torsade de pointes after dofetilide (a known proarrhythmic drug) and was associated with disproportionate reporting similar to that of antiarrhythmic agents known to promote torsade de pointes. Antiretroviral drugs for HIV were the most common coadministered drugs. Limitation: Reports to FAERs are voluntary and selective, and incidence rates cannot be determined from spontaneously reported data. Conclusion: Since 2002, reports to FAERS of methadone-associated arrhythmia have increased substantially and are disproportionately represented relative to other events with the drug. Coadministration of methadone with antiretrovirals in patients with HIV may pose particular risk. Primary Funding Source: Colorado Clinical and Translational Sciences Institute, National Institutes of Health, and

[Idiopathic ventricular arrhythmia in children. Apropos of 24 cases].

PubMed

Coeurderoy, A; Almange, C; Laurent, M; Biron, Y; Leborgne, P

1985-12-01

The severity and prognosis of idiopathic ventricular arrhythmias in childhood were studied in 24 patients (12 boys, 12 girls) with an average age of 8 years at the time of diagnosis of the arrhythmia. Investigations included clinical assessment and analysis of basal ECG (morphology of the arrhythmias) and dynamic recordings (Holter and exercise stress testing). The clinical course was followed for an average of 3.8 years. The patients were classified in two groups: monomorphic arrhythmias (Group I) and polymorphic arrhythmias (Group II). Group I was divided into 4 subgroups: isolated ventricular extrasystoles (IA), 11 patients; ventricular extrasystoles with bursts of ventricular tachycardia (IB), 6 patients; sustained ventricular tachycardia without intercritical extrasystoles (IC), 1 patient; accelerated idioventricular rhythm (ID), 2 patients. Subgroups IA, IB and ID were characterised by the absence of symptoms, the disappearance of the arrhythmia on exercise, the decreased efficacy of antiarrhythmic drugs and an excellent prognosis. Therapeutic abstention was the rule in these patients. Patients in Group IC were characterised by the variability of their symptoms, the absence of exercise induced arrhythmias, the need for treatment in most cases and a good long-term prognosis. Group II was divided into 2 subgroups: adrenergic polymorphic ventricular tachycardia (IIA), 2 patients, and non-adrenergic polymorphic ventricular tachycardia (IIB), 2 patients. Patients in Subgroup IIA were characterised by syncope on exercise or emotion, the need for betablocker therapy which considerably improved the patients symptoms but which did not usually prevent sudden death.(ABSTRACT TRUNCATED AT 250 WORDS)

β1-Adrenoceptor blocker aggravated ventricular arrhythmia.

PubMed

Wang, Yan; Patel, Dimpi; Wang, Dao Wu; Yan, Jiang Tao; Hsia, Henry H; Liu, Hao; Zhao, Chun Xia; Zuo, Hou Juan; Wang, Dao Wen

2013-11-01

To assess the impact of β1 -adrenoceptor blockers (β1 -blocker) and isoprenaline on the incidence of idiopathic repetitive ventricular arrhythmia that apparently decreases with preprocedural anxiety. From January 2010 to July 2012, six patients were identified who had idiopathic ventricular arrhythmias that apparently decreased (by greater than 90%) with preprocedural anxiety. The number of ectopic ventricular beats per hour (VPH) was calculated from Holter or telemetry monitoring to assess the ectopic burden. The mean VPH of 24 hours from Holter before admission (VPH-m) was used as baseline (100%) for normalization. β1 -Blockers, isoprenaline, and/or aminophylline were administrated successively on the ward and catheter lab to evaluate their effects on the ventricular arrhythmias. Among 97 consecutive patients with idiopathic ventricular arrhythmias, six had reduction in normalized VPHs in the hour before the scheduled procedure time from (104.6 ± 4.6%) to (2.8 ± 1.6%) possibly due to preprocedural anxiety (P < 0.05), then increased to (97.9 ± 9.7%) during β1 -blocker administration (P < 0.05), then quickly reduced to (1.6 ± 1.0%) during subsequent isoprenaline infusion. Repeated β1 -blocker quickly counteracted the inhibitory effect of isoprenaline, and VPHs increased to (120.9 ± 2.4%) from (1.6 ± 1.0%; P < 0.05). Isoprenaline and β1 -blocker showed similar effects on the arrhythmias in catheter lab. In some patients with structurally normal heart and ventricular arrhythmias there is a marked reduction of arrhythmias associated with preprocedural anxiety. These patients exhibit a reproducible sequence of β1 -blocker aggravation and catecholamine inhibition of ventricular arrhythmias, including both repetitive ventricular premature beats and monomorphic ventricular tachycardia. ©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.

[Complex ventricular arrhythmias and carvedilol: efficacy in hemodialyzed uremic patients].

PubMed

Cice, G; Tagliamonte, E; Ferrara, L; Di Benedetto, A; Iacono, A

1998-06-01

Carvedilol has been shown to be effective in systemic hypertension and coronary artery disease in patients with end-stage renal disease, on maintenance hemodialysis. The aim of our study was to assess the effects of carvedilol on ventricular arrhythmias in these patients. Ninety-eight uremic patients maintained on hemodialysis, with complex ventricular arrhythmias (class III, IV and V of Lown's classification), not only during dialysis, were included in the study. They were divided into two groups, with mild-to-moderate hypertension or coronary artery disease. The efficacy and safety of carvedilol (50 mg/day) was compared to placebo in a 6-week randomized, double-blind study. Carvedilol significantly reduced, in both hypertensive and ischemic patients, total ventricular premature contractions (82.7 +/- 11.3 vs 358.1 +/- 73.9, p < 0.001; 88.3 +/- 24.4 vs 369.9 +/- 77.8, p < 0.001), repetitive ventricular premature contractions (1.3 +/- 1.3 vs 6.3 +/- 3.5, p < 0.001; 1.2 +/- 0.7 vs 6.9 +/- 2.6, p < 0.001) and episodes of ventricular tachycardia (1.1 +/- 1.2 vs 11.8 +/- 7.5, p < 0.001; 1.4 +/- 1.2 vs 14.0 +/- 8.3, p < 0.001). In placebo-treated patients, instead, these parameters were not significantly changed (329.1 +/- 76.5 vs 361.7 +/- 71.7, NS, and 324.6 +/- 79.7 vs 359.3 +/- 58.1, NS; 6.2 +/- 3.7 vs 7.3 +/- 3.7, NS, and 4.9 +/- 2.2 vs 6.1 +/- 3.2, NS; 9.8 +/- 6.3 vs 13.3 +/- 8.0, NS, and 9.0 +/- 6.2 vs 12.4 +/- 7.8, NS). Carvedilol confirmed a significant effect on myocardial ischemia and systemic hypertension. No significant side effects were reported. Ventricular arrhythmias are frequent in patients with end-stage renal disease maintained on hemodialysis. They are often due to an underlying cardiac disease, namely systemic hypertension with left ventricular hypertrophy and coronary artery disease. The results of our study show that the antiarrhythmic effect of carvedilol is linked, at least partly, to an improvement of the underlying cardiac disease. Uremic

[Risk of arrhythmia and domestic low-voltage electrical injury].

PubMed

Claudet, I; Maréchal, C; Debuisson, C; Salanne, S

2010-04-01

Analysis of domestic low-voltage (220-240 V) electrical injury in children admitted to a pediatric emergency department to illustrate the low risk of initial or delayed risk of arrhythmia. Retrospective study between 2001 and 2008 analyzing all children aged less than 15 years admitted for a low-voltage electrical injury. The data collected were age, sex, time and circumstances of the accident, time and day of admission, transport modalities, presence of risk factors for arrhythmia (transthoracic current, wet skin, tetany, loss of consciousness or neurological symptoms, and initial EKG abnormalities), injuries, EKG, muscular and/or cardiac enzyme values, progression and complications. For statistical analysis, data were entered in Microsoft Excel tables. Analysis was done with StatView5.1 (SAS Institute) and Epi Info 6.04fr (VF, ENSP epiconcept). In the descriptive analysis, the data are presented as mean values with SD, median and range. Forty-eight children were included. The mean annual number of admissions was equal to 6 (range, 3-12). The mean age was 6.2 + or - 4.3 years (median, 4.6 years). There was a male predominance: the overall sex ratio was 1.5, i.e., 3 before the age of 2 and 2.6 before the age of 10. The electrical injury occurred after contact with a wire or a connected cord or after the introduction of a metallic object in a wall socket. Ten children had risk factors of arrhythmia (mainly wet skin or thoracic pain). Twenty-nine children suffered from burns to the extremities (digits and hands, 70 %). At admission, 45 children had an EKG performed. The initial EKG was considered abnormal in 8 cases showing: sinusal tachycardia (n=4), incomplete right bundle branch block (n=4), and V(1) negative T waves (n=1). The EKG normalized within the first 12h. Hospitalization for cardiac monitoring was required for 18 children. No delayed arrhythmia occurred. In a mean time of 3.5h after the accident, a troponin dosage was given to 15 children and was normal

venice: Mask utility

NASA Astrophysics Data System (ADS)

Coupon, Jean

2018-02-01

venice reads a mask file (DS9 or fits type) and a catalogue of objects (ascii or fits type) to create a pixelized mask, find objects inside/outside a mask, or generate a random catalogue of objects inside/outside a mask. The program reads the mask file and checks if a point, giving its coordinates, is inside or outside the mask, i.e. inside or outside at least one polygon of the mask.

Arrhythmias in Adults with Congenital Heart Disease: What Are Risk Factors for Specific Arrhythmias?

PubMed

Loomba, Rohit S; Buelow, Matthew W; Aggarwal, Saurabh; Arora, Rohit R; Kovach, Joshua; Ginde, Salil

2017-04-01

An increasing number of patients with congenital heart disease are now surviving into adulthood. This has also led to the emergence of complications from the underlying congenital heart disease, related surgical interventions, and associated combordities. While the prevalence of particular arrhythmias with specific congenital heart disease has been previously described, a detailed analysis of all lesions and a large number of comorbidities has not been previously published. Admissions with congenital heart disease were identified in the National Inpatient Sample. Associated comorbidities were also identified for these patients. Univariate analysis was done to compare those risk factors associated with specific arrhythmias in the setting of congenital heart disease. Next, regression analysis was done to identify what patient characteristics and comorbidities were associated with increased risk of specific arrhythmias. A total of 52,725,227 admissions were included in the analysis. Of these, 109,168 (0.21%) had congenital heart disease. Of those with congenital heart disease, 27,088 (25%) had an arrhythmia at some point. The most common arrhythmia in those with congenital heart disease was atrial fibrillation, which was noted in 86% of those with arrhythmia followed by atrial flutter which was noted in 20% of those with congenital heart disease. The largest burden of arrhythmia was found to be in those with tricuspid atresia with a 51% prevalence of arrhythmia in this group followed by Ebstein anomaly which had an arrhythmia prevalence of 39%. Increasing age, male gender, double outlet right ventricle, atrioventricular septal defect, heart failure, obstructive sleep apnea, transposition of the great arteries, congenitally corrected transposition, and tetralogy of Fallot were frequently noted to be independent risk factors of specific arrhythmias. Approximately, 25% of adult admissions with congenital heart disease are associated with arrhythmia. The burden of

Arrhythmia Associated with Buprenorphine and Methadone Reported to the Food and Drug Administration

PubMed Central

Kao, David P; Haigney, Mark CP; Mehler, Philip S; Krantz, Mori J

2015-01-01

Aim To assess the relative frequency of reporting of adverse events involving ventricular arrhythmia, cardiac arrest, QTc prolongation, or torsade de pointes to the US Food and Drug Administration (FDA) between buprenorphine and methadone. Design Retrospective pharmacoepidemiologic study Setting Adverse drug events spontaneously reported to the FDA between 1969-June 2011 originating in 196 countries (71% events from the US). Cases Adverse event cases mentioning methadone (n=14,915) or buprenorphine (n=7,283) were evaluated against all other adverse event cases (n= 4,796,141). Measurements The primary outcome was the composite of ventricular arrhythmia or cardiac arrest. The secondary outcome was the composite of QTc prolongation or torsade de pointes. The proportional reporting ratio (PRR) was used to identify disproportionate reporting defined as a PRR>2, χ2 error>4, with ≥3 cases. Findings There were 132 (1.8%) ventricular arrhythmia/cardiac arrest and 19 (0.3%) QTc prolongation/torsade de pointes cases associated with buprenorphine compared with 1729 (11.6%) ventricular arrhythmia/cardiac arrest and 390 (2.6%) QTc prolongation/torsade de pointes cases involving methadone. PRRs associated with buprenorphine were not significant for ventricular arrhythmia/cardiac arrest (1.1 95% confidence interval (CI) 0.9–1.3, χ2=1.2) or QTc prolongation/torsade de pointes (1.0 95% CI 0.7–1.9, χ2=0.0006), but were for methadone (7.2 95% CI 6.9–7.5, χ2=9160; 10.6 95% CI 9.7–11.8, χ2=3305, respectively). Conclusion In spontaneously reported adverse events, methadone is associated with disproportionate reporting of cardiac arrhythmias, whereas buprenorphine is not. Although these findings probably reflect clinically relevant differences, a causal connection cannot be presumed and disproportionality analysis cannot quantify absolute risk per treatment episode. Population-based studies to definitively quantify differential incidence rates are warranted. PMID:26075588

Dioxins in the Venice lagoon: Present situation, projects and recovering hypotheses.

PubMed

Raccanelli, S; Bonamin, V

2000-01-01

Venice is famous around the world for its uniqueness and architectural splendours, arts and the history of the "Serenissima Repubblica", as it was known in the past, but few are aware that Venice economy is strongly dependent on the industrial activities based mainly on the adjacent Porto Marghera area. For many years, the lagoon that physically separates the city from the dry land has avoided association between the concern connected with the pollution derived from these industrial activities and the public perception of Venice. Since 1995, dioxins have appeared as a lagoon contaminant, and their presence, at such a level requiring immediate "in depth" studies and interventions, has been fully realized for decades.

Flood Forecast Accuracy and Decision Support System Approach: the Venice Case

NASA Astrophysics Data System (ADS)

Canestrelli, A.; Di Donato, M.

2016-02-01

In the recent years numerical models for weather predictions have experienced continuous advances in technology. As a result, all the disciplines making use of weather forecasts have made significant steps forward. In the case of the Safeguard of Venice, a large effort has been put in order to improve the forecast of tidal levels. In this context, the Istituzione Centro Previsioni e Segnalazioni Maree (ICPSM) of the Venice Municipality has developed and tested many different forecast models, both of the statistical and deterministic type, and has shown to produce very accurate forecasts. For Venice, the maximum admissible forecast error should be (ideally) of the order of ten centimeters at 24 hours. The entity of the forecast error clearly affects the decisional process, which mainly consists of alerting the population, activating the movable barriers installed at the three tidal inlets and contacting the port authority. This process becomes more challenging whenever the weather predictions, and therefore the water level forecasts, suddenly change. These new forecasts have to be quickly transformed into operational tasks. Therefore, it is of the utter importance to set up scheduled alerts and emergency plans by means of easy-to-follow procedures. On this direction, Technital has set up a Decision Support System based on expert procedures that minimizes the human mistakes and, as a consequence, reduces the risk of flooding of the historical center. Moreover, the Decision Support System can communicate predefined alerts to all the interested subjects. The System uses the water levels forecasts produced by the ICPSM by taking into account the accuracy at different leading times. The Decision Support System has been successfully tested with 8 years of data, 6 of them in real time. Venice experience shows that the Decision Support System is an essential tool which assesses the risks associated with a particular event, provides clear operational procedures and minimizes

21 CFR 870.1025 - Arrhythmia detector and alarm (including ST-segment measurement and alarm).

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Arrhythmia detector and alarm (including ST... Diagnostic Devices § 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm). (a) Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce...

21 CFR 870.1025 - Arrhythmia detector and alarm (including ST-segment measurement and alarm).

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Arrhythmia detector and alarm (including ST... Diagnostic Devices § 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm). (a) Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce...

21 CFR 870.1025 - Arrhythmia detector and alarm (including ST-segment measurement and alarm).

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Arrhythmia detector and alarm (including ST... Diagnostic Devices § 870.1025 Arrhythmia detector and alarm (including ST-segment measurement and alarm). (a) Identification. The arrhythmia detector and alarm device monitors an electrocardiogram and is designed to produce...

Prevention and Treatment of Arrhythmia

MedlinePlus

... your pulse – especially if you have an artificial pacemaker. Put the second and third fingers of one ... Ablation Devices for Arrhythmia - Implantable Cardioverter Defibrillator (ICD) - Pacemaker Treating Arrhythmias in Children • Arrhythmia Tools & Resources Watch, ...

Copper complexation capacity in surface waters of the Venice Lagoon.

PubMed

Delgadillo-Hinojosa, Francisco; Zirino, Alberto; Nasci, Cristina

2008-10-01

Total copper (Cu(T)), copper ion activity (pCu) and the copper complexation capacity (CuCC) were determined in samples of seawater collected in July 2003 from the Venice Lagoon. Cu(T) and CuCC showed considerable spatial variability: Cu(T) ranged from 1.8 to 70.0nM, whereas the CuCC varied from 195 to 573nM. pCu values varied from 11.6 to 12.6 and are consistent with those previously reported in estuarine and coastal areas (10.9-14.1). The range of Cu(T) values compares well with those reported in the past in the lagoon and in the adjacent Adriatic Sea. The highest concentrations of Cu(T) were found in samples collected near the industrial area of Porto Marghera, whereas the lowest were measured near the Chioggia and Malamocco inlets, where an intense tidally-driven renewal of seawater takes place. Although CuCC showed a high degree of spatial variability, the values recorded in the Venice Lagoon are comparable to those reported in other estuarine systems. In addition, CuCC was positively correlated with dissolved organic carbon (DOC), suggesting that organic ligands responsible for Cu complexation are part of the bulk organic matter pool in the lagoon. The CuCC:Cu(T) molar ratio was, on average 55:1, indicating that a large excess of complexation capacity exists in the Venice Lagoon. The high levels of CuCC and the narrow range of pCu indicates the importance of the role played by organic ligands in controlling the free ion Cu concentrations in the lagoon, and as a consequence, regulating its availability and/or toxicity.

Reasons for failed ablation for idiopathic right ventricular outflow tract-like ventricular arrhythmias.

PubMed

Yokokawa, Miki; Good, Eric; Crawford, Thomas; Chugh, Aman; Pelosi, Frank; Latchamsetty, Rakesh; Jongnarangsin, Krit; Ghanbari, Hamid; Oral, Hakan; Morady, Fred; Bogun, Frank

2013-08-01

The right ventricular outflow tract (RVOT) is the most common site of origin of ventricular arrhythmias (VAs) in patients with idiopathic VAs. A left bundle branch block, inferior axis morphology arrhythmia is the hallmark of RVOT arrhythmias. VAs from other sites of origin can mimic RVOT VAs, and ablation in the RVOT typically fails for these VAs. To analyze reasons for failed ablations of RVOT-like VAs. Among a consecutive series of 197 patients with an RVOT-like electrocardiographic (ECG) morphology who were referred for ablation, 38 patients (13 men; age 46 ± 14 years; left ventricular ejection fraction 47% ± 14%) in whom a prior procedure failed within the RVOT underwent a second ablation procedure. ECG characteristics of the VA were compared to a consecutive series of 50 patients with RVOT VAs. The origin of the VA was identified in 95% of the patients. In 28 of 38 (74%) patients, the arrhythmia origin was not in the RVOT. The VA originated from intramural sites (n = 8, 21%), the pulmonary arteries (n = 7, 18%), the aortic cusps (n = 6, 16%), and the epicardium (n = 5, 13%). The origin was within the RVOT in 10 (26%) patients. In 2 (5%) patients, the origin could not be identified despite biventricular, aortic, and epicardial mapping. The VA was eliminated in 34 of 38 (89%) patients with repeat procedures. The ECG features of patients with failed RVOT-like arrhythmias were different from the characteristics of RVOT arrhythmias. In patients in whom ablation of a VA with an RVOT-like appearance fails, mapping of the pulmonary artery, the aortic cusps, the epicardium, the left ventricular outflow tract, and the aortic cusps will help identify the correct site of origin. The 12-lead ECG is helpful in differentiating these VAs from RVOT VAs. Copyright © 2013 Heart Rhythm Society. All rights reserved.

Arrhythmia during extracorporeal shock wave lithotripsy.

PubMed

Zeng, Z R; Lindstedt, E; Roijer, A; Olsson, S B

1993-01-01

A prospective study of arrhythmia during extracorporeal shock wave lithotripsy (ESWL) was performed in 50 patients, using an EDAP LT01 piezoelectric lithotriptor. The 12-lead standard ECG was recorded continuously for 10 min before and during treatment. One or more atrial and/or ventricular ectopic beats occurred during ESWL in 15 cases (30%). The occurrence of arrhythmia was similar during right-sided and left-sided treatment. One patient developed multifocal ventricular premature beats and ventricular bigeminy; another had cardiac arrest for 13.5 s. It was found that various irregularities of the heart rhythm can be caused even by treatment with a lithotriptor using piezoelectric energy to create the shock wave. No evidence was found, however, that the shock wave itself rather than vagal activation and the action of sedo-analgesia was the cause of the arrhythmia. For patients with severe underlying heart disease and a history of complex arrhythmia, we suggest that the ECG be monitored during treatment. In other cases, we have found continuous monitoring of oxygen saturation and pulse rate with a pulse oximeter to be perfectly reliable for raising the alarm when depression of respiration and vaso-vagal reactions occur.

O-GlcNAcylation of cardiac Nav1.5 contributes to the development of arrhythmias in diabetic hearts.

PubMed

Yu, Peng; Hu, Lili; Xie, Jinyan; Chen, Sisi; Huang, Lin; Xu, Zixuan; Liu, Xiao; Zhou, Qiongqiong; Yuan, Ping; Yan, Xia; Jin, Jiejin; Shen, Yang; Zhu, Wengen; Fu, Linghua; Chen, Qi; Yu, Jianhua; Hu, Jianxin; Cao, Qing; Wan, Rong; Hong, Kui

2018-06-01

Cardiovascular complications are major causes of mortality and morbidity in diabetic patients. The mechanisms underlying the progression of diabetic heart (DH) to ventricular arrhythmias are unclear. O-linked GlcNAcylation (O-GlcNAc) is a reversible post-translational modification for the regulation of diverse cellular processes. The purpose of this study was to assess whether the cardiac voltage-gated sodium channel (Nav1.5) is subjected to O-linked GlcNAcylation (O-GlcNAc), which plays an essential role in DH-induced arrhythmias. In this study, Sprague-Dawley rats (male, 200-230 g) were treated with a single high-dose of streptozotocin (STZ, 80 mg/kg) to generate a rat model of diabetes. STZ-induced 3-month diabetic rats displayed increased susceptibility to ventricular arrhythmias. The elevated O-GlcNAc modification was correlated with decreases in both total and cytoplasmic Nav1.5 expression in vivo and in vitro. In addition, both co-immunoprecipitation and immunostaining assays demonstrated that hyperglycemia could increase the O-GlcNAc-modified Nav1.5 levels and decrease the interaction between Nav1.5 and Nav1.5-binding proteins Nedd4-2/SAP-97. Furthermore, patch-clamp measurements in HEK-293 T cells showed that Nav1.5 current densities decreased by 30% after high-glucose treatment, and the sodium currents increased via O-GlcNAc inhibition. Our data suggested that hyperglycemia increased the O-GlcNAc modification of Nav1.5 expression and decreased the interaction between Nav1.5 and Nedd4-2/SAP-97, which led to the abnormal expression and distribution of Nav1.5, loss of function of the sodium channel, and prolongation of the PR/QT interval. Excessive O-GlcNAc modification of Nav1.5 is a novel signaling event, which may be an underlying contributing factor for the development of the arrhythmogenesis in DH. Copyright © 2017. Published by Elsevier B.V.

75 FR 57017 - Venice Gathering System, LLC; Notice of Request Under Blanket Authorization

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP10-497-000] Venice Gathering System, LLC; Notice of Request Under Blanket Authorization September 10, 2010. Take notice that on September 3, 2010, Venice Gathering System, LLC (VGS), 1000 Louisiana, Suite 4300, Houston, Texas 77002...

Gypsies, Jews, and "The Merchant of Venice."

ERIC Educational Resources Information Center

McKendy, Thomas

1988-01-01

Shows how looking at Shakespeare's prejudices and their roots, as seen in "The Merchant of Venice," can teach students not only about historical attitudes but also about their own unacknowledged assumptions and stereotypes. (MM)

An environmental database for Venice and tidal zones

NASA Astrophysics Data System (ADS)

Macaluso, L.; Fant, S.; Marani, A.; Scalvini, G.; Zane, O.

2003-04-01

The natural environment is a complex, highly variable and physically non reproducible system (not in laboratory, nor in a confined territory). Environmental experimental studies are thus necessarily based on field measurements distributed in time and space. Only extensive data collections can provide the representative samples of the system behavior which are essential for scientific advancement. The assimilation of large data collections into accessible archives must necessarily be implemented in electronic databases. In the case of tidal environments in general, and of the Venice lagoon in particular, it is useful to establish a database, freely accessible to the scientific community, documenting the dynamics of such systems and their response to anthropic pressures and climatic variability. At the Istituto Veneto di Scienze, Lettere ed Arti in Venice (Italy) two internet environmental databases has been developed: one collects information regarding in detail the Venice lagoon; the other co-ordinate the research consortium of the "TIDE" EU RTD project, that attends to three different tidal areas: Venice Lagoon (Italy), Morecambe Bay (England), and Forth Estuary (Scotland). The archives may be accessed through the URL: www.istitutoveneto.it. The first one is freely available and applies to anyone is interested. It is continuously updated and has been structured in order to promote documentation concerning Venetian environment and disseminate this information for educational purposes (see "Dissemination" section). The second one is supplied by scientists and engineers working on this tidal system for various purposes (scientific, management, conservation purposes, etc.); it applies to interested researchers and grows with their own contributions. Both intend to promote scientific communication, to contribute to the realization of a distributed information system collecting homogeneous themes, and to initiate the interconnection among databases regarding different

The Association between Nocturnal Cardiac Arrhythmias and Sleep-Disordered Breathing: The DREAM Study.

PubMed

Selim, Bernardo J; Koo, Brian B; Qin, Li; Jeon, Sangchoon; Won, Christine; Redeker, Nancy S; Lampert, Rachel J; Concato, John P; Bravata, Dawn M; Ferguson, Jared; Strohl, Kingman; Bennett, Adam; Zinchuk, Andrey; Yaggi, Henry K

2016-06-15

To determine whether sleep-disordered breathing (SDB) is associated with cardiac arrhythmia in a clinic-based population with multiple cardiovascular comorbidities and severe SDB. This was a cross-sectional analysis of 697 veterans who underwent polysomnography for suspected SDB. SDB was categorized according to the apnea-hypopnea index (AHI): none (AHI < 5), mild (5 ≥ AHI < 15), and moderate-severe (AHI ≥ 15). Nocturnal cardiac arrhythmias consisted of: (1) complex ventricular ectopy, (CVE: non-sustained ventricular tachycardia, bigeminy, trigeminy, or quadrigeminy), (2) combined supraventricular tachycardia, (CST: atrial fibrillation or supraventricular tachycardia), (3) intraventricular conduction delay (ICD), (4) tachyarrhythmias (ventricular and supraventricular), and (5) any cardiac arrhythmia. Unadjusted, adjusted logistic regression, and Cochran-Armitage testing examined the association between SDB and cardiac arrhythmias. Linear regression models explored the association between hypoxia, arousals, and cardiac arrhythmias. Compared to those without SDB, patients with moderate-severe SDB had almost three-fold unadjusted odds of any cardiac arrhythmia (2.94; CI 95%, 2.01-4.30; p < 0.0001), two-fold odds of tachyarrhythmias (2.16; CI 95%,1.47-3.18; p = 0.0011), two-fold odds of CVE (2.01; 1.36-2.96; p = 0.003), and two-fold odds of ICD (2.50; 1.58-3.95; p = 0.001). A linear trend was identified between SDB severity and all cardiac arrhythmia subtypes (p value linear trend < 0.0001). After adjusting for age, BMI, gender, and cardiovascular diseases, moderate-severe SDB patients had twice the odds of having nocturnal cardiac arrhythmias (2.24; 1.48-3.39; p = 0.004). Frequency of obstructive respiratory events and hypoxia were strong predictors of arrhythmia risk. SDB is independently associated with nocturnal cardiac arrhythmias. Increasing severity of SDB was associated with an increasing risk for any cardiac arrhythmia. © 2016 American Academy of Sleep

Assessing hydrological effects of human interventions on coastal systems: numerical applications to the Venice Lagoon

NASA Astrophysics Data System (ADS)

Ferrarin, C.; Ghezzo, M.; Umgiesser, G.; Tagliapietra, D.; Camatti, E.; Zaggia, L.; Sarretta, A.

2013-05-01

The hydrological consequences of historical, contemporary and future human activities on a coastal system were investigated by means of numerical models. The changes in the morphology of the Lagoon of Venice during the last century result from the sedimentological response to the combined effects of human interventions on the environment and global changes. This study focuses on changes from 1927 to 2012 and includes the changes planned for the protection of the city of Venice from storm surges and exceptional tides under future sea level rise scenarios. The application of a hydrodynamic model allowed for the analysis of the morphological effects on the lagoon circulation, the interaction with the sea and the internal mixing processes. The absolute values of the exchange between the lagoon and sea increased from 1927 to 2002 (from 3900 to 4600 m3 s-1), while the daily fraction of lagoon water volume exchanged decreased. At the same time, the flattening of the lagoon and loss of morphological heterogeneity enhanced the internal mixing processes driven by the tide and wind, reducing thus the overall water renewal time from 11.9 days in 1927 to 10.8 days in 2002. Morphological changes during the last decade reduced the water exchange through the inlets and induced an increase of the basin-wide water renewal time of 0.5 day. In the future, Venice Lagoon will evolve to a more restricted environment due to sea level rise, which increases the lagoon volume, and periodical closure of the lagoon from the sea during flooding events, which reduces the communication with the open sea. Therefore, the flushing capacity of the lagoon will decrease considerably, especially in its central part. Furthermore, some considerations on the impact of the hydromorphological changes on the ecological dynamics are proposed.

Land Subsidence International Symposium held in Venice

NASA Astrophysics Data System (ADS)

The Third International Symposium on Land Subsidence was held March 18-25, 1984, in Venice, Italy. Sponsors were the Ground-Water Commission of the International Association of Hydrological Sciences (IAHS), the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the Italian National Research Council (CNR), the Italian Regions of Veneto and Emilia-Romagna, the Italian Municipalities of Venice, Ravenna, and Modena, the Venice Province, and the European Research Office. Cosponsors included the International Association of Hydrogeologists (IAH), the International Society for Soil Mechanics and Foundation Engineering (ISSMFE), and the Association of Geoscientists for International Development (AGID).Organized within the framework of UNESCO's International Hydrological Program, the symposium brought together over 200 international interdisciplinary specialists in the problems of land subsidence due to fluid and mineral withdrawal. Because man's continuing heavy development of groundwater, gas, oil, and minerals is changing the natural regime and thus causing more and more subsiding areas in the world, there had been sufficient new land subsidence occurrence, problems, research, and remedial measures since the 1976 Second International Symposium held in Anaheim, California, to develop a most interesting program of nearly 100 papers from about 30 countries. The program consisted of papers covering case histories of fluid and mineral withdrawal, engineering theory and analysis, karst “sink-hole”-type subsidence, subsidence due to dewatering of organic deposits or due to application of water (hydrocompaction), instrumentation, legal, socioeconomic, and environmental effects of land subsidence, and remedial works.

Overview of ecotoxicological studies performed in the Venice Lagoon (Italy).

PubMed

Losso, C; Ghirardini, A Volpi

2010-01-01

This work reports on the state of the art of the bioindicators used to assess environmental quality (regarding chemical pollutant impacts) in the Venice lagoon. After a brief description of the roles, advantages and limitations of bioindicators in marine and transitional environments and a summary of the Venice lagoon characteristics, the ecotoxicological methods used during scientific studies and research projects in the Lagoon are reported. Since not all data are available and no database can be formulated, the main evidence from toxicity bioassays, biomarkers and bioaccumulation analyses since the end of the 1970s is spatially synthesized using maps and discussed according to the four Venice lagoon basins. The majority of indicators showed that the Lido basin (north-central lagoon), affected by the presence of the industrial area and the city of Venice, is the one most highly impacted (particularly in the sites located within or in front of the industrial area, which showed very high sediment toxicity and high levels of DNA damage). The Malamocco basin (south-central lagoon) seems to be the least problematic. The southern basin (Chioggia basin) was shown to be impacted by urban contaminants from the town of Chioggia. The northern basin (Treporti basin) presented both impacted sites (high toxicity and high bioaccumulation factor) and relatively unpolluted sites (absence of toxicity, absence of imposex and low levels of bioaccumulation). This review can serve as a basis on which to select pragmatic, cost-effective biomonitoring techniques for environmental effects in lagoon ecosystems.

Arrhythmias Following Comprehensive Stage II Surgical Palliation in Single Ventricle Patients.

PubMed

Wilhelm, Carolyn M; Paulus, Diane; Cua, Clifford L; Kertesz, Naomi J; Cheatham, John P; Galantowicz, Mark; Fernandez, Richard P

2016-03-01

Post-operative arrhythmias are common in pediatric patients following cardiac surgery. Following hybrid palliation in single ventricle patients, a comprehensive stage II palliation is performed. The incidence of arrhythmias in patients following comprehensive stage II palliation is unknown. The purpose of this study is to determine the incidence of arrhythmias following comprehensive stage II palliation. A single-center retrospective chart review was performed on all single ventricle patients undergoing a comprehensive stage II palliation from January 2010 to May 2014. Pre-operative, operative, and post-operative data were collected. A clinically significant arrhythmia was defined as an arrhythmia which led to cardiopulmonary resuscitation or required treatment with either pacing or antiarrhythmic medication. Statistical analysis was performed with Wilcoxon rank-sum test and Fisher's exact test with p < 0.05 significant. Forty-eight single ventricle patients were reviewed (32 hypoplastic left heart syndrome, 16 other single ventricle variants). Age at surgery was 185 ± 56 days. Cardiopulmonary bypass time was 259 ± 45 min. Average vasoactive-inotropic score was 5.97 ± 7.58. Six patients (12.5 %) had clinically significant arrhythmias: four sinus bradycardia, one 2:1 atrioventricular block, and one slow junctional rhythm. No tachyarrhythmias were documented for this patient population. Presence of arrhythmia was associated with elevated lactate (p = 0.04) and cardiac arrest (p = 0.002). Following comprehensive stage II palliation, single ventricle patients are at low risk for development of tachyarrhythmias. The most frequent arrhythmia seen in these patients was sinus bradycardia associated with respiratory compromise.

Asymptomatic Intradialytic Supraventricular Arrhythmias and Adverse Outcomes in Patients on Hemodialysis

PubMed Central

Pérez de Prado, Armando; López-Gómez, Juan M.; Quiroga, Borja; Goicoechea, Marian; García-Prieto, Ana; Torres, Esther; Reque, Javier; Luño, José

2016-01-01

Background and objectives Supraventricular arrhythmias are associated with high morbidity and mortality. Nevertheless, this condition has received little attention in patients on hemodialysis. The objective of this study was to analyze the incidence of intradialysis supraventricular arrhythmia and its long–term prognostic value. Design, setting, participants, & measurements We designed an observational and prospective study in a cohort of patients on hemodialysis with a 10-year follow-up period. All patients were recruited for study participation and were not recruited for clinical indications. The study population comprised 77 patients (42 men and 35 women; mean age =58±15 years old) with sinus rhythm monitored using a Holter electrocardiogram over six consecutive hemodialysis sessions at recruitment. Results Hypertension was present in 68.8% of patients, and diabetes was present in 29.9% of patients. Supraventricular arrhythmias were recorded in 38 patients (49.3%); all of these were short, asymptomatic, and self-limiting. Age (hazard ratio, 1.04 per year; 95% confidence interval, 1.00 to 1.08) and right atrial enlargement (hazard ratio, 4.29; 95% confidence interval, 1.30 to 14.09) were associated with supraventricular arrhythmia in the multivariate analysis. During a median follow-up of 40 months, 57 patients died, and cardiovascular disease was the main cause of death (52.6%). The variables associated with all-cause mortality in the Cox model were age (hazard ratio, 1.04 per year; 95% confidence interval, 1.00 to 1.08), C-reactive protein (hazard ratio, 1.04 per 1 mg/L; 95% confidence interval, 1.00 to 1.08), and supraventricular arrhythmia (hazard ratio, 3.21; 95% confidence interval, 1.29 to 7.96). Patients with supraventricular arrhythmia also had a higher risk of nonfatal cardiovascular events (hazard ratio, 4.32; 95% confidence interval, 2.11 to 8.83) and symptomatic atrial fibrillation during follow-up (hazard ratio, 17.19; 95% confidence interval, 2

Asymptomatic Intradialytic Supraventricular Arrhythmias and Adverse Outcomes in Patients on Hemodialysis.

PubMed

Verde, Eduardo; Pérez de Prado, Armando; López-Gómez, Juan M; Quiroga, Borja; Goicoechea, Marian; García-Prieto, Ana; Torres, Esther; Reque, Javier; Luño, José

2016-12-07

Supraventricular arrhythmias are associated with high morbidity and mortality. Nevertheless, this condition has received little attention in patients on hemodialysis. The objective of this study was to analyze the incidence of intradialysis supraventricular arrhythmia and its long-term prognostic value. We designed an observational and prospective study in a cohort of patients on hemodialysis with a 10-year follow-up period. All patients were recruited for study participation and were not recruited for clinical indications. The study population comprised 77 patients (42 men and 35 women; mean age =58±15 years old) with sinus rhythm monitored using a Holter electrocardiogram over six consecutive hemodialysis sessions at recruitment. Hypertension was present in 68.8% of patients, and diabetes was present in 29.9% of patients. Supraventricular arrhythmias were recorded in 38 patients (49.3%); all of these were short, asymptomatic, and self-limiting. Age (hazard ratio, 1.04 per year; 95% confidence interval, 1.00 to 1.08) and right atrial enlargement (hazard ratio, 4.29; 95% confidence interval, 1.30 to 14.09) were associated with supraventricular arrhythmia in the multivariate analysis. During a median follow-up of 40 months, 57 patients died, and cardiovascular disease was the main cause of death (52.6%). The variables associated with all-cause mortality in the Cox model were age (hazard ratio, 1.04 per year; 95% confidence interval, 1.00 to 1.08), C-reactive protein (hazard ratio, 1.04 per 1 mg/L; 95% confidence interval, 1.00 to 1.08), and supraventricular arrhythmia (hazard ratio, 3.21; 95% confidence interval, 1.29 to 7.96). Patients with supraventricular arrhythmia also had a higher risk of nonfatal cardiovascular events (hazard ratio, 4.32; 95% confidence interval, 2.11 to 8.83) and symptomatic atrial fibrillation during follow-up (hazard ratio, 17.19; 95% confidence interval, 2.03 to 145.15). The incidence of intradialysis supraventricular arrhythmia was high

Arrhythmias

MedlinePlus

... sign of other heart problems, or an immediate danger to your health. ... patient with suspected arrhythmia. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine . 25th ed. Philadelphia, PA: ...

Pupil Exchange in the European Community Venice Colloquium (October 24-28, 1977). Collection Studies. Education Series No. 5.

ERIC Educational Resources Information Center

Commission des Communautes Europeennes (Luxembourg).

This publication contains the papers of the Venice Colloquium held in October, 1977 by educators from European countries to discuss the topic of visits and exchanges for pupils. There are seven chapters. Chapter one discusses the context and objectives of the colloquium. Chapter two describes pupil visits and exchanges in the European community.…

Arrhythmias in left ventricular noncompaction.

PubMed

Miyake, Christina Y; Kim, Jeffrey J

2015-06-01

Left ventricular noncompaction (LVNC) is a newly recognized form of cardiomyopathy that has been associated with heart failure, arrhythmias, thromboembolic events, and sudden death. Both ventricular and supraventricular arrhythmias are now well described as prominent clinical components of LVNC. Throughout the spectrum of age, these arrhythmias have been associated with prognosis and outcome, and their clinical management is therefore an important aspect of patient care. The risk of sudden death seems to be associated with ventricular dilation, systolic dysfunction, and the presence of arrhythmias. Proposed management strategies shown to have efficacy include antiarrhythmic therapy, ablation techniques, and implantable cardioverter-defibrillator implantation. Copyright © 2015 Elsevier Inc. All rights reserved.

Patient characteristics associated with false arrhythmia alarms in intensive care

PubMed Central

Harris, Patricia R; Zègre-Hemsey, Jessica K; Schindler, Daniel; Bai, Yong; Pelter, Michele M; Hu, Xiao

2017-01-01

Introduction A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. Objective The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. Methods This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 days in 2013. All monitor alarms and continuous waveforms were stored on a secure server. Nurse scientists with expertise in cardiac monitoring used a standardized protocol to annotate six clinically important types of arrhythmia alarms (asystole, pause, ventricular fibrillation, ventricular tachycardia, accelerated ventricular rhythm, and ventricular bradycardia) as true or false. Total monitoring time for each patient was measured, and the number of false alarms per hour was calculated for these six alarm types. Medical records were examined to acquire data on patient characteristics. Results A total of 461 unique patients (mean age =60±17 years) were enrolled, generating a total of 2,558,760 alarms, including all levels of arrhythmia, parameter, and technical alarms. There were 48,404 hours of patient monitoring time, and an average overall alarm rate of 52 alarms/hour. Investigators annotated 12,671 arrhythmia alarms; 11,345 (89.5%) were determined to be false. Two hundred and fifty patients (54%) generated at least one of the six annotated alarm types. Two patients generated 6,940 arrhythmia alarms (55%). The number of false alarms per monitored hour for patients’ annotated arrhythmia alarms ranged from 0.0 to 7.7, and the duration of these false alarms per hour ranged from 0.0 to 158.8 seconds. Patient

Patient characteristics associated with false arrhythmia alarms in intensive care.

PubMed

Harris, Patricia R; Zègre-Hemsey, Jessica K; Schindler, Daniel; Bai, Yong; Pelter, Michele M; Hu, Xiao

2017-01-01

A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 days in 2013. All monitor alarms and continuous waveforms were stored on a secure server. Nurse scientists with expertise in cardiac monitoring used a standardized protocol to annotate six clinically important types of arrhythmia alarms (asystole, pause, ventricular fibrillation, ventricular tachycardia, accelerated ventricular rhythm, and ventricular bradycardia) as true or false. Total monitoring time for each patient was measured, and the number of false alarms per hour was calculated for these six alarm types. Medical records were examined to acquire data on patient characteristics. A total of 461 unique patients (mean age =60±17 years) were enrolled, generating a total of 2,558,760 alarms, including all levels of arrhythmia, parameter, and technical alarms. There were 48,404 hours of patient monitoring time, and an average overall alarm rate of 52 alarms/hour. Investigators annotated 12,671 arrhythmia alarms; 11,345 (89.5%) were determined to be false. Two hundred and fifty patients (54%) generated at least one of the six annotated alarm types. Two patients generated 6,940 arrhythmia alarms (55%). The number of false alarms per monitored hour for patients' annotated arrhythmia alarms ranged from 0.0 to 7.7, and the duration of these false alarms per hour ranged from 0.0 to 158.8 seconds. Patient characteristics were compared in relation to 1) the

Remote Arrhythmia Monitoring System Developed

NASA Technical Reports Server (NTRS)

York, David W.; Mackin, Michael A.; Liszka, Kathy J.; Lichter, Michael J.

2004-01-01

Telemedicine is taking a step forward with the efforts of team members from the NASA Glenn Research Center, the MetroHealth campus of Case Western University, and the University of Akron. The Arrhythmia Monitoring System is a completed, working test bed developed at Glenn that collects real-time electrocardiogram (ECG) signals from a mobile or homebound patient, combines these signals with global positioning system (GPS) location data, and transmits them to a remote station for display and monitoring. Approximately 300,000 Americans die every year from sudden heart attacks, which are arrhythmia cases. However, not all patients identified at risk for arrhythmias can be monitored continuously because of technological and economical limitations. Such patients, who are at moderate risk of arrhythmias, would benefit from technology that would permit long-term continuous monitoring of electrical cardiac rhythms outside the hospital environment. Embedded Web Technology developed at Glenn to remotely command and collect data from embedded systems using Web technology is the catalyst for this new telemetry system (ref. 1). In the end-to-end system architecture, ECG signals are collected from a patient using an event recorder and are transmitted to a handheld personal digital assistant (PDA) using Bluetooth, a short-range wireless technology. The PDA concurrently tracks the patient's location via a connection to a GPS receiver. A long distance link is established via a standard Internet connection over a 2.5-generation Global System for Mobile Communications/General Packet Radio Service (GSM/GPRS)1 cellular, wireless infrastructure. Then, the digital signal is transmitted to a call center for monitoring by medical professionals.

75 FR 38589 - Culturally Significant Objects Imported for Exhibition Determinations: “Venice: Canaletto and His...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-02

... DEPARTMENT OF STATE [Public Notice: 7072] Culturally Significant Objects Imported for Exhibition Determinations: ``Venice: Canaletto and His Rivals'' SUMMARY: Notice is hereby given of the following... exhibition ``Venice: Canaletto and His Rivals,'' imported from abroad for temporary exhibition within the...

Ability of a 5-minute electrocardiography (ECG) for predicting arrhythmias in Doberman Pinschers with cardiomyopathy in comparison with a 24-hour ambulatory ECG.

PubMed

Wess, G; Schulze, A; Geraghty, N; Hartmann, K

2010-01-01

Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24-hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time-consuming and often not as readily available as common ECG. Comparison of 5-minute ECGs with Holter examinations. Eight hundred and seventy-five 5-minute ECGs and Holter examinations of 431 Doberman Pinschers. Each examination included a 5-minute ECG and Holter examination. A cut-off value of > 100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value. Holter examinations revealed > 100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5-minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5-minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5-minute ECG with at least 1 VPC as cut-off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of > 100 VPCs/24 hours. A 5-minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.

Assessing hydrological effects of human interventions on coastal systems: numerical applications to the Venice Lagoon

NASA Astrophysics Data System (ADS)

Ferrarin, C.; Ghezzo, M.; Umgiesser, G.; Tagliapietra, D.; Camatti, E.; Zaggia, L.; Sarretta, A.

2012-12-01

The hydrological consequences of historical, contemporary and future human activities on a coastal system were investigated by means of numerical models. The changes in the morphology of the Lagoon of Venice during the last century result from the sedimentological response to the combined effects of human interventions on the environment and global changes. This study focuses on changes from 1927 to 2012 and includes the changes planned for the protection of the city of Venice from storm surges and exceptional tides under future sea level rise scenarios. The application of a hydrodynamic model to simulate the circulation of water masses and the transport of a passive tracer enabled the analysis of the morphodynamic effects on the lagoon circulation and the interaction with the sea. The absolute values of the exchange between the lagoon and sea increased from 1927 to 2002 (from 3900 to 4600 m3 s-1), while the daily fraction of lagoon water volume exchanged decreased. At the same time, the water renewal time shortened from 11.9 to 10.8 days. Morphological changes during the last decade induced an increase of the basin-wide water renewal time (from 10.8 to 11.3 days). In the future, Venice Lagoon will evolve to a more restricted environment due to sea level rise and periodical closure of the lagoon from the sea during flooding events. Simulated scenarios of sea level rise showed that under fall-winter conditions the water renewal time will increased considerably especially in the central part of the lagoon. Furthermore, some considerations on the impact of the hydromorphological changes on the ecological dynamics are proposed.

Cholinesterase inhibition reduces arrhythmias in asymptomatic Chagas disease.

PubMed

Castro, Renata R T; Porphirio, Graciema; Xavier, Sergio S; Moraes, Ruy S; Ferlin, Elton L; Ribeiro, Jorge P; da Nóbrega, Antonio C L

2017-10-01

Parasympathetic dysfunction may play a role in the genesis of arrhythmias in Chagas disease. This study evaluates the acute effects of pyridostigmine (PYR), a reversible cholinesterase inhibitor, on the occurrence of arrhythmias in patients with Chagas cardiac disease. Following a double-blind, randomized, placebo-controlled, cross-over protocol, 17 patients (age 50±2 years) with Chagas cardiac disease type B underwent 24-hour Holter recordings after oral administration of either pyridostigmine bromide (45 mg, 3 times/day) or placebo (PLA). Pyridostigmine reduced the 24-hours incidence (median [25%-75%]) of premature ventricular beats-PLA: 2998 (1920-4870), PYR: 2359 (940-3253), P=.044; ventricular couplets-PLA: 84 (15-159), PYR: 33 (6-94), P=.046. Although the total number of nonsustained ventricular tachycardia in the entire group was not different (P=.19) between PLA (1 [0-8]) and PYR (0 [0-4]), there were fewer episodes under PYR in 72% of the patients presenting this type of arrhythmia (P=.033). Acute administration of pyridostigmine reduced the incidence of nonsustained ventricular arrhythmias in patients with Chagas cardiac disease. Further studies that address the use of pyridostigmine by patients with Chagas cardiac disease under a more prolonged follow-up are warranted. © 2017 John Wiley & Sons Ltd.

Inter-annual trend of the primary contribution of ship emissions to PM2.5 concentrations in Venice (Italy): Efficiency of emissions mitigation strategies

NASA Astrophysics Data System (ADS)

Contini, Daniele; Gambaro, Andrea; Donateo, Antonio; Cescon, Paolo; Cesari, Daniela; Merico, Eva; Belosi, Franco; Citron, Marta

2015-02-01

Ships and harbour emissions are currently increasing, due to the increase of tourism and trade, with potential impact on global air pollution and climate. At local scale, in-port ship emissions influence air quality in coastal areas impacting on health of coastal communities. International legislations to reduce ship emissions, both at Worldwide and European levels, are mainly based on the use of low-sulphur content fuel. In this work an analysis of the inter-annual trends of primary contribution, ε, of tourist shipping to the atmospheric PM2.5 concentrations in the urban area of Venice has been performed. Measurements have been taken in the summer periods of 2007, 2009 and 2012. Results show a decrease of ε from 7% (±1%) in 2007 to 5% (±1%) in 2009 and to 3.5% (±1%) in 2012. The meteorological and micrometeorological conditions of the campaigns were similar. Tourist ship traffic during measurement campaigns increased, in terms of gross tonnage, of about 25.4% from 2007 to 2009 and of 17.6% from 2009 to 2012. The decrease of ε was associated to the effect of a voluntary agreement (Venice Blue Flag) for the use of low-sulphur content fuel enforced in the area between 2007 and 2009 and to the implementation of the 2005/33/CE Directive in 2010. Results show that the use of low-sulphur fuel could effectively reduce the impact of shipping to atmospheric primary particles at local scale. Further, voluntary agreement could also be effective in reducing the impact of shipping on local air quality in coastal areas.

Thromboprophylaxis for atrial arrhythmias in congenital heart disease: A multicenter study.

PubMed

Khairy, Paul; Aboulhosn, Jamil; Broberg, Craig S; Cohen, Scott; Cook, Stephen; Dore, Annie; Fernandes, Susan M; Fournier, Anne; Kay, Joseph; Levesque, Sylvie; Macle, Laurent; Marcotte, François; Mondésert, Blandine; Mongeon, François-Pierre; Opotowsky, Alexander R; Proietti, Anna; Rivard, Lena; Ting, Jennifer; Thibault, Bernard; Zaidi, Ali; Hamilton, Robert

2016-11-15

There is a paucity of data to guide decisions regarding thromboprophylaxis for atrial arrhythmias in congenital heart disease. A retrospective multicenter cohort study enrolled patients with documented sustained atrial arrhythmias and congenital heart disease from 12 North American centers to quantify thromboembolic and bleeding rates associated with antiplatelet and anticoagulation therapy, and explore associated factors. A blinded committee adjudicated all qualifying arrhythmias and outcomes. A total of 482 patients, 45.2% female, age 32.0±18.0years, were followed for 11.3±9.4years since the qualifying arrhythmia. Antiplatelet therapy was administered to 37.8%, anticoagulation to 54.4%, and neither to 7.9%. Congenital heart disease complexity was simple, moderate, and severe in 18.5%, 34.4%, and 47.1%, respectively. Freedom from thromboembolic events was 84.7±2.7% at 15years, with no difference between anticoagulation versus antiplatelet therapy (P=0.97). Congenital heart disease complexity was independently associated with thromboembolic events, with rates of 0.00%, 0.93%, and 1.95%/year in those with simple, moderate, and severe forms (P<0.001). CHADS 2 and CHA 2 DS 2 -VASc scores were not predictive of thromboembolic risk. Annualized bleeding rates with antiplatelet and anticoagulation therapy were 0.66% and 1.82% (P=0.039). In multivariable analyses, anticoagulation [hazard ratio (HR) 4.76, 95% CI (1.05-21.58), P=0.043] and HAS-BLED score [HR 3.15, 95% CI (1.02, 9.78), P=0.047] were independently associated with major bleeds. Current management of atrial arrhythmias in congenital heart disease is associated with a modest rate of thromboembolic events, which is predicted by disease complexity but not CHADS 2 /CHA 2 DS 2 -VASc scores. HAS-BLED score is applicable to the congenital population in predicting major bleeds. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A novel NaV1.5 voltage sensor mutation associated with severe atrial and ventricular arrhythmias.

PubMed

Wang, Hong-Gang; Zhu, Wandi; Kanter, Ronald J; Silva, Jonathan R; Honeywell, Christina; Gow, Robert M; Pitt, Geoffrey S

2016-03-01

Inherited autosomal dominant mutations in cardiac sodium channels (NaV1.5) cause various arrhythmias, such as long QT syndrome and Brugada syndrome. Although dozens of mutations throughout the protein have been reported, there are few reported mutations within a voltage sensor S4 transmembrane segment and few that are homozygous. Here we report analysis of a novel lidocaine-sensitive recessive mutation, p.R1309H, in the NaV1.5 DIII/S4 voltage sensor in a patient with a complex arrhythmia syndrome. We expressed the wild type or mutant NaV1.5 heterologously for analysis with the patch-clamp and voltage clamp fluorometry (VCF) techniques. p.R1309H depolarized the voltage-dependence of activation, hyperpolarized the voltage-dependence of inactivation, and slowed recovery from inactivation, thereby reducing the channel availability at physiologic membrane potentials. Additionally, p.R1309H increased the "late" Na(+) current. The location of the mutation in DIIIS4 prompted testing for a gating pore current. We observed an inward current at hyperpolarizing voltages that likely exacerbates the loss-of-function defects at resting membrane potentials. Lidocaine reduced the gating pore current. The p.R1309H homozygous NaV1.5 mutation conferred both gain-of-function and loss-of-function effects on NaV1.5 channel activity. Reduction of a mutation-induced gating pore current by lidocaine suggested a therapeutic mechanism. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is Venice an ideal habitat for Legionella pneumophila?

PubMed

Ziprani, C; Selle, V; Palazzi, B; Capretta, F; Ghio, L; Flora, M E; Baldo, V

2012-09-01

Legionella bacterium manifests itself in Legionnaire's disease and Pontiac fever, it is mainly found and transmitted by aerosol produced in cooling towers, water distribution plants and medical equipment, and it affects mainly elder persons in poor health. The population of Venice Local Health Unit was divided in two areas of study and the incidence of legionellosis in residents of Venice historical centre (Distretto Sanitario 1) and in residents of the mainland and coastal areas (Distretti Sanitari 2, 3, 4) was calculated. The cases were those notified to the Public Health Unit by law, and the population of residents was that of the eligible for health care in the archives of the Local Health Unit. Only cases of legionellosis in residents who had not travelled in the 10 days previous of the onset of disease, and not related to nosocomial clusters were considered. The standardized incidence ratio was then calculated and confidence interval were defined by Poisson distribution. Given the population of the two areas, 59801 in Distretto Sanitario 1 and 237555 in Distretti 2, 3, 4, the raw incidence of disease is respectively 87 per 100000 and 20 per 100000 in time 2002-2010. The standardized incidence ratio for the population of Distretto Sanitario 1 vs the remaining population is 4.3. The difference in risk of getting the disease in this two residential areas geographically very close, is probably related to the different buildings' characteristics, old and difficult to maintain in Venice historical centre.

Management of unstable arrhythmias in cardiogenic shock.

PubMed

Saidi, Abdulfattah; Akoum, Nazem; Bader, Feras

2011-08-01

Atrial and ventricular arrhythmias commonly arise in the setting of cardiogenic shock and often result in hemodynamic deterioration. Causative factors include myocardial ischemia, volume overload, and metabolic disturbances. Correcting these factors plays an important role in managing arrhythmias in this setting. Ventricular arrhythmias are more ominous compared to atrial arrhythmias but both require prompt intervention with electrical shock and anti-arrhythmic drug suppression. Coronary reperfusion is key to improving survival, including reducing the risk of sudden cardiac arrest, in acute myocardial infarction. Case series have also demonstrated the value of intra-aortic balloon pump counter-pulsation in suppressing ventricular arrhythmias in cardiogenic shock. The mechanism of arrhythmia suppression may be due to improved coronary perfusion and afterload reduction. Percutaneous ventricular assist device placement may be effective in this setting; however, data addressing this specific endpoint are lacking. Anti-arrhythmic drug options for ventricular and atrial arrhythmia suppression, in the setting of cardiogenic shock, are relatively limited. Common class I agents are excluded due to the inherent abnormal cardiac structure and function in the setting of cardiogenic shock. Class III drug options include dofetilide and amiodarone. The other Class III agents, sotalol and dronedarone, are excluded due to associated mortality observed in the SWORD and ANDROMEDA trials, respectively. Dofetilide is renally excreted and causes QT interval prolongation. Care should be taken to avoid excessive drug accumulation due to poor kidney perfusion and function. Dofetilide is approved for use for atrial arrhythmias and has not been studied for ventricular arrhythmia suppression. The DIAMOND-CHF trial established its safety in the setting of heart failure. Amiodarone is very effective in suppressing both atrial and ventricular arrhythmias. It is often the drug of choice in heart

Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic.

PubMed

Grossberg, Anna L; Carranza, Dafnis; Lamp, Karen; Chiu, Melvin W; Lee, Catherine; Craft, Noah

2012-01-01

Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns in this population. Because the homeless population may be subject to increased sun exposure compared to the nonhomeless population, they also may be at increased risk for skin cancer. We sought to describe the spectrum of dermatologic diseases seen in a free clinic in Venice, California--the Venice Family Clinic (VFC)--as well as the differences in diagnoses between the homeless and nonhomeless patients seen at this clinic. A retrospective chart review was performed of dermatology patients (N = 82) seen at VFC throughout the 2006 calendar year. The homeless population (n = 22) was found to have more diagnoses of malignant/premalignant growths (25% [16/64] of all homeless diagnoses) compared to their nonhomeless (n = 60) counterparts (6.1% [8/132] of all nonhomeless diagnoses; P < .0001). This difference was sustained when ethnicity was controlled, with 29.6% [16/54] of diagnoses in the homeless white group consisting of malignant/ premalignant growths compared to 8.9% [4/45] of diagnoses in the nonhomeless white cohort (P < .005). Homeless patients may have a higher incidence of skin cancers and precancerous skin lesions due to increased sun exposure and/or limited access to dermatologic care.

α-Adrenoceptor blockade modifies neurally induced atrial arrhythmias

PubMed Central

Richer, Louis-Philippe; Vinet, Alain; Kus, Teresa; Cardinal, René; Ardell, Jeffrey L.; Armour, John Andrew

2008-01-01

Our objective was to determine whether neuronally induced atrial arrhythmias can be modified by α-adrenergic receptor blockade. In 30 anesthetized dogs, trains of five electrical stimuli (1 mA; 1 ms) were delivered immediately after the P wave of the ECG to mediastinal nerves associated with the superior vena cava. Regional atrial electrical events were monitored with 191 atrial unipolar electrodes. Mediastinal nerve sites were identified that reproducibly initiated atrial arrhythmias. These sites were then restimulated following 1 h (time control, n = 6), or the intravenous administration of naftopidil (α1-adrenergic blocker: 0.2 mg/kg, n = 6), yohimbine (α2-adrenergic blocker: 1 mg/kg, n = 6) or both (n = 8). A ganglionic blocker (hexamethonium: 1 mg/kg) was tested in four dogs. Stimulation of mediastinal nerves sites consistently elicited atrial tachyarrhythmias. Repeat stimulation after 1 h in the time-control group exerted a 19% decrease of the sites still able to induce atrial tachyarrhythmias. Hexamethonium inactivated 78% of the previously active sites. Combined α-adrenoceptor blockade inactivated 72% of the previously active sites. Bradycardia responses induced by mediastinal nerve stimulation were blunted by hexamethonium, but not by α1,2-adrenergic blockade. Naftopidil or yohimbine alone eliminated atrial arrhythmia induction from 31% and 34% of the sites (similar to time control). We conclude that heterogeneous activation of the intrinsic cardiac nervous system results in atrial arrhythmias that involve intrinsic cardiac neuronal α-adrenoceptors. In contrast to the global suppression exerted by hexamethonium, we conclude that α-adrenoceptor blockade targets intrinsic cardiac local circuit neurons involved in arrhythmia formation and not the flow-through efferent projections of the cardiac nervous system. PMID:18716036

Alpha-adrenoceptor blockade modifies neurally induced atrial arrhythmias.

PubMed

Richer, Louis-Philippe; Vinet, Alain; Kus, Teresa; Cardinal, René; Ardell, Jeffrey L; Armour, John Andrew

2008-10-01

Our objective was to determine whether neuronally induced atrial arrhythmias can be modified by alpha-adrenergic receptor blockade. In 30 anesthetized dogs, trains of five electrical stimuli (1 mA; 1 ms) were delivered immediately after the P wave of the ECG to mediastinal nerves associated with the superior vena cava. Regional atrial electrical events were monitored with 191 atrial unipolar electrodes. Mediastinal nerve sites were identified that reproducibly initiated atrial arrhythmias. These sites were then restimulated following 1 h (time control, n = 6), or the intravenous administration of naftopidil (alpha(1)-adrenergic blocker: 0.2 mg/kg, n = 6), yohimbine (alpha(2)-adrenergic blocker: 1 mg/kg, n = 6) or both (n = 8). A ganglionic blocker (hexamethonium: 1 mg/kg) was tested in four dogs. Stimulation of mediastinal nerves sites consistently elicited atrial tachyarrhythmias. Repeat stimulation after 1 h in the time-control group exerted a 19% decrease of the sites still able to induce atrial tachyarrhythmias. Hexamethonium inactivated 78% of the previously active sites. Combined alpha-adrenoceptor blockade inactivated 72% of the previously active sites. Bradycardia responses induced by mediastinal nerve stimulation were blunted by hexamethonium, but not by alpha(1,2)-adrenergic blockade. Naftopidil or yohimbine alone eliminated atrial arrhythmia induction from 31% and 34% of the sites (similar to time control). We conclude that heterogeneous activation of the intrinsic cardiac nervous system results in atrial arrhythmias that involve intrinsic cardiac neuronal alpha-adrenoceptors. In contrast to the global suppression exerted by hexamethonium, we conclude that alpha-adrenoceptor blockade targets intrinsic cardiac local circuit neurons involved in arrhythmia formation and not the flow-through efferent projections of the cardiac nervous system.

Global change and relative sea level rise at Venice: what impact in term of flooding

NASA Astrophysics Data System (ADS)

Carbognin, Laura; Teatini, Pietro; Tomasin, Alberto; Tosi, Luigi

2010-11-01

Relative sea level rise (RSLR) due to climate change and geodynamics represents the main threat for the survival of Venice, emerging today only 90 cm above the Northern Adriatic mean sea level (msl). The 25 cm RSLR occurred over the 20th century, consisting of about 12 cm of land subsidence and 13 cm of sea level rise, has increased the flood frequency by more than seven times with severe damages to the urban heritage. Reasonable forecasts of the RSLR expected to the century end must be investigated to assess the suitability of the Mo.S.E. project planned for the city safeguarding, i.e., the closure of the lagoon inlets by mobile barriers. Here we consider three RSLR scenarios as resulting from the past sea level rise recorded in the Northern Adriatic Sea, the IPCC mid-range A1B scenario, and the expected land subsidence. Available sea level measurements show that more than 5 decades are required to compute a meaningful eustatic trend, due to pseudo-cyclic 7-8 year long fluctuations. The period from 1890 to 2007 is characterized by an average rate of 0.12 ± 0.01 cm/year. We demonstrate that linear regression is the most suitable model to represent the eustatic process over these 117 year. Concerning subsidence, at present Venice is sinking due to natural causes at 0.05 cm/year. The RSLR is expected to range between 17 and 53 cm by 2100, and its repercussions in terms of flooding frequency are associated here to each scenario. In particular, the frequency of tides higher than 110 cm, i.e., the value above which the gates would close the lagoon to the sea, will increase from the nowadays 4 times per year to a range between 20 and 250. These projections provide a large spread of possible conditions concerning the survival of Venice, from a moderate nuisance to an intolerable aggression. Hence, complementary solutions to Mo.S.E. may well be investigated.

Venice and I: How a City Can Determine the Fate of a Career.

PubMed

Malanotte-Rizzoli, Paola

2017-01-03

Quoting the ancient Romans: Audentes Fortuna iuvat. Being in the right place at the right time is useless if you do not grasp your Fortuna and build upon it. In this article, I expound on the milestones of my multiform research career, which over more than 40 years brought me from Venice to California to MIT; from the Venice problem to highly nonlinear, coherent structures in the ocean and atmosphere; and from the mare nostrum (the Mediterranean Sea), a laboratory for global processes, to the tropical ocean-atmosphere systems and regional coupled climate models of the Maritime Continent. The climate system, with its daunting complexity, is arguably the greatest challenge for, and the future of, the entirety of the earth sciences. Finally, living in and working for Venice has been the privilege and Fortuna of my life.

The high resolution mapping of the Venice Lagoon tidal network

NASA Astrophysics Data System (ADS)

Madricardo, Fantina; Foglini, Federica; Kruss, Aleksandra; Bellafiore, Debora; Trincardi, Fabio

2017-04-01

One of the biggest challenges of the direct observation of the ocean is to achieve a high resolution mapping of its seafloor morphology and benthic habitats. So far, sonars have mapped just 0.05% of the ocean floor with less than ten-meter resolution. The recent efforts of the scientific community have been devoted towards the mapping of both Deep Ocean and very shallow coastal areas. Coastal and transitional environments in particular undergo strong morphological changes due to natural and anthropogenic pressure. Nowadays, only about 5% of the seafloor of these environments † have been mapped: the shallowness of these environments has prevented the use of underwater acoustics to reveal their morphological features. The recent technological development of multibeam echosounder systems, however, enables these instruments to achieve very high performances also in such shallow environments. In this work, we present results and case studies of an extensive multibeam survey carried out in the Lagoon of Venice in 2013. The Lagoon of Venice is the biggest lagoon in the Mediterranean Sea with a surface of about 550 km2 and with an average depth of about 1 m. In the last century, the morphological and ecological properties of the lagoon changed dramatically: the surface of the salt marshes was reduced by 60% and some parts of the lagoon are deepening with a net sediment flux exiting from the inlets. Moreover, major engineering interventions are currently ongoing at the inlets (MOSE project). These changes at the inlets could affect substantially the lagoon environment. To understand and monitor the future evolution of the Lagoon of Venice, ISMAR within the project RITMARE (a National Research Programme funded by the Italian Ministry of University and Research) carried out an extensive survey, involving a team of more than 25 scientists, to collect high resolution (0.5 m) bathymetry of key study areas such as the tidal inlets and channels. Following a broad

Atmospheric fall-out of metals around the Murano glass-making district (Venice, Italy).

PubMed

Rossini, Paolo; Matteucci, Gabriele; Guerzoni, Stefano

2010-01-01

Murano's glass-makers have held a monopoly on quality glass-making for centuries known all over the world. Artistic glass manufacture entails exposure to complex mixtures of pollutants, including metals. A few studies have reported high levels of trace elements in marine waters, sediments and mussels around Murano and shown that emissions from Murano glass-making workshops significantly influence air quality in the Venice area. Nevertheless, to date, there is very little information on atmospheric concentrations and virtually none on atmospheric deposition fluxes of trace elements around the island. This study presents data on the distribution of trace elements in the air and atmospheric depositions around Murano, based on a 2-year sampling period. Airborne PM10 particulate matter was collected daily in the period December 2001-June 2003 (254 air samples), and atmospheric depositions were collected every 19 +/- 6 days, in the period August 2001-July 2003 (38 samples) on the roof of the Experimental Glass Laboratory on the island of Murano. All samples were analysed by ICP-MS for As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Sb, Se and Zn contents. Atmospheric concentrations of As, Cd, Cr, Ni, Pb, Se and Zn were 1-2 orders of magnitude greater on the island of Murano than in the nearest urban areas (Venice and Mestre), with values higher than those reported for European industrial sites. The atmospheric deposition fluxes of all elements were also higher in Murano than those detected by other studies in Venice and Mestre and in the Porto Marghera industrial zone, with As, Cd, Sb and Se 1-2 orders of magnitude higher. In order to study the spatial variability of the atmospheric fall-out, data from other sampling stations belonging to Venice atmospheric deposition monitoring networks were used. A decreasing gradient from Murano to the closer leeward stations was observed for As, Cd and Se. Pb and Zn deposition fluxes in Venice were also comparable to those observed in the Porto

Computers and clinical arrhythmias.

PubMed

Knoebel, S B; Lovelace, D E

1983-02-01

Cardiac arrhythmias are ubiquitous in normal and abnormal hearts. These disorders may be life-threatening or benign, symptomatic or unrecognized. Arrhythmias may be the precursor of sudden death, a cause or effect of cardiac failure, a clinical reflection of acute or chronic disorders, or a manifestation of extracardiac conditions. Progress is being made toward unraveling the diagnostic and therapeutic problems involved in arrhythmogenesis. Many of the advances would not be possible, however, without the availability of computer technology. To preserve the proper balance and purposeful progression of computer usage, engineers and physicians have been exhorted not to work independently in this field. Both should learn some of the other's trade. The two disciplines need to come together to solve important problems with computers in cardiology. The intent of this article was to acquaint the practicing cardiologist with some of the extant and envisioned computer applications and some of the problems with both. We conclude that computer-based database management systems are necessary for sorting out the clinical factors of relevance for arrhythmogenesis, but computer database management systems are beset with problems that will require sophisticated solutions. The technology for detecting arrhythmias on routine electrocardiograms is quite good but human over-reading is still required, and the rationale for computer application in this setting is questionable. Systems for qualitative, continuous monitoring and review of extended time ECG recordings are adequate with proper noise rejection algorithms and editing capabilities. The systems are limited presently for clinical application to the recognition of ectopic rhythms and significant pauses. Attention should now be turned to the clinical goals for detection and quantification of arrhythmias. We should be asking the following questions: How quantitative do systems need to be? Are computers required for the detection of

Introduction of human papillomavirus (HPV) vaccination into national immunisation schedules in Europe: Results of the VENICE 2007 survey.

PubMed

King, L A; Lévy-Bruhl, D; O'Flanagan, D; Bacci, S; Lopalco, P L; Kudjawu, Y; Salmaso, S

2008-08-14

The European Union Member States are simultaneously considering introducing HPV vaccination into their national immunisation schedules. The Vaccine European New Integrated Collaboration Effort (VENICE) project aims to develop a collaborative European vaccination network. A survey was undertaken to describe the decision status and the decision-making process regarding the potential introduction of human papillomavirus (HPV) vaccination in to their national immunisation schedules. A web-based questionnaire was developed and completed online in 2007 by 28 countries participating in VENICE. As of 31 October 2007,five countries had decided to introduce HPV vaccination into the national immunisation schedule, while another seven had started the decision-making process with a recommendation favouring introduction. Varying target populations were selected by the five countries which had introduced the vaccination. Half of the surveyed countries had undertaken at least one ad hoc study to support the decision-making process. According to an update of the decision-status from January 2008, the number of countries which had made a decision or recommendation changed to 10 and 5 respectively. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe and the existence of expertise and experience among EU Member States. The VENICE network is capable of following this process and supporting countries in making vaccine introduction decisions. A VENICE collaborative web-space is being developed as a European resource for the decision-making process for vaccine introduction.

Leptospirosis acquired by tourists in Venice, Italy.

PubMed

Lagi, Filippo; Corti, Giampaolo; Meli, Massimo; Pinto, Antonella; Bartoloni, Alessandro

2013-01-01

We present the case of two Australian tourists aged 25 and 26  years who, after immersion in a canal in Venice, developed severe leptospirosis. After a 1-week history of fever, headache, myalgia, and vomiting they developed jaundice and renal failure. Complete remission was achieved by antibiotic therapy and hemodialysis. © 2012 International Society of Travel Medicine.

LITERATURE CURRICULUM III--TEST FOR "THE MERCHANT OF VENICE."

ERIC Educational Resources Information Center

KITZHABER, ALBERT R.

THIS TEST--"THE MERCHANT OF VENICE"--WAS DESIGNED BY THE OREGON CURRICULUM STUDY CENTER FOR A NINTH-GRADE LITERATURE CURRICULUM. IT IS INTENDED TO ACCOMPANY CURRICULUM UNITS AVAILABLE AS ED 010 815 AND ED 010 816. (MM)

Particulate air pollution induces arrhythmia via oxidative stress and calcium calmodulin kinase II activation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Jin-Bae; Kim, Changsoo; Choi, Eunmi

2012-02-15

Ambient particulate matter (PM) can increase the incidence of arrhythmia. However, the arrhythmogenic mechanism of PM is poorly understood. This study investigated the arrhythmogenic mechanism of PM. In Sprague–Dawley rats, QT interval was increased from 115.0 ± 14.0 to 142.1 ± 18.4 ms (p = 0.02) after endotracheal exposure of DEP (200 μg/ml for 30 min, n = 5). Ventricular premature contractions were more frequently observed after DEP exposure (100%) than baseline (20%, p = 0.04). These effects were prevented by pretreatment of N-acetylcysteine (NAC, 5 mmol/L, n = 3). In 12 Langendorff-perfused rat hearts, DEP infusion of 12.5 μg/mlmore » for 20 min prolonged action potential duration (APD) at only left ventricular base increasing apicobasal repolarization gradients. Spontaneous early afterdepolarization (EAD) and ventricular tachycardia (VT) were observed in 8 (67%) and 6 (50%) hearts, respectively, versus no spontaneous triggered activity or VT in any hearts before DEP infusion. DEP-induced APD prolongation, EAD and VT were successfully prevented with NAC (5 mmol/L, n = 5), nifedipine (10 μmol/L, n = 5), and active Ca{sup 2+}/calmodulin-dependent protein kinase II (CaMKII) blockade, KN 93 (1 μmol/L, n = 5), but not by thapsigargin (200 nmol/L) plus ryanodine (10 μmol/L, n = 5) and inactive CaMKII blockade, KN 92 (1 μmol/L, n = 5). In neonatal rat cardiomyocytes, DEP provoked ROS generation in dose dependant manner. DEP (12.5 μg/ml) induced apoptosis, and this effect was prevented by NAC and KN 93. Thus, this study shows that in vivo and vitro exposure of PM induced APD prolongation, EAD and ventricular arrhythmia. These effects might be caused by oxidative stress and CaMKII activation. -- Highlights: ► The ambient PM consistently prolonged repolarization. ► The ambient PM induced triggered activity and ventricular arrhythmia. ► These effects were prevented by antioxidants, I{sub CaL} blockade and CaMKII blockade. ► The ambient PM can induce

Computer-assisted education system for arrhythmia (CAESAR).

PubMed

Fukushima, M; Inoue, M; Fukunami, M; Ishikawa, K; Inada, H; Abe, H

1984-08-01

A computer-assisted education system for arrhythmia (CAESAR) was developed for students to acquire the ability to logically diagnose complicated arrhythmias. This system has a logical simulator of cardiac rhythm using a mathematical model of the impulse formation and conduction system of the heart. A simulated arrhythmia (ECG pattern) is given on a graphic display unit with simulated series of the action potential of five pacemaker centers and the "ladder diagram" of impulse formation and conduction, which show the mechanism of that arrhythmia. For the purpose of the evaluation of this system, 13 medical students were given two types of tests concerning arrhythmias before and after 2-hr learning with this system. The scores they obtained after learning increased significantly from 73.3 +/- 11.9 to 93.2 +/- 3.0 (P less than 0.001) in one test and from 47.2 +/- 17.9 to 64.9 +/- 19.6 (P less than 0.001) in another one. These results proved that this CAI system is useful and effective for training ECG interpretation of arrhythmias.

Perspective: A Dynamics-Based Classification of Ventricular Arrhythmias

PubMed Central

Weiss, James N.; Garfinkel, Alan; Karagueuzian, Hrayr S.; Nguyen, Thao P.; Olcese, Riccardo; Chen, Peng-Sheng; Qu, Zhilin

2015-01-01

Despite key advances in the clinical management of life-threatening ventricular arrhythmias, culminating with the development of implantable cardioverter-defibrillators and catheter ablation techniques, pharmacologic/biologic therapeutics have lagged behind. The fundamental issue is that biological targets are molecular factors. Diseases, however, represent emergent properties at the scale of the organism that result from dynamic interactions between multiple constantly changing molecular factors. For a pharmacologic/biologic therapy to be effective, it must target the dynamic processes that underlie the disease. Here we propose a classification of ventricular arrhythmias that is based on our current understanding of the dynamics occurring at the subcellular, cellular, tissue and organism scales, which cause arrhythmias by simultaneously generating arrhythmia triggers and exacerbating tissue vulnerability. The goal is to create a framework that systematically links these key dynamic factors together with fixed factors (structural and electrophysiological heterogeneity) synergistically promoting electrical dispersion and increased arrhythmia risk to molecular factors that can serve as biological targets. We classify ventricular arrhythmias into three primary dynamic categories related generally to unstable Ca cycling, reduced repolarization, and excess repolarization, respectively. The clinical syndromes, arrhythmia mechanisms, dynamic factors and what is known about their molecular counterparts are discussed. Based on this framework, we propose a computational-experimental strategy for exploring the links between molecular factors, fixed factors and dynamic factors that underlie life-threatening ventricular arrhythmias. The ultimate objective is to facilitate drug development by creating an in silico platform to evaluate and predict comprehensively how molecular interventions affect not only a single targeted arrhythmia, but all primary arrhythmia dynamics

The Challenge of High-resolution Mapping of Very Shallow Coastal Areas: Case Study of the Lagoon of Venice, Italy

NASA Astrophysics Data System (ADS)

Madricardo, F.; Foglini, F.; Kruss, A.; Bajo, M.; Campiani, E.; Ferrarin, C.; Fogarin, S.; Grande, V.; Janowski, L.; Keppel, E.; Leidi, E.; Lorenzetti, G.; Maicu, F.; Maselli, V.; Montereale Gavazzi, G.; Pellegrini, C.; Petrizzo, A.; Prampolini, M.; Remia, A.; Rizzetto, F.; Rovere, M.; Sarretta, A.; Sigovini, M.; Toso, C.; Zaggia, L.; Trincardi, F.

2017-12-01

Very shallow coastal environments are often highly urbanized with half of the world's population and 13 of the largest mega-cities located close to the coast. These environments undergo rapid morphological changes due to natural and anthropogenic pressure that will likely be enhanced in the near future by mean sea-level rise. Therefore, there is a strong need for high resolution seafloor mapping to monitor and protect shallow coastal areas. To date, only about 5% of their seafloor has been mapped: their shallowness has prevented so far the use of underwater acoustics to reveal their morphological features; their turbidity often hindered the efficient use of LIDAR technology, particularly in lagoons and estuaries. The recent technological development of multibeam echosounder systems, however, enables these instruments to achieve very high performances also in such shallow environments. In this work, we present the results of an extensive multibeam survey carried out in the Lagoon of Venice (Italy) in 2013. The Lagoon of Venice is the biggest lagoon in the Mediterranean Sea (surface area of about 550 km2, average depth of about 1 m) and it is a UNESCO World Cultural and Natural Heritage site together with the historical city of Venice which is currently endangered by relative sea-level rise. Major engineering works are ongoing at the lagoon inlets (MOSE project) to protect Venice from flood events. In the last century, the morphology and ecology of the lagoon changed dramatically: the extent of the salt marshes was reduced by 60% and some parts of the lagoon deepened by more than 1 m with a net sediment flux exiting from the inlets. To understand and monitor the future evolution of the Lagoon of Venice in view of the inlet modifications and mean sea-level rise, CNR-ISMAR within the project RITMARE (a National Research Programme funded by the Italian Ministry of University and Research) carried out an extensive survey, involving a team of more than 25 scientists, to

Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial.

PubMed

Soltani, Ghasem; Jahanbakhsh, Saeed; Tashnizi, Mohammad Abbasi; Fathi, Mehdi; Amini, Shahram; Zirak, Nahid; Sheybani, Shima

2017-10-01

Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for preventing intraoperative heart arrhythmias has not been recognized. This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart arrhythmias and anesthetic required in off-pump coronary artery bypass surgery. This randomized clinical trial was conducted on patients who were candidates for off-pump coronary artery bypass referring to Imam Reza Hospital of Mashhad, Iran, from July 2016 through January 2017. The patients were randomly assigned to two groups of intervention (infusion of 0.5 mcg/kg/h dexmedetomidine together with induction followed by infusion of 0.5 mcg/kg/h by the end of the surgery) or control (saline infusion). Mean arterial pressure (MAP) and heart rate (HR) were measured before induction, during surgery operation and ICU admission. Data were analyzed by SPSS version 18 using Chi Square and independent-samples t-test. A total of 76 patients with a mean age of 59.8 ± 8.2 years (in two groups of 38) were studied. The two groups had no statistically significant difference in terms of background variables. The MAP and HR values before induction, during surgery and ICU admission were significantly higher in the control group than in the intervention group (p=0.001). Out of the studied arrhythmias, the values of PAC (55.2% vs. 15.7%), PVC (81.5% vs. 21.0%), AF (26.3% vs. 7.8%), VTAC (21.0% vs. 2.6%) were significantly lower in dexmedetomidine group (p=0.001). It seems that dexmedetomidine administration during induction and surgery can cause significant reduction in most of the common arrhythmias in off-pump coronary bypass surgery. The use of dexmedetomidine maintains MAP and HR at significantly lower values, and changes

Effects of dexmedetomidine on heart arrhythmia prevention in off-pump coronary artery bypass surgery: A randomized clinical trial

PubMed Central

Soltani, Ghasem; Jahanbakhsh, Saeed; Tashnizi, Mohammad Abbasi; Fathi, Mehdi; Amini, Shahram; Zirak, Nahid; Sheybani, Shima

2017-01-01

Background Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for preventing intraoperative heart arrhythmias has not been recognized. Objective This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart arrhythmias and anesthetic required in off-pump coronary artery bypass surgery. Methods This randomized clinical trial was conducted on patients who were candidates for off-pump coronary artery bypass referring to Imam Reza Hospital of Mashhad, Iran, from July 2016 through January 2017. The patients were randomly assigned to two groups of intervention (infusion of 0.5 mcg/kg/h dexmedetomidine together with induction followed by infusion of 0.5 mcg/kg/h by the end of the surgery) or control (saline infusion). Mean arterial pressure (MAP) and heart rate (HR) were measured before induction, during surgery operation and ICU admission. Data were analyzed by SPSS version 18 using Chi Square and independent-samples t-test. Results A total of 76 patients with a mean age of 59.8 ± 8.2 years (in two groups of 38) were studied. The two groups had no statistically significant difference in terms of background variables. The MAP and HR values before induction, during surgery and ICU admission were significantly higher in the control group than in the intervention group (p=0.001). Out of the studied arrhythmias, the values of PAC (55.2% vs. 15.7%), PVC (81.5% vs. 21.0%), AF (26.3% vs. 7.8%), VTAC (21.0% vs. 2.6%) were significantly lower in dexmedetomidine group (p=0.001). Conclusion It seems that dexmedetomidine administration during induction and surgery can cause significant reduction in most of the common arrhythmias in off-pump coronary bypass surgery. The use of dexmedetomidine maintains MAP

Comparison of two teaching methods for cardiac arrhythmia interpretation among nursing students.

PubMed

Varvaroussis, Dimitrios P; Kalafati, Maria; Pliatsika, Paraskevi; Castrén, Maaret; Lott, Carsten; Xanthos, Theodoros

2014-02-01

The aim of this study was to compare the six-stage method (SSM) for instructing primary cardiac arrhythmias interpretation to students without basic electrocardiogram (ECG) knowledge with a descriptive teaching method in a single educational intervention. This is a randomized trial. Following a brief instructional session, undergraduate nursing students, assigned to group A (SSM) and group B (descriptive teaching method), undertook a written test in cardiac rhythm recognition, immediately after the educational intervention (initial exam). Participants were also examined with an unannounced retention test (final exam), one month after instruction. Altogether 134 students completed the study. Interpretation accuracy for each cardiac arrhythmia was assessed. Mean score at the initial exam was 8.71±1.285 for group A and 8.74±1.303 for group B. Mean score at the final exam was 8.25±1.46 for group A vs 7.84±1.44 for group B. Overall results showed that the SSM was equally effective with the descriptive teaching method. The study showed that in each group bradyarrhythmias were identified correctly by more students than tachyarrhythmias. No significant difference between the two teaching methods was seen for any specific cardiac arrhythmia. The SSM effectively develops staff competency for interpreting common cardiac arrhythmias in students without ECG knowledge. More research is needed to support this conclusion and the method's effectiveness must be evaluated if being implemented to trainee groups with preexisting basic ECG interpretation knowledge. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Cardiac Arrhythmias in Experimental Syncope

DTIC Science & Technology

1958-11-01

cardiac toward respiratory alkalosis . Regardless of arriythmias by stress procedures. It follows these two extremes in the assumed change in that previous...frequently induced by respiratory maneuvers without syncope. Intravenous aidministration of atropine appatently prevented recurrence of cardiac...arrhythmia induced by respiratory maneuvers. Significant cardiac arrhythmia was also noted in simple orthostatic syncope. Loss of consciousness presents a

In permanent atrial fibrillation, PDE3 reduces force responses to 5‐HT, but PDE3 and PDE4 do not cause the blunting of atrial arrhythmias

PubMed Central

Schwarz, Simon; Ravens, Ursula; Knaut, Michael

2016-01-01

Abstract Background and Purpose 5‐HT increases force and L‐type Ca2 + current (ICa,L) and causes arrhythmias through 5‐HT4 receptors in human atrium. In permanent atrial fibrillation (peAF), atrial force responses to 5‐HT are blunted, arrhythmias abolished but ICa,L responses only moderately attenuated. We investigated whether, in peAF, this could be due to an increased function of PDE3 and/or PDE4, using the inhibitors cilostamide (300 nM) and rolipram (1 μM) respectively. Experimental Approach Contractile force, arrhythmic contractions and ICa,L were assessed in right atrial trabeculae and myocytes, obtained from patients with sinus rhythm (SR), paroxysmal atrial fibrillation (pAF) and peAF. Key Results Maximum force responses to 5‐HT were reduced to 15% in peAF, but not in pAF. Cilostamide, but not rolipram, increased both the blunted force responses to 5‐HT in peAF and the inotropic potency of 5‐HT fourfold to sevenfold in trabeculae of patients with SR, pAF and peAF. Lusitropic responses to 5‐HT were not decreased in peAF. Responses of ICa,L to 5‐HT did not differ and were unaffected by cilostamide or rolipram in myocytes from patients with SR or peAF. Concurrent cilostamide and rolipram increased 5‐HT's propensity to elicit arrhythmias in trabeculae from patients with SR, but not with peAF. Conclusions and Implications PDE3, but not PDE4, reduced inotropic responses to 5‐HT in peAF, independently of lusitropy and ICa,L, but PDE3 activity was the same as that in patients with SR and pAF. Atrial remodelling in peAF abolished the facilitation of 5‐HT to induce arrhythmias by inhibition of PDE3 plus PDE4. PMID:27238373

Carbon monoxide induces cardiac arrhythmia via induction of the late Na+ current.

PubMed

Dallas, Mark L; Yang, Zhaokang; Boyle, John P; Boycott, Hannah E; Scragg, Jason L; Milligan, Carol J; Elies, Jacobo; Duke, Adrian; Thireau, Jérôme; Reboul, Cyril; Richard, Sylvain; Bernus, Olivier; Steele, Derek S; Peers, Chris

2012-10-01

Clinical reports describe life-threatening cardiac arrhythmias after environmental exposure to carbon monoxide (CO) or accidental CO poisoning. Numerous case studies describe disruption of repolarization and prolongation of the QT interval, yet the mechanisms underlying CO-induced arrhythmias are unknown. To understand the cellular basis of CO-induced arrhythmias and to identify an effective therapeutic approach. Patch-clamp electrophysiology and confocal Ca(2+) and nitric oxide (NO) imaging in isolated ventricular myocytes was performed together with protein S-nitrosylation to investigate the effects of CO at the cellular and molecular levels, whereas telemetry was used to investigate effects of CO on electrocardiogram recordings in vivo. CO increased the sustained (late) component of the inward Na(+) current, resulting in prolongation of the action potential and the associated intracellular Ca(2+) transient. In more than 50% of myocytes these changes progressed to early after-depolarization-like arrhythmias. CO elevated NO levels in myocytes and caused S-nitrosylation of the Na(+) channel, Na(v)1.5. All proarrhythmic effects of CO were abolished by the NO synthase inhibitor l-NAME, and reversed by ranolazine, an inhibitor of the late Na(+) current. Ranolazine also corrected QT variability and arrhythmias induced by CO in vivo, as monitored by telemetry. Our data indicate that the proarrhythmic effects of CO arise from activation of NO synthase, leading to NO-mediated nitrosylation of Na(V)1.5 and to induction of the late Na(+) current. We also show that the antianginal drug ranolazine can abolish CO-induced early after-depolarizations, highlighting a novel approach to the treatment of CO-induced arrhythmias.

[Work-related stress in nursery school educators in the Venice and Marghera districts].

PubMed

Camerino, Donatella; Fichera, G P; Punzi, Silvia; Campanini, P; Conway, P M; Prevedello, Laura; Costa, G

2011-01-01

Based on an investigation on organizational well-being in the Municipality of Venice (2009), we examined 110 public nursery school and preschool teachers working in the Venice and Marghera districts. The aim of this study was to develop and implement a procedure for work-related stress assessment and management in Municipality of Venice, in the light of Law 81/2008. Occupational stress and its impact on teachers' well-being and health were assessed by means of self-administered questionnaires and semi-structured interviews. Descriptive analyses were conducted to compare teachers' data with those concerning employees operating in other services in the Venice and Marghera districts. According to the results, while nursery school and preschool teachers work with considerable commitment, vigor, dedication and involvement, problems were observed related to: assignment of administrative tasks without appropriate support from the district offices; difficult access to support services; shortage of temporary teachers and auxiliary personnel and, limited to some facilities, lack of adequate physical space devoted to teaching activities. Such adverse conditions result in an increase in vigilance levels required to ensure children's safety. Personnel also suffer from a lack of career prospects, with scarce opportunities for contact with other facilities in the area and inadequate involvement in the decisional processes at Municipality level. Improving such adverse conditions could solve the current marginalization of public nursery school and preschool teachers and encourage mutual exchange of information, which would in turn favour more appropriate methods of managing each single facility.

Atrial arrhythmias after lung transplant: underlying mechanisms, risk factors, and prognosis.

PubMed

Orrego, Carlos M; Cordero-Reyes, Andrea M; Estep, Jerry D; Seethamraju, Harish; Scheinin, Scott; Loebe, Matthias; Torre-Amione, Guillermo

2014-07-01

Atrial arrhythmias (AAs) early after lung transplant are frequent and have a significant impact on morbidity and mortality. However, the pathogenesis of AAs after lung transplant remains incompletely understood. In this study we aimed to determine the prevalence of atrial fibrillation (AF) and other AAs, as well as risk factors, clinical outcomes and possible underlying mechanisms associated with AAs after lung transplant. A retrospective analysis was performed on 382 patients who underwent lung transplantation from 2000 to 2010. A 12-lead electrocardiogram (ECG) was obtained and AAs classified as AF and other AAs (atrial flutter [AFL] and supraventricular tachycardia [SVT]). Multivariate logistic regression analysis was performed to determine predictors, and Kaplan-Meier survival curves were constructed. The incidence of AAs was 25%; 17.8% developed AF and 7.6% other AAs (AFL/SVT). The major indication for transplant was idiopathic pulmonary fibrosis (IPF, 35%). Significant predictors of AF were as follows: age; IPF; left atrial enlargement; diastolic dysfunction; and history of coronary artery disease (CAD). Risk factors for other AAs (AFL/SVT) were: age; right ventricle dysfunction; right ventricular enlargement; and elevated right atrial pressure (RAP). One-year mortality was higher in the arrhythmia group (21.5% arrhythmia vs 15.7% no-arrhythmia group; p < 0.05). In addition, patients treated with anti-arrhythmic medications had higher mortality (p < 0.05). AAs are common after lung transplantation. Risk factors for developing either AF or other AAs (AFL/SVT) are different. The development of early AAs post-transplant is associated with prolonged post-operative stay and increased mortality. A rate-control strategy should be used as first-line therapy and anti-arrhythmic agents reserved for those patients who do not respond to the initial treatment. Copyright © 2014 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights

Demons, nature, or God? Witchcraft accusations and the French disease in early modern Venice.

PubMed

McGough, Laura J

2006-01-01

In early modern Venice, establishing the cause of a disease was critical to determining the appropriate cure: natural remedies for natural illnesses, spiritual solutions for supernatural or demonic ones. One common ailment was the French disease (syphilis), widely distributed throughout Venice's neighborhoods and social hierarchy, and evenly distributed between men and women. The disease was widely regarded as curable by the mid-sixteenth century, and cases that did not respond to natural remedies presented problems of interpretation to physicians and laypeople. Witchcraft was one possible explanation; using expert testimony from physicians, however, the Holy Office ruled out witchcraft as a cause of incurable cases and reinforced perceptions that the disease was of natural origin. Incurable cases were explained as the result of immoral behavior, thereby reinforcing the associated stigma. This article uses archival material from Venice's Inquisition records from 1580 to 1650, as well as mortality data.

[Catheter ablation in patients with refractory cardiac arrhythmias with radiofrequency techniques].

PubMed

de Paola, A A; Balbão, C E; Silva Netto, O; Mendonça, A; Villacorta, H; Vattimo, A C; Souza, I A; Guiguer Júnior, N; Portugal, O P; Martinez Filho, E E

1993-02-01

evaluate the efficacy of radiofrequency catheter ablation in patients with refractory cardiac arrhythmias. twenty patients with refractory cardiac arrhythmias were undertaken to electrophysiologic studies for diagnosis and radiofrequency catheter ablation of their reentrant arrhythmias. Ten patients were men and 10 women with ages varying from 13 to 76 years (mean = 42.4 years). Nineteen patients had supraventricular tachyarrhythmias: One patient had atrial tachycardia and 1 atrial fibrillation with rapid ventricular rate, 5 patients had reentrant nodal tachycardia, 12 patients had reentrant atrioventricular tachycardia and 1 patient had right ventricular outflow tract tachycardia. the mean time of the procedure was 4.1 hours. The radiofrequency current energy applied was 40-50 V for 30-40 seconds. Ablation was successful in 18/20 (90%) patients; in 15/18 (83%) of successfully treated patients the same study was done for diagnosis and radiofrequency ablation. One patient had femoral arterial occlusion and was treated with no significant sequelae. During a mean follow-up of 4 months no preexcitation or reentrant tachycardia occurred. the results of our experience with radiofrequency catheter ablation of cardiac arrhythmias suggest that this technique can benefit an important number of patients with cardiac arrhythmias.

Diagnosis of diabetes mellitus at the hospital of Venice in 1863.

PubMed

Dall'Olio, G; Dorizzi, R M

2000-07-01

In 1674 Thomas Willis reported that the presence of urine 'as sweet as honey' was the pathognomonic sign of diabetes mellitus. In the 19th Century several reactions for the detection of glucose in urine were proposed and glucose measurement became common in the laboratories that were being set up in Europe. A case of diabetes mellitus, diagnosed by Namias, the head of the Women's Section of the Medicine Department of Venice Hospital, was reported in 1863 in the 'Giornale Veneto di Scienze Mediche' which contains clinical and laboratory information. A 34-year-old woman was admitted to the hospital for polydypsia, polyuria, bulimia and fatigue. Urine was weighed for 2 months (2-10 kgday(-1)) and the relative density ranged from 1.045 to 1.038. Glucose was measured in the urine using Moore, Trommer and Fehling reagents. A few days after admission a urine sample showed 7.69 parts/100 parts of urine and a blood sample showed 547 mg of glucose/100 g of serum. The assays were carried out in the Clinical Laboratory of Venice Hospital, founded in 1863, directed by Giovanni Bizio, one of the first chemists who graduated at Padua University. In 1863 chemical analyses were commonly carried out in Venice as in the other parts of Habsburg empire.

Proposition of novel classification approach and features for improved real-time arrhythmia monitoring.

PubMed

Kim, Yoon Jae; Heo, Jeong; Park, Kwang Suk; Kim, Sungwan

2016-08-01

Arrhythmia refers to a group of conditions in which the heartbeat is irregular, fast, or slow due to abnormal electrical activity in the heart. Some types of arrhythmia such as ventricular fibrillation may result in cardiac arrest or death. Thus, arrhythmia detection becomes an important issue, and various studies have been conducted. Additionally, an arrhythmia detection algorithm for portable devices such as mobile phones has recently been developed because of increasing interest in e-health care. This paper proposes a novel classification approach and features, which are validated for improved real-time arrhythmia monitoring. The classification approach that was employed for arrhythmia detection is based on the concept of ensemble learning and the Taguchi method and has the advantage of being accurate and computationally efficient. The electrocardiography (ECG) data for arrhythmia detection was obtained from the MIT-BIH Arrhythmia Database (n=48). A novel feature, namely the heart rate variability calculated from 5s segments of ECG, which was not considered previously, was used. The novel classification approach and feature demonstrated arrhythmia detection accuracy of 89.13%. When the same data was classified using the conventional support vector machine (SVM), the obtained accuracy was 91.69%, 88.14%, and 88.74% for Gaussian, linear, and polynomial kernels, respectively. In terms of computation time, the proposed classifier was 5821.7 times faster than conventional SVM. In conclusion, the proposed classifier and feature showed performance comparable to those of previous studies, while the computational complexity and update interval were highly reduced. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of maritime traffic on polycyclic aromatic hydrocarbons, metals and particulate matter in Venice air.

PubMed

Gregoris, Elena; Barbaro, Elena; Morabito, Elisa; Toscano, Giuseppa; Donateo, Antonio; Cesari, Daniela; Contini, Daniele; Gambaro, Andrea

2016-04-01

Harbours are important hubs for economic growth in both tourism and commercial activities. They are also an environmental burden being a source of atmospheric pollution often localized near cities and industrial complexes. The aim of this study is to quantify the relative contribution of maritime traffic and harbour activities to atmospheric pollutant concentration in the Venice lagoon. The impact of ship traffic was quantified on various pollutants that are not directly included in the current European legislation for shipping emission reduction: (i) gaseous and particulate PAHs; (ii) metals in PM10; and (iii) PM10 and PM2.5. All contributions were correlated with the tonnage of ships during the sampling periods and results were used to evaluate the impact of the European Directive 2005/33/EC on air quality in Venice comparing measurements taken before and after the application of the Directive (year 2010). The outcomes suggest that legislation on ship traffic, which focused on the issue of the emissions of sulphur oxides, could be an efficient method also to reduce the impact of shipping on primary particulate matter concentration; on the other hand, we did not observe a significant reduction in the contribution of ship traffic and harbour activities to particulate PAHs and metals. Graphical abstract Impact of maritime traffic on polycyclic aromatic hydrocarbons, metals and particulate matter and evaluation of the effect of an European Directive on air quality in Venice.

Alcohol, cardiac arrhythmias and sudden death.

PubMed

Kupari, M; Koskinen, P

1998-01-01

Studies in experimental animals have shown varying and apparently opposite effects of alcohol on cardiac rhythm and conduction. Given acutely to non-alcoholic animals, ethanol may even have anti-arrhythmic properties whereas chronic administration clearly increases the animals' susceptibility to cardiac arrhythmias. Chronic heavy alcohol use has been incriminated in the genesis of cardiac arrhythmias in humans. The evidence has come from clinical observations, retrospective case-control studies, controlled studies of consecutive admissions for arrhythmias, and prospective epidemiological investigations. Furthermore, electrophysiological studies have shown that acute alcohol administration facilitates the induction of tachyarrhythmias in selected heavy drinkers. The role of alcohol appears particularly conspicuous in idiopathic atrial fibrillation. Occasionally, ventricular tachyarrhythmias have also been provoked by alcohol intake. Several lines of evidence suggest that heavy drinking increases the risk of sudden cardiac death with fatal arrhythmia as the most likely mechanism. According to epidemiological studies this effect appears most prominent in middle-aged men and is only partly explained by confounding traits such as smoking and social class. The basic arrhythmogenic effects of alcohol are still insufficiently delineated. Subclinical heart muscle injury from chronic heavy use may be instrumental in producing patchy delays in conduction. The hyperadrenergic state of drinking and withdrawal may also contribute, as may electrolyte abnormalities, impaired vagal heart rate control, repolarization abnormalities with prolonged QT intervals and worsening of myocardial ischaemia or sleep apnoea. Most of what we know about alcohol and arrhythmias relates to heavy drinking. The effect of social drinking on clinical arrhythmias in non-alcoholic cardiac patients needs to be addressed further.

Genetically engineered SCN5A mutant pig hearts exhibit conduction defects and arrhythmias

PubMed Central

Park, David S.; Cerrone, Marina; Morley, Gregory; Vasquez, Carolina; Fowler, Steven; Liu, Nian; Bernstein, Scott A.; Liu, Fang-Yu; Zhang, Jie; Rogers, Christopher S.; Priori, Silvia G.; Chinitz, Larry A.; Fishman, Glenn I.

2014-01-01

SCN5A encodes the α subunit of the major cardiac sodium channel NaV1.5. Mutations in SCN5A are associated with conduction disease and ventricular fibrillation (VF); however, the mechanisms that link loss of sodium channel function to arrhythmic instability remain unresolved. Here, we generated a large-animal model of a human cardiac sodium channelopathy in pigs, which have cardiac structure and function similar to humans, to better define the arrhythmic substrate. We introduced a nonsense mutation originally identified in a child with Brugada syndrome into the orthologous position (E558X) in the pig SCN5A gene. SCN5AE558X/+ pigs exhibited conduction abnormalities in the absence of cardiac structural defects. Sudden cardiac death was not observed in young pigs; however, Langendorff-perfused SCN5AE558X/+ hearts had an increased propensity for pacing-induced or spontaneous VF initiated by short-coupled ventricular premature beats. Optical mapping during VF showed that activity often began as an organized focal source or broad wavefront on the right ventricular (RV) free wall. Together, the results from this study demonstrate that the SCN5AE558X/+ pig model accurately phenocopies many aspects of human cardiac sodium channelopathy, including conduction slowing and increased susceptibility to ventricular arrhythmias. PMID:25500882

Atrial Arrhythmia Summit: Post Summit Report

NASA Technical Reports Server (NTRS)

Barr, Yael

2010-01-01

The Atrial Arrhythmia Summit brought together nationally and internationally recognized experts in cardiology, electrophysiology, exercise physiology, and space medicine in an effort to elucidate the mechanisms, risk factors, and management of atrial arrhythmias in the unique occupational cohort of the U.S. astronaut corps.

Effect of long-term application of Crataegus oxyacantha on ischemia and reperfusion induced arrhythmias in rats.

PubMed

Rothfuss, M A; Pascht, U; Kissling, G

2001-01-01

The effect of long-term application of Crataegus oxyacantha on ischemia and reperfusion induced arrhythmias was investigated in Wistar rats on the heart in situ and on Langendorff preparations. Seventeen rats were fed for 8 weeks with 0.5 g/kg b.w. Crataegus extract per day, standardised to 2.2% flavonoids. Twenty age-matched untreated rats served as controls. In the hearts in situ as well as in the Langendorff preparations the left anterior descending coronary artery (LAD) was ligated for 20 min and subsequently reperfused for 30 min. ECG was continuously recorded and the time spent between start of ischemia and onset of arrhythmias was measured. In addition, during ischemia and reperfusion the number of ventricular premature beats and bigemini and the duration of salvos and ventricular flutter and fibrillation were determined. The ischemic area was evaluated in all experiments and coronary flow was measured in Langendorff preparations. In the present experiments, no cardioprotective effects of Crataegus oxyacantha could be detected, neither in the heart in situ nor in the Langendorff preparations. Although the ischemic areas were identical, arrhythmias occurred even earlier in the Crataegus collectives than in the controls. Also the number and duration of ischemia and reperfusion induced arrhythmias tended to occur longer and more frequently in the Crataegus collectives, whilst coronary flow remained unchanged. The phenomenon that Crataegus rather aggravates than prevents arrhythmias may be reduced to a Crataegus induced increase in intracellular Ca(2+)-concentration proven true for the positive inotropic effects of Crataegus.

Burden of arrhythmia in recreational marijuana users.

PubMed

Desai, Rupak; Patel, Upenkumar; Deshmukh, Abhishek; Sachdeva, Rajesh; Kumar, Gautam

2018-08-01

Marijuana or Cannabis is extensively used as a recreational substance globally. Case reports have reported cardiac arrhythmias immediately following recreational marijuana use. However, the burden of arrhythmias in hospitalized marijuana users have not been evaluated through prospective or cross-sectional studies. Therefore, we planned to measure temporal trends of the frequency of arrhythmias in hospitalized marijuana users using National Inpatient Sample (NIS) database in the United States. Copyright © 2018 Elsevier B.V. All rights reserved.

Riluzole reduces arrhythmias and myocardial damage induced by coronary occlusion in anaesthetized pigs.

PubMed

Weiss, Steven M; Dahlstrom, Jane E; Saint, David A

2013-12-01

The cardiac persistent sodium current (IN aP ) presents a novel target for cardiac ischaemic protection. Herein we investigated the effects of the IN aP blocker riluzole in a pig model of regional myocardial ischaemia. Landrace or Large White pigs were subjected to 3 h ligation of the left anterior descending coronary artery (LAD). Pigs received either saline (500 mL/h, i.v.) throughout the experiment (control; n = 7) or riluzole (2 mg/kg in 2 mL propylene glycol in 100 mL saline, i.v.; RIL; n = 7) between 15 and 5 min prior to ligation. The arrhythmia score was calculated in 5 min epochs. Myocardial damage was assessed using epicardial image analysis and histological sectioning. In the control group, all seven pigs developed premature ventricular contractions (PVC), seven developed non-sustained arrhythmias and six of seven developed sustained arrhythmias. Of the sustained arrhythmias, 23 of 28 instances were initiated by R-on-T extrasytoles (extrasystoles within the vulnerable period that can trigger re-entrant arrhythmias). In the RIL group, all seven pigs developed PVC, six of seven developed non-sustained arrhythmias and only three developed sustained arrhythmias, of which two of five instances were R-on-T initiated. The riluzole-treated pigs exhibited less myocardial damage than pigs in the control group (65% smaller surface area (P = 0.008) on gross epicardial inspection, 51% less oedema (P = 0.01), 53% less fibre waviness (P = 0.029) assessed by haematoxylin and eosin staining and 79% fewer fragmented nuclei (P = 0.009) assessed by terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling). In conclusion, riluzole significantly reduced Phase 2 (the period associated with irreversible damage) ischaemic R-on-T triggered and non-R-on-T arrhythmias and myocardial damage occurring during the 3 h period of regional ischaemia. © 2013 Wiley Publishing Asia Pty Ltd.

Using "The Merchant of Venice" in Teaching Monetary Economics.

ERIC Educational Resources Information Center

Kish-Goodling, Donna M.

1998-01-01

Uses the theme of usury in Shakespeare's "The Merchant of Venice," and the history of Christian and Jewish beliefs concerning the charging of interest on loans to crystallize lending practices throughout history, particularly the medieval period and the transition to modern capitalism. Outlines themes addressed in the unit and…

The sediments of the Venice Lagoon (Italy) evaluated in a screening risk assessment approach: part I--application of international sediment quality guidelines.

PubMed

Apitz, Sabine E; Barbanti, Andrea; Bocci, Martina; Carlin, Anna; Montobbio, Laura; Bernstein, Alberto Giulio

2007-07-01

A number of studies carried out in recent years have shown the presence of a wide range of contaminants in the Venice Lagoon. It is important to have a good understanding of the ecological quality of Venice Lagoon sediments in order to 1) define and locate areas where a threat to the environment is present and therefore an intervention is needed (i.e., in situ assessment and management); and 2) define sustainable and environmentally correct ways of managing sediments that are to be dredged for navigational purposes or in relation to other interventions (i.e., ex situ management). This study reports on a critical comparison of chemical quality of sediments in Venice Lagoon and its subregions. Data on the Venice Lagoon were compiled from several studies conducted during the past decade on surface sediment contamination; temporal variation and risks for contaminants at depth were not addressed. The comparison of observed pollutant concentrations with local and internationally used sediment quality guidelines (SQGs) was used as a tool to benchmark different sites and for a tier I (screening) ecological risk assessment. Meaning and relevance of a number of SQGs are discussed, together with the options available for carrying out the comparison with sediment data. The screening of the Venice Lagoon sediment quality is discussed from a risk-assessment perspective and appropriate values for use in an in situ-ex situ management framework are suggested. Although there were some differences depending upon which specific SQGs were applied, different SQGs provided the same general picture of screening risk in Venice Lagoon: Although there are geographic differences, median levels for several contaminants in surface sediments exceeded a number of SQGs. Many contaminants exceed threshold effects SQGs, and Hg exceeds probable effects SQGs in most sub-basins except the southern Lagoon. Venice Lagoon south has the lowest screening risk levels, Venice Lagoon central/north has the

Impact of remote monitoring on the management of arrhythmias in patients with implantable cardioverter-defibrillator.

PubMed

Marcantoni, Lina; Toselli, Tiziano; Urso, Giulia; Pratola, Claudio; Ceconi, Claudio; Bertini, Matteo

2015-11-01

In the last decade, there has been an exponential increase in cardioverter-defibrillator (ICD) implants. Remote monitoring systems, allow daily follow-ups of patients with ICD. To evaluate the impact of remote monitoring on the management of cardiovascular events associated with supraventricular and ventricular arrhythmias during long-term follow-up. A total of 207 patients undergoing ICD implantation/replacement were enrolled: 79 patients received remote monitoring systems and were followed up every 12 months, and 128 patients were followed up conventionally every 6 months. All patients were followed up and monitored for the occurrence of supraventricular and ventricular arrhythmia-related cardiovascular events (ICD shocks and/or hospitalizations). During a median follow-up of 842 days (interquartile range 476-1288 days), 32 (15.5%) patients experienced supraventricular arrhythmia-related events and 51 (24.6%) patients experienced ventricular arrhythmia-related events. Remote monitoring had a significant role in the reduction of supraventricular arrhythmia-related events, but it had no effect on ventricular arrhythmia-related events. In multivariable analysis, remote monitoring remained as an independent protective factor, reducing the risk of supraventricular arrhythmia-related events of 67% [hazard ratio, 0.33; 95% confidence interval (CI), 0.13-0.82; P = 0.017]. Remote monitoring systems improved outcomes in patients with supraventricular arrhythmias by reducing the risk of cardiovascular events, but no benefits were observed in patients with ventricular arrhythmias.

Amiodarone in the treatment of refractory supraventricular and ventricular arrhythmias

PubMed Central

Wheeler, P. J.; Ingram, D. V.; Puritz, R.; Chamberlain, D. A.

1979-01-01

Amiodarone is an antiarrhythmic agent unrelated to other drugs in current use. It has been little used in Britain, and no formal clinical trials have been possible because the drug has not been licensed by the Committee on Safety of Medicines. Nevertheless it has unique properties which can be valuable in the treatment of a wide spectrum of arrhythmias, particularly supraventricular tachycardias. Amiodarone has a slow onset of action and is cumulative. A sustained action is therefore achieved without the need for frequent maintenance dosage. Fifty patients have been treated with amiodarone in maintenance doses ranging from 200 mg on alternate days to 200 mg twice daily either alone, or in combination with conventional therapy. All were resistant to conventional therapy alone or could not be treated with usual agents because of unwanted drug effects. Of 27 patients with supraventricular arrhythmias, 18 were completely controlled and the other 9 were markedly improved. Six of 8 patients with recurrent life-threatening ventricular arrhythmias were well controlled symptomatically. Results were predictably less satisfactory in 15 high risk post-infarction patients with malignant arrhythmias and severe myocardial damage, but 6 were probably improved as a result of amiodarone. All patients on maintenance therapy for 3 months or more developed corneal microdeposits. None has any visual symptoms or other ocular defect, and treatment has not been curtailed as a result of this well recognized effect which is believed to be reversible and benign. Amiodarone can control patients with otherwise refractory arrhythmias including some which are life-threatening. Formal clinical trials are needed to define accurately its future role in the prevention and treatment of serious rhythm disorders of the heart. PMID:432163

Reduction in dynamin-2 is implicated in ischaemic cardiac arrhythmias

PubMed Central

Shi, Dan; Xie, Duanyang; Zhang, Hong; Zhao, Hong; Huang, Jian; Li, Changming; Liu, Yi; Lv, Fei; The, Erlinda; Liu, Yuan; Yuan, Tianyou; Wang, Shiyi; Chen, Jinjin; Pan, Lei; Yu, Zuoren; Liang, Dandan; Zhu, Weidong; Zhang, Yuzhen; Li, Li; Peng, Luying; Li, Jun; Chen, Yi-Han

2014-01-01

Ischaemic cardiac arrhythmias cause a large proportion of sudden cardiac deaths worldwide. The ischaemic arrhythmogenesis is primarily because of the dysfunction and adverse remodelling of sarcolemma ion channels. However, the potential regulators of sarcolemma ion channel turnover and function in ischaemic cardiac arrhythmias remains unknown. Our previous studies indicate that dynamin-2 (DNM2), a cardiac membrane-remodelling GTPase, modulates ion channels membrane trafficking in the cardiomyocytes. Here, we have found that DNM2 plays an important role in acute ischaemic arrhythmias. In rat ventricular tissues and primary cardiomyocytes subjected to acute ischaemic stress, the DNM2 protein and transcription levels were markedly down-regulated. This DNM2 reduction was coupled with severe ventricular arrhythmias. Moreover, we identified that the down-regulation of DNM2 within cardiomyocytes increases the action potential amplitude and prolongs the re-polarization duration by depressing the retrograde trafficking of Nav1.5 and Kir2.1 channels. These effects are likely to account for the DNM2 defect-induced arrhythmogenic potentials. These results suggest that DNM2, with its multi-ion channel targeting properties, could be a promising target for novel antiarrhythmic therapies. PMID:25092467

Effect of magnesium on arrhythmia incidence in patients undergoing coronary artery bypass grafting.

PubMed

Mohammadzadeh, Alireza; Towfighi, Farshad; Jafari, Naser

2018-06-01

Cardiac arrhythmia after coronary artery bypass grafting (CABG) surgery is a common complication of cardiac surgery. The effect of serum magnesium, hypomagnesaemia treatment and prophylactic administration of magnesium in the development and prevention of arrhythmias is controversial and there are many different ideas. This study evaluates the therapeutic effects of magnesium in cardiac arrhythmia after CABG surgery. The clinical trial enrolled 250 patients who underwent CABG. Based on the initial serum levels of magnesium, patients were divided into two groups: hypomagnesium and normomagnesium. Based on bioethics committee requirements, patients in the hypo-magnesium group received magnesium treatments until they attained normal magnesium blood levels. Both groups underwent CABG with normal blood levels of magnesium. After surgery, each group was randomly divided into two subgroups: one subgroup received a bolus dose of magnesium sulphate (30 mg/kg in 5 min) and the other subgroup received a placebo. Subgroups were under observation in the intensive care unit for 3 days and arrhythmias were recorded. Data from all four subgroups were analysed statistically and interpreted. The results of this study showed that the occurrence of arrhythmia was not significantly different among subgroups (P > 0.05). There was no significant relationship between blood levels of magnesium and arrhythmia during the 3 days post-surgery (P > 0.05). The results of this study showed that magnesium sulphate administration did not significantly improve the incidence of arrhythmias in hypo- and normo-magnesium patients after CABG. There was no significant correlation between post-operative serum levels of magnesium and arrhythmia during 3 days. © 2017 Royal Australasian College of Surgeons.

MERCHANT OF VENICE. LITERATURE CURRICULUM III, TEACHER VERSION.

ERIC Educational Resources Information Center

KITZHABER, ALBERT R.

THIS TEACHING GUIDE ON "THE MERCHANT OF VENICE" WAS PREPARED FOR USE IN A NINTH-GRADE LITERATURE CURRICULUM. THE PURPOSE OF THE GUIDE WAS TO ILLUMINATE THE PLAY AS A WHOLE, AND TO SUGGEST TO THE TEACHER SOME USEFUL PRINCIPLES FOR FRAMING QUESTIONS AND GUIDING DISCUSSIONS IN THE CLASSROOM. THE GUIDE WAS NOT TO BE USED, HOWEVER, AS A BASE…

The association between domperidone and ventricular arrhythmia in the postpartum period.

PubMed

Smolina, Kate; Mintzes, Barbara; Hanley, Gillian E; Oberlander, Tim F; Morgan, Steven G

2016-10-01

The aim of this study is to examine the relationship between domperidone (commonly used off-label for lactation stimulation), ventricular arrhythmia and all-cause mortality during the postpartum period. This is a retrospective, population-based cohort study of all women with a live birth between 1 January 2002 and 31 December 2011 in British Columbia, Canada. Cox proportional hazards models, yielding hazard ratios (HRs), were used to estimate the risk of hospitalization for ventricular arrhythmia associated with domperidone exposure within six months postpartum. The study population consisted of 225 532 women with 320 351 live births. There was only one death during the six-month postpartum period among the study population, and thus we did not perform any analyses of all-cause mortality. We identified 21 hospitalizations for ventricular arrhythmia. Adjusting for age, smoking and prior history of ventricular arrhythmia and cardiovascular disease, the risk of ventricular arrhythmia hospitalization was approximately double among those exposed to domperidone, but the results were not statistically significant (HR = 2.25, 95%CI 0.84-6.01). Adjustment for body mass index in the 74% of women for whom it was known further reduced the association (HR = 1.69, 95%CI 0.48-5.96). We found a possible association between exposure to domperidone and hospitalization for ventricular arrhythmia among a cohort of women who have recently given birth. Future studies are needed to confirm this association. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Management of Arrhythmias in Heart Failure

PubMed Central

Masarone, Daniele; Limongelli, Giuseppe; Rubino, Marta; Valente, Fabio; Vastarella, Rossella; Ammendola, Ernesto; Gravino, Rita; Verrengia, Marina; Salerno, Gemma; Pacileo, Giuseppe

2017-01-01

Heart failure patients are predisposed to develop arrhythmias. Supraventricular arrhythmias can exacerbate the heart failure symptoms by decreasing the effective cardiac output and their control require pharmacological, electrical, or catheter-based intervention. In the setting of atrial flutter or atrial fibrillation, anticoagulation becomes paramount to prevent systemic or cerebral embolism. Patients with heart failure are also prone to develop ventricular arrhythmias that can present a challenge to the managing clinician. The management strategy depends on the type of arrhythmia, the underlying structural heart disease, the severity of heart failure, and the range from optimization of heart failure therapy to catheter ablation. Patients with heart failure, irrespective of ejection fraction are at high risk for developing sudden cardiac death, however risk stratification is a clinical challenge and requires a multiparametric evaluation for identification of patients who should undergo implantation of a cardioverter defibrillator. Finally, patients with heart failure can also develop symptomatic bradycardia, caused by sinus node dysfunction or atrio-ventricular block. The treatment of bradycardia in these patients with pacing is usually straightforward but needs some specific issue. PMID:29367535

Case Studies in Censorship: Censoring "The Merchant of Venice."

ERIC Educational Resources Information Center

Gray, Richard A.

1991-01-01

Reviews censorship of "The Merchant of Venice," which has been based on its portrayal of the Jewish character Shylock. Background information is followed by an annotated bibliography which includes 15 citations dealing with Shylock, 22 citations to articles that address the censorship of the play, and 64 works of literature that have…

Using "The Merchant of Venice" in Teaching Monetary Economics.

ERIC Educational Resources Information Center

Kish-Goodling, Donna M.

1999-01-01

Describes the use of Shakespeare's "The Merchant of Venice" in an undergraduate course in monetary economics, focusing on the usury theme origins of usury laws, scholastic arguments on paying interest for using money, civil usury laws, and modern theories of interest. It is argued that the play provides an interesting vehicle for an…

Cardiac arrhythmias during or after epileptic seizures

PubMed Central

van der Lende, Marije; Surges, Rainer; Sander, Josemir W; Thijs, Roland D

2016-01-01

Seizure-related cardiac arrhythmias are frequently reported and have been implicated as potential pathomechanisms of Sudden Unexpected Death in Epilepsy (SUDEP). We attempted to identify clinical profiles associated with various (post)ictal cardiac arrhythmias. We conducted a systematic search from the first date available to July 2013 on the combination of two terms: ‘cardiac arrhythmias’ and ‘epilepsy’. The databases searched were PubMed, Embase (OVID version), Web of Science and COCHRANE Library. We attempted to identify all case reports and case series. We identified seven distinct patterns of (post)ictal cardiac arrhythmias: ictal asystole (103 cases), postictal asystole (13 cases), ictal bradycardia (25 cases), ictal atrioventricular (AV)-conduction block (11 cases), postictal AV-conduction block (2 cases), (post)ictal atrial flutter/atrial fibrillation (14 cases) and postictal ventricular fibrillation (3 cases). Ictal asystole had a mean prevalence of 0.318% (95% CI 0.316% to 0.320%) in people with refractory epilepsy who underwent video-EEG monitoring. Ictal asystole, bradycardia and AV-conduction block were self-limiting in all but one of the cases and seen during focal dyscognitive seizures. Seizure onset was mostly temporal (91%) without consistent lateralisation. Postictal arrhythmias were mostly found following convulsive seizures and often associated with (near) SUDEP. The contrasting clinical profiles of ictal and postictal arrhythmias suggest different pathomechanisms. Postictal rather than ictal arrhythmias seem of greater importance to the pathophysiology of SUDEP. PMID:26038597

Devices for Arrhythmia

MedlinePlus

... with recurrent arrhythmias, medical devices such as a pacemaker and implantable cardioverter defibrillator (ICD) can help by ... with an ICD Questions to ask your doctor Pacemakers Learn what an artificial pacemaker is, how it ...

Autogenous Crack Control during Construction Phases of MOSE Venice Dams

NASA Astrophysics Data System (ADS)

Bertagnoli, Gabriele; Anerdi, Constanza; Malavisi, Marzia; Zoratto, Nadia

2017-10-01

The design of concrete structures exposed to severe environmental attack, like in marine environment, requires serious attention for concrete durability. Early age cracking due to autogenous deformations can be detrimental to the performance of tidal structures. The study of the structural effects of hydration heat and rheological behaviour of a set of huge concrete structures of the Mobile Venice Dams known with the MOSE acronym (Experimental Electromechanical Module) is presented in this paper. Together with other measures such as coastal reinforcement, the raising of quaysides, and the paving and improvement of the lagoon, MOSE is designed to protect Venice and the lagoon from tides of up to 3 meters. Construction began simultaneously in 2003 at all three lagoon inlets, and the project has been completed in 2014. Floods have caused damage since ancient times and have become more frequent and intense as a result of the combined effect of eustatism (a rise in sea level) and subsidence (a drop in land level) caused by natural and man-induced phenomena. Nowadays, towns and villages in the lagoon are about 23 cm lower with respect to the water level than at the beginning of the 1900s. Each year, floods can cause serious problems for the inhabitants as well as deterioration of architecture, urban structures and the ecosystem. Over the entire lagoon area, there is also a constant risk of a catastrophic event such as that of 4 November 1966, when a tide of 194 cm submerged Venice, Chioggia and the other built-up areas.

Obstructive sleep apnoea-hypopnoea and arrhythmias: new updates.

PubMed

Vizzardi, Enrico; Sciatti, Edoardo; Bonadei, Ivano; D'Aloia, Antonio; Curnis, Antonio; Metra, Marco

2017-07-01

Obstructive sleep apnoea-hypopnoea (OSAH) is a prevalent condition characterized by repetitive pharyngeal collapse during sleep, leading to hypoxemia, hypercapnia, and persistent inspiratory efforts against an occluded airway until arousal. Several studies demonstrated that OSAH exerts acute and chronic effects on the cardiovascular system. Thus, although being a respiratory problem, the most important consequences of OSAH are cardiovascular, among which there are arrhythmias. The purpose of this review is to systematically analyse what has been recently published about the relationship between OSAH and every cardiac arrhythmia separately. We searched Pubmed, Scopus, Web of Science and Cochrane Collaboration databases for 'OSAHS arrhythmias', 'OSAH arrhythmias' and 'OSA arrhythmias'. We analyse 1298 articles and meta-analyses, excluding already edited reviews. Arrhythmias, especially of ventricular origin, are frequent in OSAH. Ventricular premature beats, couplets and ventricular tachycardia runs are even more frequent in patients suffering from heart failure. They may be due to left heart remodelling, overwork and ischaemia and can explain at least some sudden deaths occurring between midnight and 6 a.m. Sinus pauses and atrioventricular blocks are increased according to the severity of the disturbance and may be reduced by continuous positive airway pressure therapy, preventing pace-maker implantation. Finally, atrial fibrillation, resistance against antiarrhythmic drugs and recurrences after surgical procedures are strongly related to OSAH. Arrhythmias are frequent in OSAH. Treatment of OSAH may reduce some of them. An implantable cardioverter-defibrillator and continuous positive airway pressure should be considered in some patients.

Added value of cardiac magnetic resonance in etiological diagnosis of ventricular arrhythmias.

PubMed

Cabanelas, Nuno; Vidigal Ferreira, Maria João; Donato, Paulo; Gaspar, António; Pinto, Joana; Caseiro-Alves, Filipe; Providência, Luís Augusto

2013-10-01

Cardiac magnetic resonance (CMR) imaging is increasingly important in the diagnostic work-up of a wide range of heart diseases, including those with arrhythmogenic potential. To assess the added value of CMR in etiological diagnosis of ventricular arrhythmias after an inconclusive conventional investigation. Patients undergoing CMR between 2005 and 2011 for investigation of ventricular arrhythmias were included (n=113). All had documented arrhythmias. Those with a definite diagnosis from a previous investigation and those with evidence of coronary artery disease (acute coronary syndrome, typical angina symptoms, increase in biomarkers or positive stress test) were excluded. CMR results were considered relevant when they fulfilled diagnostic criteria. Of the 113 patients, 57.5% were male and mean age was 41.7 ± 16.2 years. Regarding the initial arrhythmia, 38.1% had ventricular fibrillation/sustained ventricular tachycardia (VF/VT) and 61.9% had less complex ventricular ectopy. CMR imaging showed criteria of a specific diagnosis in 42.5% of patients, was totally normal in 36.3%, and showed non-specific alterations in the remainder. In VF/VT patients, specific criteria were found in 60.4%, and in 31.4% of those with less complex ectopy. The most frequent diagnoses were arrhythmogenic right ventricular dysplasia, ventricular non-compaction and myopericarditis. It is worth noting that, although there was no evidence of previous coronary artery disease, 6.2% of patients had a late gadolinium enhancement distribution pattern compatible with myocardial infarction. CMR gives additional and important information in the diagnostic work-up of ventricular arrhythmias after an inconclusive initial investigation. The proportion of patients with diagnostic criteria was 42.5% (60.0% in those with VF/VT), and CMR was completely normal in 36.6%. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

A Teacher's Guide for "The Merchant of Venice" and "Othello."

ERIC Educational Resources Information Center

WGBH-TV, Boston, MA.

William Shakespeare has influenced most, if not all, Western playwrights. His techniques, themes, characters, and plots are contained in much of what is produced today, from television to Broadway. This teacher's guide provides summaries of the plays "The Merchant of Venice" and "Othello," essays, and corresponding student…

[Surgery of refractory ischemic arrhythmia].

PubMed

Viganò, M; Graffigna, A; Salerno, G

1992-03-01

Since June 1980, 138 patients have undergone surgical treatment for refractory ventricular tachycardia due to ischemic heart disease. Electrically guided surgical ablation (EGSA) of the focus was performed in 117 patients, while 14 patients underwent application of automatic implantable cardioverter-defibrillator (AICD), and 8 patients underwent heart transplantation. During the whole period considered, among the EGSA patients an operative mortality of 13 patients was observed (11.4%), with a late mortality of another 14 patients (13.4%). Two early and six late recurrences were described, and 4 cases of sudden or unexplained death, with 2 cases clearly due to an arrhythmic event. Multivariate analysis showed preoperative ejection fraction lower than 25% as a powerful predictor of early mortality (32% vs 0%). Actuarial survival rate of patients with LVEF lower than 25% was 67 +/- 12% vs 95 +/- 2% at one year and 37 +/- 25% vs 94 +/- 8% at 8 years. A high operative mortality was then observed in patients who underwent aneurysmectomy alone or visually guided procedures as compared to electrically guided procedures (75% or 3 deaths out of 4 patients vs 8.5% or 10 out of 113 patients, respectively). Patients who received an AICD with or without associated procedures showed 1 case of in-hospital mortality and no late mortality; in 6 patients at least one shock was delivered; in two patients the AICD was implanted during an EGSA procedure, due to multiple or difficult origins of the arrhythmias. Of patients who underwent heart transplantation one case of later mortality was observed due to malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Deposition in St. Mark's Basilica of Venice.

PubMed

Morabito, E; Zendri, E; Piazza, R; Ganzerla, R; Montalbani, S; Marcoleoni, E; Bonetto, F; Scandella, A; Barbante, C; Gambaro, A

2013-04-01

Atmospheric pollutants may cause damage to monuments and historical buildings. Besides air contaminants, soluble salts are also responsible for stone deterioration and decay in outdoor and indoor monuments. The problem of how to conserve works of arts thus requires a deep knowledge of contaminants' concentration and distribution inside buildings. In this work, water-soluble ions inside St. Mark's Basilica in Venice were studied, with the aim of understanding their principal source and distribution inside the building. With the aid of Fourier transform infrared spectroscopy and scanning electron microscopy analysis, the interaction between ions and surface's material was also investigated. Ion chromatographic analysis of depositions highlighted a large amount of "deteriorating agents" such as sulphates and chlorides. A possible source in the innermost area of the basilica has been found for formates and nitrates. On the contrary, a decrease of chloride, from the entrance to the innermost area, has been found, which indicates that the source is outside the building. It is emphasized that different contaminants behave differently on different material, and the effect of pollution inside churches and monuments is not easy to predict. Wood and brick seem to react differently than stone and mortar to the damaging action of salts and pollutants. The present work should be considered a useful tool for the future preservation of St. Mark's Basilica in Venice.

THE MERCHANT OF VENICE. LITERATURE CURRICULUM III, STUDENT VERSION.

ERIC Educational Resources Information Center

KITZHABER, ALBERT R.

A GUIDE WAS PRODUCED FOR STUDENT USE IN NINTH-GRADE STUDY OF "THE MERCHANT OF VENICE." THE GUIDE PRESENTED SEVERAL ALTERNATE APPROACHES FOR UNDERSTANDING THE PLAY AND LEARNING ITS CONTENT. A MAJOR EMPHASIS OF THE GUIDE WAS PLACED ON THREE FORMS OF STUDENT QUESTIONS, RELATED TO SPECIFIC ACTS AND SCENES, THE CHARACTERS IN THE DRAMA, AND…

Discrete potentials guided radiofrequency ablation for idiopathic outflow tract ventricular arrhythmias.

PubMed

Liu, Enzhao; Xu, Gang; Liu, Tong; Ye, Lan; Zhang, Qitong; Zhao, Yanshu; Li, Guangping

2015-03-01

Discrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias. The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs). Seventeen consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation were included. Intracardiac electrograms during the mapping and ablation were analysed. During sinus rhythm, sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular electrograms in all of the 17 patients, peak amplitude 0.51 ± 0.21 mV. The same potential was recorded prior to the local ventricular potential of the PVCs/VTs. Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram during the arrhythmias was noted. The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping. At the sites with DPs, lower unipolar and bipolar ventricular voltage of sinus beats were noted compared with the adjacent regions without DPs (unipolar: 6.1 ± 1.8 vs. 8.3 ± 2.3 mV, P < 0.05; bipolar: 0.62 ± 0.45 vs. 1.03 ± 0.60 mV, P < 0.05). The targeted DPs were still present in 12 patients after successful elimination of the ectopies. Discrete potentials were not present in seven controls. Discrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias. Discrete potential- and substrate-guided ablation strategy will help to reduce the recurrence of idiopathic outflow tract arrhythmias. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

The eSurge-Venice project: how satellite data can improve the storm surge forecasting in the northern Adriatic Sea

NASA Astrophysics Data System (ADS)

Zecchetto, Stefano; Vignudelli, Stefano; Donlon, Craig; De Biasio, Francesco; Della Valle, Antonio; Umgiesser, Georg; Bajo, Marco

The Data User Element (DUE) program of the European Space Agency (ESA) is funding two projects (eSurge and eSurge-Venice) aimed to demonstrate the improvement of the storm surge forecasting through the use of Earth Observation (EO) data. eSurge-Venice (http://www.esurge-venice.eu/), is specifically focused on the Gulf of Venice, northern Adriatic Sea. The project objectives are: a) Select a number of Storm Surge Events occurred in the Venice lagoon since 1999; b) Provide the available satellite EO data related to the Storm Surge Events, mainly satellite winds and altimeter data, as well as all the available in-situ data and model forecasts; c) Provide a demonstration Near Real Time service (eSurge-Venice live) of EO data products and services in support of operational and experimental forecasting and warning services; d) Run a number of re-analysis cases, both for historical and contemporary storm surge events, to demonstrate the usefulness of EO data. Present storm surge models use atmospheric model wind fields as forcing. These are know to underestimate the wind in small basins like the Adriatic Sea (~1000 km by 300 km), where the orography plays an important role in shaping the winds. Therefore there is the need to verify and tune the atmospheric model wind fields used in the storm surge modeling, an activity which can easily done using satellite scatterometer winds. The project is now in the middle of his life, and promising preliminary results have been achieved using satellite scatterometer wind data to forge the atmospheric model wind fields forcing the storm surge model. This contribution will present the methodology adopted to tune the model wind fields according to the bias with scatterometer winds and the improvements induced in the storm surge model hindcast.

Carbon monoxide and lethal arrhythmias

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farber, J.P.; Schwartz, P.J.; Vanoli, E.

1990-12-01

The effect of acute exposure to carbon monoxide on ventricular arrhythmias was studied in a previously described chronically maintained animal model of sudden cardiac death. In 60 percent of dogs with a healed anterior myocardial infarction, the combination of mild exercise and acute myocardial ischemia induces ventricular fibrillation. The events in this model are highly reproducible, thus allowing study by internal control analysis. Dogs that develop ventricular fibrillation during the test of exercise and acute myocardial ischemia are considered at high risk for sudden death and are defined as 'susceptible'; dogs that survive the test without a fatal arrhythmia aremore » considered at low risk for sudden death and are defined as 'resistant.' In the current study, the effects of carboxyhemoglobin levels ranging from 5 to 15 percent were tested in resistant and susceptible dogs. A trend toward higher heart rates was observed at all levels of carboxyhemoglobin, although significant differences were observed only with 15 percent carboxyhemoglobin. This trend was observed at rest and during exercise in both resistant and susceptible dogs. In resistant animals, in which acute myocardial ischemia is typically associated with bradycardia even under the control condition, this reflex response occurred earlier and was augmented after exposure to carbon monoxide. This effect may depend on the increased hypoxic challenge caused by carbon monoxide, and thus on an augmentation of the neural reflex activation or a sensitization of the sinus node to acetylcholine induced by hypoxia. In both resistant and susceptible dogs, carbon monoxide exposure induced a worsening of ventricular arrhythmias in a minority of cases. This worsening was not reproducible in subsequent trials. These data indicate that acute exposure to carbon monoxide is seldom arrhythmogenic in dogs that have survived myocardial infarction. (Abstract Truncated)« less

Chemical and mineralogical characterisation of weathered historical bricks from the Venice lagoonal environment

NASA Astrophysics Data System (ADS)

Schiavon, Nick; Mazzocchin, Gian Antonio; Baudo, Fulvio

2008-12-01

Surficial and bulk samples of historical bricks of different age (from XII to XVIII centuries) recovered from a campaign of archaeological excavations recently carried out at the site of a medieval monastery in the S. Giacomo in Paludo Island in theVenice Lagoon have been characterised by FT-IR, TGA-DTG and DTA, XRD, SEM + EDS. The samples belong to a particular brick type commonly used in the Venice region: the " altinella brick". The bulk relative abundance of primary (i.e. calcite and dolomite) and secondary firing minerals (i.e. diopside and wollastonite) in the bricks coupled with their relative geometrical dimensions allows placing the samples in a chronological sequence according to known historical changes in brickmaking firing temperatures and practices. Most of the bricks were used as paving material and have been exposed to the action of seawater salts (chlorides and sulphates) due to periodical submersion following high tide episodes. Salt-laden (gypsum, halite, mirabilite) surficial patinas are indeed present but salt weathering does not appear to have affected the overall structural soundness of the bricks in this now abandoned island as it is the case with brickwork located in other more populated (and polluted) areas in Venice and its lagoon.

Ventricular arrhythmias and sudden cardiac arrest in Takotsubo cardiomyopathy: Incidence, predictive factors, and clinical implications.

PubMed

Jesel, Laurence; Berthon, Charlotte; Messas, Nathan; Lim, Han S; Girardey, Mélanie; Marzak, Halim; Marchandot, Benjamin; Trinh, Annie; Ohlmann, Patrick; Morel, Olivier

2018-04-06

Takotsubo cardiomyopathy (TTC) is a stress-related transient cardiomyopathy. Life-threatening arrhythmias (LTA) can occur and worsen prognosis. The purpose of this study was to assess the incidence and outcome of LTA in TTC, as well as its predictive factors and clinical implications. We studied 214 consecutive cases of TTC over 8 years. The study cohort was divided into 2 groups: those with LTA (LTA group) and those without (non-LTA group). LTA was defined as ventricular tachycardia, ventricular fibrillation, or cardiac arrest. LTA occurred in 10.7% of patients mainly in the first 24 hours of hospitalization: ventricular tachycardia (n = 2), ventricular fibrillation (n = 11), cardiac arrest (n = 10: 5 asystole, 3 complete heart block, and 2 sinoatrial block). LTA were associated with lower left ventricular ejection fraction (LVEF) and a high rate of conduction disturbances. In-hospital (39.1% vs 8.9%; P < .001) and 1-year mortality (47.8% vs 14.1%; P < .001) rates were significantly increased in the LTA group. LVEF and QRS duration >105 ms were independent predictors of LTA. In cases where a device was implanted, conduction disturbances persisted after the index event despite complete recovery of LVEF. There was no ventricular arrhythmia recurrence during follow-up. LTA occur early in patients presenting with TTC and is associated with significantly worse short- and long-term prognosis. Left ventricular impairment and QRS duration >105 ms are independent predictors of LTA. Ventricular arrhythmias occurred in the acute phase without further recurrence recorded in hospital survivors, whereas severe conduction disorders persisted during long-term follow-up. These findings may have implications on the choice of device therapy for this specific patient subgroup. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Fieldwork as Theatre: A Week's Performance in Venice and Its Region.

ERIC Educational Resources Information Center

Cosgrove, Denis; Daniels, Stephen

1989-01-01

Describes the concluding activity of a cultural geography course in which students went on a field trip to Venice (Italy) during spring vacation. Emphasizes the representation in relations between land and life, using the metaphor of theatre to conceptualize these relations. (GG)

Real-time ECG monitoring and arrhythmia detection using Android-based mobile devices.

PubMed

Gradl, Stefan; Kugler, Patrick; Lohmuller, Clemens; Eskofier, Bjoern

2012-01-01

We developed an application for Android™-based mobile devices that allows real-time electrocardiogram (ECG) monitoring and automated arrhythmia detection by analyzing ECG parameters. ECG data provided by pre-recorded files or acquired live by accessing a Shimmer™ sensor node via Bluetooth™ can be processed and evaluated. The application is based on the Pan-Tompkins algorithm for QRS-detection and contains further algorithm blocks to detect abnormal heartbeats. The algorithm was validated using the MIT-BIH Arrhythmia and MIT-BIH Supraventricular Arrhythmia databases. More than 99% of all QRS complexes were detected correctly by the algorithm. Overall sensitivity for abnormal beat detection was 89.5% with a specificity of 80.6%. The application is available for download and may be used for real-time ECG-monitoring on mobile devices.

Effects of Heterogeneous Diffuse Fibrosis on Arrhythmia Dynamics and Mechanism

PubMed Central

Kazbanov, Ivan V.; ten Tusscher, Kirsten H. W. J.; Panfilov, Alexander V.

2016-01-01

Myocardial fibrosis is an important risk factor for cardiac arrhythmias. Previous experimental and numerical studies have shown that the texture and spatial distribution of fibrosis may play an important role in arrhythmia onset. Here, we investigate how spatial heterogeneity of fibrosis affects arrhythmia onset using numerical methods. We generate various tissue textures that differ by the mean amount of fibrosis, the degree of heterogeneity and the characteristic size of heterogeneity. We study the onset of arrhythmias using a burst pacing protocol. We confirm that spatial heterogeneity of fibrosis increases the probability of arrhythmia induction. This effect is more pronounced with the increase of both the spatial size and the degree of heterogeneity. The induced arrhythmias have a regular structure with the period being mostly determined by the maximal local fibrosis level. We perform ablations of the induced fibrillatory patterns to classify their type. We show that in fibrotic tissue fibrillation is usually of the mother rotor type but becomes of the multiple wavelet type with increase in tissue size. Overall, we conclude that the most important factor determining the formation and dynamics of arrhythmia in heterogeneous fibrotic tissue is the value of maximal local fibrosis. PMID:26861111

Epicardial phrenic nerve displacement during catheter ablation of atrial and ventricular arrhythmias: procedural experience and outcomes.

PubMed

Kumar, Saurabh; Barbhaiya, Chirag R; Baldinger, Samuel H; Koplan, Bruce A; Maytin, Melanie; Epstein, Laurence M; John, Roy M; Michaud, Gregory F; Tedrow, Usha B; Stevenson, William G

2015-08-01

Arrhythmia origin in close proximity to the phrenic nerve (PN) can hinder successful catheter ablation. We describe our approach with epicardial PN displacement in such instances. PN displacement via percutaneous pericardial access was attempted in 13 patients (age 49±16 years, 9 females) with either atrial tachycardia (6 patients) or atrial fibrillation triggered from a superior vena cava focus (1 patient) adjacent to the right PN or epicardial ventricular tachycardia origin adjacent to the left PN (6 patients). An epicardially placed steerable sheath/4 mm-catheter combination (5 patients) or a vascular or an esophageal balloon (8 patients) was ultimately successful. Balloon placement was often difficult requiring manipulation via a steerable sheath. In 2 ventricular tachycardia cases, absence of PN capture was achieved only once the balloon was directly over the ablation catheter. In 3 atrial tachycardia patients, PN displacement was not possible with a balloon; however, a steerable sheath/catheter combination was ultimately successful. PN displacement allowed acute abolishment of all targeted arrhythmias. No PN injury occurred acutely or in follow up. Two patients developed acute complications (pleuro-pericardial fistula 1 and pericardial bleeding 1). Survival free of target arrhythmia was achieved in all atrial tachycardia patients; however, a nontargeted ventricular tachycardia recurred in 1 patient at a median of 13 months' follow up. Arrhythmias originating in close proximity to the PN can be targeted successfully with PN displacement with an epicardially placed steerable sheath/catheter combination, or balloon, but this strategy can be difficult to implement. Better tools for phrenic nerve protection are desirable. © 2015 American Heart Association, Inc.

The Renin-Angiotensin-Aldosterone System (RAAS) and Cardiac Arrhythmias

PubMed Central

Iravanian, Shahriar; Dudley, Samuel C.

2008-01-01

The role of the renin-angiotensin-aldosterone system (RAAS) in many cardiovascular disorders, including hypertension, cardiac hypertrophy, and atherosclerosis is well established, whereas its relationship with cardiac arrhythmias is a new area of investigation. Atrial fibrillation and malignant ventricular tachyarrhythmias, especially in the setting of cardiac hypertrophy or failure, appear to be examples of RAAS-related arrhythmias, since treatment with RAAS modulators, including angiotensin converting enzyme inhibitors, angiotensin receptor blockers and mineralocorticoid receptor blockers, reduces the incidence of these arrhythmias. RAAS has a multitude of electrophysiological effects and can potentially cause arrhythmia through a variety of mechanisms. We review new experimental results that suggest RAAS has pro-arrhythmic effects on membrane and sarcoplasmic reticulum ion channels and that increased oxidative stress is likely contributing to the increased arrhythmic incidence. A summary of ongoing clinical trials that will address the clinical usefulness of RAAS modulators for prevention or treatment of arrhythmias is presented. PMID:18456194

The renin-angiotensin-aldosterone system (RAAS) and cardiac arrhythmias.

PubMed

Iravanian, Shahriar; Dudley, Samuel C

2008-06-01

The role of the renin-angiotensin-aldosterone system (RAAS) in many cardiovascular disorders, including hypertension, cardiac hypertrophy, and atherosclerosis, is well established, whereas its relationship with cardiac arrhythmias is a new area of investigation. Atrial fibrillation and malignant ventricular tachyarrhythmias, especially in the setting of cardiac hypertrophy or failure, seem to be examples of RAAS-related arrhythmias because treatment with RAAS modulators, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor blockers, reduces the incidence of these arrhythmias. RAAS has a multitude of electrophysiological effects and can potentially cause arrhythmia through a variety of mechanisms. We review new experimental results that suggest that RAAS has proarrhythmic effects on membrane and sarcoplasmic reticulum ion channels and that increased oxidative stress is likely contributing to the increased arrhythmic incidence. A summary of ongoing clinical trials that will address the clinical usefulness of RAAS modulators for prevention or treatment of arrhythmias is presented.

Association of Arrhythmia-Related Genetic Variants With Phenotypes Documented in Electronic Medical Records.

PubMed

Van Driest, Sara L; Wells, Quinn S; Stallings, Sarah; Bush, William S; Gordon, Adam; Nickerson, Deborah A; Kim, Jerry H; Crosslin, David R; Jarvik, Gail P; Carrell, David S; Ralston, James D; Larson, Eric B; Bielinski, Suzette J; Olson, Janet E; Ye, Zi; Kullo, Iftikhar J; Abul-Husn, Noura S; Scott, Stuart A; Bottinger, Erwin; Almoguera, Berta; Connolly, John; Chiavacci, Rosetta; Hakonarson, Hakon; Rasmussen-Torvik, Laura J; Pan, Vivian; Persell, Stephen D; Smith, Maureen; Chisholm, Rex L; Kitchner, Terrie E; He, Max M; Brilliant, Murray H; Wallace, John R; Doheny, Kimberly F; Shoemaker, M Benjamin; Li, Rongling; Manolio, Teri A; Callis, Thomas E; Macaya, Daniela; Williams, Marc S; Carey, David; Kapplinger, Jamie D; Ackerman, Michael J; Ritchie, Marylyn D; Denny, Joshua C; Roden, Dan M

2016-01-05

Large-scale DNA sequencing identifies incidental rare variants in established Mendelian disease genes, but the frequency of related clinical phenotypes in unselected patient populations is not well established. Phenotype data from electronic medical records (EMRs) may provide a resource to assess the clinical relevance of rare variants. To determine the clinical phenotypes from EMRs for individuals with variants designated as pathogenic by expert review in arrhythmia susceptibility genes. This prospective cohort study included 2022 individuals recruited for nonantiarrhythmic drug exposure phenotypes from October 5, 2012, to September 30, 2013, for the Electronic Medical Records and Genomics Network Pharmacogenomics project from 7 US academic medical centers. Variants in SCN5A and KCNH2, disease genes for long QT and Brugada syndromes, were assessed for potential pathogenicity by 3 laboratories with ion channel expertise and by comparison with the ClinVar database. Relevant phenotypes were determined from EMRs, with data available from 2002 (or earlier for some sites) through September 10, 2014. One or more variants designated as pathogenic in SCN5A or KCNH2. Arrhythmia or electrocardiographic (ECG) phenotypes defined by International Classification of Diseases, Ninth Revision (ICD-9) codes, ECG data, and manual EMR review. Among 2022 study participants (median age, 61 years [interquartile range, 56-65 years]; 1118 [55%] female; 1491 [74%] white), a total of 122 rare (minor allele frequency <0.5%) nonsynonymous and splice-site variants in 2 arrhythmia susceptibility genes were identified in 223 individuals (11% of the study cohort). Forty-two variants in 63 participants were designated potentially pathogenic by at least 1 laboratory or ClinVar, with low concordance across laboratories (Cohen κ = 0.26). An ICD-9 code for arrhythmia was found in 11 of 63 (17%) variant carriers vs 264 of 1959 (13%) of those without variants (difference, +4%; 95% CI, -5% to +13

Situation Venice: Towards a Performative "Ex-Planation" of a City

ERIC Educational Resources Information Center

Whybrow, Nicolas

2011-01-01

The article's main concern is to analyse theoretical and artistic factors influencing the attempt by a group of undergraduate students (at the University of Warwick, UK) to produce a "performative mapping" of the city of Venice. In other words, it asks what kind of performance-based strategies might usefully be applied in the process of…

The effect of inhibitors of endogenous opioid degradation, bacitracin, bestatin, captopril, and D-phenylalanine, on digoxin-induced arrhythmias in guinea pigs.

PubMed

Rabkin, S W; Redston, M

1989-08-01

The purpose of this study was to investigate the effect of inhibition of endogenous opioid degradation on digitalis-induced arrhythmias, utilizing the inhibitors bacitracin, bestatin, captopril, and D-phenylalanine. Guinea pigs, anesthetized with pentobarbital, 50 mg/kg i.p., and breathing spontaneously received intracerebroventricular (i.c.v.) injection of bacitracin (6.8 mg/kg), bestatin (1 mg/kg), captopril (2 mg/kg), D-phenylalanine (1.2 mg/kg) or the diluent, saline. Digitalis arrhythmias were induced by a 50 micrograms/kg i.v. bolus of digoxin followed by 500 micrograms.kg-1.h-1 i.v. Bacitracin and bestatin, but not captopril or D-phenylalanine, significantly (p less than 0.05) altered the relationship between the digoxin dose and the first occurrence of arrhythmias, i.e., digoxin-induced ventricular arrhythmias became manifest at lower digoxin doses. The mean digoxin dose and ED50s, at which arrhythmias first occurred, were significantly (p less than 0.05) reduced by bacitracin and bestatin. The findings were similar for fatal arrhythmias, although D-phenylalanine appeared to decrease the digoxin dose at the development of fatal arrhythmias. The opioid antagonist naloxone, in a 50 micrograms/kg bolus and 50 micrograms.kg-1.h-1 i.c.v., completely prevented these effects of bacitracin and reduced the effect of bestatin. The relationship to arrhythmias could not be ascribed to an effect on blood pressure, as the blood pressure response to digoxin was the same in bestatin, D-phenylalanine, and control groups. To examine whether systemic administration of an inhibitor of opioid degradation had similar effects, a second protocol was selected with systemic administration of bacitracin because it altered the dose effect relationship after i.c.v. administration and systemic concentrations could be readily attained. Bacitracin, in a 13.5 mg/kg i.v. bolus and 135 mg.kg-1.h-1 i.v., was followed by 100 micrograms/kg digoxin i.v. every 15 min.(ABSTRACT TRUNCATED AT 250

Ventricular Arrhythmias in the North American Multidisciplinary Study of ARVC

PubMed Central

Link, Mark S.; Laidlaw, Douglas; Polonsky, Bronislava; Zareba, Wojciech; McNitt, Scott; Gear, Kathleen; Marcus, Frank; Mark Estes, NA

2015-01-01

BACKGROUND Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with sudden cardiac death. However, the selection of patients for implanted cardioverter-defibrillators (ICDs), as well as programming of the ICD, is unclear. OBJECTIVES The objective of this study was to identify predictors, characteristics, and treatment of ventricular arrhythmias in patients with ARVC. METHODS The Multidisciplinary Study of Right Ventricular Cardiomyopathy established the North American ARVC Registry and enrolled patients with a diagnosis of ARVC. Patients were followed prospectively. RESULTS Of 137 patients enrolled, 108 received ICDs. Forty-eight patients had 502 sustained episodes of ventricular arrhythmias, including 489 that were monomorphic and 13 that were polymorphic. In the patients with ICDs, independent predictors of ventricular arrhythmias in follow-up included spontaneous sustained ventricular arrhythmias before ICD implantation and T-wave inversions inferiorly. The only independent predictor for life-threatening arrhythmias, defined as sustained ventricular tachycardia (VT) ≥240 beats/min or ventricular fibrillation, was a younger age at enrollment. Anti-tachycardia pacing (ATP), independent of the cycle length of the VT, was successful in terminating 92% of VT episodes. CONCLUSIONS In the North American ARVC Registry, the majority of ventricular arrhythmias in follow-up are monomorphic. Risk factors for ventricular arrhythmias were spontaneous ventricular arrhythmias before enrollment and a younger age at ICD implantation. ATP is highly successful in terminating VT, and all ICDs should be programmed for ATP, even for rapid VT. PMID:25011714

Eight years of groundwater monitoring at the building site of the MOSE system for the safeguard of Venice

NASA Astrophysics Data System (ADS)

Casasso, Alessandro; Sethi, Rajandrea; Di Molfetta, Antonio

2015-04-01

The survival of Venice is threatened by the continuous increase of frequency and intensity of tidal floods. To prevent these events, a safeguarding system known as MOSE is under construction at the inlets of the Lagoon of Venice. Four arrays of mobile barriers will be lifted in the case of exceptionally high tides (>1.10 m) to insulate the Lagoon. The prefabrication of the mobile barriers required a large construction area close to the final installation sites. Given the lack of space in the inlets of Lido and Chioggia, two basins of the future navigation locks were used for this purpose, and a system of water pumps and wells was therefore installed in each site to ensure the accessibility and safety of the construction areas. The impact of dewatering on the aquifers on the mainland in Punta Sabbioni (inlet of Lido) was monitored by means of continuous hydraulic head measurements in a network 25 piezometers, 11 screened in the phreatic aquifer and 14 in the shallowest confined aquifer. These aquifers are separated by a 5 m thick clayey aquiclude, and a 30 m thick impervious layer isolates them from the underlying confined aquifers, which were therefore not monitored. Each monitoring well was equipped with an automatic water pressure transducer and the hourly recorded hydraulic heads were compensated with the barometric pressure. The time series were compared with the natural driving forces (tides, rainfall, evapotranspiration) and the anthropogenic impact sources (dewatering pumping, slurry walls, land reclamation channels). The dynamics of seawater intrusion were also studied through monthly measurements of the vertical profiles of the electrical conductivity (EC) of groundwater. The monitoring activity was successful in assessing the impacts of the construction works. A drawdown was observed in the confined aquifer due to the dewatering pumping, with a maximum displacement of some 5 m on the mainland and an extension of some 1000 m from the dewatered basin. By

Hyperkalaemia, cardiac arrhythmias, and cerebral lesions in high risk neonates.

PubMed Central

Shortland, D; Trounce, J Q; Levene, M I

1987-01-01

The case notes of 20 infants with hyperkalaemia (defined as two successive serum potassium measurements of greater than 7.5 mmol/l) were reviewed. The incidence of hyperkalaemia was also looked at in an unselected population of 200 low birthweight infants. The mean gestational age of the 20 affected infants was 29 weeks and the mean birth weight 1235 g. The incidence of hyperkalemia in the cohort of 200 infants weighing less than 1500 g at birth was 3.5%. Hyperkalaemia was associated with a high incidence of cardiac arrhythmia (60%), impaired renal function (50%), and changes on cerebral ultrasonography (88%). Hyperkalaemia responds slowly to conventional treatment with dextrose, insulin, and exchange resins. There is a close temporal relation in some infants between hyperkalaemia and cardiac arrhythmias and periventricular leukomalacia, suggesting a causal association. PMID:3688918

Venice: Fifty years after the great flood of November 4, 1966

NASA Astrophysics Data System (ADS)

Rizzoli, P. M.

2017-12-01

Fifty years ago Venice and its lagoon suffered the most devastating flood in their millennial history. The causes of the increasingly recurring floods will be examined, namely the man-induced subsidence in the period 1925-1970 and the storm surges of the Adriatic sea. The engineering solution designed for their protection , named the MOSE system, will be discussed in detail. The MOSE was started in 2003 and is near completion. It consists of four barriers , invisible in normal conditions, which will close the inlets to the lagoon under the prediction of a forthcoming flood. Finally, the perspective of the MOSE capability of protecting the city under scenarios of future global sea level rise will be assessed. This assessment must critically take into account that Venice and its lagoon are confined in the northernmost corner of the semi-enclosed, marginal Mediterranean sea for which the uncertainties of future sea level rise greatly exceed the uncertainties of the global averages.

The use of external event monitoring (web-loop) in the elucidation of symptoms associated with arrhythmias in a general population

PubMed Central

Epifanio, Hindalis Ballesteros; Katz, Marcelo; Borges, Melania Aparecida; Corrêa, Alessandra da Graça; Cintra, Fátima Dumas; Grinberg, Rodrigo Leandro; Ludovice, Ana Cristina Pinotti Pedro; Valdigem, Bruno Pereira; da Silva, Nilton José Carneiro; Fenelon, Guilherme

2014-01-01

Objective To correlate arrhythmic symptoms with the presence of significant arrhythmias through the external event monitoring (web-loop). Methods Between January and December 2011, the web-loop was connected to 112 patients (46% of them were women, mean age 52±21 years old). Specific arrhythmic symptoms were defined as palpitations, pre-syncope and syncope observed during the monitoring. Supraventricular tachycardia, atrial flutter or fibrillation, ventricular tachycardia, pauses greater than 2 seconds or advanced atrioventricular block were classified as significant arrhythmia. The association between symptoms and significant arrhythmias were analyzed. Results The web-loop recorded arrhythmic symptoms in 74 (66%) patients. Of these, in only 14 (19%) patients the association between symptoms and significant cardiac arrhythmia was detected. Moreover, significant arrhythmia was found in 11 (9.8%) asymptomatic patients. There was no association between presence of major symptoms and significant cardiac arrhythmia (OR=0.57, CI95%: 0.21-1.57; p=0.23). Conclusion We found no association between major symptoms and significant cardiac arrhythmia in patients submitted to event recorder monitoring. Event loop recorder was useful to elucidate cases of palpitations and syncope in symptomatic patients. PMID:25295448

Pharmacy Students’ Performance and Perceptions in a Flipped Teaching Pilot on Cardiac Arrhythmias

PubMed Central

Ip, Eric J.; Lopes, Ingrid; Rajagopalan, Vanishree

2014-01-01

Objective. To implement the flipped teaching method in a 3-class pilot on cardiac arrhythmias and to assess the impact of the intervention on academic performance and student perceptions. Design. An intervention group of 101 first-year pharmacy students, who took the class with the flipped teaching method, were supplied with prerecorded lectures prior to their 3 classes (1 class in each of the following subjects: basic sciences, pharmacology, and therapeutics) on cardiac arrhythmias. Class time was focused on active-learning and case-based exercises. Students then took a final examination that included questions on cardiac arrhythmias. The examination scores of the intervention group were compared to scores of the Spring 2011 control group of 105 first-year students who took the class with traditional teaching methods. An online survey was conducted to assess student feedback from the intervention group. Assessment. The mean examination scores of the intervention group were significantly higher than the mean examination scores of the control group for the cardiac arrhythmia classes in pharmacology (with 89.6 ± 2.0% vs 56.8 ± 2.2%, respectively) and therapeutics (89.2 ± 1.4% vs 73.7 ± 2.1%, respectively). The survey indicated higher student satisfaction for flipped classes with highly rated learning objectives, recordings, and in-class activities. Conclusion. Use of the flipped teaching method in a 3-class pilot on cardiac arrhythmias improved examination scores for 2 of the 3 classes (pharmacology and therapeutics). Student satisfaction was influenced by the quality of the learning objectives, prerecorded lectures, and inclass active-learning activities. PMID:25657372

Bacterioplankton diversity and community composition in the Southern Lagoon of Venice.

PubMed

Simonato, Francesca; Gómez-Pereira, Paola R; Fuchs, Bernhard M; Amann, Rudolf

2010-04-01

The Lagoon of Venice is a large water basin that exchanges water with the Northern Adriatic Sea through three large inlets. In this study, the 16S rRNA approach was used to investigate the bacterial diversity and community composition within the southern basin of the Lagoon of Venice and at one inlet in October 2007 and June 2008. Comparative sequence analysis of 645 mostly partial 16S rRNA gene sequences indicated high diversity and dominance of Alphaproteobacteria, Gammaproteobacteria and Bacteroidetes at the lagoon as well as at the inlet station, therefore pointing to significant mixing. Many of these sequences were close to the 16S rRNA of marine, often coastal, bacterioplankton, such as the Roseobacter clade, the family Vibrionaceae, and class Flavobacteria. Sequences of Actinobacteria were indicators of a freshwater input. The composition of the bacterioplankton was quantified by catalyzed reporter deposition fluorescence in situ hybridization (CARD-FISH) with a set of rRNA-targeted oligonucleotide probes. CARD-FISH counts corroborated the dominance of members of the phyla Alphaproteobacteria, Gammaproteobacteria and Bacteroidetes. When assessed by a probe set for the quantification of selected clades within Alphaproteobacteria and Gammaproteobacteria, bacterioplankton composition differed between October 2007 and June 2008, and also between the inlet and the lagoon. In particular, members of the readily culturable copiotrophic gammaproteobacterial genera Vibrio, Alteromonas and Pseudoalteromonas were enriched in the southern basin of the Lagoon of Venice. Interestingly, the alphaproteobacterial SAR11 clade and related clusters were also present in high abundances at the inlet and within the lagoon, which was indicative of inflow of water from the open sea.

TerraSAR-X InSAR multipass analysis on Venice, Italy)

NASA Astrophysics Data System (ADS)

Nitti, D. O.; Nutricato, R.; Bovenga, F.; Refice, A.; Chiaradia, M. T.; Guerriero, L.

2009-09-01

The TerraSAR-X (copyright) mission, launched in 2007, carries a new X-band Synthetic Aperture Radar (SAR) sensor optimally suited for SAR interferometry (InSAR), thus allowing very promising application of InSAR techniques for the risk assessment on areas with hydrogeological instability and especially for multi-temporal analysis, such as Persistent Scatterer Interferometry (PSI) techniques, originally developed at Politecnico di Milano. The SPINUA (Stable Point INterferometry over Unurbanised Areas) technique is a PSI processing methodology which has originally been developed with the aim of detection and monitoring of coherent PS targets in non or scarcely-urbanized areas. The main goal of the present work is to describe successful applications of the SPINUA PSI technique in processing X-band data. Venice has been selected as test site since it is in favorable settings for PSI investigations (urban area containing many potential coherent targets such as buildings) and in view of the availability of a long temporal series of TerraSAR-X stripmap acquisitions (27 scenes in all). The Venice Lagoon is affected by land sinking phenomena, whose origins are both natural and man-induced. The subsidence of Venice has been intensively studied for decades by determining land displacements through traditional monitoring techniques (leveling and GPS) and, recently, by processing stacks of ERS/ENVISAT SAR data. The present work is focused on an independent assessment of application of PSI techniques to TerraSAR-X stripmap data for monitoring the stability of the Venice area. Thanks to its orbital repeat cycle of only 11 days, less than a third of ERS/ENVISAT C-band missions, the maximum displacement rate that can be unambiguously detected along the Line-of-Sight (LOS) with TerraSAR-X SAR data through PSI techniques is expected to be about twice the corresponding value of ESA C-band missions, being directly proportional to the sensor wavelength and inversely proportional to the

Nadolol decreases the incidence and severity of ventricular arrhythmias during exercise stress testing compared with β1-selective β-blockers in patients with catecholaminergic polymorphic ventricular tachycardia.

PubMed

Leren, Ida S; Saberniak, Jørg; Majid, Eman; Haland, Trine F; Edvardsen, Thor; Haugaa, Kristina H

2016-02-01

Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inheritable cardiac disease predisposing to malignant ventricular arrhythmias. We aimed to explore the incidence and severity of ventricular arrhythmias in patients with CPVT before the initiation of β-blocker treatment, when treated with β1-selective β-blockers, and when treated with nadolol. In this study, 34 patients with CPVT were included (mean age 34 ± 19 years; 15 (44%) women; 30 (88%) ryanodine receptor 2 variant positive). We performed 3 bicycle exercise stress tests in each patient: (1) before the initiation of β-blocker treatment, (2) after >6 weeks of treatment with β1-selective β-blockers and (3) after >6 weeks of treatment with nadolol. We recorded resting and maximum heart rates and the most severe ventricular arrhythmia occurring. Severity of arrhythmias was scored as 1 point for no arrhythmias or only single ventricular extrasystoles, 2 points for >10 ventricular extrasystoles per minute or bigeminy, 3 points for couplets, and 4 points for nonsustained ventricular tachycardia or sustained ventricular tachycardia. Resting heart rate was similar during treatment with nadolol and β1-selective β-blockers (54 ± 10 beats/min vs 56 ± 14 beats/min; P = .50), while maximum heart rate was lower during treatment with nadolol compared with β1-selective β-blockers (122 ± 21 beats/min vs 139 ± 24 beats/min; P = .001). Arrhythmias during exercise stress testing were less severe during treatment with nadolol compared with during treatment with β1-selective β-blockers (arrhythmic score 1.6 ± 0.9 vs 2.5 ± 0.8; P < .001) and before the initiation of β-blocker treatment (arrhythmic score 1.6 ± 0.9 vs 2.7 ± 0.9; P = .001); however, no differences were observed during treatment with β1-selective β-blockers compared with before the initiation of β-blocker treatment (arrhythmic score 2.5 ± 0.8 vs 2.7 ± 0.9; P = .46). The incidence and severity of ventricular arrhythmias decreased

Classification of arrhythmia using hybrid networks.

PubMed

Haseena, Hassan H; Joseph, Paul K; Mathew, Abraham T

2011-12-01

Reliable detection of arrhythmias based on digital processing of Electrocardiogram (ECG) signals is vital in providing suitable and timely treatment to a cardiac patient. Due to corruption of ECG signals with multiple frequency noise and presence of multiple arrhythmic events in a cardiac rhythm, computerized interpretation of abnormal ECG rhythms is a challenging task. This paper focuses a Fuzzy C- Mean (FCM) clustered Probabilistic Neural Network (PNN) and Multi Layered Feed Forward Network (MLFFN) for the discrimination of eight types of ECG beats. Parameters such as fourth order Auto Regressive (AR) coefficients along with Spectral Entropy (SE) are extracted from each ECG beat and feature reduction has been carried out using FCM clustering. The cluster centers form the input of neural network classifiers. The extensive analysis of Massachusetts Institute of Technology- Beth Israel Hospital (MIT-BIH) arrhythmia database shows that FCM clustered PNNs is superior in cardiac arrhythmia classification than FCM clustered MLFFN with an overall accuracy of 99.05%, 97.14%, respectively.

Does Deep Bradycardia Increase the Risk of Arrhythmias and Syncope in Endurance Athletes?

PubMed

Matelot, D; Schnell, F; Khodor, N; Endjah, N; Kervio, G; Carrault, G; Thillaye du Boullay, N; Carre, F

2016-09-01

The aim of this study was to evaluate whether endurance athletes who exhibit deep bradycardia are more prone to arrhythmias and reflex syncope than their non-bradycardic peers. 46 healthy men (ages 19-35) were divided into 3 groups based on whether they were sedentary (SED,<2 h/week) or endurance trained (ET,>6 h/week), and non-bradycardic (NB, resting heart rate (HR)≥60 bpm) or bradycardic (B, resting HR<50 bpm). Resting HR was lower in ETB vs. ETNB and SED (43.8±3.1, 61.3±3.3, 66.1±5.9 bpm, respectively; p<0.001). Thus, 16 SED, 13 ETNB and 17 ETB underwent resting echocardiography, maximal exercise test, tilt test (TT) and 24 h-Holter ECG. Subjects were followed-up during 4.7±1.1 years for training, syncope and cardiac events. Our results showed that incidence of arrhythmias and hypotensive susceptibility did not differ between groups. During follow-up, no episode of syncope or near-syncope was reported. However, cardio-inhibitory syncope occurrence tended to be higher in ETB. Left ventricular end-diastolic diameter index was increased in ETB vs. ETNB and was correlated with resting HR (r=- 0.64; p<0.001). As a result, athletes with deep bradycardia do not present more arrhythmias and more hypotensive susceptibility than their non-bradycardic peers. Cardiac enlargement and autonomic alteration both seem to be involved in an athlete's bradycardia. © Georg Thieme Verlag KG Stuttgart · New York.

Venturing into ventricular arrhythmia storm: a systematic review and meta-analysis.

PubMed

Nayyar, Sachin; Ganesan, Anand N; Brooks, Anthony G; Sullivan, Thomas; Roberts-Thomson, Kurt C; Sanders, Prashanthan

2013-02-01

Ablation has substantial evidence base in the management of ventricular arrhythmia (VA). It can be a 'lifesaving' procedure in the acute setting of VA storm. Current reports on ablation in VA storm are in the form of small series and have relative small representation in a large observational series. The purpose of this study was to systematically synthesize the available literature to appreciate the efficacy and safety of ablation in the setting of VA storm. The medical electronic databases through 31 January 2012 were searched. Ventricular arrhythmia storm was defined as recurrent (≥ 3 episodes or defibrillator therapies in 24 h) or incessant (continuous >12 h) VA. Studies reporting data on VA storm patients at the individual or study level were included. A total of 471 VA storm patients from 39 publications were collated for the analysis. All VAs were successfully ablated in 72% [95% confidence interval (CI) 71-89%] and 9% (95% CI: 3-10%) had a failed procedure. Procedure-related mortality occurred in three patients (0.6%). Only 6% patients had a recurrence of VA storm. The recurrence of VA was significantly higher after ablation for arrhythmic storm of monomorphic ventricular tachycardia (VT) relative to ventricular fibrillation or polymorphic VT with underlying cardiomyopathy (odds ratio 3.76; 95% CI: 1.65-8.57; P = 0.002). During the follow-up (61 ± 37 weeks), 17% of patients died (heart failure 62%, arrhythmias 23%, and non-cardiac 15%) with 55% deaths occurring within 12 weeks of intervention. The odds of death were four times higher after a failed procedure compared with those with a successful procedure (95% CI: 2.04-8.01, P < 0.001). Ventricular arrhythmia storm ablation has high-acute success rates, with a low rate of recurrent storms. Heart failure is the dominant cause of death in the long term. Failure of the acute procedure carries a high mortality.

A Vision of Venice in the next Fin-de-Siècle

NASA Astrophysics Data System (ADS)

Tagliapietra, Davide

2014-05-01

The IPCC's Fifth Assessment Report projections of sea level rise are larger than in the previous one. In the Adriatic a sea level rise higher than 60 cm is considered possible and rise of one meter cannot be excluded. An end-of-century a scenario in which the mobile barrier at the inlets will not be sufficient to protect the City of Venice from permanent floods is realistic and the closure of the lagoon will become inevitable. The possibility of converting the lagoon of Venice in an enclosed non-tidal basin is discussed. The aim is to protect the City preserving as much as possible the features of a healthy brackish ecosystem able to provide many of the ecosystem services it provides at present. This involves technological challenges, a deeper understanding of the ecological functioning of enclosed coastal basins, and last but not least, a shift in the educational and cultural paradigms. There is the need to endorse a coordinated and large-scale research effort to understand what will be the new hydrology and ecohydrology of the lagoon. The relationship between ecosystem metabolism and hydrology should be approached in the conceptual framework of lagoonal saprobity. Ad hoc research programs with experimental studies and observational monitoring should be implemented to improve our understanding of new ecological scenarios. Among the new opportunities arising from an heavy hydrological management there is the possibility to keep the water at an optimum level for the fruition of the City as it was a few centuries ago. It is likely that the sea level rise would change the entire geographical context. Brackish and freshwater wetlands surrounding the lagoon of Venice, reclaimed during the last century, will be probably ingressed by the sea. An attentive adaptive policy of wetland re-creation could supply both the ecological functions and the ecosystem services lost by the lagoon of Venice. The rapid adoption of a long-term strategy is therefore needed. Strategies should

Emotional behavior and arrhythmias induced in cats by hypothalamic stimulation.

PubMed

Tashiro, N; Tanaka, T; Fukumoto, T; Hirata, K; Nakao, H

1985-03-18

As the relationship between emotional behavior and electrocardiographic (ECG) change induced by hypothalamic stimulation is poorly understood, eighty-four points in various areas within the hypothalamus in conscious cats were stimulated electrically through chronically implanted electrodes, the objective being to clarify the behavior accompanying ECG changes, in particular poststimulus arrhythmias. Forty-one of 84 points elicited behavioral patterns such as defense reaction, pseudo-rage and restlessness (classified as group A), and in twenty-one (51%) of these 41 points arrhythmias occurred after cessation of stimulation. Forty-three of 84 points elicited behavioral patterns including predatory, exploratory and other behavioral responses (classified as group B), and in three (7%) of 43 points, poststimulus arrhythmias followed. Under light anesthesia, stimulations of twofold current intensity were applied at these points, and the incidences of the arrhythmias did not change in either group. The arrhythmia-inducing area in the cases of group A was found to lie dorsal and caudal to the optic chiasma and to extend caudally in the fornix. Three points in the cases of group B were located in the outer area of the aforementioned area. These studies showed that arrhythmias and group A behavior were observed mainly from stimulation of the anterior hypothalamus, whereas stimulation of other areas of the hypothalamus, including the lateral and the posterolateral hypothalamus, produced group B behavior and no arrhythmias.

Arrhythmias in Patients with Atrial Defects.

PubMed

Contractor, Tahmeed; Mandapati, Ravi

2017-06-01

Atrial arrhythmias are common in patients with atrial septal defects. A myriad of factors are responsible for these that include remodeling related to the defect and scar created by the repair or closure. An understanding of potential arrhythmias, along with entrainment and high-density activation mapping can result in accurate diagnosis and successful ablation. Atrial fibrillation is being seen increasingly after patent foramen ovale closure and may be the primary etiology of recurrent stroke in these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Environmental quality of transitional waters: the lagoon of Venice case study.

PubMed

Micheletti, C; Gottardo, S; Critto, A; Chiarato, S; Marcomini, A

2011-01-01

The health status of European aquatic environments, including transitional waters such as coastal lagoons, is regulated by the Water Framework Directive (WFD), which requires the classification of the water bodies' environmental quality and the achievement of a good ecological status by 2015. In the Venice lagoon, a transitional water body located in the northeastern part of Italy, the achievement of a good ecological status is hampered by several anthropogenic and natural pressures, such as sediment and water chemical contamination, and sediment erosion. In order to evaluate the lagoon's environmental quality according to the WFD (i.e. 5 quality classes, from High to Bad), an integrated Weight-of-Evidence methodology was developed and applied to classify the quality of the lagoon water bodies, integrating biological, physico-chemical, chemical, ecotoxicological, and hydromorphological data (i.e. Lines of Evidence, LOE). The quality assessment was carried out in two lagoon habitat typologies (previously defined on the basis of morphological, sediment, and hydrodynamic characteristics) which were selected taking into account the ecological gradient from sea to land, and the differences in anthropogenic pressure and contamination levels. The LOE classification was carried out by using indicators scored by comparing site specific conditions to reference conditions measured in lagoon reference sites, or provided by local, national or European regulations (e.g. Environmental Quality Standards, EQS, for chemicals). Finally, the overall quality status for each water body was calculated by a probabilistic approach, i.e. by reporting the final result as the frequency distribution of quality classes. The developed procedure was applied by using data and information concerning selected LOE and collected from monitoring programs and research studies carried out in the last 15 years in the lagoon of Venice. A set of sampling stations characterized by spatially and temporally

Cardiac arrhythmias during exercise testing in healthy men.

NASA Technical Reports Server (NTRS)

Beard, E. F.; Owen, C. A.

1973-01-01

Clinically healthy male executives who participate in a long-term physical conditioning program have demonstrated cardiac arrhythmia during and after periodic ergometric testing at submaximal and maximal levels. In 1,385 tests on 248 subjects, it was found that 34% of subjects demonstrated an arrhythmia at some time and 13% of subjects developed arrhythmia on more than one test. Premature systoles of ventricular origin were most common, but premature systoles of atrial origin, premature systoles of junctional origin, paroxysmal atrial tachycardia, atrioventricular block, wandering pacemaker, and pre-excitation were also seen. Careful post-test monitoring and pulse rate regulated training sessions are suggested for such programs.

Protective effect of Crataegus oxyacantha against reperfusion arrhythmias after global no-flow ischemia in the rat heart.

PubMed

al Makdessi, S; Sweidan, H; Dietz, K; Jacob, R

1999-04-01

The protective effect against reperfusion arrhythmias of a 3-month oral pretreatment with a dried extract of Crataegus oxyacantha (LI 132)(standardized to 2.2% flavonoids) was studied with the Langendorff heart of the rat after global no-flow ischemia. The heart was perfused with a modified Krebs-Henseleit solution in which the K+ content was reduced to 3.4 mmol/l in order to lower the fibrillation threshold. According to pilot experiments which considered various durations of global no-flow ischemia ranging from 10 to 20 minutes, two durations were chosen for the present study: 20 minutes (group 20) in which ventricular fibrillation (VF) was the predominant form of arrhythmias, and 18 minutes (group 18) in which the prevalence of VF was markedly lower despite the small difference in the duration of ischemia. Crataegus pretreatment significantly (p = 0.02) reduced the average prevalence of malignant arrhythmias (VF + Flutter) as observed during the 20-min-period of reperfusion as follows: group 20: from 89% (control, n = 9) to 51% (LI 132, n = 7), group 18: from 48% (control, n = 8) to 8% (LI 132, n = 8). In group 20, ventricular tachycardia (VT) could be observed only in the treated group, because of the predominance of VF in the control group. LI 132 pretreatment reduced the average prevalence of VT in group 18 in spite of the identical percentage of occurrence (6 out of 8 rats, with and without treatment) due to a shorter duration of the VT episodes. Thus, under the conditions of our experiments, effective prevention against reperfusion arrhythmias by Crataegus pretreatment was evident.

Management of supraventricular arrhythmias in adults with congenital heart disease.

PubMed

Wasmer, Kristina; Eckardt, Lars

2016-10-15

Supraventricular arrhythmias are a frequent complication in adults with congenital heart disease (ACHD). The prevalence increases with time since surgery, complexity of the underlying defect, type of repair and older age at surgery. Arrhythmias are the most frequent reason for hospital admission and along with heart failure the leading cause of death. The arrhythmia-associated increase in morbidity and mortality makes their management a key task in patients with ACHD. Intra-atrial re-entry is the most frequent arrhythmia mechanism. Less common arrhythmia mechanisms are supraventricular tachycardias in the presence of an accessory pathway, atrioventricular nodal re-entrant tachycardia or focal tachycardias. Patient management includes stroke prevention, acute termination and prevention of arrhythmia recurrence. Acute treatment depends on patients' symptoms. In cases of haemodynamic instability, immediate cardioversion is warranted. For stable patients, acute treatment includes rate control and termination by antiarrhythmic drugs or electrical cardioversion. Following a symptomatic arrhythmia, catheter ablation or treatment with antiarrhythmic drugs is recommended to prevent recurrences. Advances in mapping and ablation technology are now associated with high success rates of catheter ablation. In patients with a complex substrate recurrence rates of 50% remain high. However, in the presence of side effects and complications associated with long-term antiarrhythmic drug therapy, redo procedures are encouraged by current guidelines. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Influence of ambient temperature and diurnal temperature range on incidence of cardiac arrhythmias

NASA Astrophysics Data System (ADS)

Kim, Jayeun; Kim, Ho

2017-03-01

We investigated the association between ambient temperature and diurnal temperature range (DTR) and the exacerbation of arrhythmia symptoms, using data from 31,629 arrhythmia-related emergency department (ED) visits in Seoul, Korea. Linear regression analyses with allowances for over-dispersion were applied to temperature variables and ED visits, adjusted for various environmental factors. The effects were expressed as percentage changes in the risk of arrhythmia-related ED visits up to 5 days later, with 95 % confidence intervals (CI), per 1 °C increase in DTR and 1 °C decrease in mean temperature. The overall risk of ED visits increased by 1.06 % (95 % CI 0.39 %, 1.73 %) for temperature and by 1.84 % (0.34, 3.37 %) for DTR. A season-specific effect was detected for temperature during both fall (1.18 % [0.01, 2.37 %]) and winter (0.87 % [0.07, 1.67 %]), and for DTR during spring (3.76 % [0.34, 7.29 %]). Females were more vulnerable, with 1.57 % [0.56, 2.59 %] and 3.84 % [1.53, 6.20 %] for the changes in temperature and DTR, respectively. An age-specific effect was detected for DTR, with 3.13 % [0.95, 5.36 %] for age ≥ 65 years, while a greater increased risk with temperature decrease was observed among those aged <65 (1.08 % [0.17, 2.00 %]) than among those aged ≥65 (1.02 % [0.06, 1.99 %]). Cardiac arrest was inversely related with temperature (1.61 % [0.46, 2.79 %]), while other cardiac arrhythmias depended more on the change in DTR (4.72 % [0.37, 9.26 %]). These findings provide evidence that low-temperature and elevated DTR influence the occurrence of arrhythmia exacerbations or symptoms, suggesting a possible strategy for reducing risk by encouraging vulnerable populations to minimize exposure.

Total Beta-Adrenoceptor Knockout Slows Conduction and Reduces Inducible Arrhythmias in the Mouse Heart

PubMed Central

Stöckigt, Florian; Brixius, Klara; Lickfett, Lars; Andrié, René; Linhart, Markus; Nickenig, Georg; Schrickel, Jan Wilko

2012-01-01

Introduction Beta-adrenoceptors (β-AR) play an important role in the neurohumoral regulation of cardiac function. Three β-AR subtypes (β1, β2, β3) have been described so far. Total deficiency of these adrenoceptors (TKO) results in cardiac hypotrophy and negative inotropy. TKO represents a unique mouse model mimicking total unselective medical β-blocker therapy in men. Electrophysiological characteristics of TKO have not yet been investigated in an animal model. Methods In vivo electrophysiological studies using right heart catheterisation were performed in 10 TKO mice and 10 129SV wild type control mice (WT) at the age of 15 weeks. Standard surface ECG, intracardiac and electrophysiological parameters, and arrhythmia inducibility were analyzed. Results The surface ECG of TKO mice revealed a reduced heart rate (359.2±20.9 bpm vs. 461.1±33.3 bpm; p<0.001), prolonged P wave (17.5±3.0 ms vs. 15.1±1.2 ms; p = 0.019) and PQ time (40.8±2.4 ms vs. 37.3±3.0 ms; p = 0.013) compared to WT. Intracardiac ECG showed a significantly prolonged infra-Hisian conductance (HV-interval: 12.9±1.4 ms vs. 6.8±1.0 ms; p<0.001). Functional testing showed prolonged atrial and ventricular refractory periods in TKO (40.5±15.5 ms vs. 21.3±5.8 ms; p = 0.004; and 41.0±9.7 ms vs. 28.3±6.6 ms; p = 0.004, respectively). In TKO both the probability of induction of atrial fibrillation (12% vs. 24%; p<0.001) and of ventricular tachycardias (0% vs. 26%; p<0.001) were significantly reduced. Conclusion TKO results in significant prolongations of cardiac conduction times and refractory periods. This was accompanied by a highly significant reduction of atrial and ventricular arrhythmias. Our finding confirms the importance of β-AR in arrhythmogenesis and the potential role of unspecific beta-receptor-blockade as therapeutic target. PMID:23133676

Atrial Arrhythmias in Astronauts. Summary of a NASA Summit

NASA Technical Reports Server (NTRS)

Barr, Yael; Watkins, Sharmila; Polk, J. D.

2011-01-01

This slide presentation reviews the findings of a panel of heart experts brought together to study if atrial arrhythmias more prevalent in astronauts, and potential risk factors that may predispose astronauts to atrial arrhythmias. The objective of the panel was to solicit expert opinion on screening, diagnosis, and treatment options, identify gaps in knowledge, and propose relevant research initiatives. While Atrial Arrhythmias occur in approximately the same percents in astronauts as in the general population, they seem to occur at younger ages in astronauts. Several reasons for this predisposition were given: gender, hypertension, endurance training, and triggering events. Potential Space Flight-Related Risk factors that may play a role in precipitating lone atrial fibrillation were reviewed. There appears to be no evidence that any variable of the space flight environment increases the likelihood of developing atrial arrhythmias during space flight.

Sediment budget in the Lagoon of Venice, Italy

NASA Astrophysics Data System (ADS)

Sarretta, A.; Pillon, S.; Molinaroli, E.; Guerzoni, S.; Fontolan, G.

2010-05-01

A comparison of 1927, 1970 and 2002 bathymetric surveys in the Lagoon of Venice was used to reconstruct historical changes in sedimentation. A detailed GIS-based analysis of the charts revealed the timing and pattern of geomorphic changes and allowed calculation of sediment deposition and erosion for the entire lagoon and each of its four sub-basins: Treporti, Lido, Malamocco and Chioggia. Two main developments are discernible from comparative observation of the areal distribution of the main elevation ranges: the diminution in area of the saltmarshes, which decreased by more than 50%, from 68 km 2 in 1927 to 32 km 2 in 2002, and the progressive deepening of the lagoon, with a huge increase in the area of subtidal flats (between -0.75 and -2.00 m depth), from 88 to 206 km 2 during the same period. Generally, the lagoon showed a clear-cut change in the most frequent depths (modal depth) from a value of -0.62 m in 1927 to -0.88 m in 2002. The deepening of the lagoon affected mostly the lagoonal sub-basins south of the town of Venice, where modal depth increased from -0.65 to -1.12 m in Lido, from -0.64 to -1.75 m in Malamocco and from -0.39 to -0.88 m in Chioggia. Large changes in lagoonal morphology were caused by human-induced subsidence, the dredging of navigation channels between 1927 and 1970, and intense natural erosion enhanced by sediment re-suspension due to Manila clam fishing between 1970 and 2002. There was a net loss of about 110 Mm 3 of sediment from the lagoon, most of which (73 Mm 3, ca.70%) was in the earlier period. A significant amount was lost by dredging and direct disposal outside the system, either on land or at sea, and there was a net loss of 39 Mm 3 from the lagoon to the sea through the inlets, at an annual rate of 0.5 Mm 3. Comparison of erosion rates in the two periods revealed an alarming acceleration, from a net sediment loss of 0.3 Mm 3 yr -1 in the period 1927-1970 to 0.8 Mm 3 yr -1 in 1970-2002. Deterioration caused a shift from a

Emerging molecular therapies targeting myocardial infarction-related arrhythmias.

PubMed

Driessen, Helen E; van Veen, Toon A B; Boink, Gerard J J

2017-04-01

Cardiac disease is the leading cause of death in the developed world. Ventricular arrhythmias associated with myocardial ischaemia and/or infarction are a major contributor to cardiovascular mortality, and require improved prevention and treatment. Drugs, devices, and radiofrequency catheter ablation have made important inroads, but have significant limitations ranging from incomplete success to undesired toxicities and major side effects. These limitations derive from the nature of the intervention. Drugs are frequently ineffective, target the entire heart, and often do not deal with the specific arrhythmia trigger or substrate. Devices can terminate rapid rhythms but at best indirectly affect the underlying disease, while ablation, even when appropriately targeted, induces additional tissue damage. In contrast, exploration of gene and cell therapies are expected to provide a targeted, non-destructive, and potentially regenerative approach to ischaemia- and infarction-related arrhythmias. Although these approaches are in the early stages of development, they carry substantial potential to advance arrhythmia prevention and treatment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System.

PubMed

Li, Hongqiang; Yuan, Danyang; Wang, Youxi; Cui, Dianyin; Cao, Lu

2016-10-20

Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG) recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias.

Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System

PubMed Central

Li, Hongqiang; Yuan, Danyang; Wang, Youxi; Cui, Dianyin; Cao, Lu

2016-01-01

Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG) recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias. PMID:27775596

Regional and local land subsidence at the Venice coastland by TerraSAR-X PSI

NASA Astrophysics Data System (ADS)

Tosi, L.; Strozzi, T.; Da Lio, C.; Teatini, P.

2015-11-01

Land subsidence occurred at the Venice coastland over the 2008-2011 period has been investigated by Persistent Scatterer Interferometry (PSI) using a stack of 90 TerraSAR-X stripmap images with a 3 m resolution and a 11-day revisiting time. The regular X-band SAR acquisitions over more than three years coupled with the very-high image resolution has significantly improved the monitoring of ground displacements at regional and local scales, e.g., the entire lagoon, especially the historical palaces, the MoSE large structures under construction at the lagoon inlets to disconnect the lagoon from the Adriatic Sea during high tides, and single small structures scattered within the lagoon environments. Our results show that subsidence is characterized by a certain variability at the regional scale with superimposed important local displacements. The movements range from a gentle uplift to subsidence rates of up to 35 mm yr-1. For instance, settlements of 30-35 mm yr-1 have been detected at the three lagoon inlets in correspondence of the MoSE works, and local sinking bowls up to 10 mm yr-1 connected with the construction of new large buildings or restoration works have been measured in the Venice and Chioggia historical centers. Focusing on the city of Venice, the mean subsidence of 1.1 ± 1.0 mm yr-1 confirms the general stability of the historical center.

Design of a hybrid model for cardiac arrhythmia classification based on Daubechies wavelet transform.

PubMed

Rajagopal, Rekha; Ranganathan, Vidhyapriya

2018-06-05

Automation in cardiac arrhythmia classification helps medical professionals make accurate decisions about the patient's health. The aim of this work was to design a hybrid classification model to classify cardiac arrhythmias. The design phase of the classification model comprises the following stages: preprocessing of the cardiac signal by eliminating detail coefficients that contain noise, feature extraction through Daubechies wavelet transform, and arrhythmia classification using a collaborative decision from the K nearest neighbor classifier (KNN) and a support vector machine (SVM). The proposed model is able to classify 5 arrhythmia classes as per the ANSI/AAMI EC57: 1998 classification standard. Level 1 of the proposed model involves classification using the KNN and the classifier is trained with examples from all classes. Level 2 involves classification using an SVM and is trained specifically to classify overlapped classes. The final classification of a test heartbeat pertaining to a particular class is done using the proposed KNN/SVM hybrid model. The experimental results demonstrated that the average sensitivity of the proposed model was 92.56%, the average specificity 99.35%, the average positive predictive value 98.13%, the average F-score 94.5%, and the average accuracy 99.78%. The results obtained using the proposed model were compared with the results of discriminant, tree, and KNN classifiers. The proposed model is able to achieve a high classification accuracy.

Noninvasive Predictors of Malignant Arrhythmias.

PubMed

Golukhova, Elena Z; Gromova, Olga; Grigoryan, Marina; Merzlyakov, Vadim; Shumkov, Konstantin; Bockeria, Leo; Serebruany, Victor L

2016-01-01

Prediction and potential prevention of sudden cardiac death (SCD) due to malignant ventricular arrhythmia (MVA) represent an obvious unmet medical need. We estimated the prognostic relevance of numerous biomarkers associated with future MVA development in patients with coronary artery disease (CAD) over 2 years of follow-up. Patients with stable documented CAD (n = 97) with a mean age of 61 ± 10 years were prospectively enrolled in a single-center observational cohort study. Heart failure was diagnosed in 68% of the patients (NYHA class II-III). The mean left ventricular ejection fraction (LVEF) was 50 ± 13%, while 20% of patients had LVEF ≤35%. Sixty-two patients underwent myocardial revascularization during the follow-up (mean 25 ± 11 months). Clinical characteristics (age, gender, diabetes, history of coronary disease and arrhythmias, prior interventions and antecedent medications), noninvasive electrophysiological markers [microvolt T-wave alterations, signal-averaged electrocardiography, QT interval duration and alteration, and heart rate turbulence (HRT) and HR variability], laboratory indices [serum creatinine and creatinine clearance, brain natriuretic peptide (BNP), NT-proBNP, and C-reactive protein and troponin T levels] were assessed with regard to the MVA prognosis. MVA was diagnosed in 11 patients during the prospective follow-up. Prior percutaneous coronary intervention (p < 0.05), MVA or syncope (p < 0.05), on-pump coronary artery bypass grafting during follow-up (p < 0.01), LVEF ≤47% (p < 0.01), a left atrium size ≥4.7 cm (p < 0.05), left atrium index (p = 0.01), filtered QRS duration (p < 0.05), abnormal HRT (x03C7;2 = 6.2, p = 0.01) or turbulence slope (x03C7;2 = 9.5, p < 0.01), BNP ≥158 pg/ml (p < 0.01) and NT-proBNP ≥787 pg/ml (x03C7;2 = 4.4, p < 0.05) were significantly associated with MVA risk by univariate analysis. However, only prior MVA or syncope [odds ratio (OR) 11.1; 95% confidence interval (CI) 2.8-44.4; p < 0

GPU based cloud system for high-performance arrhythmia detection with parallel k-NN algorithm.

PubMed

Tae Joon Jun; Hyun Ji Park; Hyuk Yoo; Young-Hak Kim; Daeyoung Kim

2016-08-01

In this paper, we propose an GPU based Cloud system for high-performance arrhythmia detection. Pan-Tompkins algorithm is used for QRS detection and we optimized beat classification algorithm with K-Nearest Neighbor (K-NN). To support high performance beat classification on the system, we parallelized beat classification algorithm with CUDA to execute the algorithm on virtualized GPU devices on the Cloud system. MIT-BIH Arrhythmia database is used for validation of the algorithm. The system achieved about 93.5% of detection rate which is comparable to previous researches while our algorithm shows 2.5 times faster execution time compared to CPU only detection algorithm.

Respiratory sinus arrhythmia is a limited measure of cardiac parasympathetic control in man.

PubMed Central

Kollai, M; Mizsei, G

1990-01-01

1. Respiratory modulation of cardiac parasympathetic activity and the relationship between respiratory sinus arrhythmia and parasympathetic control has been studied in twenty-nine conscious, healthy young adult subjects. 2. Changes in heart period in propranolol-treated subjects were taken as the measure of changes in cardiac parasympathetic activity; respiratory sinus arrhythmia was quantified as the difference between maximum and minimum heart periods in a given respiratory cycle; cardiac parasympathetic control was defined as the change in heart period after administration of a full dose of atropine. 3. During normal quiet breathing the inspiratory level of cardiac parasympathetic activity was not reduced to zero. The expiratory level was influenced by excitatory inputs whose activation was related to respiratory cycle length. 4. Slow breathing was associated with augmented sinus arrhythmia, but in different individuals the influence on minimum and maximum heart periods varied so that mean heart period was increased in some subjects but decreased in others. This occurred both in control conditions and after administration of a full dose of propranolol. 5. During normal breathing the correlation across subjects between respiratory sinus arrhythmia and parasympathetic control, although significant, was not close (r = 0.61). The relationship was not affected by beta-adrenergic blockade (r = 0.63). The strength of the correlation improved when multiple regression of respiratory sinus arrhythmia was performed on three variables: parasympathetic control, respiratory cycle length and tidal volume (R = 0.93). 6. It is concluded that in conscious human subjects the respiratory modulation of cardiac parasympathetic activity is different from that observed in the anaesthetized dog, and that variations in the amplitude of respiratory sinus arrhythmia do not necessarily reflect proportional changes in cardiac parasympathetic control. PMID:2391653

AV-block and conduction slowing prevail over TdP arrhythmias in the methoxamine-sensitized pro-arrhythmic rabbit model.

PubMed

Varkevisser, Rosanne; Vos, Marc A; Beekman, Jet D; Tieland, Ralph G; Van Der Heyden, Marcel A

2015-01-01

The methoxamine-sensitized rabbit model is widely used to screen drugs for proarrhythmic properties, especially repolarization-dependent TdP arrhythmias. With the change of anesthesia and/or sensitizing agent, conduction disturbances have been reported as well. Therefore, we compared currently available in-house anesthetics in order to preserve arrhythmia sensitivity and preclude conduction disturbances. Rabbits were randomly assigned to 3 groups: (1) 35 mg/kg ketamine + 5 mg/kg xylazine; (2) 0.5 mL/kg hypnorm + 3 mg/kg midazolam; (3) 35 mg/kg ketamine + 20 mg/kg propofol. Anesthesia was maintained by 1.5% isoflurane. Concomitant infusion of methoxamine (17 μg/kg/min for 40 minutes) and dofetilide (10 μg/kg/min for 30 minutes) was used to induce arrhythmias. Sole methoxamine infusion exclusively decreased HR in groups 1 and 3. Dofetilide lengthened repolarization, followed in time by PQ/QRS prolongation, second-degree AV block, and subsequently TdP arrhythmias. TdP was seen in 80%, 0%, and 33% of the rabbits in groups 1, 2, and 3, respectively. Decreasing the dose of dofetilide to 5 μg/kg/min in ketamine/xylazine anesthetized rabbits resulted in a drop in TdP incidence (25%) while conduction disturbances persisted. Flunarizine (n = 6) suppressed all TdP arrhythmias while conduction disturbances remained present. TdP incidence in the methoxamine-sensitized rabbit could be dramatically influenced by anesthesia, drug dose, and flunarizine, while conduction slowing remained present. Thus, conduction slowing seems to be the integral outcome in this model. © 2014 Wiley Periodicals, Inc.

Resolving land subsidence within the Venice Lagoon by persistent scatterer SAR interferometry

NASA Astrophysics Data System (ADS)

Teatini, P.; Tosi, L.; Strozzi, T.; Carbognin, L.; Cecconi, G.; Rosselli, R.; Libardo, S.

Land subsidence is a severe geologic hazard threatening the lowlying transitional coastal areas worldwide. Monitoring land subsidence has been significantly improved over the last decade by space borne earth observation techniques based on Synthetic Aperture Radar (SAR) interferometry. Within the INLET Project, funded by Magistrato alle Acque di Venezia - Venice Water Authority (VWA) and Consorzio Venezia Nuova (CVN), we use Interferometric Point Target Analysis (IPTA) to characterize the ground displacements within the Venice Lagoon. IPTA measures the movement of backscattering point targets (PTs) at the ground surface that persistently reflect radar signals emitted by the SAR system at different passes. For this study 80 ERS-1/2 and 44 ENVISAT SAR scenes recorded from 1992 to 2005 and from 2003 to 2007, respectively, have been processed. Highly reliable displacement measurements have been detected for thousands of PTs located on the lagoon margins, along the littorals, in major and small islands, and on single structures scattered within the lagoon. On the average, land subsidence ranges from less than 1 mm/year to 5 mm/year, with some PTs that exhibit values also larger than 10 mm/year depending on both the local geologic conditions and the anthropic activities. A network of a few tens of artificial square trihedral corner reflectors (TCRs) has been established before summer 2007 in order to monitor land subsidence in the inner lagoon areas where “natural” reflectors completely lack (e.g., on the salt marshes). The first interferometric results on the TCRs appear very promising.

Prejudice, Pedagogy, and the Play: A Study of "The Merchant of Venice."

ERIC Educational Resources Information Center

Eiferman, Sharon

There is little critical agreement on the meaning of Shakespeare's "The Merchant of Venice." One must confront the mindset of the play that systematically dehumanizes, stereotypes, excoriates, and seeks the extermination of one group on the grounds that their existence is repugnant to the controlling majority. Such a mindset is the…

Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats.

PubMed

Alp, Hayrullah; Soner, Burak Cem; Baysal, Tamer; Şahin, Ayşe Saide

2015-01-01

Digitalis preparations are commonly used by children and adults with heart diseases worldwide, although excessive doses may cause cardiac effects. The aim of the study is to evaluate the antiarrhythmic effect of Crataegus oxyacantha extract on digoxin-induced arrhythmias in anesthetized Wistar rats. Control and experimental groups were evaluated for arrhythmias induced by digoxin. Fifteen rats (7 as controls and 8 as the experimental group) were included in the study. The dry fruits of 100 mg Crataegus oxyacantha were extracted by percolation method. Digoxin, at a dose of 40 µg/kg/min, was infused to form the arrhythmias in all rats. Simultaneously, the extract was infused into the experimental group, while 0.9% NaCl was infused into control group. Electrocardiographic QRS prolongation and arterial blood pressure changes were analyzed. The experimental group lived longer (62.13±2.20 min) than the controls (p=0.002). On the other hand, the time to beginning of QRS prolongation did not differ between the two groups (p=0.812). Bradycardia was significant in the control group (288.01±10.54 beat/min and p=0.01). The maximum QRS duration was observed in the control group during the digoxin and 0.9% NaCl infusion period (53.29±3.99 ms and p=0.001). Also, the durations of atrial and ventricular arrhythmias were shorter in the experimental group. However, arterial blood pressure dipping was significant in the experimental group (23.67±10.89 mm Hg and p<0.001). Crataegus oxyacantha alcoholic extract produced an antiarrhythmic effect that was induced by digoxin in Wistar rats. However, in the clinical use of this extract, the hypotensive effect should be considered. Also, the alcoholic extract of Crataegus oxyacantha may be an alternative treatment medication for arrhythmias induced by digoxin toxicity in humans.

Protective effects of Hawthorn (Crataegus oxyacantha) extract against digoxin-induced arrhythmias in rats

PubMed Central

Alp, Hayrullah; Soner, Burak Cem; Baysal, Tamer; Şahin, Ayşe Saide

2016-01-01

Objective: Digitalis preparations are commonly used by children and adults with heart diseases worldwide, although excessive doses may cause cardiac effects. The aim of the study is to evaluate the antiarrhythmic effect of Crataegus oxyacantha extract on digoxin-induced arrhythmias in anesthetized Wistar rats. Methods: Control and experimental groups were evaluated for arrhythmias induced by digoxin. Fifteen rats (7 as controls and 8 as the experimental group) were included in the study. The dry fruits of 100 mg Crataegus oxyacantha were extracted by percolation method. Digoxin, at a dose of 40 μg/kg/min, was infused to form the arrhythmias in all rats. Simultaneously, the extract was infused into the experimental group, while 0.9% NaCl was infused into control group. Electrocardiographic QRS prolongation and arterial blood pressure changes were analyzed. Results: The experimental group lived longer (62.13±2.20 min) than the controls (p=0.002). On the other hand, the time to beginning of QRS prolongation did not differ between the two groups (p=0.812). Bradycardia was significant in the control group (288.01±10.54 beat/min and p=0.01). The maximum QRS duration was observed in the control group during the digoxin and 0.9% NaCl infusion period (53.29±3.99 ms and p=0.001). Also, the durations of atrial and ventricular arrhythmias were shorter in the experimental group. However, arterial blood pressure dipping was significant in the experimental group (23.67±10.89 mm Hg and p<0.001). Conclusion: Crataegus oxyacantha alcoholic extract produced an antiarrhythmic effect that was induced by digoxin in Wistar rats. However, in the clinical use of this extract, the hypotensive effect should be considered. Also, the alcoholic extract of Crataegus oxyacantha may be an alternative treatment medication for arrhythmias induced by digoxin toxicity in humans. PMID:25880053

Incidence of cardiac arrhythmias in asymptomatic hereditary hemochromatosis subjects with C282Y homozygosity.

PubMed

Shizukuda, Yukitaka; Tripodi, Dorothy J; Zalos, Gloria; Bolan, Charles D; Yau, Yu-Ying; Leitman, Susan F; Waclawiw, Myron A; Rosing, Douglas R

2012-03-15

It is not well known whether systemic iron overload per se in hereditary hemochromatosis (HH) is associated with cardiac arrhythmias before other signs and symptoms of cardiovascular disease occur. In the present study, we examined the incidence of cardiac arrhythmia in cardiac asymptomatic subjects with HH (New York Heart Association functional class I) and compared it to that in age- and gender-matched normal volunteers. The 42 subjects with HH and the 19 normal control subjects were recruited through the National Heart, Lung, and Blood Institute-sponsored "Heart Study of Hemochromatosis." They completed 48-hour Holter electrocardiography ambulatory monitoring at the baseline evaluation. The subjects with HH were classified as newly diagnosed (group A) and chronically treated (group B) subjects. All subjects with HH had C282Y homozygosity, and the normal volunteers lacked any HFE gene mutations known to cause HH. Although statistically insignificant, the incidence of ventricular and supraventricular ectopy tended to be greater in the combined HH groups than in the controls. Supraventricular ectopy was more frequently noted in group B compared to in the controls (ectopy rate per hour 11.1 ± 29.9 vs 1.5 ± 3.5, p < 0.05, using the Kruskal-Wallis test). No examples of heart block, other than first-degree atrioventricular node block, were seen in any of the subjects. The incidence of cardiac arrhythmias was not significantly reduced after 6 months of intensive iron removal therapy in the group A subjects. No life-threatening arrhythmias were observed in our subjects with HH. In conclusion, our data suggest that the incidence of cardiac arrhythmias is, at most, marginally increased in asymptomatic subjects with HH. A larger clinical study is warranted to further clarify our observation. Published by Elsevier Inc.

International Education and Sustainable Development: An American Experience in Bangkok, Venice and Guayaquil.

ERIC Educational Resources Information Center

Hansen, Peter H.

1995-01-01

Describes environmental projects completed by Worcester Polytechnic Institute students in Bangkok, Venice, and Guayaquil as part of a program studying the interaction of science or technology and society. The lessons provide a model for environmental education at other institutions. These interdisciplinary projects promote environmental awareness…

[Analysis of the heart sound with arrhythmia based on nonlinear chaos theory].

PubMed

Ding, Xiaorong; Guo, Xingming; Zhong, Lisha; Xiao, Shouzhong

2012-10-01

In this paper, a new method based on the nonlinear chaos theory was proposed to study the arrhythmia with the combination of the correlation dimension and largest Lyapunov exponent, through computing and analyzing these two parameters of 30 cases normal heart sound and 30 cases with arrhythmia. The results showed that the two parameters of the heart sounds with arrhythmia were higher than those with the normal, and there was significant difference between these two kinds of heart sounds. That is probably due to the irregularity of the arrhythmia which causes the decrease of predictability, and it's more complex than the normal heart sound. Therefore, the correlation dimension and the largest Lyapunov exponent can be used to analyze the arrhythmia and for its feature extraction.

A troubled beginning: evolving concepts of an old arrhythmia.

PubMed

Hanon, Sam; Shapiro, Michael; Schweitzer, Paul

2005-07-01

The development of the sphygmograph in the nineteenth century marked the beginning of graphic registration of the arterial and venous pulse. Mackenzie, among other investigators, used this technique to study cardiac rhythm. In the early 20th century, Einthoven developed the electrocardiogram, which replaced the less sophisticated arterial and venous registrations of cardiac events and allowed for more detailed arrhythmia analysis. Interestingly, the early study of cardiac arrhythmias was obscured by misinterpretation. Specifically, atrial fibrillation stands out as a rhythm that was extensively studied though misconstrued in its early history. What follows is an in-depth consideration of the original investigations and evolving theories of this important arrhythmia.

Simulation system of arrhythmia using ActiveX control.

PubMed

Takeuchi, Akihiro; Hirose, Minoru; Hamada, Atsushi; Ikeda, Noriaki

2005-07-01

A simulation system for arrhythmias has been developed using Windows-based software technology, ActiveX control. The cardiac module consists of six cells, the sinus, atrium, AV node, ventricle, and ectopic foci. The physiological properties of the cells, the automaticity and conduction delay, were modelled, respectively, by the phase response curve and the excitability recovery curve. Cell functions were implemented in the ActiveX control and incorporated into the cardiac module. The system draws the ECG sequence as a ladder diagram in real time. The system interactively shows diverse arrhythmias for various user settings of the cell function and bidirectional conduction between the cells. Users are able to experiment virtually by setting up a so-called electrophysiological stimulation. This system is useful for learning and for teaching the interaction between the cells and arrhythmias.

Idiopathic accelerated idioventricular rhythm or ventricular tachycardia originating from the right bundle branch: unusual type of ventricular arrhythmia.

PubMed

Chen, Minglong; Gu, Kai; Yang, Bing; Chen, Hongwu; Ju, Weizhu; Zhang, Fengxiang; Yang, Gang; Li, Mingfang; Lu, Xinzheng; Cao, Kejiang; Ouyang, Feifan

2014-12-01

Accelerated idioventricular rhythm (AIVR) or ventricular tachycardia (VT) originating from the right bundle branch (RBB) is rare and published clinical data on such arrhythmia are scarce. In this study, we will describe the clinical manifestations, diagnosis, and management of a cohort of patients with this novel arrhythmia. Eight patients (5 men; median age, 25 years) with RBB-AIVR/VT were consecutively enrolled in the study. Pharmacological testing, exercise treadmill testing, electrophysiological study, and catheter ablation were performed in the study patients, and ECG features were characterized. All RBB-AIVR/VTs were of typical left bundle-branch block morphology with atrioventricular dissociation. The arrhythmias, which demonstrated chronotropic variability, were often isorhythmic with sinus rhythm and were accelerated by physical exercise, stress, and intravenous isoprenaline infusion. The rate of RBB-AIVR/VT varied from 45 to 200 beats per minute. Two patients experienced syncope, and 3 had impaired left ventricular function. Metoprolol was proven to be the most effective drug to decelerate the arrhythmia rate and relieve symptoms. Electrophysiology study was performed in 5 patients and the earliest activation with a sharp RBB potential was localized in the mid or distal RBB area. Catheter ablation terminated the arrhythmia with subsequent RBB block morphology during sinus rhythm. During follow-up, patients' symptoms were controlled with normalization of left ventricular function either on metoprolol or by catheter ablation. RBB-AIVR/VT is an unusual type of ventricular arrhythmia. It can result in significant symptoms and depressed ventricular function and can be successfully treated with catheter ablation. © 2014 American Heart Association, Inc.

Circadian and seasonal variation of malignant arrhythmias in a pediatric and congenital heart disease population.

PubMed

Stephenson, Elizabeth A; Collins, Kathryn K; Dubin, Anne M; Epstein, Michael R; Hamilton, Robert M; Kertesz, Naomi J; Alexander, Mark E; Cecchin, Frank; Triedman, John K; Walsh, Edward P; Berul, Charles I

2002-10-01

Recent studies in adult populations have revealed seasonal variation in the frequency of acute cardiovascular events, including life-threatening arrhythmias, demonstrating increased events during winter and early spring. Trends in the time of day that arrhythmias occur also were noted. We sought to establish whether pediatric and young adult congenital heart disease implantable cardioverter defibrillator (ICD) recipients have circadian or seasonal variability in shock frequency, similar to adult populations. Data from ICD patients at six pediatric centers in North America were analyzed to assess the timing of life-threatening arrhythmias. The populations consisted of children and adults with congenital heart disease and ICDs placed for malignant arrhythmias. Data were considered in 46 patients who received appropriate therapy (total 139 episodes) for ventricular tachycardia or ventricular fibrillation. Multiple variables were analyzed, including time of day, day of week, and month of year. In contrast to previously studied adult patients, fewer events occurred in the early morning (7.5%), with the most therapies occurring between 6 P.M. and midnight (35%). An increased frequency of therapies was observed in the fall and winter (September-January), representing 60% of all appropriate shocks. Unlike adult populations, Mondays did not have an increased frequency of malignant arrhythmias. Pediatric and adult congenital heart disease populations have moderate seasonal and 24-hour variation in ICD event rate, with some distinctly different peaks than those seen in typical adult ICD populations. These findings suggest circadian variation in arrhythmia vulnerability that may differ from conventional occupational, physical, or emotional stressors. (J Cardiovasc Electrophysiol, Vol. 13, pp.

The risk of life-threatening ventricular arrhythmias in presence of high-intensity endurance exercise along with chronic administration of nandrolone decanoate.

PubMed

Abdollahi, Farzane; Joukar, Siyavash; Najafipour, Hamid; Karimi, Abdolah; Masumi, Yaser; Binayi, Fateme

2016-01-01

Anabolic steroids used to improve muscular strength and performance in athletics. Its long-term consumption may induce cardiovascular adverse effects. We assessed the risk of ventricular arrhythmias in rats which subjected to chronic nandrolone plus high-intensity endurance exercise. Animals were grouped as; control (CTL), exercise (Ex): 8 weeks under exercise, vehicle group (Arach): received arachis oil, and Nan group: received nandrolone decanoate 5 mg/kg twice a week for 8 weeks, Arach+Ex group, and Nan+Ex. Finally, under anesthesia, arrhythmia was induced by infusion of 1.5 μg/0.1 mL/min of aconitine IV and ventricular arrhythmias were recorded for 15 min. Then, animals' hearts were excised and tissue samples were taken. Nandrolone plus exercise had no significant effect on blood pressure but decreased the heart rate (P<0.01) and increased the RR (P<0.01) and JT intervals (P<0.05) of electrocardiogram. Nandrolone+exercise significantly increased the ventricular fibrillation (VF) frequency and also decreased the VF latency (P<0.05 versus CTL group). Combination of exercise and nandrolone could not recover the decreasing effects of nandrolone on animals weight gain but, it enhanced the heart hypertrophy index (P<0.05). In addition, nandrolone increased the level of hydroxyproline (HYP) and malondialdehyde (MDA) but had not significant effect on glutathione peroxidase of heart. Exercise only prevented the effect of nandrolone on HYP. Nandrolone plus severe exercise increases the risk of VF that cannot be explained only by the changes in redox system. The intensification of cardiac hypertrophy and prolongation of JT interval may be a part of involved mechanisms. Copyright © 2015 Elsevier Inc. All rights reserved.

76 FR 60113 - Culturally Significant Objects Imported for Exhibition Determinations: “Masters of Venice...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... DEPARTMENT OF STATE [Public Notice 7616] Culturally Significant Objects Imported for Exhibition Determinations: ``Masters of Venice: Renaissance Paintings of Passion and Power from Kunsthistorisches Museum...: Renaissance Paintings of Passion and Power from Kunsthistorisches Museum, Vienna,'' imported from abroad for...

Organic micropollutants in wet and dry depositions in the Venice Lagoon.

PubMed

Gambaro, Andrea; Radaelli, Marta; Piazza, Rossano; Stortini, Angela Maria; Contini, Daniele; Belosi, Franco; Zangrando, Roberta; Cescon, Paolo

2009-08-01

Atmospheric transport is an important route by which pollutants are conveyed from the continents to both coastal and open sea. The role of aerosol deposition in the transport of polycyclic aromatic hydrocarbons (PAHs), polychlorobiphenyls (PCBs) and polybromodiphenyls ethers (PBDEs) to water and soil systems has been evaluated by measuring their concentrations in wet and dry depositions to the Venice Lagoon. The organic micropollutant flux data indicate that they contribute to the total deposition flux in different ways through wet and dry deposition, showing that the prevalent contribution derives from wet deposition. The fluxes calculated for PBDEs, showed the prevalence of 47, 99, 100 and 183 congeners, both in dry and wet fluxes. With regard to PCBs, the flux of summation operatorPCB for wet deposition is in the same order of magnitude of the diffusive flux at the air-water interface. The PAH fluxes obtained in the present study are similar to those obtained in previous studies on the atmospheric bulk deposition to the Venice Lagoon. The ratios between Phe/Ant and Fl/Py indicate that the pollutants sources are pyrolytic, deriving from combustion fuels.

Risk of malignant arrhythmias in initially symptomatic patients with Wolff-Parkinson-White syndrome: results of a prospective long-term electrophysiological follow-up study.

PubMed

Pappone, Carlo; Vicedomini, Gabriele; Manguso, Francesco; Baldi, Mario; Pappone, Alessia; Petretta, Andrea; Vitale, Raffaele; Saviano, Massimo; Ciaccio, Cristiano; Giannelli, Luigi; Calovic, Zarko; Tavazzi, Luigi; Santinelli, Vincenzo

2012-02-07

The available amount of detailed long-term data in patients with Wolff-Parkinson-White syndrome is limited, and no prospective electrophysiological studies looking at predictors of malignant arrhythmia are available. Among 8575 symptomatic Wolff-Parkinson-White patients with atrioventricular reentrant tachycardia referred for electrophysiological test, 369 (mean age, 23±12.5 years) declined catheter ablation and were followed up. The primary end point of the study was to evaluate over a 5-year follow-up the predictors and characteristics of patients who develop malignant arrhythmias. After a mean follow-up of 42.1±10 months, malignant arrhythmias developed in 29 patients (mean age, 13.9±5.6 years; 26 male), resulting in presyncope/syncope (25 patients), hemodynamic collapse (3 patients), or cardiac arrest caused by ventricular fibrillation (1 patient). Of the remaining 340 patients, 168 (mean age, 34.2±9.0 years) remained asymptomatic up to 5 years, and 172 (mean age, 13.6±5.1 years) had benign recurrence, including sustained atrioventricular reentrant tachycardia (132 patients) or atrial fibrillation (40 patients). Compared with the group with no malignant arrhythmias, the group with malignant arrhythmias showed shorter accessory-pathway effective refractory period (P<0.001) and more often exhibited multiple accessory pathways (P<0.001), and atrioventricular reentrant tachycardia triggering sustained pre-excited atrial fibrillation was more frequently inducible (P<0.001). Multivariable analysis demonstrated that short accessory-pathway effective refractory period (P<0.001) and atrioventricular reentrant tachycardia triggering sustained pre-excited atrial fibrillation (P<0.001) were independent predictors of malignant arrhythmias. Symptomatic patients with Wolff-Parkinson-White syndrome generally have a good outcome, and predictors of malignant arrhythmias are similar to those reported for asymptomatic patients with ventricular pre-excitation.

Transcriptomic resources for environmental risk assessment: a case study in the Venice lagoon.

PubMed

Milan, M; Pauletto, M; Boffo, L; Carrer, C; Sorrentino, F; Ferrari, G; Pavan, L; Patarnello, T; Bargelloni, L

2015-02-01

The development of new resources to evaluate the environmental status is becoming increasingly important representing a key challenge for ocean and coastal management. Recently, the employment of transcriptomics in aquatic toxicology has led to increasing initiatives proposing to integrate eco-toxicogenomics in the evaluation of marine ecosystem health. However, several technical issues need to be addressed before introducing genomics as a reliable tool in regulatory ecotoxicology. The Venice lagoon constitutes an excellent case, in which the assessment of environmental risks derived from the nearby industrial activities represents a crucial task. In this context, the potential role of genomics to assist environmental monitoring was investigated through the definition of reliable gene expression markers associated to chemical contamination in Manila clams, and their subsequent employment for the classification of Venice lagoon areas. Overall, the present study addresses key issues to evaluate the future outlooks of genomics in the environmental monitoring and risk assessment. Copyright © 2014 Elsevier Ltd. All rights reserved.

Epicardial Radiofrequency Ablation Failure During Ablation Procedures for Ventricular Arrhythmias: Reasons and Implications for Outcomes.

PubMed

Baldinger, Samuel H; Kumar, Saurabh; Barbhaiya, Chirag R; Mahida, Saagar; Epstein, Laurence M; Michaud, Gregory F; John, Roy; Tedrow, Usha B; Stevenson, William G

2015-12-01

Radiofrequency ablation (RFA) from the epicardial space for ventricular arrhythmias is limited or impossible in some cases. Reasons for epicardial ablation failure and the effect on outcome have not been systematically analyzed. We assessed reasons for epicardial RFA failure relative to the anatomic target area and the type of heart disease and assessed the effect of failed epicardial RFA on outcome after ablation procedures for ventricular arrhythmias in a large single-center cohort. Epicardial access was attempted during 309 ablation procedures in 277 patients and was achieved in 291 procedures (94%). Unlimited ablation in an identified target region could be performed in 181 cases (59%), limited ablation was possible in 22 cases (7%), and epicardial ablation was deemed not feasible in 88 cases (28%). Reasons for failed or limited ablation were unsuccessful epicardial access (6%), failure to identify an epicardial target (15%), proximity to a coronary artery (13%), proximity to the phrenic nerve (6%), and complications (<1%). Epicardial RFA was impeded in the majority of cases targeting the left ventricular summit region. Acute complications occurred in 9%. The risk for acute ablation failure was 8.3× higher (4.5-15.0; P<0.001) after no or limited epicardial RFA compared with unlimited RFA, and patients with unlimited epicardial RFA had better recurrence-free survival rates (P<0.001). Epicardial RFA for ventricular arrhythmias is often limited even when pericardial access is successful. Variability of success is dependent on the target area, and the presence of factors limiting ablation is associated with worse outcomes. © 2015 American Heart Association, Inc.

Dual chamber arrhythmia detection in the implantable cardioverter defibrillator.

PubMed

Dijkman, B; Wellens, H J

2000-10-01

Dual chamber implantable cardioverter defibrillator (ICD) technology extended ICD therapy to more than termination of hemodynamically unstable ventricular tachyarrhythmias. It created the basis for dual chamber arrhythmia management in which dependable detection is important for treatment and prevention of both ventricular and atrial arrhythmias. Dual chamber detection algorithms were investigated in two Medtronic dual chamber ICDs: the 7250 Jewel AF (33 patients) and the 7271 Gem DR (31 patients). Both ICDs use the same PR Logic algorithm to interpret tachycardia as ventricular tachycardia (VT), supraventricular tachycardia (SVT), or dual (VT+ SVT). The accuracy of dual chamber detection was studied in 310 of 1,367 spontaneously occurring tachycardias in which rate criterion only was not sufficient for arrhythmia diagnosis. In 78 episodes there was a double tachycardia, in 223 episodes SVT was detected in the VT or ventricular fibrillation zone, and in 9 episodes arrhythmia was detected outside the boundaries of the PR Logic functioning. In 100% of double tachycardias the VT was correctly diagnosed and received priority treatment. SVT was seen in 59 (19%) episodes diagnosed as VT. The causes of inappropriate detection were (1) algorithm failure (inability to fulfill the PRarrhythmias. Dual chamber detection algorithms evaluated in a subset of diagnostically difficult arrhythmias allow safe detection of double tachycardias but require further extension and programmability to

Cardiac arrhythmias from a malpositioned Greenfield filter in a traumatic quadriplegic.

PubMed

Bach, J R; Zaneuski, R; Lee, H

1990-10-01

A case study is presented of premature Greenfield filter discharge with intracardiac migration and resulting life-threatening arrhythmias. These arrhythmias also interfered with the patient's transition from ventilatory support via orotracheal intubation to noninvasive positive airway pressure ventilatory support methods. The patient's arrhythmias were controlled by a demand cardiac pacemaker and cardiac glycoside therapy. No anticoagulants were used. She had no further filter migration nor significant complications for 16 months after hospital discharge.

Types of Arrhythmia in Children

MedlinePlus

... even though they may need to keep taking medicine. Your child will probably need periodic check-ups but will ... minute. Understand and manage medications Parents of a child taking medicine for an arrhythmia should give the medicine at ...

Improvements of Storm Surge Modelling in the Gulf of Venice with Satellite Data: The ESA Due Esurge-Venice Project

NASA Astrophysics Data System (ADS)

De Biasio, F.; Bajo, M.; Vignudelli, S.; Papa, A.; della Valle, A.; Umgiesser, G.; Donlon, C.; Zecchetto, S.

2016-08-01

Among the most detrimental natural phenomena, storm surges heavily endanger the environment, the economy and the everyday life of sea-side countries and coastal zones. Considering that 120.000.000 people live in the Mediterranean area, with additional 200.000.000 presences in Summer for tourism purposes, the correct prediction of storm surges is crucial to avoid fatalities and economic losses. Earth Observation (EO) can play an important role in operational storm surge forecasting, yet it is not widely diffused in the storm surge community. In 2011 the European Space Agency (ESA), through its Data User Element (DUE) programme, financed two projects aimed at encouraging the uptake of EO data in this sector: eSurge and eSurge-Venice (eSV). The former was intended to address the issues of a wider users' community, while the latter was focused on a restricted geographical area: the northern Adriatic Sea and the Gulf of Venice. Among the objectives of the two projects there were a number of storm surge hindcast experiments using satellite data, to demonstrate the improvements on the surge forecast brought by EO. We report here the results of the hindcast experiments of the eSV project. They were aimed to test the sensitivity of a storm surge model to a forcing wind field modified with scatterometer data in order to reduce the bias between simulated and observed winds. Hindcast experiments were also performed to test the response of the storm surge model to the assimilation, with a dual 4D-Var system, of satellite altimetry observations as model errors of the initial state of the sea surface level. Remarkable improvements on the storm surge forecast have been obtained for what concerns the modified model wind forcing. Encouraging results have been obtained also in the assimilation experiments.

Vibrio trends in the ecology of the Venice lagoon.

PubMed

Rahman, Mohammad Shamsur; Martino, Maria Elena; Cardazzo, Barbara; Facco, Pierantonio; Bordin, Paola; Mioni, Renzo; Novelli, Enrico; Fasolato, Luca

2014-04-01

Vibrio is a very diverse genus that is responsible for different human and animal diseases. The accurate identification of Vibrio at the species level is important to assess the risks related to public health and diseases caused by aquatic organisms. The ecology of Vibrio spp., together with their genetic background, represents an important key for species discrimination and evolution. Thus, analyses of population structure and ecology association are necessary for reliable characterization of bacteria and to investigate whether bacterial species are going through adaptation processes. In this study, a population of Vibrionaceae was isolated from shellfish of the Venice lagoon and analyzed in depth to study its structure and distribution in the environment. A multilocus sequence analysis (MLSA) was developed on the basis of four housekeeping genes. Both molecular and biochemical approaches were used for species characterization, and the results were compared to assess the consistency of the two methods. In addition, strain ecology and the association between genetic information and environment were investigated through statistical models. The phylogenetic and population analyses achieved good species clustering, while biochemical identification was demonstrated to be imprecise. In addition, this study provided a fine-scale overview of the distribution of Vibrio spp. in the Venice lagoon, and the results highlighted a preferential association of the species toward specific ecological variables. These findings support the use of MLSA for taxonomic studies and demonstrate the need to consider environmental information to obtain broader and more accurate bacterial characterization.

Vibrio Trends in the Ecology of the Venice Lagoon

PubMed Central

Rahman, Mohammad Shamsur; Cardazzo, Barbara; Facco, Pierantonio; Bordin, Paola; Mioni, Renzo; Novelli, Enrico; Fasolato, Luca

2014-01-01

Vibrio is a very diverse genus that is responsible for different human and animal diseases. The accurate identification of Vibrio at the species level is important to assess the risks related to public health and diseases caused by aquatic organisms. The ecology of Vibrio spp., together with their genetic background, represents an important key for species discrimination and evolution. Thus, analyses of population structure and ecology association are necessary for reliable characterization of bacteria and to investigate whether bacterial species are going through adaptation processes. In this study, a population of Vibrionaceae was isolated from shellfish of the Venice lagoon and analyzed in depth to study its structure and distribution in the environment. A multilocus sequence analysis (MLSA) was developed on the basis of four housekeeping genes. Both molecular and biochemical approaches were used for species characterization, and the results were compared to assess the consistency of the two methods. In addition, strain ecology and the association between genetic information and environment were investigated through statistical models. The phylogenetic and population analyses achieved good species clustering, while biochemical identification was demonstrated to be imprecise. In addition, this study provided a fine-scale overview of the distribution of Vibrio spp. in the Venice lagoon, and the results highlighted a preferential association of the species toward specific ecological variables. These findings support the use of MLSA for taxonomic studies and demonstrate the need to consider environmental information to obtain broader and more accurate bacterial characterization. PMID:24487545

Testing the burden of rare variation in arrhythmia-susceptibility genes provides new insights into molecular diagnosis for Brugada syndrome.

PubMed

Le Scouarnec, Solena; Karakachoff, Matilde; Gourraud, Jean-Baptiste; Lindenbaum, Pierre; Bonnaud, Stéphanie; Portero, Vincent; Duboscq-Bidot, Laëtitia; Daumy, Xavier; Simonet, Floriane; Teusan, Raluca; Baron, Estelle; Violleau, Jade; Persyn, Elodie; Bellanger, Lise; Barc, Julien; Chatel, Stéphanie; Martins, Raphaël; Mabo, Philippe; Sacher, Frédéric; Haïssaguerre, Michel; Kyndt, Florence; Schmitt, Sébastien; Bézieau, Stéphane; Le Marec, Hervé; Dina, Christian; Schott, Jean-Jacques; Probst, Vincent; Redon, Richard

2015-05-15

The Brugada syndrome (BrS) is a rare heritable cardiac arrhythmia disorder associated with ventricular fibrillation and sudden cardiac death. Mutations in the SCN5A gene have been causally related to BrS in 20-30% of cases. Twenty other genes have been described as involved in BrS, but their overall contribution to disease prevalence is still unclear. This study aims to estimate the burden of rare coding variation in arrhythmia-susceptibility genes among a large group of patients with BrS. We have developed a custom kit to capture and sequence the coding regions of 45 previously reported arrhythmia-susceptibility genes and applied this kit to 167 index cases presenting with a Brugada pattern on the electrocardiogram as well as 167 individuals aged over 65-year old and showing no history of cardiac arrhythmia. By applying burden tests, a significant enrichment in rare coding variation (with a minor allele frequency below 0.1%) was observed only for SCN5A, with rare coding variants carried by 20.4% of cases with BrS versus 2.4% of control individuals (P = 1.4 × 10(-7)). No significant enrichment was observed for any other arrhythmia-susceptibility gene, including SCN10A and CACNA1C. These results indicate that, except for SCN5A, rare coding variation in previously reported arrhythmia-susceptibility genes do not contribute significantly to the occurrence of BrS in a population with European ancestry. Extreme caution should thus be taken when interpreting genetic variation in molecular diagnostic setting, since rare coding variants were observed in a similar extent among cases versus controls, for most previously reported BrS-susceptibility genes. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Ecotoxicological evaluation of industrial port of Venice (Italy) sediment samples after a decontamination treatment.

PubMed

Libralato, Giovanni; Losso, Chiara; Arizzi Novelli, Alessandra; Citron, Marta; Della Sala, Stefano; Zanotto, Emanuele; Cepak, Franka; Volpi Ghirardini, Annamaria

2008-12-01

This work assesses the ecotoxicological effects of polluted sediment after a decontamination treatment process using a new sediment washing technique. Sediment samples were collected from four sites in Marghera Port industrial channels (Venice, Italy). Ecotoxicological evaluations were performed with Vibrio fischeri and Crassostrea gigas bioassays. Whole sediment and elutriate were deemed as the most suitable environmental matrices for this study. Toxicity scores developed in the Lagoon of Venice for V. fischeri on whole sediment and for C. gigas on elutriate were considered for the final ranking of samples. Ecotoxicological results showed that the treated sediment samples presented both acute and sub-chronic toxicities, which were mainly attributed to the presence of some remaining chemicals such as metals and polyaromatic hydrocarbons. The acute toxicity ranged from low to medium, while the sub-chronic one from absent to very high, suggesting that treated sediments could not be reused in direct contact with seawater.

Catheter radiofrequency ablation for arrhythmias under the guidance of the Carto 3 three-dimensional mapping system in an operating room without digital subtraction angiography.

PubMed

Huang, Xingfu; Chen, Yanjia; Huang, Zheng; He, Liwei; Liu, Shenrong; Deng, Xiaojiang; Wang, Yongsheng; Li, Rucheng; Xu, Dingli; Peng, Jian

2018-06-01

Several studies have reported the efficacy of a zero-fluoroscopy approach for catheter radiofrequency ablation of arrhythmias in a digital subtraction angiography (DSA) room. However, no reports are available on the ablation of arrhythmias in the absence of DSA in the operating room. To investigate the efficacy and safety of catheter radiofrequency ablation for arrhythmias under the guidance of a Carto 3 three-dimensional (3D) mapping system in an operating room without DSA. Patients were enrolled according to the type of arrhythmia. The Carto 3 mapping system was used to reconstruct heart models and guide the electrophysiologic examination, mapping, and ablation. The total procedure, reconstruction, electrophysiologic examination, and mapping times were recorded. Furthermore, immediate success rates and complications were also recorded. A total of 20 patients were enrolled, including 12 males. The average age was 51.3 ± 17.2 (19-76) years. Nine cases of atrioventricular nodal re-entrant tachycardia, 7 cases of frequent ventricular premature contractions, 3 cases of Wolff-Parkinson-White syndrome, and 1 case of typical atrial flutter were included. All arrhythmias were successfully ablated. The procedure time was 127.0 ± 21.0 (99-177) minutes, the reconstruction time was 6.5 ± 2.9 (3-14) minutes, the electrophysiologic study time was 10.4 ± 3.4 (6-20) minutes, and the mapping time was 11.7 ± 8.3 (3-36) minutes. No complications occurred. Radiofrequency ablation of arrhythmias without DSA is effective and feasible under the guidance of the Carto 3 mapping system. However, the electrophysiology physician must have sufficient experience, and related emergency measures must be present to ensure safety.

Atrial Arrhythmias and Their Implications for Space Flight - Introduction

NASA Technical Reports Server (NTRS)

Polk, J. D.; Barr, Y. R.; Bauer, P.; Hamilton, D. R.; Kerstman, E.; Tarver, B.

2010-01-01

This panel will discuss the implications of atrial arrhythmias in astronauts from a variety of perspectives; including historical data, current practices, and future challenges for exploration class missions. The panelists will present case histories, outline the evolution of current NASA medical standards for atrial arrhythmias, discuss the use of predictive tools, and consider potential challenges for current and future missions.

Inhibition of Angiotensin-II Production Increases Susceptibility to Acute Ischemia/Reperfusion Arrhythmia

PubMed Central

Taskin, Eylem; Tuncer, Kadir Ali; Guven, Celal; Kaya, Salih Tunc; Dursun, Nurcan

2016-01-01

Background Myocardial ischemia and reperfusion lead to impairment of electrolyte balance and, eventually, lethal arrhythmias. The aim of this study was to investigate the effects of pharmacological inhibition of angiotensin-II (Ang-II) production on heart tissue with ischemia-reperfusion damage, arrhythmia, and oxidative stress. Material/Methods Rats were divided into 4 groups: only ischemia/reperfusion (MI/R), captopril (CAP), aliskiren (AL), and CAP+AL. The drugs were given by gavage 30 min before anesthesia. Blood pressure and electrocardiography (ECG) were recorded during MI/R procedures. The heart tissue and plasma was kept so as to evaluate the total oxidant (TOS), antioxidant status (TAS), and creatine kinase-MB (CK-MB). Results Creatine kinase-MB was not different among the groups. Although TAS was not affected by inhibition of Ang-II production, TOS was significantly lower in the CAP and/or AL groups than in the MI/R group. Furthermore, oxidative stress index was significantly attenuated in the CAP and/or AL groups. Captopril significantly increased the duration of VT during ischemia; however, it did not have any effect on the incidence of arrhythmias. During reperfusion periods, aliskiren and its combinations with captopril significantly reduced the incidence of other types of arrhythmias. Captopril alone had no effect on the incidence of arrhythmias, but significantly increased arrhythmias score and durations of arrhythmias during reperfusion. MAP and heart rate did not show changes in any groups during ischemic and reperfusion periods. Conclusions Angiotensin-II production appears to be associated with elevated levels of reactive oxygen species, but Ang-II inhibitions increases arrhythmia, mainly by initiating ventricular ectopic beats. PMID:27889788

Organical residue and agriculture like energetic reservoir: Study of economic and environmental effects in electricity production from biomass in Venice county

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bertoni, G.; Tromboni, S.

1996-12-31

The study proposes, through a technical analysis of feasibility, the individulation of a concrete solution that allows an reduction of pollution`s fonts that they burden on the Venice`s basin. This area, for his particular formation and position, contains a strongs intrinsic brittleness that progressively gets worse because of organic nature environmental pollution. This particularly forms of pollution are provoked by the agricultural activity and by other economic activity. This study examine an alternative and integrated system to utilize organic material coming from livestock farming, urban communities and various production activities that gravitates on the Venice`s logoon. This research exploits anmore » innovative context where {open_quotes}waste implementation{close_quotes} by different methodologies is none of the most powerful means to defend the environment and to recuperate their potential energetical resources. In the present study we will try to transform the current concept of {open_quotes}eliminating and destroying{close_quotes} into a more progressive one where organic wastes take the role of raw material to be converted in energy. The loss of a high quantity of the potential energy that they present can be avoided by technologies and know-how, now available, by which we are able to transform such latent energy in alternative forms that can be directly utilized.« less

An international multicenter study comparing arrhythmia prevalence between the intracardiac lateral tunnel and the extracardiac conduit type of Fontan operations.

PubMed

Balaji, Seshadri; Daga, Ankana; Bradley, David J; Etheridge, Susan P; Law, Ian H; Batra, Anjan S; Sanatani, Shubayan; Singh, Anoop K; Gajewski, Kelly K; Tsao, Sabrina; Singh, Harinder R; Tisma-Dupanovic, Svjetlana; Tateno, Shigeru; Takamuro, Motoki; Nakajima, Hiromichi; Roos-Hesselink, Jolien W; Shah, Maully

2014-08-01

The study objective was to determine whether the extracardiac conduit Fontan confers an arrhythmia advantage over the intracardiac lateral tunnel Fontan. This multicenter study of 1271 patients compared bradyarrhythmia (defined as need for pacing) and tachyarrhythmia (defined as needing antiarrhythmic therapy) between 602 patients undergoing the intracardiac Fontan and 669 patients undergoing the extracardiac Fontan. The median age at the time of the Fontan procedure was 2.1 years (interquartile range, 1.6-3.2 years) for the intracardiac group and 3.0 years (interquartile range, 2.4-3.9) for the extracardiac group (P < .0001). The median follow-up was 9.2 years (interquartile range, 5-12.8) for the intracardiac group and 4.7 years (interquartile range, 2.8-7.7) for the extracardiac group (P < .0001). Early postoperative (<30 days) bradyarrhythmia occurred in 24 patients (4%) in the intracardiac group and 73 patients (11%) in the extracardiac group (P < .0001). Early postoperative (<30 days) tachyarrhythmia occurred in 32 patients (5%) in the intracardiac group and 53 patients (8%) in the extracardiac group (P = not significant). Late (>30 days) bradyarrhythmia occurred in 105 patients (18%) in the intracardiac group and 63 patients (9%) in the extracardiac group (P < .0001). Late (>30 days) tachyarrhythmia occurred in 58 patients (10%) in the intracardiac group and 23 patients (3%) in the extracardiac group (P < .0001). By multivariate analysis factoring time since surgery, more patients in the extracardiac group had early bradycardia (odds ratio, 2.9; 95% confidence interval, 1.8-4.6), with no difference in early tachycardia, late bradycardia, or late tachycardia. Overall arrhythmia burden is similar between the 2 groups, but the extracardiac Fontan group had a higher incidence of early bradyarrhythmias. There was no difference in the incidence of late tachyarrhythmias over time between the 2 operations. Therefore, the type of Fontan performed should

The Taming of the Jew: "The Merchant of Venice" Is No Laughing Matter

ERIC Educational Resources Information Center

Beck, Bernard

2005-01-01

A new movie version of Shakespeare's classic troubling comedy, "The Merchant of Venice" (Brokaw, Cowan, Navidi, Piette, & Radford, 2004), has appeared, bringing up an ancient issue of the possible bigotry of the greatest writer in the English language. Shakespeare's plays about minority characters in the Venetian Republic have caused more and more…

[Silent myocardial ischemia and exercise-induced arrhythmia detected by the exercise test in the total health promotion plan (THP)].

PubMed

Iwane, M; Shibe, Y; Itoh, K; Kinoshita, F; Kanagawa, Y; Kobayashi, M; Mugitani, K; Ohta, M; Ohata, H; Yoshikawa, A; Ikuta, Z; Nakamura, Y; Mohara, O

2001-03-01

We investigated the prevalence and characteristics of ischemic heart disease especially silent myocardial ischemia (SMI) and arrhythmia in need of careful observation in the exercise stress tests in the Total Health Promotion Plan (THP), which was conducted between 1994-96 for the purpose of measuring cardiopulmonary function. All workers (n = 4,918, 4,426 males) aged 18-60 yr old in an occupational field were studied. Exercise tests with an ergometer were performed by the LOPS protocol, in which the maximal workload was set up as a presumed 70-80% maximal oxygen intake, or STEP (original multistage protocol). ECG changes were evaluated with a CC5 lead. Two hundred and fifteen people refused the study because of a common cold, lumbago and so on. Of 4,703 subjects, 17 with abnormal rest ECG and 19 with probable anginal pain were excluded from the exercise tests. Of 4,667 who underwent the exercise test, 37 (0.79%) had ischemic ECG change, and 155 (3.32%) had striking arrhythmia. These 228 subjects then did a treadmill exercise test with Bruce protocol. Twenty-two (0.47% of 4,703) showed positive ECG change, 9 (0.19%) of 22 had abnormal findings on a 201Tl scan. 8 (0.17%) were diagnosed as SMI (Cohn I), in which the prevalence of hypertension, hyperlipidemia, diabetes mellitus, smoker and positive familial history of ischemic heart disease was greater than that of all subjects. In a 15-30 month follow up, none has developed cardiac accidents. Exercise-induced arrhythmia was detected in 11 (0.23%) subjects. Four were non-sustained ventricular tachycardia without any organic disease, 4 were ventricular arrhythmia based on cardiomyopathy detected by echocardiography, 2 were atrial fibrillation and another was WPW syndrome. It is therefore likely that the ergometer exercise test in THP was effective in preventing sudden death caused by ischemic heart disease or striking arrhythmia.

Masterplan to safeguard Venice and to restore the lagoon and conterminous areas

NASA Astrophysics Data System (ADS)

Bini, Claudio; Gallo, Alba; Nadimi-Goki, Mandana; Wahsha, Mohammad

2015-04-01

Venice and its lagoon constitute a complex system, well known all over the world for the peculiarity of the town and for the fragility of the lagoon ecosystem with its delicate equilibrium. The whole system has been, and is currently, affected by human activities (industry, agriculture, settlements, tourism) that impact severely the ecosystem. Discharge from the agricultural drainage basin affects particularly the area North of the city of Venice; the central and southern areas, instead, receive important pollutant inputs from the industrial zone of Porto Marghera since the early'50s. Additional sources of pollution are domestic sewage and waste disposal from the urban area, that is visited by more than 10M people every year. As a consequence of the increasing land contamination, significant amounts of contaminants (both organic and inorganic) are accumulated in soils of the borderline, in water and in lagoon sediments, which constitute a potential source of secondary pollution. Results of surveys carried out in recent years in the whole area show that contaminants concentration increased from the beginning of the industrial activities until the '90s, when Porto Marghera declined. Most of contaminants have concentrations above the background levels. The highest metal levels were found in an area between Porto Marghera and the city of Venice, where both industrial and urban sewage are discharged, provoking environmental and human health hazard. In order to safeguard the city of Venice, and to restore its lagoon and conterminous areas, a Master Plan of intervention has been developed since the early 2000s. The land currently interested by environmental analysis and/or restoration covers approximately 1350ha; 78% of these (1100ha) proved variously contaminated, with 85% of sites overcoming the National Reference Values. Contamination, besides being diffused, is quite complex, involving the co-existence of several contaminant families (PAH, PCB, dioxin, heavy metals

Atrial Arrhythmias in Astronauts - Summary of a NASA Summit

NASA Technical Reports Server (NTRS)

Barr, Yael R.; Watkins, Sharmila D.; Polk, J. D.

2010-01-01

Background and Problem Definition: To evaluate NASA s current standards and practices related to atrial arrhythmias in astronauts, Space Medicine s Advanced Projects Section at the Johnson Space Center was tasked with organizing a summit to discuss the approach to atrial arrhythmias in the astronaut cohort. Since 1959, 11 cases of atrial fibrillation, atrial flutter, or supraventricular tachycardia have been recorded among active corps crewmembers. Most of the cases were paroxysmal, although a few were sustained. While most of the affected crewmembers were asymptomatic, those slated for long-duration space flight underwent radiofrequency ablation treatment to prevent further episodes of the arrhythmia. The summit was convened to solicit expert opinion on screening, diagnosis, and treatment options, to identify gaps in knowledge, and to propose relevant research initiatives. Summit Meeting Objectives: The Atrial Arrhythmia Summit brought together a panel of six cardiologists, including nationally and internationally renowned leaders in cardiac electrophysiology, exercise physiology, and space flight cardiovascular physiology. The primary objectives of the summit discussions were to evaluate cases of atrial arrhythmia in the astronaut population, to understand the factors that may predispose an individual to this condition, to understand NASA s current capabilities for screening, diagnosis, and treatment, to discuss the risks associated with treatment of crewmembers assigned to long-duration missions or extravehicular activities, and to discuss recommendations for prevention or management of future cases. Summary of Recommendations: The summit panel s recommendations were grouped into seven categories: Epidemiology, Screening, Standards and Selection, Treatment of Atrial Fibrillation Manifesting Preflight, Atrial Fibrillation during Flight, Prevention of Atrial Fibrillation, and Future Research

Capture of activation during ventricular arrhythmia using distributed stimulation.

PubMed

Meunier, Jason M; Ramalingam, Sanjiv; Lin, Shien-Fong; Patwardhan, Abhijit R

2007-04-01

Results of previous studies suggest that pacing strength stimuli can capture activation during ventricular arrhythmia locally near pacing sites. The existence of spatio-temporal distribution of excitable gap during arrhythmia suggests that multiple and timed stimuli delivered over a region may permit capture over larger areas. Our objective in this study was to evaluate the efficacy of using spatially distributed pacing (DP) to capture activation during ventricular arrhythmia. Data were obtained from rabbit hearts which were placed against a lattice of parallel wires through which biphasic pacing stimuli were delivered. Electrical activity was recorded optically. Pacing stimuli were delivered in sequence through the parallel wires starting with the wire closest to the apex and ending with one closest to the base. Inter-stimulus delay was based on conduction velocity. Time-frequency analysis of optical signals was used to determine variability in activation. A decrease in standard deviation of dominant frequencies of activation from a grid of locations that spanned the captured area and a concurrence with paced frequency were used as an index of capture. Results from five animals showed that the average standard deviation decreased from 0.81 Hz during arrhythmia to 0.66 Hz during DP at pacing cycle length of 125 ms (p = 0.03) reflecting decreased spatio-temporal variability in activation during DP. Results of time-frequency analysis during these pacing trials showed agreement between activation and paced frequencies. These results show that spatially distributed and timed stimulation can be used to modify and capture activation during ventricular arrhythmia.

Feline arrhythmias: an update.

PubMed

Côté, Etienne

2010-07-01

In the cat, electrocardiography is indicated for assessing the rhythm of the heartbeat and identifying and monitoring the effect of certain systemic disorders on the heart. Basic information regarding feline electrocardiography is contained in several textbooks, and the reader is referred to these sources for background reading. This article describes selected clinical advances in feline cardiac arrhythmias and electrocardiography from the past decade.

Biologically-controlled multiple equilibria of tidal landforms and the fate of the Venice lagoon

NASA Astrophysics Data System (ADS)

Marani, Marco; D'Alpaos, Andrea; Lanzoni, Stefano; Carniello, Luca; Rinaldo, Andrea

2007-06-01

Looking across a tidal landscape, can one foresee the signs of impending shifts among different geomorphological structures? This is a question of paramount importance considering the ecological, cultural and socio-economic relevance of tidal environments and their worldwide decline. In this Letter we argue affirmatively by introducing a model of the coupled tidal physical and biological processes. Multiple equilibria, and transitions among them, appear in the evolutionary dynamics of tidal landforms. Vegetation type, disturbances of the benthic biofilm, sediment availability and marine transgressions or regressions drive the bio-geomorphic evolution of the system. Our approach provides general quantitative routes to model the fate of tidal landforms, which we illustrate in the case of the Venice lagoon (Italy), for which a large body of empirical observations exists spanning at least five centuries. Such observations are reproduced by the model, which also predicts that salt marshes in the Venice lagoon may not survive climatic changes in the next century if IPCC's scenarios of high relative sea level rise occur.

Increased Short-Term Variability of the QT Interval in Professional Soccer Players: Possible Implications for Arrhythmia Prediction

PubMed Central

Lengyel, Csaba; Orosz, Andrea; Hegyi, Péter; Komka, Zsolt; Udvardy, Anna; Bosnyák, Edit; Trájer, Emese; Pavlik, Gábor; Tóth, Miklós; Wittmann, Tibor; Papp, Julius Gy.; Varró, András; Baczkó, István

2011-01-01

Background Sudden cardiac death in competitive athletes is rare but it is significantly more frequent than in the normal population. The exact cause is seldom established and is mostly attributed to ventricular fibrillation. Myocardial hypertrophy and slow heart rate, both characteristic changes in top athletes in response to physical conditioning, could be associated with increased propensity for ventricular arrhythmias. We investigated conventional ECG parameters and temporal short-term beat-to-beat variability of repolarization (STVQT), a presumptive novel parameter for arrhythmia prediction, in professional soccer players. Methods Five-minute 12-lead electrocardiograms were recorded from professional soccer players (n = 76, all males, age 22.0±0.61 years) and age-matched healthy volunteers who do not participate in competitive sports (n = 76, all males, age 22.0±0.54 years). The ECGs were digitized and evaluated off-line. The temporal instability of beat-to-beat heart rate and repolarization were characterized by the calculation of short-term variability of the RR and QT intervals. Results Heart rate was significantly lower in professional soccer players at rest (61±1.2 vs. 72±1.5/min in controls). The QT interval was prolonged in players at rest (419±3.1 vs. 390±3.6 in controls, p<0.001). QTc was significantly longer in players compared to controls calculated with Fridericia and Hodges correction formulas. Importantly, STVQT was significantly higher in players both at rest and immediately after the game compared to controls (4.8±0.14 and 4.3±0.14 vs. 3.5±0.10 ms, both p<0.001, respectively). Conclusions STVQT is significantly higher in professional soccer players compared to age-matched controls, however, further studies are needed to relate this finding to increased arrhythmia propensity in this population. PMID:21526208

The evolution of the Lagoon of Venice as a paradigm of anthropogenic alteration of ecosystems: a palaeoenvironmental reconstruction through wide-area acoustic surveys and core sampling

NASA Astrophysics Data System (ADS)

Madricardo, Fantina; Donnici, Sandra

2013-04-01

The Lagoon of Venice (Italy) is the unique result of natural and anthropogenic changes. Through the centuries, human activities, steadily modified its environment, bringing it to the point that the Lagoon of Venice is itself a signature of human activities. Moreover, the historical city of Venice, a world heritage site, is threatened by flooding caused by sea level rises, so much so that major modifications of the lagoon inlets are ongoing in order to protect it. For these reasons, the Lagoon of Venice is at the same time a paradigm of a relatively circumscribed ecosystem in which the Anthropocene has started long ago, and a sensitive testbed of the environmental changes that are taking place at the global level. In this context, a large geophysical survey was carried out to explore the Holocene sediments in order to establish the natural evolution of the lagoon and the impact of human activities. The survey is the basis of an interdisciplinary study that has allowed the reconstruction of ancient landscapes of the lagoon from before its origin to present days. In particular, thanks to acoustic and geologic investigation of the lagoon sub-bottom, and by crossing our data with the environmental records provided by archaeological findings and by the city's historical archives, we could distinguish different phases of the lagoon evolution and evaluate the weight of human-induced changes We first mapped the position and the depth of the alluvial plain that was flooded during the last marine transgression, about 6000 years before present (BP), when the lagoon originated. Then, we mapped the areal extension of a dense network of palaeochannels and palaeosurfaces corresponding to different hydrological conditions and relative mean sea levels. Using many radiocarbon dating and the acoustical sub-bottom reconstruction, we could establish an average sedimentation rate of about 1 mm/year from 2500 and 1500 BP and 0.5 mm/year from 1500 BP up to present and an average migration

Nandrolone Plus Moderate Exercise Increases the Susceptibility to Lethal Arrhythmias

PubMed Central

Ghorbani Baravati, Hamideh; Joukar, Siyavash; Fathpour, Hossein; Kordestani, Zeinab

2015-01-01

Background: Until now, no experimental study has directly assessed the arrhythmogenesis of chronic consumption of anabolic androgenic steroids along with moderate-intensity endurance exercise. Objectives: We evaluated the influence of integration of anabolic androgenic steroids along with moderate-intensity endurance exercise on susceptibility to lethal ventricular arrhythmias in rat. Materials and Methods: The animal groups were as follows: control group (CTL); exercise group (EX) which were under 6 weeks of treadmill exercise; nandrolone group (Nan) which received 5 mg/kg of nandrolone decanoate twice a week; vehicle group (Arach) which received Arachis oil (solvent of nandrolone); trained vehicle group (Arach + Ex); and trained nandrolone group (Nan + Ex). One day after ending of the intervention period, arrhythmia was inducted by intravenous infusion of aconitine and ventricular arrhythmias were recorded. Then malondialdehyde (MDA) and glutathione peroxidase (GPX) of heart tissue were measured. Results: Nandrolone, exercise, and their combination were associated with heart hypertrophy. Exercise could prevent the incremental effect of nandrolone on MDA/GPX ratio. Chronic administration of nandrolone with moderate-intensity endurance exercise had no significant effect on blood pressure, heart rate, and basal electrocardiographic parameters. Combination of nandrolone and exercise significantly increased the incidence of ventricular fibrillation (VF) and reduced the VF latency (P < 0.05). Conclusions: The findings suggest that chronic coadministration of nandrolone with moderate-intensity endurance exercise facilitates the VF occurrence in rat. Complementary studies are needed to elucidate the involved mechanisms of this abnormality. PMID:26396972

Time trend of butyl- and phenyl-tin contamination in organisms of the Lagoon of Venice (1999-2003).

PubMed

Zanon, F; Rado, N; Centanni, E; Zharova, N; Pavoni, B

2009-05-01

In the period 1999-2003 a monitoring study on the accumulation of organotin compounds in edible organisms in the Lagoon of Venice was conducted. Butyl and Phenyl derivatives were determined in pooled samples of Mytilus galloprovincialis and Tapes spp. with the aims of assessing organotin contamination in the Lagoon of Venice in the period just preceding their ban in Europe, monitoring the concentrations in organisms with a high commercial use, evaluating a potential hazard for human health due to seafood and identifying the possible contamination sources. Sampling stations (up to 20) were distributed around the Lagoon and particularly concentrated in the area close to the town of Chioggia. Significantly higher (analysis of variance (ANOVA), p < 0.05) tributyltin (TBT) concentrations were found in mussels (from 38 +/- 8 to 6,666 +/- 1,333 microg kg(-1) d.w., as TBT(+)), than in clams (from 6 +/- 1 to 2,256 +/- 451 microg kg(-1) d.w., as TBT(+)). During the 3 years of the survey no increase in average concentrations of the butyltin compounds (tributyltin (TBT) + dibutyltin (DBT) + monobutyltin (MBT)) was observed (ANOVA, p > 0.05) in either species. Furthermore, by analyzing the entire data set, it is evident that most stations show analogous concentrations in the 3 years for both species, whereas few have anomalously higher concentrations. If organotin concentrations in specimens from some sites are compared with the Tolerable Average Residue Level, a possible risk for human health must be considered.

Biomarker responses and contamination levels in the clam Ruditapes philippinarum for biomonitoring the Lagoon of Venice (Italy).

PubMed

Matozzo, Valerio; Binelli, Andrea; Parolini, Marco; Locatello, Lisa; Marin, Maria Gabriella

2010-03-01

A multibiomarker approach was used to assess effects of environmental contaminants in the clam Ruditapes philippinarum from the Lagoon of Venice. Bivalves were collected in 8 sites of the Lagoon (Campalto, Marghera, Palude del Monte, Valle di Brenta, Cà Roman, San Servolo, Fusina and Canale Dese), differently influenced by both anthropogenic impact and natural conditions. The following biomarkers were chosen: total haemocyte count and lysozyme activity in cell-free haemolymph as immunomarkers, acetylcholinesterase activity in gills as a biomarker of exposure to neurotoxic compounds, vitellogenin-like protein levels in both digestive gland and cell-free haemolymph as a biomarker of exposure to estrogenic compounds, and survival-in-air widely used to evaluate general stress conditions in clams. In addition, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), 1,1,1-Trichloro-2,2-bis(p-chlorophenyl)ethane (p,p'-DDT) and its breakdown products (DDE, DDD), hexachlorobenzene (HCB) and hexachlorocyclohexane (HCH) were measured in clams. Results demonstrated that the integrated approach between biomarkers and chemical analyses in R. philippinarum is a useful tool in biomonitoring the Lagoon of Venice. The biomarker responses suggested quite similar contamination levels in the entire Lagoon, although the relative impact of differing classes of pollutants changed among sites according to potential sources, as chemical analyses demonstrated. Overall, among the sampling sites investigated, Palude del Monte can represent an environmental risk area, bearing in mind its peculiar use for clam culture.

Iron does not cause arrhythmias in the guinea pig model of transfusional iron overload.

PubMed

Kaiser, Lana; Davis, John; Patterson, Jon; Boyd, Ryan F; Olivier, N Bari; Bohart, George; Schwartz, Kenneth A

2007-08-01

Cardiac events, including heart failure and arrhythmias, are the leading cause of death in patients with beta thalassemia. Although cardiac arrhythmias in humans are believed to result from iron overload, excluding confounding factors in the human population is difficult. The goal of the current study was to determine whether cardiac arrhythmias occurred in the guinea pig model of secondary iron overload. Electrocardiograms were recorded by using surgically implanted telemetry devices in guinea pigs loaded intraperitoneally with iron dextran (test animals) or dextran alone (controls). Loading occurred over approximately 6 wk. Electrocardiograms were recorded for 1 wk prior to loading, throughout loading, and for approximately 4 wk after loading was complete. Cardiac and liver iron concentrations were significantly increased in the iron-loaded animals compared with controls and were in the range of those reported for humans with thalassemia. Arrhythmias were rare in both iron-loaded and control guinea pigs. No life-threatening arrhythmias were detected in either group. These data suggest that iron alone may be insufficient to cause cardiac arrhythmias in the iron-loaded guinea pig model and that arrhythmias detected in human patients with iron overload may be the result of a complex interplay of factors.

Floating call boys and agile homosexuals: homophobia/Venice/history.

PubMed

Champagne, John

2014-01-01

Because works of nonfiction are always composed of literary tropes and metaphors, they have to be read critically for the ways in which their truth claims are potentially structured by ideologies and stereotypes. This essay reads passages from Richard Sennett's sociological analysis Flesh and Stone, The Body and the City in Western Civilization and Joseph Brodsky's memoir Watermark in order to demonstrate how these alleged works of nonfiction shore up some dishearteningly familiar literary stereotypes of male homosexuality and participate in a tradition, dating from the 19th century, of linking the city of Venice with homosexuality and death.

Research and development of the device for diagnostics of arrhythmia

NASA Astrophysics Data System (ADS)

Lezhnina, I. A.; Boyakhchyan, A. A.; Overchuk, K. V.; Uvarov, A. A.

2017-08-01

The article describes the results of the research for sensors optimal arrangement during one limb ECG detection. The found placement provides the registration of the enough quality signal sufficient for the diagnosis of arrhythmia, the QRS complex is clearly recognized. Authors also show the test results of the device developed for the diagnosis of arrhythmia and sudden cardiac death.

Severe Hypoglycemia–Induced Lethal Cardiac Arrhythmias Are Mediated by Sympathoadrenal Activation

PubMed Central

Reno, Candace M.; Daphna-Iken, Dorit; Chen, Y. Stefanie; VanderWeele, Jennifer; Jethi, Krishan; Fisher, Simon J.

2013-01-01

For people with insulin-treated diabetes, severe hypoglycemia can be lethal, though potential mechanisms involved are poorly understood. To investigate how severe hypoglycemia can be fatal, hyperinsulinemic, severe hypoglycemic (10–15 mg/dL) clamps were performed in Sprague-Dawley rats with simultaneous electrocardiogram monitoring. With goals of reducing hypoglycemia-induced mortality, the hypotheses tested were that: 1) antecedent glycemic control impacts mortality associated with severe hypoglycemia; 2) with limitation of hypokalemia, potassium supplementation could limit hypoglycemia-associated deaths; 3) with prevention of central neuroglycopenia, brain glucose infusion could prevent hypoglycemia-associated arrhythmias and deaths; and 4) with limitation of sympathoadrenal activation, adrenergic blockers could prevent hypoglycemia-induced arrhythmic deaths. Severe hypoglycemia–induced mortality was noted to be worsened by diabetes, but recurrent antecedent hypoglycemia markedly improved the ability to survive an episode of severe hypoglycemia. Potassium supplementation tended to reduce mortality. Severe hypoglycemia caused numerous cardiac arrhythmias including premature ventricular contractions, tachycardia, and high-degree heart block. Intracerebroventricular glucose infusion reduced severe hypoglycemia–induced arrhythmias and overall mortality. β-Adrenergic blockade markedly reduced cardiac arrhythmias and completely abrogated deaths due to severe hypoglycemia. Under conditions studied, sudden deaths caused by insulin-induced severe hypoglycemia were mediated by lethal cardiac arrhythmias triggered by brain neuroglycopenia and the marked sympathoadrenal response. PMID:23835337

Use of bipolar radiofrequency catheter ablation in treatment of cardiac arrhythmias.

PubMed

Soucek, Filip; Starek, Zdenek

2018-05-23

Background Arrhythmia management is a complex process involving both pharmacological and non-pharmacological approaches. Radiofrequency ablation is the pillar of non-pharmacological arrhythmia treatment. Unipolar ablation is considered to be the gold standard in the treatment of the majority of arrhythmias; however, its efficacy is limited to specific cases. In particular, the creation of deep or transmural lesions to eliminate intramurally originating arrhythmias remains inadequate. Bipolar ablation is proposed as an alternative to overcome unipolar ablation boundaries. Results Despite promising results gained from in vitro and animal studies showing that bipolar ablation is superior in creating transmural lesions, the use of bipolar ablation in daily clinical practice is limited. Several studies have been published showing that bipolar ablation is effective in the treatment of clinical arrhythmias after failed unipolar ablation, however there is inconsistency regarding safety of bipolar ablation within the available research papers. According to research evidence the most common indications for bipolar ablation use are ventricular originating rhythmic disorders in patients with structural heart disease resistant to standard radiofrequency ablation. Conclusions To allow wider clinical application the efficiency and safety of bipolar ablation need to be verified in future studies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Development and validation of a risk calculator predicting exercise-induced ventricular arrhythmia in patients with cardiovascular disease.

PubMed

Hermes, Ilarraza-Lomelí; Marianna, García-Saldivia; Jessica, Rojano-Castillo; Carlos, Barrera-Ramírez; Rafael, Chávez-Domínguez; María Dolores, Rius-Suárez; Pedro, Iturralde

2016-10-01

Mortality due to cardiovascular disease is often associated with ventricular arrhythmias. Nowadays, patients with cardiovascular disease are more encouraged to take part in physical training programs. Nevertheless, high-intensity exercise is associated to a higher risk for sudden death, even in apparently healthy people. During an exercise testing (ET), health care professionals provide patients, in a controlled scenario, an intense physiological stimulus that could precipitate cardiac arrhythmia in high risk individuals. There is still no clinical or statistical tool to predict this incidence. The aim of this study was to develop a statistical model to predict the incidence of exercise-induced potentially life-threatening ventricular arrhythmia (PLVA) during high intensity exercise. 6415 patients underwent a symptom-limited ET with a Balke ramp protocol. A multivariate logistic regression model where the primary outcome was PLVA was performed. Incidence of PLVA was 548 cases (8.5%). After a bivariate model, thirty one clinical or ergometric variables were statistically associated with PLVA and were included in the regression model. In the multivariate model, 13 of these variables were found to be statistically significant. A regression model (G) with a X(2) of 283.987 and a p<0.001, was constructed. Significant variables included: heart failure, antiarrhythmic drugs, myocardial lower-VD, age and use of digoxin, nitrates, among others. This study allows clinicians to identify patients at risk of ventricular tachycardia or couplets during exercise, and to take preventive measures or appropriate supervision. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Predictors of cardiac arrhythmias in patients with arterial hypertension during exercise stress testing].

PubMed

Kolesnik, M Iu; Sokolova, M V

2014-02-01

Arterial hypertension is an important risk factor for atrial and ventricular arrhythmias. 203 male patients were examined in order to identify predictors of cardiac arrhythmias in patients with arterial hypertension during exercise stress testing. All participants were studied by 24-hour ambulatory blood pressure monitoring, transthoracic echocardiography, an ultrasound scan of the carotid arteries and treadmill test. 47,3% of patients presented cardiac arrhythmias during exercise stress testing. The left ventricular mass, diastolic function and carotid intima-media thickness were found to be independent predictors of exercise-induced arrhythmias. The use of the exercise stress testing may be reasonable for additional risk stratification in hypertensive patients.

Venice Park landfill: Working with the community

DOE Office of Scientific and Technical Information (OSTI.GOV)

McAdams, C.L.

1993-09-01

Venice Park landfill was one of the first sites to be permitted under Michigan's proposed Public Act 641. PA 641 essentially changed the rules and regulations for landfills from the simple design of digging a hole and filling it. It also upgraded standards to those that are more sophisticated, including liners, leachate collection systems, and gas extraction systems. In 1992, methane gas from the landfill was collected into wells drilled into the trash varying in depth from 30-50 feet in depth. A vacuum pulls the gas from the trash into the wells, then through a piping system. The landfill usesmore » about 80-100 kilowatts in-house. The remainder of the gas is sold to Consumers Power Co. which uses landfill gas to supply power to homes.« less

The association of air temperature with cardiac arrhythmias

NASA Astrophysics Data System (ADS)

Čulić, Viktor

2017-11-01

The body response to meteorological influences may activate pathophysiological mechanisms facilitating the occurrence of cardiac arrhythmias in susceptible patients. Putative underlying mechanisms include changes in systemic vascular resistance and blood pressure, as well as a network of proinflammatory and procoagulant processes. Such a chain reaction probably occurs within the time window of several hours, so use of daily average values of meteorological elements do not seem appropriate for investigation in this area. In addition, overall synoptic situation, and season-specific combinations of meteorological elements and air pollutant levels probably cause the overall effect rather than a single atmospheric element. Particularly strong interrelations have been described among wind speed, air pressure and temperature, relative air humidity, and suspended particulate matter. This may be the main reason why studies examining the association between temperature and ventricular arrhythmias have found linear positive, negative, J-shaped or no association. Further understanding of the pathophysiological adaptation to atmospheric environment may help in providing recommendations for protective measures during "bad" weather conditions in patients with cardiac arrhythmias.

Clam bioaccumulation of Alkylphenols and Polyciclic aromatic hydrocarbons in the Venice lagoon under different pressures.

PubMed

Ademollo, N; Patrolecco, L; Matozzo, V; Marin, M G; Valsecchi, S; Polesello, S

2017-11-15

Biota-Sediment Accumulation Factors (BSAFs) of nonylphenols (NPs) and polycyclic aromatic hydrocarbons (PAHs) in Ruditapes philippinarum from the Venice Lagoon (Italy) were determined with the aim to verify whether the routine biomonitoring studies are reliable in contaminated sites. Clams and sediments were collected in field campaigns (October 2003 to June 2004) in three sites of the Venice Lagoon. Results showed that Marghera and Campalto sediments were more contaminated by NPs and PAHs than Poveglia. Different trends were observed in the contamination of clams with the highest BSAFs found at Poveglia. BSAF trend appeared to be inversely related to the contaminant pressure on the sites. These results suggest that clam bioaccumulation is not always representative of the chemical pressure on aquatic biota. The direct correlation between sediment and biota concentrations in contaminated sites can be lost as a function of the site-specific conditions such as sediment toxicity and food availability. Copyright © 2017 Elsevier Ltd. All rights reserved.

Radar-driven high-resolution hydro-meteorological forecasts of the 26 September 2007 Venice flash flood

NASA Astrophysics Data System (ADS)

Rossa, Andrea M.; Laudanna Del Guerra, Franco; Borga, Marco; Zanon, Francesco; Settin, Tommaso; Leuenberger, Daniel

2010-11-01

SummaryThis study aims to assess the feasibility of assimilating carefully checked radar rainfall estimates into a numerical weather prediction (NWP) to extend the forecasting lead time for an extreme flash flood. The hydro-meteorological modeling chain includes the convection-permitting NWP model COSMO-2 and a coupled hydrological-hydraulic model. Radar rainfall estimates are assimilated into the NWP model via the latent heat nudging method. The study is focused on 26 September 2007 extreme flash flood which impacted the coastal area of North-eastern Italy around Venice. The hydro-meteorological modeling system is implemented over the 90 km2 Dese river basin draining to the Venice Lagoon. The radar rainfall observations are carefully checked for artifacts, including rain-induced signal attenuation, by means of physics-based correction procedures and comparison with a dense network of raingauges. The impact of the radar rainfall estimates in the assimilation cycle of the NWP model is very significant. The main individual organized convective systems are successfully introduced into the model state, both in terms of timing and localization. Also, high-intensity incorrectly localized precipitation is correctly reduced to about the observed levels. On the other hand, the highest rainfall intensities computed after assimilation underestimate the observed values by 20% and 50% at a scale of 20 km and 5 km, respectively. The positive impact of assimilating radar rainfall estimates is carried over into the free forecast for about 2-5 h, depending on when the forecast was started. The positive impact is larger when the main mesoscale convective system is present in the initial conditions. The improvements in the precipitation forecasts are propagated to the river flow simulations, with an extension of the forecasting lead time up to 3 h.

Effect of different doses of oxytocin on cardiac electrophysiology and arrhythmias induced by ischemia.

PubMed

Houshmand, Fariba; Faghihi, Mahdieh; Imani, Alireza; Kheiri, Soleiman

2017-01-01

The onset of acute myocardial ischemia (MI) is accompanied by a rapid increase in electrical instability and often fatal ventricular arrhythmias. This study investigated that whether oxytocin (OT) can modulate ischemia-induced arrhythmias and considered relationships between the severity of arrhythmia and the electrocardiogram parameters during ischemia. OT (0.0001-1 μg) was administrated intraperitoneally 30 min before ischemia. To examine receptor involved, a selective OT-receptor antagonist, atosiban (ATO), was infused 10 min before OT. OT caused a significant and biphasic dose-dependent reduction in ectopic heart activity and arrhythmia score. OT doses that reduced ventricular arrhythmia elicited significant increase in QT interval. OT attenuated the electrophysiological changes associated with MI and there was significant direct relationship between QRS duration and arrhythmia score. ATO treatment reduced beneficial effects of OT on arrhythmogenesis. Nevertheless, ATO failed to alter OT effects on premature ventricular contractions. We assume that the ability of OT to modulate the electrical activity of the heart may play an important role in the antiarrhythmic actions of OT.

Effect of different doses of oxytocin on cardiac electrophysiology and arrhythmias induced by ischemia

PubMed Central

Houshmand, Fariba; Faghihi, Mahdieh; Imani, Alireza; Kheiri, Soleiman

2017-01-01

The onset of acute myocardial ischemia (MI) is accompanied by a rapid increase in electrical instability and often fatal ventricular arrhythmias. This study investigated that whether oxytocin (OT) can modulate ischemia-induced arrhythmias and considered relationships between the severity of arrhythmia and the electrocardiogram parameters during ischemia. OT (0.0001–1 μg) was administrated intraperitoneally 30 min before ischemia. To examine receptor involved, a selective OT-receptor antagonist, atosiban (ATO), was infused 10 min before OT. OT caused a significant and biphasic dose-dependent reduction in ectopic heart activity and arrhythmia score. OT doses that reduced ventricular arrhythmia elicited significant increase in QT interval. OT attenuated the electrophysiological changes associated with MI and there was significant direct relationship between QRS duration and arrhythmia score. ATO treatment reduced beneficial effects of OT on arrhythmogenesis. Nevertheless, ATO failed to alter OT effects on premature ventricular contractions. We assume that the ability of OT to modulate the electrical activity of the heart may play an important role in the antiarrhythmic actions of OT. PMID:29184844

Geophysical techniques in the historical center of Venice (Italy): preliminary results from HVSR and multichannel analysis of surface waves

NASA Astrophysics Data System (ADS)

Trevisani, Sebastiano; Rocca, Michele; Boaga, Jacopo

2014-05-01

This presentation aims to outline the preliminary findings related to an extensive seismic survey conducted in the historical center of Venice, Italy. The survey was conducted via noninvasive and low-cost seismic techniques based on surface waves analysis and microtremor methods, mainly using single station horizontal to vertical spectral ratio techninques (HVSR) and multichannel analysis of surface waves in passive (ReMI) and active (MASW) configurations. The importance and the fragility of the cultural heritage of Venice, coupled with its peculiar geological and geotechnical characteristics, stress the importance of a good knowledge of its geological architecture and seismic characteristics as an opportunity to improve restoration and conservation planning. Even if Venice is located in a relatively low seismic hazard zone, a local characterization of soil resonance frequencies and surficial shear waves velocities could improve the planning of engineering interventions, furnishing important information on possible local effects related to seismic amplification and possible coupling within buildings and soil resonance frequencies. In the specific we collected more than 50 HVSR single station noise measurements and several passive and active multichannel analysis of surface waves located in the historical center. In this work we report the characteristics of the conducted seismic surveys (instrumentation, sampling geometry, etc.) and the preliminary findings of our analysis. Moreover, we discuss briefly the practical issues, mainly of logistic nature, of conducting this kind of surveys in a peculiar and crowed historical center as represented by Venice urban contest. Acknowledgments Instrumentation acquired in relation to the project co-financed by Regione Veneto, POR-CRO, FESR, 2007-2013, action 1.1.1. "Supporto ad attività di ricerca, processi e reti di innovazione e alla creazione di imprese in settori a elevato contenuto tecnologico"

Worldwide surplus of LP-gases to grow, expert tells European meet in Venice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1988-07-01

There appears to be a growing consensus among students of the LP-gas industry that (1) the worldwide surplus of supplies of LP-gases will continue and grow, and (2) this will provide ample opportunity for market development between now and the year 2000, but (3) that development will be largely in the field of petro-chemical feedstocks, although (4) if the price should not remain competitive with feedstocks such as naphtha, the surpluses could find their way into the U.S., if (5) the price is right. This viewpoint was set forth for the benefit of the delegates to the convention May 19-20more » of the European LP-Gas Association in Venice, Italy, by Rick Haun, vice president of Purvin and Gertz, the Dallas consulting firm.« less

Understanding "The Merchant of Venice": A Student Casebook to Issues, Sources, and Historical Documents.

ERIC Educational Resources Information Center

Halio, Jay L.

"The Merchant of Venice," even in its own time, was considered William Shakespeare's most controversial play. Now, one of the most popular read and performed works, the play raises even more important issues for today, particularly anti-Semitism and the treatment of Jews. The analysis of the play in this casebook helps students interpret…

Living on a knife edge-the daily struggle of coping with symptomatic cardiac arrhythmias.

PubMed

Withers, Kathleen L; Wood, Kathryn A; Carolan-Rees, Grace; Patrick, Hannah; Lencioni, Mauro; Griffith, Michael

2015-06-24

In 2010 a retrospective audit was undertaken to assess the viability of using PROMs in patients with symptomatic cardiac arrhythmias having undergone percutaneous arrhythmia ablation. A response rate of 74 % was achieved, with finding suggesting that arrhythmia patients reported a significant impact on their work, social and family life. To conduct a qualitative cross sectional survey to understand patients' perspectives of how cardiac arrhythmias affect their daily lives, as part of a program to develop a Patient Reported Outcome Measure (PROM). Twenty five patients aged 18 or over, diagnosed with a variety of symptomatic cardiac arrhythmias referred for a cardiac ablation procedure took part in cognitive interviews. These aimed to inform the development of a patient reported outcome measure and to determine factors important to this patient group. Common themes were identified using content analysis. Participants reported that symptoms of their arrhythmia caused them considerable problems and impacted adversely on their quality of life in many ways. This extended through daily routine, work and social activities and also to friends and family, with fear and anxiety being significant factors for most responders. Patients felt their illness was poorly understood, even by health professionals, and often reported that they felt isolated, lacking support and information. Symptomatic cardiac arrhythmias are a source of debilitating and life limiting symptoms, having a negative impact on quality of life. Symptoms and related complications are relevant across different arrhythmia substrates and patient groups. The study is registered on the Clinical Trials website, Identifier NCT01672528.

Pulmonary Vein Antral Isolation and Nonpulmonary Vein Trigger Ablation Are Sufficient to Achieve Favorable Long-Term Outcomes Including Transformation to Paroxysmal Arrhythmias in Patients With Persistent and Long-Standing Persistent Atrial Fibrillation.

PubMed

Liang, Jackson J; Elafros, Melissa A; Muser, Daniele; Pathak, Rajeev K; Santangeli, Pasquale; Zado, Erica S; Frankel, David S; Supple, Gregory E; Schaller, Robert D; Deo, Rajat; Garcia, Fermin C; Lin, David; Hutchinson, Mathew D; Riley, Michael P; Callans, David J; Marchlinski, Francis E; Dixit, Sanjay

2016-11-01

Transformation from persistent to paroxysmal atrial fibrillation (AF) after ablation suggests modification of the underlying substrate. We examined the nature of initial arrhythmia recurrence in patients with nonparoxysmal AF undergoing antral pulmonary vein isolation and nonpulmonary vein trigger ablation and correlated recurrence type with long-term ablation efficacy after the last procedure. Three hundred and seventeen consecutive patients with persistent (n=200) and long-standing persistent (n=117) AF undergoing first ablation were included. AF recurrence was defined as early (≤6 weeks) or late (>6 weeks after ablation) and paroxysmal (either spontaneous conversion or treated with cardioversion ≤7 days) or persistent (lasting >7 days). During median follow-up of 29.8 (interquartile range: 14.8-49.9) months, 221 patients had ≥1 recurrence. Initial recurrence was paroxysmal in 169 patients (76%) and persistent in 52 patients (24%). Patients experiencing paroxysmal (versus persistent) initial recurrence were more likely to achieve long-term freedom off antiarrhythmic drugs (hazard ratio, 2.2; 95% confidence interval, 1.5-3.2; P<0.0001), freedom on/off antiarrhythmic drugs (hazard ratio, 2.5; 95% confidence interval, 1.6-3.8; P<0.0001), and arrhythmia control (hazard ratio, 5.2; 95% confidence interval, 2.9-9.2; P<0.0001) after last ablation. In patients with persistent and long-standing persistent AF, limited ablation targeting pulmonary veins and documented nonpulmonary vein triggers improves the maintenance of sinus rhythm and reverses disease progression. Transformation to paroxysmal AF after initial ablation may be a step toward long-term freedom from recurrent arrhythmia. © 2016 American Heart Association, Inc.

The association of ambient temperature with incidence of cardiac arrhythmias in a short timescale

NASA Astrophysics Data System (ADS)

Kim, Jayeun; Kim, Ho

2017-11-01

The body response time and an association between the exposure to outdoor temperature and cardiac arrhythmia were not fully understood. Hence, we further investigated the association between ambient temperature and the exacerbations of arrhythmia symptoms on a short timescale using the emergency department (ED) visit data. We used a total of 17,088 arrhythmia-related ED visits in Seoul, from 2008 to 2011 and fitted the model adjusting for other meteorological variables and air pollutants under the case-crossover analysis with the same year-month time stratification. The association was presented as an odds ratio (OR) with a 95% confidence interval (CI) by a 5 °C decrease in the ambient temperature. The delay time (h) between exposure and the onset of arrhythmia exacerbation was considered with time blocks for every 3 h as 1-3 h, up to 118-120 h; and daily lags (1 day), from 25-48 h to 97-120 h, as a multi-time average of exposures. The overall association was increased at lag 4-6 h and the increased association was statistically significant at lag 40-42 h (OR 1.027, 95% CI 1.003-1.051) and the adverse association continued at 97-120 h (OR 1.053, 95% CI 1.027-1.080). However, the delay of several days between ambient temperature and body response should be further investigated considering the modification according to varied demographic characteristics or different environmental circumstances.

Characteristics and circadian distribution of cardiac arrhythmias in patients with heart failure and sleep-disordered breathing.

PubMed

Omran, Hazem; Bitter, Thomas; Horstkotte, Dieter; Oldenburg, Olaf; Fox, Henrik

2018-05-08

Cardiac arrhythmias and sleep-disordered breathing (SDB) are common comorbidities in heart failure with reduced ejection fraction (HFrEF). However, understanding of the association between arrhythmias and SDB is poor. This study assessed the occurrence and circadian distribution of ventricular arrhythmias in HFrEF patients with and without SDB. This retrospective analysis included HFrEF patients admitted for unattended overnight cardiorespiratory polygraphy and 24-h Holter-ECG recording. Holter-ECG data (events/h) were categorized by time of day: morning, 06:00-13:59; afternoon, 14:00-21:59; nighttime, 22:00-05:59. Respiratory events were expressed using the apnea-hypopnea index (AHI) and an AHI ≥ 15/h was categorized as moderate to severe SDB. 167 patients were included (82% male, age 65 ± 10.4 years, left ventricular ejection fraction 30.9 ± 7.9%); SDB was predominantly central sleep apnea (CSA) in 45.5%, obstructive sleep apnea (OSA) in 23.9% or none/mild (nmSDB) in 17.4%. Morning premature ventricular contractions (PVCs) were detected significantly more frequently in CSA versus nmSDB patients (44.4/h versus 1.8/h; p = 0.02). Non-sustained VT was more frequent in patients with CSA versus versus OSA or nmSDB (17.9 versus 3.2 or 3.2%/h; p = 0.003 and p = 0.005, respectively). There was no significant variation in VT occurrence by time of day in HFrEF patients with CSA (p = 0.3). CSA was an independent predictor of VT occurrence in HFrEF in multivariate logistic regression analysis (odds ratio 4.1, 95% confidence interval 1.5-11.4, p = 0.007). CSA was associated with VT occurrence irrespective of sleep/wake status in HFrEF patients, and independently predicted the occurrence of VT. This association may contribute to chances by which CSA increases sudden death risk in HFrEF patients.

Diagnosis and Treatment of Fetal Arrhythmia

PubMed Central

Wacker-Gussmann, Annette; Strasburger, Janette F.; Cuneo, Bettina F.; Wakai, Ronald T.

2014-01-01

Detection and careful stratification of fetal heart rate (FHR) is extremely important in all pregnancies. The most lethal cardiac rhythm disturbances occur during apparently normal pregnancies where FHR and rhythmare regular and within normal or low-normal ranges. These hidden depolarization and repolarization abnormalities, associated with genetic ion channelopathies cannot be detected by echocardiography, and may be responsible for up to 10% of unexplained fetal demise, prompting a need for newer and better fetal diagnostic techniques. Other manifest fetal arrhythmias such as premature beats, tachycardia, and bradycardia are commonly recognized. Heart rhythm diagnosis in obstetrical practice is usually made by M-mode and pulsed Doppler fetal echocardiography, but not all fetal cardiac time intervals are captured by echocardiographic methods. This article reviews different types of fetal arrhythmias, their presentation and treatment strategies, and gives an overview of the present and future diagnostic techniques. PMID:24858320

Five hundred years of specialty certification and compulsory continuing medical education. Venice 1300-1801.

PubMed

Ell, S R

1984-02-10

From 1300 to 1801, Venice required an early form of specialty certification for medical practice and the yearly attendance of refresher courses in anatomy by all licensed practitioners in the city. The latter requirement provoked ingenious evasions, which the Venetian government continually tried to overcome. This article describes the system and its implementation, based on Venetian archival documents.

BPC 157: The counteraction of succinylcholine, hyperkalemia, and arrhythmias.

PubMed

Stambolija, Vasilije; Stambolija, Tamara Perleta; Holjevac, Jadranka Katancic; Murselovic, Tamara; Radonic, Jelena; Duzel, Viktor; Duplancic, Bozidar; Uzun, Sandra; Zivanovic-Posilovic, Gordana; Kolenc, Danijela; Drmic, Domagoj; Romic, Zeljko; Seiwerth, Sven; Sikiric, Predrag

2016-06-15

After the demonstration of its life-saving effect in severe hyperkalemia and the recovery of skeletal muscle after injury, pentadecapeptide BPC 157 has been shown to attenuate the local paralytic effect induced by succinylcholine, in addition to systemic muscle disability (and consequent muscle damage). Hyperkalemia, arrhythmias and a rise in serum enzyme values, were counteracted in rats. Assessments were made at 3 and 30min and 1, 3, 5, and 7 days after succinylcholine administration (1.0mg/kg into the right anterior tibial muscle). BPC 157 (10µg/kg, 10ng/kg) (given intraperitoneally 30min before or immediately after succinylcholine or per-orally in drinking water through 24h until succinylcholine administration) mitigated both local and systemic disturbances. BPC 157 completely eliminated hyperkalemia and arrhythmias, markedly attenuated or erradicated behavioral agitation, muscle twitches, motionless resting and completely eliminated post-succinylcholine hyperalgesia. BPC 157 immediately eliminated leg contractures and counteracted both edema and the decrease in muscle fibers in the diaphragm and injected/non-injected anterior tibial muscles. Therefore, the depolarizing neuromuscular blocker effects of succinylcholine were successfully antagonized. Copyright © 2016 Elsevier B.V. All rights reserved.

Cardiac arrhythmias during aerobatic flight and its simulation on a centrifuge.

PubMed

Zawadzka-Bartczak, Ewelina K; Kopka, Lech H

2011-06-01

It is well known that accelerations during centrifuge training and during flight can provoke cardiac arrhythmias. Our study was designed to investigate both the similarities and differences between heart rhythm disturbances during flights and centrifuge tests. There were 40 asymptomatic, healthy pilots who performed two training flights and were also tested in a human centrifuge according to a program of rapid onset rate acceleration (ROR) and of centrifuge simulation of the actual acceleration experienced in flight (Simulation). During the flight and centrifuge tests ECG was monitored with the Holter method. ECG was examined for heart rhythm changes and disturbances. During flights, premature ventricular contractions (PVCs) were found in 25% of the subjects, premature supraventricular contractions (PSVCs) and PVCs with bigeminy in 5%, and pairs of PVCs in 2.5% of subjects. During the centrifuge tests, PVCs were experienced by 45% of the subjects, PSVCs and pairs of PVCs by 7.5%, and PVCs with bigeminy by 2.5%. Sinus bradycardia was observed during flights and centrifuge tests in 7.5% of subjects. Comparative evaluation of electrocardiographic records in military pilots during flights and centrifuge tests demonstrated that: 1) there were no clinically significant arrhythmias recorded; and 2) the frequency and kind of heart rhythm disturbances during aerobatic flight and its simulation on a centrifuge were not identical and did not occur repetitively in the same persons during equal phases of the tests.

Carbon monoxide and lethal arrhythmias. Research report, Jul 85-Jan 89

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farber, J.P.; Schwartz, P.J.; Vanoli, E.

1990-01-01

The effect of acute exposure to carbon monoxide on ventricular arrhythmias was studied in dogs with a healed anterior myocardial infarction. The combination of mild exercise and acute myocardial ischemia induces ventricular fibrillation in 60 percent of the animals. Dogs that develop ventricular fibrillation are considered at high risk for sudden death and are defined as susceptible; dogs that survive the test without fatal arrhythmia are considered at low risk and are defined as 'resistant.' The effects of carboxyhemoglobin levels ranging from 5 to 15 percent were tested in resistant and susceptible dogs. A trend toward higher heart rates wasmore » observed at rest and during exercise in both resistant and susceptible dogs at all levels of carboxyhemoglobin, although significant differences were observed only with 15 percent carboxyhemoglobin. In resistant animals, in which acute myocardial ischemia is typically associated with bradycardia even under the control condition, the reflex response occurred earlier and was augmented after exposure to carbon monoxide. In both resistant and susceptible dogs, carbon monoxide exposure induced a worsening of ventricular arrhythmias in a minority of cases. The worsening was not reproducible in subsequent trials. These data indicate that acute exposure to carbon monoxide is seldom arrhythmogenic in dogs that have survived myocardial infarction. Nevertheless, the observation that carbon monoxide exposure increases heart rate at rest and during moderate exercise may have clinical implications relevant to patients with coronary artery disease.« less

Inhalation of diluted diesel engine emission impacts heart rate variability and arrhythmia occurrence in a rat model of chronic ischemic heart failure.

PubMed

Anselme, Frédéric; Loriot, Stéphane; Henry, Jean-Paul; Dionnet, Frédéric; Napoleoni, Jean-Gérard; Thuillez, Christian; Morin, Jean-Paul

2007-04-01

Both increase in cardiac arrhythmia incidence and decrease in heart rate variability (HRV) have been described following human and experimental animal exposures to air pollutants. However, the potential causal relationship between these two factors remains unclear. Incidence of ventricular arrhythmia and HRV were evaluated during and after a 3 h period of Diesel engine exhaust exposure in ten healthy and ten chronic ischemic heart failure (CHF, 3 months after coronary ligation) Wistar rats using implantable ECG telemetry. Air pollutants were delivered to specifically designed whole body individual exposure chambers at particulate matter concentrations similar to those measured inside cabins of cars inserted in congested urban traffic. Recordings were obtained from unrestrained and unsedated vigil rats. Immediate decrease in RMSSD was observed in both healthy (6.64 +/- 2.62 vs. 4.89 +/- 1.67 ms, P < 0.05) and CHF rats (8.01 +/- 0.89 vs. 6.6 +/- 1.37 ms, P < 0.05) following exposure. An immediate 200-500% increase in ventricular premature beats was observed in CHF rats only. Whereas HRV progressively returned to baseline values within 2.5 h after exposure start, the proarrhythmic effect persisted as late as 5 h after exposure termination in CHF rats. Persistence of ventricular proarrhythmic effects after HRV normalization suggests that HRV reduction is not the mechanism of cardiac arrhythmias in this model. Our methodological approach, closely reflecting the real clinical situations, appeared to be a unique tool to provide further insight into the pathophysiological mechanisms of traffic related airborne pollution health impact.

Ventricular arrhythmias in the absence of structural heart disease.

PubMed

Prystowsky, Eric N; Padanilam, Benzy J; Joshi, Sandeep; Fogel, Richard I

2012-05-15

Ventricular arrhythmia (VA) in structurally normal hearts can be broadly considered under non-life-threatening monomorphic and life-threatening polymorphic rhythms. Monomorphic VA is classified on the basis of site of origin in the heart, and the most common areas are the ventricular outflow tracts and left ventricular fascicles. The morphology of the QRS complexes on electrocardiogram is an excellent tool to identify the site of origin of the rhythm. Although these arrhythmias are common and generally carry an excellent prognosis, rare sudden death events have been reported. Very frequent ventricular ectopy may also result in a cardiomyopathy in a minority of patients. Suppression of VA may be achieved using calcium-channel blockers, beta-adrenergic blockers, and class I or III antiarrhythmic drugs. Radiofrequency ablation has emerged as an excellent option to eliminate these arrhythmias, although certain foci including aortic cusps and epicardium may be technically challenging. Polymorphic ventricular tachycardia (VT) is rare and generally occurs in patients with genetic ion channel disorders including long QT syndrome, Brugada syndrome, catecholaminergic polymorphic VT, and short QT syndrome. Unlike monomorphic VT, these arrhythmic syndromes are associated with sudden death. While the cardiac gross morphology is normal, suggesting a structurally normal heart, abnormalities exist at the molecular level and predispose them to arrhythmias. Another fascinating area, idiopathic ventricular fibrillation and early repolarization syndrome, are undergoing research for a genetic basis. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Importance of the atrial channel for ventricular arrhythmia therapy in the dual chamber implantable cardioverter defibrillator.

PubMed

Dijkman, B; Wellens, H J

2000-12-01

Performance of dual chamber implantable cardioverter defibrillator (ICD) systems has been judged based on functioning of the ventricular tachycardia:supraventricular tachycardia (VT:SVT) discrimination criteria and DDD pacing. The purpose of this study was to evaluate the use of dual chamber diagnostics to improve the electrical and antiarrhythmic therapy of ventricular arrhythmias. Information about atrial and ventricular rhythm in relation to ventricular arrhythmia occurrence and therapy was evaluated in 724 spontaneous arrhythmia episodes detected and treated by three types of dual chamber ICDs in 41 patients with structural heart disease. Device programming was based on clinically documented and induced ventricular arrhythmias. In ambulatory patients, sinus tachycardia preceded ventricular arrhythmias more often than in the hospital during exercise testing. The incidence of these VTs could be reduced by increasing the dose of a beta-blocking agent in only two patients. In five patients in whom sinus tachycardia developed after onset of hemodynamic stable VT, propranolol was more effective than Class III antiarrhythmics combined with another beta-blocking agent with regard to the incidence of VT and pace termination. In all but three cases, atrial arrhythmias were present for a longer time before the onset of ventricular arrhythmias. During atrial arrhythmias, fast ventricular rates before the onset of ventricular rate were observed more often than RR irregularities and short-long RR sequences. Dual chamber diagnostics allowed proper interpretation of detection and therapy outcome in patients with different types of ventricular arrhythmia. The advantages of the dual chamber ICD system go further than avoiding the shortcomings of the single chamber system. Information from the atrial chamber allows better device programming and individualization of drug therapy for ventricular arrhythmia.

Trajectories of Children's Internalizing Symptoms: The Role of Maternal Internalizing Symptoms, Respiratory Sinus Arrhythmia and Child Sex

ERIC Educational Resources Information Center

Wetter, Emily K.; El-Sheikh, Mona

2012-01-01

Background: We assessed trajectories of children's internalizing symptoms as predicted by interactions among maternal internalizing symptoms, respiratory sinus arrhythmia (RSA) and child sex. Method: An ethnically and socioeconomically diverse sample of children (n = 251) participated during three study waves. Children's mean ages were 8.23 years…

Protective effects of isorhynchophylline on cardiac arrhythmias in rats and guinea pigs.

PubMed

Gan, Runtao; Dong, Guo; Yu, Jiangbo; Wang, Xu; Fu, Songbin; Yang, Shusen

2011-09-01

As one important constituent extracted from a traditional Chinese medicine, Uncaria Rhynchophylla Miq Jacks, isorhynchophylline has been used to treat hypertension, epilepsy, headache, and other illnesses. Whether isorhynchophylline protects hearts against cardiac arrhythmias is still incompletely investigated. This study was therefore aimed to examine the preventive effects of isorhynchophylline on heart arrhythmias in guinea pigs and rats and then explore their electrophysiological mechanisms. In vivo, ouabain and calcium chloride were used to establish experimental arrhythmic models in guinea pigs and rats. In vitro, the whole-cell patch-lamp technique was used to study the effect of isorhynchophylline on action potential duration and calcium channels in acutely isolated guinea pig and rat cardiomyocytes. The dose of ouabain required to induce cardiac arrhythmias was much larger in guinea pigs administered with isorhynchophylline. Additionally, the onset time of cardiac arrhythmias induced by calcium chloride was prolonged, and the duration was shortened in rats pretreated with isorhynchophylline. The further study showed that isorhynchophylline could significantly decrease action potential duration and inhibit calcium currents in isolated guinea pig and rat cardiomyocytes in a dose-dependent manner. In summary, isorhynchophylline played a remarkably preventive role in cardiac arrhythmias through the inhibition of calcium currents in rats and guinea pigs. © Georg Thieme Verlag KG Stuttgart · New York.

The Lido as Venice's refuse tip: Dalmatian sheep and the 1819 elephant.

PubMed

Giormani, Virgilio

2004-01-01

The Lido of Venice is an island twelve kilometers long and between a hundred and one thousand meters wide. The citizans of Venice and many turists can't imagine today, what Lido was some centuries ago Initially totally sandy, it was fertilized by means of a continuous supply of Venice's garbage (the "scoasse"). In addition to the "scoasse", damaged foodstuffs and the waste of the vegetable market were also sent to the Lido. Other fertilisers originated from the dung of the cattle and sheep arriving by ship from Dalmatia, which were landed on the Lido, where they could pasture before slaughter to regain weight lost during their voyage. The sheep dung, especially, was important for the proto-industrial production of saltpetre, a material of the greatest strategic importance, like uranium at the present time. Saltpetre is the most important component of gun powder, which was the only explosive known up to the second half of 19th century. There were plans to establish an "artificial nitriary" in the Lido, making use of the garbage and of the animal waste. In all probability, the most bulky item ever buried in the Lido is the corpse of an enraged elephant, which escaped from its cage on the Riva degli Schiavoni where it was performing during the 1819 carnival, and was killed by a cannon shot in a church where it took refuge. The original title of the paper, published in Italian is: V. Giormani, II Lido di Venezia "scoassera" della città. I montoni dalmati e l'elefante del 1819, in Atti del III Convegno nazionale di storia della medicina veterinaria, Lastra a Signa (Firenze), 23-24 settembre 2000, a cura di Alba Veggetti, Brescia, 2001, pp. 333-339. Other information has been added in order to facilitate non-italians readers and articles appearing after the publication of the Proceedings of the Third National Congress for the History of Veterinary Medicine, Lastra a Signa, (Florence), Italy, have also been used. I am deeply grateful to Mrs. Mary Moors for the

High storm surge events in Venice and the 11-yr solar cycle

NASA Astrophysics Data System (ADS)

Barriopedro, David; García-Herrera, Ricardo; Lionello, Piero; Pino, Cosimo

2010-05-01

In the last years the Venice lagoon has received much attention as a case of coastal vulnerability, mainly because of relative sea level rise and increase frequency of storm surge events, the so-called "aqua alta", which, particularly during autumn, cause the flooding of the Venice historical city center. Long-term fluctuations in solar activity and large-scale climate patterns have been suggested as feasible factors of flooding variability. This study explores the long-term frequency variability of High Surge Events (HSE) in Venice for the period 1948-2008 and its modulation by the 11-yr solar cycle. A significant decadal variability in the frequency of HSE is found in good correspondence with the 11-yr cycle, solar maxima being associated to a significant increase of the October-November-December HSE frequency. A Storm Surge Pattern (SSP), i.e. the seasonal 1000 hPa height pattern associated to increased frequency of HSE, is identified and found similar to the positive phase of the main variability mode of the regional atmospheric circulation (EOF1). However, further analyses indicate that the increase of HSE in solar maxima cannot be simply explained by a higher recurrence of positive EOF1 phases during high solar years. It rather seems that solar activity modulates the spatial patterns of the atmospheric circulation (EOF) and the favorable conditions for HSE occurrence (SSP). Thus, under solar maxima, the occurrence of HSE is enhanced by the EOF1, namely a large-scale wave train pattern that is symptomatic of storm track paths over northern Europe. Solar minima reveal a substantially different and less robust SSP, consisting of a meridionally oriented dipole with a preferred southward path of storm track activity, which is not associated to any EOF during low solar periods. It is concluded that solar activity plays an indirect role in the frequency of HSE by modulating the spatial patterns of the main modes of atmospheric regional variability, the favorable

Effect of Cardiac Arrhythmia Simulation on Nursing Students' Knowledge Acquisition and Retention.

PubMed

Tubaishat, Ahmad; Tawalbeh, Loai I

2015-09-01

The realistic and practical environment that simulation provides is an extremely useful part of the teaching process. Simulation is widely used in health and nursing education today. This study aims to evaluate the effect of simulation-based teaching on the acquisition and retention of arrhythmia-related knowledge among nursing students. A randomized controlled design involving a pretest-posttest was used. Nursing students were allocated randomly either to the experimental group (n = 47), who attended simulation scenarios on cardiac arrhythmia, or to the control group (n = 44) who received a traditional lecture on the same topic. A paired t test showed that the mean knowledge score at the posttest was significantly higher than at the pretest for both groups. However, participants in the experimental group demonstrated significantly increased knowledge of cardiac arrhythmia in the first and the second posttest compared with those in the control group. Thus, simulation is superior and significantly improves students' arrhythmia knowledge. © The Author(s) 2014.

Risk of and risk factors for hypoglycemia and associated arrhythmias in patients with type 2 diabetes and cardiovascular disease: a cohort study under real-world conditions.

PubMed

Pistrosch, Frank; Ganz, Xenia; Bornstein, Stefan R; Birkenfeld, Andreas L; Henkel, Elena; Hanefeld, Markolf

2015-10-01

Severe hypoglycemia is one of the strongest predictors of adverse clinical outcomes in patients with type 2 diabetes. Our study addressed the question whether there is a relationship between hypoglycemic events (HE) and severe cardiac arrhythmias in type 2 diabetic patients with established clinical risk factors under real-world conditions. We included 94 patients with type 2 diabetes and documented cardiovascular disease, in which interstitial glucose values and Holter ECG were recorded for 5 days in parallel. Patients received a stable treatment with insulin and/or sulfonylurea and were instructed to record symptoms of hypoglycemia or arrhythmias. Continuous glucose monitoring revealed 54 HE (interstitial glucose <3.1 mmol/l) in a total of 26 patients. Patients perceived only 39 % of HE during the day and 11 % of HE during the night. Patients with HE had a significantly higher number of severe ventricular arrhythmias [ventricular tachycardia (VT) 32.8 ± 60 vs. 0.9 ± 4.2, p = 0.019], and multivariate regression analysis revealed the duration of severe HE and TSH level as independent predictors of the occurrence of a VT. In conclusion, our study suggests that hypoglycemia might be able to trigger at least under certain circumstances, such as low TSH, ventricular arrhythmias under real-world conditions. The large number of unrecognized HE and VT in vulnerable patients treated with insulin or sulfonylurea should encourage the practitioner to focus on stable glucose control and to search for silent HE.

Interactions between pacing and arrhythmia detection algorithms in the dual chamber implantable cardioverter defibrillator.

PubMed

Dijkman, B; Wellens, H J

2001-09-01

Dual chamber implantable cardioverter defibrillator (ICD) combines the possibility to detect and treat ventricular and atrial arrhythmias with the possibility of modern heart stimulation techniques. Advanced pacing algorithms together with extended arrhythmia detection capabilities can give rise to new types of device-device interactions. Some of the possible interactions are illustrated by four cases documented in four models of dual chamber ICDs. Functioning of new features in dual chamber devices is influenced by the fact that the pacemaker is not a separate device but a part of the ICD system and that both are being used in a patient with arrhythmia. Programming measures are suggested to optimize use of new pacing algorithms while maintaining correct arrhythmia detection.

Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study.

PubMed

Qirjazi, Elena; McArthur, Eric; Nash, Danielle M; Dixon, Stephanie N; Weir, Matthew A; Vasudev, Akshya; Jandoc, Racquel; Gula, Lorne J; Oliver, Matthew J; Wald, Ron; Garg, Amit X

2016-01-01

The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia. We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701) or escitalopram (n = 38 436), compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620). After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days. Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29), and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18). Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68), but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18). Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia.

Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study

PubMed Central

Qirjazi, Elena; McArthur, Eric; Nash, Danielle M.; Dixon, Stephanie N.; Weir, Matthew A.; Vasudev, Akshya; Jandoc, Racquel; Gula, Lorne J.; Oliver, Matthew J.; Wald, Ron; Garg, Amit X.

2016-01-01

Background The risk of ventricular arrhythmia with citalopram and escitalopram is controversial. In this study we investigated the association between these two drugs and the risk of ventricular arrhythmia. Methods We conducted a population-based retrospective cohort study of older adults (mean age 76 years) from 2002 to 2012 in Ontario, Canada, newly prescribed citalopram (n = 137 701) or escitalopram (n = 38 436), compared to those prescribed referent antidepressants sertraline or paroxetine (n = 96 620). After inverse probability of treatment weighting using a propensity score, the baseline characteristics of the comparison groups were similar. The primary outcome was a hospital encounter with ventricular arrhythmia within 90 days of a new prescription, assessed using hospital diagnostic codes. The secondary outcome was all-cause mortality within 90 days. Results Citalopram was associated with a higher risk of a hospital encounter with ventricular arrhythmia compared with referent antidepressants (0.06% vs. 0.04%, relative risk [RR] 1.53, 95% confidence intervals [CI]1.03 to 2.29), and a higher risk of mortality (3.49% vs. 3.12%, RR 1.12, 95% CI 1.06 to 1.18). Escitalopram was not associated with a higher risk of ventricular arrhythmia compared with the referent antidepressants (0.03% vs. 0.04%, RR 0.84, 95% CI 0.42 to 1.68), but was associated with a higher risk of mortality (2.86% vs. 2.63%, RR 1.09, 95% CI 1.01 to 1.18). Conclusion Among older adults, initiation of citalopram compared to two referent antidepressants was associated with a small but statistically significant increase in the 90-day risk of a hospital encounter for ventricular arrhythmia. PMID:27513855

Sympathetic restraint of respiratory sinus arrhythmia: implications for vagal-cardiac tone assessment in humans

NASA Technical Reports Server (NTRS)

Taylor, J. A.; Myers, C. W.; Halliwill, J. R.; Seidel, H.; Eckberg, D. L.

2001-01-01

Clinicians and experimentalists routinely estimate vagal-cardiac nerve traffic from respiratory sinus arrhythmia. However, evidence suggests that sympathetic mechanisms may also modulate respiratory sinus arrhythmia. Our study examined modulation of respiratory sinus arrhythmia by sympathetic outflow. We measured R-R interval spectral power in 10 volunteers that breathed sequentially at 13 frequencies, from 15 to 3 breaths/min, before and after beta-adrenergic blockade. We fitted changes of respiratory frequency R-R interval spectral power with a damped oscillator model: frequency-dependent oscillations with a resonant frequency, generated by driving forces and modified by damping influences. beta-Adrenergic blockade enhanced respiratory sinus arrhythmia at all frequencies (at some, fourfold). The damped oscillator model fit experimental data well (39 of 40 ramps; r = 0.86 +/- 0.02). beta-Adrenergic blockade increased respiratory sinus arrhythmia by amplifying respiration-related driving forces (P < 0.05), without altering resonant frequency or damping influences. Both spectral power data and the damped oscillator model indicate that cardiac sympathetic outflow markedly reduces heart period oscillations at all frequencies. This challenges the notion that respiratory sinus arrhythmia is mediated simply by vagal-cardiac nerve activity. These results have important implications for clinical and experimental estimation of human vagal cardiac tone.

Ambient Air Pollution and Daily Outpatient Visits for Cardiac Arrhythmia in Shanghai, China

PubMed Central

Zhao, Ang; Chen, Renjie; Kuang, Xingya; Kan, Haidong

2014-01-01

Background Cardiac arrhythmias are cardiac rhythm disorders that comprise an important public health problem. Few prior studies have examined the association between ambient air pollution and arrhythmias in general populations in mainland China. Methods We performed a time-series analysis to investigate the short-term association between air pollution (particulate matter with an aerodynamic diameter less than 10 µm [PM10], sulfur dioxide [SO2], and nitrogen dioxide [NO2]) and outpatient visits for arrhythmia in Shanghai, China. We applied the over-dispersed Poisson generalized additive model to analyze the associations after control for seasonality, day of the week, and weather conditions. We then stratified the analyses by age, gender, and season. Results We identified a total of 56 940 outpatient visits for cardiac arrhythmia. A 10-µg/m3 increase in the present-day concentrations of PM10, SO2, and NO2 corresponded to increases of 0.56% (95% CI 0.42%, 0.70%), 2.07% (95% CI 1.49%, 2.64%), and 2.90% (95% CI 2.53%, 3.27%), respectively, in outpatient arrhythmia visits. The associations were stronger in older people (aged ≥65 years) and in females. This study provides the first evidence that ambient air pollution is significantly associated with increased risk of cardiac arrhythmia in mainland China. Conclusions Our analyses provide evidence that the current air pollution levels have an adverse effect on cardiovascular health and strengthened the rationale for further limiting air pollution levels in the city. PMID:24835409

The application of profile imaging for monitoring organic and metal pollution in the Venice lagoon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bona, F.; Maffiotti, A.

1995-12-31

Since 1993 the technique of Sediment Profile Imaging (SPI) has been applied in monitoring the Venice Lagoon. The purposes of the monitoring were several, ranging from an initial baseline survey of sediment quality, to the control of Ulva rigida proliferation, to sediment quality assessment for dredging and capping activities in restricted areas of the lagoon. Data resulting from each computer image analysis have been summarized in one index which takes into consideration the mutual interactions between the physical and chemical conditions and the benthic community. In this way a spatial and seasonal gradient in the quality Venice Lagoon sediments hasmore » been established and the key roles of the organic enrichment and of the ecosystem hydrodynamics have been confirmed. The underwater camera and image analysis have also been an effective screening tool to address further investigations in those areas of particular concern for sediment contamination. On the basis of the SPI indices a selection of stations has been made in order to sample and perform sediment toxicity tests and chemical analyses to assess contamination levels.« less

Contaminant fate and transport in the Venice Lagoon: results from a multi-segment multimedia model.

PubMed

Sommerfreund, J K; Gandhi, N; Diamond, M L; Mugnai, C; Frignani, M; Capodaglio, G; Gerino, M; Bellucci, L G; Giuliani, S

2010-03-01

Contaminant loadings to the Venice Lagoon peaked from 1950s-1980s and although they have since declined, contaminant concentrations remain elevated in sediment and seafood. In order to identify the relative importance of contaminant sources, inter-media exchange and removal pathways, a modified 10-segment fugacity/aquivalence-based model was developed for octachlorodibenzodioxin/furan (OCDD/F), PCB-180, Pb and Cu in the Venice Lagoon. Results showed that in-place pollution nearby the industrial area, current industrial discharges, and tributary loadings were the main sources of contaminants to the lagoon, with negligible contributions from the atmosphere. The fate of these contaminants was governed by sediment-water exchange with simultaneous advective transport by water circulation. Contaminants circulated amongst the northern and central basins with a small fraction reaching the far southern basin and the Chioggia inlet. As a consequence, we estimated limited contaminant transfer to the Adriatic Sea, trapping the majority of contaminants in the sediment in this "average" circulation scenario which does not account for periodic flooding events. (c) 2009 Elsevier Inc. All rights reserved.

Cardiac Arrhythmia Classification by Multi-Layer Perceptron and Convolution Neural Networks.

PubMed

Savalia, Shalin; Emamian, Vahid

2018-05-04

The electrocardiogram (ECG) plays an imperative role in the medical field, as it records heart signal over time and is used to discover numerous cardiovascular diseases. If a documented ECG signal has a certain irregularity in its predefined features, this is called arrhythmia, the types of which include tachycardia, bradycardia, supraventricular arrhythmias, and ventricular, etc. This has encouraged us to do research that consists of distinguishing between several arrhythmias by using deep neural network algorithms such as multi-layer perceptron (MLP) and convolution neural network (CNN). The TensorFlow library that was established by Google for deep learning and machine learning is used in python to acquire the algorithms proposed here. The ECG databases accessible at PhysioBank.com and kaggle.com were used for training, testing, and validation of the MLP and CNN algorithms. The proposed algorithm consists of four hidden layers with weights, biases in MLP, and four-layer convolution neural networks which map ECG samples to the different classes of arrhythmia. The accuracy of the algorithm surpasses the performance of the current algorithms that have been developed by other cardiologists in both sensitivity and precision.

Associations between arrhythmia episodes and temporally and spatially resolved black carbon and particulate matter in elderly patients

PubMed Central

Zanobetti, Antonella; Coull, Brent A.; Gryparis, Alexandros; Kloog, Itai; Sparrow, David; Vokonas, Pantel S; Wright, Robert O.; Gold, Diane R; Schwartz, Joel

2015-01-01

Objectives Ambient air pollution has been associated with sudden deaths, some of which are likely due to ventricular arrhythmias. Defibrillator discharge studies have examined the association of air pollution with arrhythmias in sensitive populations. No studies have assessed this association using residence-specific estimates of air pollution exposure. Methods In the Normative Aging Study, we investigated the association between temporally-and spatially-resolved black carbon (BC) and PM2.5 and arrhythmia episodes (bigeminy, trigeminy or couplets episodes) measured as ventricular ectopy (VE) by 4-min electrocardiogram (ECG) monitoring in repeated measures of 701 subjects, during the years 2000 to 2010. We used a binomial distribution (having or not a VE episode) in a mixed effect model with a random intercept for subject, controlling for seasonality, temperature, day of the week, medication use, smoking, having diabetes, BMI and age. We also examined whether these associations were modified by genotype or phenotype. Results We found significant increases in VE with both pollutants and lags; for the estimated concentration averaged over the three days prior to the health assessment we found increases in the odds of having VE with an OR of 1.52 (95% CI: 1.19–1.94) for an IQR (0.30 μg/m3) increase in BC and an OR of 1.39 (95% CI: 1.12–1.71) for an IQR (5.63 μg/m3) increase in PM2.5. We also found higher effects in subjects with the GSTT1 and GSTM1 variants and in obese (P-values<0.05). Conclusion Increased levels of short-term traffic related pollutants may increase the risk of ventricular arrhythmia in elderly subjects. PMID:24142987

Tpeak - Tend and Tpeak - Tend /QT ratio as markers of ventricular arrhythmia risk in cardiac resynchronization therapy patients.

PubMed

Barbhaiya, Chirag; Po, Jose Ricardo F; Hanon, Sam; Schweitzer, Paul

2013-01-01

Cardiac resynchronization therapy (CRT) increases transmural dispersion of repolarization (TDR) and can be pro-arrhythmic. However, overall arrhythmia risk was not increased in large-scale CRT clinical trials. Increased TDR as measured by T(peak ) -T(end) (TpTe) was associated with arrhythmia risk in CRT in a single-center study. This study investigates whether QT interval, TpTe, and TpTe/QT ratio are associated with ventricular arrhythmias in patients with CRT-defibrillator (CRT-D). Post-CRT-D implant electrocardiograms of 128 patients (age 71.3 years ± 10.3) with at least 2 months of follow-up at our institution's device clinic (mean follow-up of 28.5 months ± 17) were analyzed for QT interval, TpTe, and TpTe/QT ratio. Incidence of ventricular arrhythmias was determined based on routine and directed device interrogations. Appropriate implantable cardioverter-defibrillator therapy for sustained ventricular tachycardia or ventricular fibrillation was delivered in 18 patients (14%), and nonsustained ventricular tachycardia (NSVT) was detected but did not require therapy in 58 patients (45%). Patients who received appropriate defibrillator therapy had increased TpTe/QT ratio (0.24 ± 0.03 ms vs 0.20 ± 0.04, P = 0.0002) and increased TpTe (105.56 ± 20.36 vs 87.82 ± 22.32 ms, P = 0.002), and patients with NSVT had increased TpTe/QT ratio (0.22 ± 0.04 vs 0.20 ± 0.04, P = 0.016). Increased QT interval was not associated with risk of ventricular arrhythmia. The relative risk for appropriate defibrillator therapy of T(p) T(e) /QT ratio ≥ 0.25 was 3.24 (P = 0.016). Increased TpTe and increased TpTe/QT ratio are associated with increased incidence of ventricular arrhythmias in CRT-D. The utility of TpTe interval and TpTe/QT ratio as potentially modifiable risk factors for ventricular arrhythmias in CRT requires further study. ©2012, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.

Computational approaches to understand cardiac electrophysiology and arrhythmias

PubMed Central

Roberts, Byron N.; Yang, Pei-Chi; Behrens, Steven B.; Moreno, Jonathan D.

2012-01-01

Cardiac rhythms arise from electrical activity generated by precisely timed opening and closing of ion channels in individual cardiac myocytes. These impulses spread throughout the cardiac muscle to manifest as electrical waves in the whole heart. Regularity of electrical waves is critically important since they signal the heart muscle to contract, driving the primary function of the heart to act as a pump and deliver blood to the brain and vital organs. When electrical activity goes awry during a cardiac arrhythmia, the pump does not function, the brain does not receive oxygenated blood, and death ensues. For more than 50 years, mathematically based models of cardiac electrical activity have been used to improve understanding of basic mechanisms of normal and abnormal cardiac electrical function. Computer-based modeling approaches to understand cardiac activity are uniquely helpful because they allow for distillation of complex emergent behaviors into the key contributing components underlying them. Here we review the latest advances and novel concepts in the field as they relate to understanding the complex interplay between electrical, mechanical, structural, and genetic mechanisms during arrhythmia development at the level of ion channels, cells, and tissues. We also discuss the latest computational approaches to guiding arrhythmia therapy. PMID:22886409

Cascade Classification with Adaptive Feature Extraction for Arrhythmia Detection.

PubMed

Park, Juyoung; Kang, Mingon; Gao, Jean; Kim, Younghoon; Kang, Kyungtae

2017-01-01

Detecting arrhythmia from ECG data is now feasible on mobile devices, but in this environment it is necessary to trade computational efficiency against accuracy. We propose an adaptive strategy for feature extraction that only considers normalized beat morphology features when running in a resource-constrained environment; but in a high-performance environment it takes account of a wider range of ECG features. This process is augmented by a cascaded random forest classifier. Experiments on data from the MIT-BIH Arrhythmia Database showed classification accuracies from 96.59% to 98.51%, which are comparable to state-of-the art methods.

Natural versus anthropogenic subsidence of Venice.

PubMed

Tosi, Luigi; Teatini, Pietro; Strozzi, Tazio

2013-09-26

We detected land displacements of Venice by Persistent Scatterer Interferometry using ERS and ENVISAT C-band and TerraSAR-X and COSMO-SkyMed X-band acquisitions over the periods 1992-2010 and 2008-2011, respectively. By reason of the larger observation period, the C-band sensors was used to quantify the long-term movements, i.e. the subsidence component primarily ascribed to natural processes. The high resolution X-band satellites reveal a high effectiveness to monitor short-time movements as those induced by human activities. Interpolation of the two datasets and removal of the C-band from the X-band map allows discriminating between the natural and anthropogenic components of the subsidence. A certain variability characterizes the natural subsidence (0.9 ± 0.7 mm/yr), mainly because of the heterogeneous nature and age of the lagoon subsoil. The 2008 displacements show that man interventions are responsible for movements ranging from -10 to 2 mm/yr. These displacements are generally local and distributed along the margins of the city islands.

Natural versus anthropogenic subsidence of Venice

PubMed Central

Tosi, Luigi; Teatini, Pietro; Strozzi, Tazio

2013-01-01

We detected land displacements of Venice by Persistent Scatterer Interferometry using ERS and ENVISAT C-band and TerraSAR-X and COSMO-SkyMed X-band acquisitions over the periods 1992–2010 and 2008–2011, respectively. By reason of the larger observation period, the C-band sensors was used to quantify the long-term movements, i.e. the subsidence component primarily ascribed to natural processes. The high resolution X-band satellites reveal a high effectiveness to monitor short-time movements as those induced by human activities. Interpolation of the two datasets and removal of the C-band from the X-band map allows discriminating between the natural and anthropogenic components of the subsidence. A certain variability characterizes the natural subsidence (0.9 ± 0.7 mm/yr), mainly because of the heterogeneous nature and age of the lagoon subsoil. The 2008 displacements show that man interventions are responsible for movements ranging from −10 to 2 mm/yr. These displacements are generally local and distributed along the margins of the city islands. PMID:24067871

Variability of cannabis potency in the Venice area (Italy): a survey over the period 2010-2012.

PubMed

Zamengo, Luca; Frison, Giampietro; Bettin, Chiara; Sciarrone, Rocco

2014-01-01

Cannabis is the most widely used illicit substance globally, with an estimated annual prevalence in 2010 of 2.6-5.0% of the adult population. Concerns have been expressed about increases in the potency of cannabis products. A high tetrahydrocannabinol (THC) content can increase anxiety, depression, and psychotic symptoms, and can increase the risk of dependence and adverse effects on the respiratory and cardiovascular systems in regular users. The aim of this study was to report statistical data about the potency of cannabis products seized in the north-east of Italy, in a geographical area centred in Venice and extending for more than 10,000  km(2) with a population of more than two million, by investigating the variability observed in THC levels of about 4000 samples of cannabis products analyzed over the period 2010-2012. Overall median THC content showed an increasing trend over the study period from about 6.0% to 8.1% (6.2-8.9% for cannabis resin, 5.1-7.6% for herbal cannabis). The variation in the THC content of individual samples was very large, ranging from 0.3% to 31% for cannabis resin and from 0.1 to 19% for herbal cannabis. Median CBN:THC ratios showed a slightly decreasing trend over the study period, from 0.09 (2010) to 0.03 (2012), suggesting an increasing freshness of submitted materials. Median CBD:THC ratios also showed a decreasing trend over the study from about 0.52 (2010) to 0.18 (2012), likely due to the increase in submissions of materials from indoor and domestic cultivation with improved breeding methods. Copyright © 2013 John Wiley & Sons, Ltd.

Non-Invasive Assessment of Susceptibility to Ventricular Arrhythmias During Simulated Microgravity

NASA Technical Reports Server (NTRS)

Cohen, Richard J.

1999-01-01

The Cardiovascular Alterations Team is currently conducting studies to determine what alterations in hemodynamic regulation result from sixteen days of simulated microgravity exposure in normal human subjects. In this project we make additional measurements on these same study subjects in order to determine whether there is an increase in susceptibility to ventricular arrhythmias resulting from simulated microgravity exposure. Numerous anecdotal and documented reports from the past 30 years suggest that the incidence of ventricular arrhythmias among astronauts is increased during space flight. For example, documented runs of ventricular tachycardia have been recorded from crew members of Skylab and Mir, there was much attention given by the lay press to Mir Commander Vasily Tslbliyev's complaints of heart rhythm irregularities in July of 1997, and cardiovascular mechanisms may have been causal in the recent death of an experimental primate shortly after return from space. In 1986, a Mir cosmonaut, Alexander Laveikin, was brought home and replaced with an alternate cosmonaut as a result of cardiac dysrhythmias that began during extravehicular activity. Furthermore, at a joint NASA/NSBRI workshop held in January 1998, cardiac arrhythmias were identified as the highest priority cardiovascular risk to a human Mars mission. Despite the evidence for the risk of a potentially lethal arrhythmia resulting from microgravity exposure, the effects of space flight and the associated physiologic stresses on cardiac conduction processes are not known, and an increase in cardiac susceptibility to arrhythmias has never been quantified. In this project, we are determining whether simulated space flight increases the risk of developing life-threatening heart rhythm disturbances such as sustained ventricular tachycardia (defined as ventricular tachycardia lasting at least 30 seconds or resulting in hemodynamic collapse) and ventricular fibrillation. We are obtaining measures of

Catheter ablation of asymptomatic longstanding persistent atrial fibrillation: impact on quality of life, exercise performance, arrhythmia perception, and arrhythmia-free survival.

PubMed

Mohanty, Sanghamitra; Santangeli, Pasquale; Mohanty, Prasant; Di Biase, Luigi; Holcomb, Shawna; Trivedi, Chintan; Bai, Rong; Burkhardt, David; Hongo, Richard; Hao, Steven; Beheiry, Salwa; Santoro, Francesco; Forleo, Giovanni; Gallinghouse, Joseph G; Horton, Rodney; Sanchez, Javier E; Bailey, Shane; Hranitzky, Patrick M; Zagrodzky, Jason; Natale, Andrea

2014-10-01

Impact of catheter ablation on exercise performance, quality of life (QoL) and symptom perception in asymptomatic longstanding persistent AF (LSP-AF) patients has not been reported yet. Sixty-one consecutive patients (mean age 62 ±13 years, 71% males) with asymptomatic LSP-AF undergoing first catheter ablation were enrolled. Extended pulmonary vein antrum isolation plus ablation of complex fractionated atrial electrograms and nonpulmonary vein triggers was performed in all. QoL survey was taken at baseline and 12-months postablation, using Short Form-36 (SF-36). Information on arrhythmia perception was obtained using a standard questionnaire and corroborating symptoms with documented evidence of arrhythmia. Exercise tests were performed on 38 patients at baseline and 5 months after procedure. Recurrence was assessed using event recorder, cardiology evaluation, electrocardiogram, and 7-day holter monitoring. After 20 ± 5 months follow-up, 36 (57%) patients remained recurrence-free off-AAD. Of the 25 patients experiencing recurrence, 21 (84%) were symptomatic. Compared to baseline, follow-up SF-36 scores improved significantly in many measures. For patients with successful ablation, physical component summary (PCS) and mental component summary (MCS) demonstrated substantial improvement ( 64.2 ± 22.3 to 70.1 ± 18.6 [P = 0.041]; PCS: 62.6 ± 18.4 to 70.0 ± 14.4 [P = 0.032]). Postablation exercise study in recurrence-free patients showed significant reduction in resting and peak heart rate (75 ± 11 vs. 90 ± 17 and 132 ± 20 vs. 154.5 ± 36, respectively, P < 0.001), increase in peak oxygen pulse (13.4 ± 3 vs. 18.9 ± 16 mL/beat, Δ5.5 ± 15, P = 0.001), peak VO2 /kg (19.7 ± 5 to 23.4 ± 13 mL/kg/min [Δ 3.7 ± 10, P = 0.043]), and corresponding MET (5.6 ± 1 to 6.7 ± 4 [Δ1.1 ± 3, P = 0.03]). No improvement was observed in patients with failed procedures. Successful ablation improves exercise performance and QoL in asymptomatic LSP-AF patients. © 2014 Wiley

Modelling ecological and human exposure to POPs in Venice lagoon - Part II: Quantitative uncertainty and sensitivity analysis in coupled exposure models.

PubMed

Radomyski, Artur; Giubilato, Elisa; Ciffroy, Philippe; Critto, Andrea; Brochot, Céline; Marcomini, Antonio

2016-11-01

The study is focused on applying uncertainty and sensitivity analysis to support the application and evaluation of large exposure models where a significant number of parameters and complex exposure scenarios might be involved. The recently developed MERLIN-Expo exposure modelling tool was applied to probabilistically assess the ecological and human exposure to PCB 126 and 2,3,7,8-TCDD in the Venice lagoon (Italy). The 'Phytoplankton', 'Aquatic Invertebrate', 'Fish', 'Human intake' and PBPK models available in MERLIN-Expo library were integrated to create a specific food web to dynamically simulate bioaccumulation in various aquatic species and in the human body over individual lifetimes from 1932 until 1998. MERLIN-Expo is a high tier exposure modelling tool allowing propagation of uncertainty on the model predictions through Monte Carlo simulation. Uncertainty in model output can be further apportioned between parameters by applying built-in sensitivity analysis tools. In this study, uncertainty has been extensively addressed in the distribution functions to describe the data input and the effect on model results by applying sensitivity analysis techniques (screening Morris method, regression analysis, and variance-based method EFAST). In the exposure scenario developed for the Lagoon of Venice, the concentrations of 2,3,7,8-TCDD and PCB 126 in human blood turned out to be mainly influenced by a combination of parameters (half-lives of the chemicals, body weight variability, lipid fraction, food assimilation efficiency), physiological processes (uptake/elimination rates), environmental exposure concentrations (sediment, water, food) and eating behaviours (amount of food eaten). In conclusion, this case study demonstrated feasibility of MERLIN-Expo to be successfully employed in integrated, high tier exposure assessment. Copyright © 2016 Elsevier B.V. All rights reserved.

Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects.

PubMed

Navas de Solis, C

2016-07-01

Arrhythmias are common in equine athletes during and immediately after exercise. Many of these rhythm variations are not clinically relevant. In horses, a link between different exercising arrhythmias and poor performance or between exercising arrhythmias and sudden cardiac death (SCD) is strongly suspected but not fully understood or proven. SCD during races or competitions is rare, but has catastrophic consequences for the safety of the human partner and public perceptions of welfare during equestrian sports. This review summarises current knowledge of equine exercise arrhythmias and their implications in SCD and compares existing principles and recommendations for equine subjects with those for human athletes. © 2016 EVJ Ltd.

Obesity and exercise-induced ectopic ventricular arrhythmias in apparently healthy middle aged adults.

PubMed

Sabbag, Avi; Sidi, Yechezkel; Kivity, Shaye; Beinart, Roy; Glikson, Michael; Segev, Shlomo; Goldenberg, Ilan; Maor, Elad

2016-03-01

Obesity and overweight are strongly associated with cardiovascular morbidity and mortality. However, there are limited data on the association between excess weight and the risk of ectopic ventricular activity. We investigated the association between body mass index (BMI) and the risk for ectopic ventricular activity (defined as multiple ventricular premature beats (≥3), ventricular bigeminy, nonsustained ventricular tachycardia or sustained ventricular tachycardia) during exercise stress testing among 22,516 apparently healthy men and women who attended periodic health screening examinations between the years 2000 and 2014. All subjects had completed maximal exercise stress testing annually according to the Bruce protocol. Subjects were divided at baseline into three groups: normal weight (BMI ≥ 18.5 kg/m(2) and<25; N = 9,994), overweight (BMI ≥ 25 and < 30; N = 9,613) and obese (BMI ≥ 30; N = 2,906). The mean age of study subjects was 47 ± 10 years and 72% were men. Kaplan-Meier survival analysis showed that the cumulative probability for the development of exercise-induced ectopic ventricular activity arrhythmias was highest among obese subjects, intermediate among overweight subjects and lowest among subjects with normal weight (3.4%, 2.7% and 2.2% respectively; p < 0.001). Multivariate binary logistic regression with repeated measures of 92,619 ESTs, showed that obese subjects were 33% more likely to have ectopic ventricular arrhythmias during exercise compared with subjects with normal weight (p = 0.005), and that each 1 kg/m(2) increase in BMI was associated with a significant 4% (p = 0.002) increased adjusted risk for exercise-induced ventricular arrhythmias. Obesity is independently associated with increased likelihood of ectopic ventricular arrhythmia during exercise. © The European Society of Cardiology 2015.

Electrical stimulation-based renal nerve mapping exacerbates ventricular arrhythmias during acute myocardial ischaemia.

PubMed

Huang, Bing; Zhou, Xiaoya; Wang, Menglong; Li, Xuefei; Zhou, Liping; Meng, Guannan; Wang, Yuhong; Wang, Zhuo; Wang, Songyun; Yu, Lilei; Jiang, Hong

2018-06-01

Blood pressure elevation in response to transient renal nerve stimulation (RNS) has been used to determine the ablation target and endpoint of renal denervation. This study aimed to evaluate the safety of transient RNS in canines with normal or ischaemic hearts. In ten normal (Group 1) and six healed myocardial infarction (HMI) (Group 2) canines, a large-tip catheter was inserted into the left or right renal artery to perform transient RNS. The left stellate ganglion neural activity (LSGNA) and ventricular electrophysiological parameters were measured at baseline and during transient RNS. In another 20 acute myocardial infarction (AMI) canines, RNS (Group 3, n = 10) or sham RNS (Group 4, n = 10) was intermittently (1 min ON and 4 min OFF) performed for 1 h following AMI induction. The LSGNA and AMI-induced ventricular arrhythmias were analysed. In normal and HMI canines, although transient RNS significantly increased the LSGNA and facilitated the action potential duration (APD) alternans, it did not induce any ventricular arrhythmias and did not change the ventricular effective refractory period, APD or maximum slope of the APD restitution curve. In AMI canines, transient RNS significantly exacerbated LSG activation and promoted the incidence of ventricular arrhythmias. Transient RNS did not increase the risk of ventricular arrhythmias in normal or HMI hearts, but it significantly promoted the occurrence of ventricular arrhythmias in AMI hearts. Therefore, electrical stimulation-based renal nerve mapping may be unsafe in AMI patients and in patients with a high risk for malignant ventricular arrhythmias.

Subsidence due to peat oxidation and impact on drainage infrastructures in a farmland catchment south of the Venice Lagoon

NASA Astrophysics Data System (ADS)

Gambolati, G.; Putti, M.; Teatini, P.; Gasparetto Stori, G.

2006-03-01

Large agricultural areas reclaimed in the past century, south of the Venice Lagoon, have experienced significant land subsidence due to oxidation of peat organic soils. This has exposed the region to flood hazard particularly during severe storms and has contributed to increase the marginal management cost of the infrastructures (ditches, levees, pumping stations) designed to operate the drainage system. Direct measurements and indirect evidence from the channel network suggest a land settlement between 1.5 and 2 m over the past 70 years. This paper provides an overview of the problem with important information on its most recent evolution.

Quantitative Assessment of Arrhythmia Using Non-linear Approach: A Non-invasive Prognostic Tool

NASA Astrophysics Data System (ADS)

Chakraborty, Monisha; Ghosh, Dipak

2017-12-01

Accurate prognostic tool to identify severity of Arrhythmia is yet to be investigated, owing to the complexity of the ECG signal. In this paper, we have shown that quantitative assessment of Arrhythmia is possible using non-linear technique based on "Hurst Rescaled Range Analysis". Although the concept of applying "non-linearity" for studying various cardiac dysfunctions is not entirely new, the novel objective of this paper is to identify the severity of the disease, monitoring of different medicine and their dose, and also to assess the efficiency of different medicine. The approach presented in this work is simple which in turn will help doctors in efficient disease management. In this work, Arrhythmia ECG time series are collected from MIT-BIH database. Normal ECG time series are acquired using POLYPARA system. Both time series are analyzed in thelight of non-linear approach following the method "Rescaled Range Analysis". The quantitative parameter, "Fractal Dimension" (D) is obtained from both types of time series. The major finding is that Arrhythmia ECG poses lower values of D as compared to normal. Further, this information can be used to access the severity of Arrhythmia quantitatively, which is a new direction of prognosis as well as adequate software may be developed for the use of medical practice.

Quantitative Assessment of Arrhythmia Using Non-linear Approach: A Non-invasive Prognostic Tool

NASA Astrophysics Data System (ADS)

Chakraborty, Monisha; Ghosh, Dipak

2018-04-01

Accurate prognostic tool to identify severity of Arrhythmia is yet to be investigated, owing to the complexity of the ECG signal. In this paper, we have shown that quantitative assessment of Arrhythmia is possible using non-linear technique based on "Hurst Rescaled Range Analysis". Although the concept of applying "non-linearity" for studying various cardiac dysfunctions is not entirely new, the novel objective of this paper is to identify the severity of the disease, monitoring of different medicine and their dose, and also to assess the efficiency of different medicine. The approach presented in this work is simple which in turn will help doctors in efficient disease management. In this work, Arrhythmia ECG time series are collected from MIT-BIH database. Normal ECG time series are acquired using POLYPARA system. Both time series are analyzed in thelight of non-linear approach following the method "Rescaled Range Analysis". The quantitative parameter, "Fractal Dimension" (D) is obtained from both types of time series. The major finding is that Arrhythmia ECG poses lower values of D as compared to normal. Further, this information can be used to access the severity of Arrhythmia quantitatively, which is a new direction of prognosis as well as adequate software may be developed for the use of medical practice.

QT dispersion and ventricular arrhythmias in children with primary mitral valve prolapse

PubMed Central

İmamoğlu, Ebru Yalın; Eroğlu, Ayşe Güler

2016-01-01

Aim: To investigate ventricular arrhythmias in children with primary mitral valve prolapse and to evaluate its relation with QT length, QT dispersion, autonomic function tests and heart rate variability measurements. Material and Methods: Fourty two children with mitral valve prolapse and 32 healthy children were enrolled into the study. Twelve-lead electrocardiograms, autonomic function tests, echocardiography and 24-hour rhythm Holter tests were performed. Electrocardiograms were magnified digitally. The QT length was corrected according to heart rate. The patients were grouped according to the number of premature ventricular contractions and presence of complex ventricular arhythmia in the 24-hour rhythm Holter monitor test. Heart rate variability measurements were calculated automatically from the 24-hour rhythm Holter monitor test. Orthostatic hypotension and resting heart rate were used as autonomic function tests. Results: The mean age was 13.9±3.3 years in the patient group and 14.6±3.1 years in the control group (p>0.05). Thirty four of the patients (81%) were female and eight (19%) were male. Twenty five of the control subjects (78%) were female and seven (22%) were male. The QT dispersion and heart rate corrected QT interval were found to be significantly increased in the children with primary mitral valve prolapse when compared with the control group (56±16 ms vs. 43±11 ms, p=0.001; 426±25 ms vs. 407±26 ms, p=0.002, respectively). In 24-hour rhythm Holter monitor tests, ventricular arrhythmias were found in 21 out of 42 patients (50%) and 6 out of 32 control subjects (18.8%) (p=0.006). QT dispersion was found to be significantly increased in patients with premature ventricular contractions ≥ 10/day and/or complex ventricular arrhythmias compared to the control group without ventricular premature beats (p=0.002). There was no significant difference in autonomic function tests and heart rate variability measurements between the patient and control

Non-contact arrhythmia assessment in natural settings: a step toward preventive cardiac care

NASA Astrophysics Data System (ADS)

Amelard, Robert; Hughson, Richard L.; Clausi, David A.; Wong, Alexander

2017-02-01

Cardiovascular disease is a major contributor to US morbidity. Taking preventive action can greatly reduce or eliminate the impact on quality of life. However, many issues often go undetected until the patient presents a physical symptom. Non-intrusive continuous cardiovascular monitoring systems may make detecting and monitoring abnormalities earlier feasible. One candidate system is photoplethysmographic imaging (PPGI), which is able to assess arterial blood pulse characteristics in one or multiple individuals remotely from a distance. In this case study, we showed that PPGI can be used to detect cardiac arrhythmia that would otherwise require contact-based monitoring techniques. Using a novel system, coded hemodynamic imaging (CHI), strong temporal blood pulse waveform signals were extracted at a distance of 1.5 m from the participant using 850-1000 nm diffuse illumination for deep tissue penetration. Data were recorded at a sampling rate of 60 Hz, providing a temporal resolution of 17 ms. The strong fidelity of the signal allowed for both temporal and spectral assessment of abnormal blood pulse waveforms, ultimately to detect the onset of abnormal cardiac events. Data from a participant with arrhythmia was analyzed and compared against normal blood pulse waveform data to validate CHI's ability to assess cardiac arrhythmia. Results indicate that CHI can be used as a non-intrusive continuous cardiac monitoring system.

Continuous seismic-reflection survey defining shallow sedimentary layers in the Charlotte Harbor and Venice areas, southwest Florida

USGS Publications Warehouse

Wolansky, R.M.; Haeni, F.P.; Sylvester, R.E.

1983-01-01

A continuous marine seismic-reflection survey system was used to define the configuration of shallow sedimentary layers underlying the Charlotte Harbor and Venice areas, southwest Florida. Seismic profiling was conducted over a distance of about 57 miles of Charlotte Harbor, the Peace and Myakka Rivers, and the Intracoastal Waterway near Venice using a high resolution energy source capable of penetrating 200 feet of sediments with a resolution of 1 to 3 feet. Five stratigraphic units defined from the seismic records includes sediments to Holocene to early Miocene age. All seismic-profile records are presented, along with geologic sections constructed from the records. Seismic reflection amplitude, frequency, continuity, configuration, external form, and areal association were utilized to interpret facies and depositional environments of the stratigraphic units. The despositional framework of the units ranges from shallow shelf to prograded slope. The stratigraphic units are correlated with the surficial aquifer and intermediate artesian aquifers, and permeable zones of the aquifers are related to the seismic records. (USGS)

Exome-based analysis of cardiac arrhythmia, respiratory control, and epilepsy genes in sudden unexpected death in epilepsy.

PubMed

Bagnall, Richard D; Crompton, Douglas E; Petrovski, Slavé; Lam, Lien; Cutmore, Carina; Garry, Sarah I; Sadleir, Lynette G; Dibbens, Leanne M; Cairns, Anita; Kivity, Sara; Afawi, Zaid; Regan, Brigid M; Duflou, Johan; Berkovic, Samuel F; Scheffer, Ingrid E; Semsarian, Christopher

2016-04-01

The leading cause of epilepsy-related premature mortality is sudden unexpected death in epilepsy (SUDEP). The cause of SUDEP remains unknown. To search for genetic risk factors in SUDEP cases, we performed an exome-based analysis of rare variants. Demographic and clinical information of 61 SUDEP cases were collected. Exome sequencing and rare variant collapsing analysis with 2,936 control exomes were performed to test for genes enriched with damaging variants. Additionally, cardiac arrhythmia, respiratory control, and epilepsy genes were screened for variants with frequency of <0.1% and predicted to be pathogenic with multiple in silico tools. The 61 SUDEP cases were categorized as definite SUDEP (n = 54), probable SUDEP (n = 5), and definite SUDEP plus (n = 2). We identified de novo mutations, previously reported pathogenic mutations, or candidate pathogenic variants in 28 of 61 (46%) cases. Four SUDEP cases (7%) had mutations in common genes responsible for the cardiac arrhythmia disease, long QT syndrome (LQTS). Nine cases (15%) had candidate pathogenic variants in dominant cardiac arrhythmia genes. Fifteen cases (25%) had mutations or candidate pathogenic variants in dominant epilepsy genes. No gene reached genome-wide significance with rare variant collapsing analysis; however, DEPDC5 (p = 0.00015) and KCNH2 (p = 0.0037) were among the top 30 genes, genome-wide. A sizeable proportion of SUDEP cases have clinically relevant mutations in cardiac arrhythmia and epilepsy genes. In cases with an LQTS gene mutation, SUDEP may occur as a result of a predictable and preventable cause. Understanding the genetic basis of SUDEP may inform cascade testing of at-risk family members. © 2016 American Neurological Association.

[Observation of antiarrhythmic effects of Cinnamomum migao H. W. Li on experimental arrhythmia].

PubMed

Sui, Y; Qiu, D; Xie, C; Chen, K

1998-08-01

To investigate the effects of Cinnamomum migao on experimental arrhythmia. Arrhythmic models of mice, rabbits, guinea pigs and rats were built using chloroform(Chl), adrenalin(Adr), strophanthin-K (Spt-K) and barium chloride (BaCl2). The affected animals were divided randomly into three groups: control group, Cinnamomum migao (CV-3) group and mexiletine (MXL) group, so as to observe and compare the antiarrhythmic effects. CV-3 could reduce the incidence of ventricular fibrillation caused by ch1 in mice and the ventricular tachycardia induced by Adr in rabbits, delay the onset time of this arrhythmia, increase the arrhythmic doses of Spt-K in guinea pigs, reduce the incidence of some arrhythmia caused by BaCl2 in rats and slow down their heart rate. CV-3 has obvious antiarrhythmic effects on experimental arrhythmia. The mechanism of these effects is probably related to the arrest of the intraflow of Na+, Ca2+ in the cardiac cells and the depression of their cardiac autoarrhythmicity and conductivity.

Sleep-Disordered Breathing and Arrhythmia in Heart Failure Patients.

PubMed

Fox, Henrik; Bitter, Thomas; Horstkotte, Dieter; Oldenburg, Olaf

2017-06-01

Heart failure (HF) treatment remains complex and challenging, with current recommendations aiming at consideration and treatment of comorbidities in patients with HF. Sleep-disordered breathing (SDB) and arrhythmia come into play, as both are associated with quality of life deterioration, and morbidity and mortality increase in patients with HF. Interactions of these diseases are versatile and may appear intransparent in daily practice. Nevertheless, because of their importance for patients' condition and prognosis, SDB and arrhythmia individually, but also through interaction on one another, necessitate attention, following the fact that treatment is requested and desired considering latest research findings and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

78 FR 39597 - Safety Zone; Hilton Fourth of July Fireworks, San Joaquin River, Venice Island, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... Zone; Hilton Fourth of July Fireworks, San Joaquin River, Venice Island, CA AGENCY: Coast Guard, DHS... the Hilton Fourth of July Fireworks in the Captain of the Port, San Francisco area of responsibility...'' W (NAD83) for the Hilton Fourth of July Fireworks in 33 CFR 165.1191, Table 1, Item number 17. This...

The effectiveness and efficiency of phytoremediation of a multicontaminated industrial site: Porto Marghera (Venice Lagoon, Italy).

PubMed

Guarino, C; Sciarrillo, R

2017-09-01

The Venice Lagoon is worldwide considered as a typical example of the human impact on the surrounding ecosystem. The development of the industrial zone of Porto Marghera begun in 1917 as an extension of the Venice Port, in order to sustain activities related to oil and coal, as well as to exploit the railway system. Despite the recent decrease in the number of employees, Porto Marghera is still one of the most important chemical districts in Italy. This study reports early results from the ongoing in-situ phytoextraction of potentially toxic elements (Cd, Hg, Zn) within the industrial area of Porto Marghera. Two agronomic plant species with high annual biomass yield (Helianthus annuus L., Brassica juncea (L.) Czern.) were used. This paper also reports the microcosms and mesocosms tests to evaluate the efficacy of the treatments to be applied to the in-situ phytoextraction process of the polluted site. The combined use of EDTA and Ammonium Thiosulfate during phytoextraction increases the efficiency of Cd, Hg, Zn removal from contaminated soil. Copyright © 2017 Elsevier Ltd. All rights reserved.

Arrhythmia-free survival and pulmonary vein reconnection patterns after second-generation cryoballoon and contact-force radiofrequency pulmonary vein isolation.

PubMed

Buist, Thomas J; Adiyaman, Ahmet; Smit, Jaap Jan J; Ramdat Misier, Anand R; Elvan, Arif

2018-06-01

The aim of this study was to compare second-generation cryoballoon and contact-force radiofrequency point-by-point pulmonary vein isolation (PVI) in atrial fibrillation (AF) patients with regard to pulmonary vein reconnection and arrhythmia-free survival. Altogether, 269 consecutive patients with drug-refractory AF undergoing PVI were included and randomly allocated to second-generation cryoballoon or contact-force point-by-point radiofrequency ablation. Median follow-up duration was 389 days (interquartile range 219-599). Mean age was 59 years (71% male); 136 patients underwent cryoballoon and 133 patients underwent radiofrequency ablation. Acute electrical PVI was 100% for both techniques. Procedure duration was significantly shorter in cryoballoon vs radiofrequency (166.5 vs 184.13 min P = 0.016). Complication rates were similar (6.0 vs 6.7%, P = 1.00). Single procedure freedom of atrial arrhythmias was significantly higher in cryoballoon as compared to radiofrequency (75.2 vs 57.4%, P = 0.013). In multivariate analysis, persistent AF, AF duration, and cryoballoon ablation were associated with freedom of atrial tachyarrhythmias. The number of repeat ablation procedures was significantly lower in the cryoballoon compared to radiofrequency (15.0 vs 24.3%, P = 0.045). At repeat ablation, pulmonary vein reconnection rate was significantly lower after cryoballoon as compared to radiofrequency ablation (36.8 vs 58.1%, P = 0.003). Improved arrhythmia-free survival and more durable pulmonary vein isolation is seen after PVI using second-generation cryoballoon as compared to contact-force radiofrequency, in patients with drug-refractory paroxysmal AF. Complication rates for both ablation techniques are low.

Inhibition of methyldigoxin-induced arrhythmias by pentadecapeptide BPC 157: a relation with NO-system.

PubMed

Balenovic, Dijana; Bencic, Martina Lovric; Udovicic, Mario; Simonji, Karol; Hanzevacki, Jadranka Separovic; Barisic, Ivan; Kranjcevic, Stjepan; Prkacin, Ingrid; Coric, Vedran; Brcic, Luka; Coric, Marijana; Brcic, Iva; Borovic, Suzana; Radic, Bozo; Drmic, Domagoj; Vrcic, Hrvoje; Seiwerth, Sven; Sikiric, Predrag

2009-08-07

Pentadecapeptide BPC 157 (GEPPPGKPADDAGLV, MW 1419) reversed congestive heart failure and various arrhythmias, influenced the NO-system and showed no proarrhythmic effect. In therapy analogy, we challenged rats with digitalis, to show attenuation by BPC 157 and the relation between the NO-system and digitalis toxicity. (i). BPC 157 prophylactic effect. Development of cumulative intravenous digitalis toxicity, BPC 157 (50 microg, 10 microg, 10 ng/kg applied intravenously immediately before a methyldigoxin increment regimen (2.0/1.5/1.5/1.0 mg/kg at 15 min-intervals, total dose 6.0 mg/kg/45 min)) reduced the number of ventricular premature beats, prolonged the time before onset of ventricular tachycardia, reduced ventricular tachycardia and AV-block duration (microg-regimes) or reduced mainly the AV-block duration (ng-regimen). (ii). BPC 157 therapy. Advanced methyldigoxin toxicity (6.0 mg/kg i.v. bolus). BPC 157 applied at the 20th second of the grade 3 AV-block shortened AV-blocks, mitigated a further digitalis toxicity course. Ventricular tachycardias were either avoided (50 microg), or markedly reduced (10 microg, 10 ng). Fatal outcome was either avoided (50 microg), reduced (10 microg), or only delayed (10 ng) (iii) BPC 157, L-NAME, l-arginine, L-NAME+l-arginine application. L-NAME-application (5 mg/kg i.p.) aggravated methyldigoxin-arrhythmias. l-arginine (200 mg/kg i.p.) alone had no effect but blunted L-NAME-exaggeration (L-NAME+l-arginine). In this respect, BPC 157 (50 microg/kg i.p.) was prophylactically and therapeutically more effective: the antagonism of L-NAME with BPC 157 produced an effect similar to BPC 157 alone. In conclusion, digitalis-induced arrhythmias in rats could be prevented and counteracted by pentadecapeptide BPC 157, mainly through an interaction with the NO-system.

Regulation for "saving" the drowned in Italy (XVIII-XIXth century), with particular reference to the Republic of Venice.

PubMed

D'Este, B R

1990-01-01

The author gives a brief chronological syntesis, starting from the XVIII century, of the various provisions issued in Italy, with particular reference to the Republic of Venice, relating to the saving of the drowned, as an introduction to the discipline of "Life-Saving" oriented swimming.

Electrical alternans during rest and exercise as predictors of vulnerability to ventricular arrhythmias

NASA Technical Reports Server (NTRS)

Estes, N. A. 3rd; Michaud, G.; Zipes, D. P.; El-Sherif, N.; Venditti, F. J.; Rosenbaum, D. S.; Albrecht, P.; Wang, P. J.; Cohen, R. J.

1997-01-01

This investigation was performed to evaluate the feasibility of detecting repolarization alternans with the heart rate elevated with a bicycle exercise protocol. Sensitive spectral signal-processing techniques are able to detect beat-to-beat alternation of the amplitude of the T wave, which is not visible on standard electrocardiogram. Previous animal and human investigations using atrial or ventricular pacing have demonstrated that T-wave alternans is a marker of vulnerability to ventricular arrhythmias. Using a spectral analysis technique incorporating noise reduction signal-processing software, we evaluated electrical alternans at rest and with the heart rate elevated during a bicycle exercise protocol. In this study we defined optimal criteria for electrical alternans to separate patients from those without inducible arrhythmias. Alternans and signal-averaged electrocardiographic results were compared with the results of vulnerability to ventricular arrhythmias as defined by induction of sustained ventricular tachycardia or fibrillation at electrophysiologic evaluation. In 27 patients alternans recorded at rest and with exercise had a sensitivity of 89%, specificity of 75%, and overall clinical accuracy of 80% (p <0.003). In this patient population the signal-averaged electrocardiogram was not a significant predictor of arrhythmia vulnerability. This is the first study to report that repolarization alternans can be detected with heart rate elevated with a bicycle exercise protocol. Alternans measured using this technique is an accurate predictor of arrhythmia inducibility.

Right Ventricular Myocardial Ischemia with Arrhythmia in an Asphyxiated Newborn

PubMed Central

Solevåg, Anne Lee; Schmölzer, Georg M.; Cheung, Po-Yin

2016-01-01

Background Infant and neonatal myocardial infarction (MI) has been described in association with congenital heart disease, coronary artery abnormalities, myocarditis, and tumors. MI in the perinatal period in a structurally normal heart and with ventricular arrhythmia as a presenting feature has not been thoroughly described. Published case reports describe treatment methods extrapolated from adult MI. However, due to the rare occurrence, the most appropriate acute treatment for both MI and ventricular arrhythmia in newborn infants remains unknown. Case A male term infant with perinatal asphyxia and need for extensive cardiopulmonary resuscitation at birth had ventricular tachyarrhythmia and ST-elevations on electrocardiogram. Four hours after birth, he died from cardiogenic failure. A thrombus at the right coronary artery was found on autopsy. Conclusion MI in the perinatal period in a structurally normal heart is very rare and mortality is high. Although acute treatments extrapolated from adult MI has been described to result in favorable outcomes in newborn infants, guidelines are lacking on how to manage acute MI and associated ventricular arrhythmia. PMID:27280062

A Novel Automatic Detection System for ECG Arrhythmias Using Maximum Margin Clustering with Immune Evolutionary Algorithm

PubMed Central

Zhu, Bohui; Ding, Yongsheng; Hao, Kuangrong

2013-01-01

This paper presents a novel maximum margin clustering method with immune evolution (IEMMC) for automatic diagnosis of electrocardiogram (ECG) arrhythmias. This diagnostic system consists of signal processing, feature extraction, and the IEMMC algorithm for clustering of ECG arrhythmias. First, raw ECG signal is processed by an adaptive ECG filter based on wavelet transforms, and waveform of the ECG signal is detected; then, features are extracted from ECG signal to cluster different types of arrhythmias by the IEMMC algorithm. Three types of performance evaluation indicators are used to assess the effect of the IEMMC method for ECG arrhythmias, such as sensitivity, specificity, and accuracy. Compared with K-means and iterSVR algorithms, the IEMMC algorithm reflects better performance not only in clustering result but also in terms of global search ability and convergence ability, which proves its effectiveness for the detection of ECG arrhythmias. PMID:23690875

Evaluation of surficial sediment toxicity and sediment physico-chemical characteristics of representative sites in the Lagoon of Venice (Italy)

NASA Astrophysics Data System (ADS)

Losso, C.; Arizzi Novelli, A.; Picone, M.; Marchetto, D.; Pessa, G.; Molinaroli, E.; Ghetti, P. F.; Volpi Ghirardini, A.

2004-11-01

Toxic hazard in sites with varying types and levels of contamination in the Lagoon of Venice was estimated by means of toxicity bioassays based on the early life-stages of the autochthonous sea urchin Paracentrotus lividus. Elutriate was chosen as the test matrix, due to its ability to highlight potential toxic effects towards sensitive biological components of the water column caused by sediment resuspension phenomena affecting the Lagoon. Surficial sediments (core-top 5 cm deep), directly influenced by resuspension/redeposition processes, and core sediments (core 20 cm deep), recording time-mediated contamination, were sampled in some sites located in the lagoonal area most greatly influenced by anthropogenic activities. Particle size, organic matter and water content were also analysed. In two sites, the results of physical parameters showed that the core-top sediments were coarser than the 20-cm core sediments. Sperm cell toxicity test results showed the negligible acute toxicity of elutriates from all investigated sites. The embryo toxicity test demonstrated a short-term chronic toxicity gradient for elutriates from the 20-cm core sediments, in general agreement both with the expected contamination gradient and with results of the Microtox® solid-phase test. Elutriates of the core-top 5-cm sediments revealed a totally inverted gradient, in comparison with that for the 20-cm core sediments, and the presence of a "hot spot" of contamination in the site chosen as a possible reference. Investigations on ammonia and sulphides as possible confounding factors excluded their contribution to this "hot spot". Integrated physico-chemical and toxicity results on sediments at various depths demonstrated the presence of disturbed sediments in the central basin of the Lagoon of Venice.

Method and apparatus for the guided ablative therapy of fast ventricular arrhythmia

NASA Technical Reports Server (NTRS)

Cohen, Richard J. (Inventor); Barley, Maya (Inventor)

2010-01-01

Method and apparatus for guiding ablative therapy of abnormal biological electrical excitation. The excitation from the previous excitatory wave is significant at the beginning of the next excitation. In particular, it is designed for treatment of fast cardiac arrhythmias. Electrical signals are acquired from recording electrodes, and an inverse dipole method is used to identify the site of origin of an arrhythmia. The location of the tip of an ablation catheter is similarly localized from signals acquired from the recording electrodes while electrical pacing energy is delivered to the tip of the catheter close to or in contact with the cardiac tissue. The catheter tip is then guided to the site of origin of the arrhythmia, and ablative radio frequency energy is delivered to its tip to ablate the site.

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

PubMed Central

Bose, Abhishek; Truong, Quynh A.

2015-01-01

Circulating biomarkers related to inflammation, neurohormones, myocardial stress, and necrosis have been associated with commonly encountered arrhythmic disorders such as atrial fibrillation (AF) and more malignant processes including ventricular arrhythmias (VA) and sudden cardiac death (SCD). Both direct and indirect biomarkers implicated in the heart failure cascade have potential prognostic value in patients undergoing cardiac resynchronization therapy (CRT). This review will focus on the role of biomarkers in AF, history of SCD, and CRT with an emphasis to improve clinical risk assessment for arrhythmias and patient selection for device therapy. Notably, information obtained from biomarkers may supplement traditional diagnostic and imaging techniques, thus providing an additional benefit in the management of patients. PMID:25715916

The land subsidence of the Venice historical center: twenty years of monitoring by SAR-based interferometry

NASA Astrophysics Data System (ADS)

Tosi, L.; Strozzi, T.; Teatini, P.

2012-12-01

The subsidence of Venice, one of the most beautiful and famous cities in the world, is well known not by reason of the magnitude of the ground movement, which amounts to less than 15 cm over the last century, but because it has seriously compromised the ground safety level of the city in relation of its small elevation above the sea. The lowering of Venice is still today a subject of debates with large rumours on press releases every time a scientific paper is published on the topic. Over the last two decades, satellites instrumented with SAR sensors provided excellent data for detecting land displacements by inteferometric processing. In particular, the accuracy achieved by Persistent Scatterer Interferometry (PSI) and the impressive number of detected measurement points have progressively reduced the use of in situ traditional measurements, i.e. leveling survey, for monitoring land displacements of Venice. In fact, the intensive urban development makes the historical center an optimal site for PSI. On the other hand, the correct interpretation of the PSI outcomes, which provide the relative movement of single churches, palaces, bridges with millimetric precision and metric spatial resolution, require a deep knowledge of the city and its subsoil due to the peculiarity of this urban area developed over the centuries within the sea. We investigate the movements of Venice by Interferometric Point Target Analysis (IPTA) over the last 20 years using SAR acquisitions of the ERS-1/2, ENVISAT, TerraSAR-X, and Cosmo-SkyMed satellites. The density of detected scatterers is one order of magnitude larger with the newest very high resolution X-band sensors from TerraSAR-X and Cosmo-SkyMed, but by reason of the larger observation period the accuracy of the mean displacement rate of the C-band ERS and ENVISAT is higher. IPTA results have been calibrated using leveling and permanent GPS stations to correct the so-called flattening problem, i.e. the slight phase tilt resulting by

Probabilistic Storm Surge Forecast For Venice

NASA Astrophysics Data System (ADS)

Mel, Riccardo; Lionello, Piero

2013-04-01

This study describes an ensemble storm surge prediction procedure for the city of Venice, which is potentially very useful for its management, maintenance and for operating the movable barriers that are presently being built. Ensemble Prediction System (EPS) is meant to complement the existing SL forecast system by providing a probabilistic forecast and information on uncertainty of SL prediction. The procedure is applied to storm surge events in the period 2009-2010 producing for each of them an ensemble of 50 simulations. It is shown that EPS slightly increases the accuracy of SL prediction with respect to the deterministic forecast (DF) and it is more reliable than it. Though results are low biased and forecast uncertainty is underestimated, the probability distribution of maximum sea level produced by the EPS is acceptably realistic. The error of the EPS mean is shown to be correlated with the EPS spread. SL peaks correspond to maxima of uncertainty and uncertainty increases linearly with the forecast range. The quasi linear dynamics of the storm surges produces a modulation of the uncertainty after the SL peak with period corresponding to that of the main Adriatic seiche.

Use of New Imaging CARTO® Segmentation Module Software to Facilitate Ablation of Ventricular Arrhythmias.

PubMed

Tovia-Brodie, Oholi; Belhassen, Bernard; Glick, Aharon; Shmilovich, Haim; Aviram, Galit; Rosso, Raphael; Michowitz, Yoav

2017-02-01

A new imaging software (CARTO® Segmentation Module, Biosense Webster) allows preprocedural 3-D reconstruction of all heart chambers based on cardiac CT. We describe our initial experience with the new module during ablation of ventricular arrhythmias. Eighteen consecutive patients with idiopathic ventricular arrhythmias or ischemic ventricular tachycardia (VT) were studied. In the latter group, a combined endocardial and epicardial ablation was performed. Of the 14 patients with idiopathic arrhythmias, 12 were ablated in the outflow tract (OT), 1 in the midseptal left ventricle, and 1 at the left posterior fascicular area; acute successful ablation was achieved in 11 (78.6%) patients. The procedure was discontinued due to close proximity of the arrhythmia origin to the coronary arteries (CA) in 2 patients. Acute successful uncomplicated ablation was achieved in all 4 patients with ischemic VT. During ablation in the coronary cusps commissures, the CARTO® Segmentation Module accurately defined the cusps anatomy. The precise anatomic location provided by the module assisted in successfully ablating when information from activation mapping was not optimal, by ablating at the opposite side of the cusps. In addition, by demonstrating the precise location of the CA, it allowed safe ablation of arrhythmias that originated in close proximity to the CA both in the OT area and the epicardium, eliminating the need for repeat angiography. The CARTO® Segmentation Module is useful for accurate definition of the exact anatomic location of ventricular arrhythmias and for safely ablating them especially in close proximity to the CA. © 2016 Wiley Periodicals, Inc.

Pre-School Education--Aims, Methods and Problems. Report of a Symposium (Venice, Italy, October 11-16, 1971).

ERIC Educational Resources Information Center

Council of Europe, Strasbourg (France). Committee for General and Technical Education.

This report provides a summary of the proceedings and recommendations of the Council of Europe symposium on preschool education held in Venice, Italy in 1971. The report is divided into three major areas: (1) historical background information; (2) summaries of general lectures, especially dealing with the functions, aims, methods, and problems of…

[The De affectibus oris, of Vittorio Trincavella of Venice].

PubMed

Vidal, F

1993-01-01

The author states that starting with a work published in 1575 in the city of Venice, it is possible to rebuild in a complete way the Dentistry History of the XVI century; it is indeed an important testimony considering specially the lack of existing information and of authors dedicated specifically to this subject. The article center its interest in the Book number V and in the 13 chapters it is composed of and where there are described the common affections of the mouth and its surroundings. It is also given a biography of Trincavella and a panorama of Medicine of that time and by XVI and XVII centuries. Prof. Vidal offers also the translation from latin to french of Vittorio Trincavella, text made by Jean Marc Galeazzi, Paris.

Natural and human-induced driving factors in the evolution of tidal channels: case studies in the Venice Lagoon (Italy).

NASA Astrophysics Data System (ADS)

Rizzetto, Federica

2013-04-01

increase of relative sea-level rise in the same period) and/or produced other hydrodynamic, morphological, sedimentological modifications in the salt marshes, often resulting in erosion. References Rizzetto F., Tosi L., 2011. Aptitude of modern salt marshes to counteract relative sea-level rise, Venice Lagoon (Italy). Geology, 39 (8), 755-758. doi: 10.1130/G31736.1. Rizzetto F., Tosi L., 2012. Rapid response of tidal channel networks to sea-level variations (Venice Lagoon, Italy). Global and Planetary Change, 92-93, 191-197, doi: 10.1016/j.gloplacha.2012.05.022.

Air--sea gaseous exchange of PCB at the Venice lagoon (Italy).

PubMed

Manodori, L; Gambaro, A; Moret, I; Capodaglio, G; Cescon, P

2007-10-01

Water bodies are important storage media for persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs) and this function is increased in coastal regions because their inputs are higher than those to the open sea. The air-water interface is extensively involved with the global cycling of PCBs because it is the place where they accumulate due to depositional processes and where they may be emitted by gaseous exchange. In this work the parallel collection of air, microlayer and sub-superficial water samples was performed in July 2005 at a site in the Venice lagoon to evaluate the summer gaseous flux of PCBs. The total concentration of PCBs (sum of 118 congeners) in air varies from 87 to 273 pg m(-3), whereas in the operationally defined dissolved phase of microlayer and sub-superficial water samples it varies from 159 to 391 pg L(-1). No significant enrichment of dissolved PCB into the microlayer has been observed, although a preferential accumulation of most hydrophobic congeners occurs. Due to this behaviour, we believe that the modified two-layer model was the most suitable approach for the evaluation of the flux at the air-sea interface, because it takes into account the influence of the microlayer. From its application it appears that PCB volatilize from the lagoon waters with a net flux varying from 58 to 195 ng m(-2)d(-1) (uncertainty: +/-50-64%) due to the strong influence of wind speed. This flux is greater than those reported in the literature for the atmospheric deposition and rivers input and reveals that PCB are actively emitted from the Venice lagoon in summer months.

Polychlorinated biphenyls in two salt marsh sediments of the Venice Lagoon.

PubMed

Mugnai, Cristian; Giuliani, Silvia; Bellucci, Luca G; Carraro, Claudio; Favotto, Maurizio; Frignani, Mauro

2011-10-01

Polychlorinated biphenyls (PCBs) were measured in two dated salt marsh cores of the Venice Lagoon to assess their input chronology and to evaluate the importance of atmospheric deposition as a source. Sampling sites were chosen in order to evidence the differences between areas located leeward and windward with respect to inputs originating in both the city of Venice and the industrial area. Concentrations of PCB indicators (0.13-15.6 ng g⁻¹) increased gradually from the 1930s, reached maxima from the 1950s to the late 1970s, and then decreased. PCB loadings to marshes are driven by both the atmospheric deposition and the resuspension of subtidal sediments, this latter being more important for heavier congeners. The downwind marsh recorded higher fluxes (0.06-9.72 ng cm⁻² year⁻¹) than the upwind one (0.01-0.53 ng cm⁻² year⁻¹). Recent fluxes are rather consistent with bulk deposition measurements. A higher contribution of CB-101 and CB-118 was detected in the intermediate layers of the downwind site, suggesting a different PCB source for the corresponding time interval. In the other marsh, PCBs showed a rather constant composition at all levels (mostly CB-153, CB-138 and CB-180), accounting for a regional influence. Deep layers showed an enrichment of higher chlorinated congeners at both sites, whereas recent samples conserve the patterns typical of surficial and subsurficial subtidal sediments. The scientific approach adopted in this research can be considered as a sort of methodological procedure for the determination of fluxes and pathways of PCBs through the study of marsh cores.

Acute Effects of Fine Particulate Air Pollution on Cardiac Arrhythmia: The APACR Study

PubMed Central

He, Fan; Shaffer, Michele L.; Rodriguez-Colon, Sol; Yanosky, Jeff D.; Bixler, Edward; Cascio, Wayne E.

2011-01-01

Background: The mechanisms underlying the relationship between particulate matter (PM) air pollution and cardiac disease are not fully understood. Objectives: We examined the effects and time course of exposure to fine PM [aerodynamic diameter ≤ 2.5 μm (PM2.5)] on cardiac arrhythmia in 105 middle-age community-dwelling healthy nonsmokers in central Pennsylvania. Methods: The 24-hr beat-to-beat electrocardiography data were obtained using a high-resolution Holter system. After visually identifying and removing artifacts, we summarized the total number of premature ventricular contractions (PVCs) and premature atrial contractions (PACs) for each 30-min segment. A personal PM2.5 nephelometer was used to measure individual-level real-time PM2.5 exposures for 24 hr. We averaged these data to obtain 30-min average time–specific PM2.5 exposures. Distributed lag models under the framework of negative binomial regression and generalized estimating equations were used to estimate the rate ratio between 10-μg/m3 increases in average PM2.5 over 30-min intervals and ectopy counts. Results: The mean ± SD age of participants was 56 ± 8 years, with 40% male and 73% non-Hispanic white. The 30-min mean ± SD for PM2.5 exposure was 13 ± 22 μg/m3, and PAC and PVC counts were 0.92 ± 4.94 and 1.22 ± 7.18. Increases of 10 μg/m3 in average PM2.5 concentrations during the same 30 min or the previous 30 min were associated with 8% and 3% increases in average PVC counts, respectively. PM2.5 was not significantly associated with PAC count. Conclusion: PM2.5 exposure within approximately 60 min was associated with increased PVC counts in healthy individuals. PMID:21398201

Nonpharmacologic control of postoperative supraventricular arrhythmias using AV nodal fat pad stimulation in a young animal open heart surgical model.

PubMed

Moak, Jeffrey P; Mercader, Marco A; He, Dingchao; Trachiotis, Gregory; Langert, Joshua; Blicharz, Andy; Montaque, Erin; Li, Xiyan; Cheng, Yao I; McCarter, Robert; Bornzin, Gene A; Martin, Gerard R; Jonas, Richard A

2013-06-01

Supraventricular arrhythmias (junctional ectopic tachycardia [JET] and atrial tachyarrhythmias) frequently complicate recovery from open heart surgery in children and can be difficult to manage. Medical treatment of JET can result in significant morbidity. Our goal was to develop a nonpharmacological approach using autonomic stimulation of selective fat pad (FP) regions of the heart in a young canine model of open heart surgery to control 2 common postoperative supraventricular arrhythmias. Eight mongrel dogs, varying in age from 5 to 8 months and weighting 22±4 kg, underwent open heart surgery replicating a nontransannular approach to tetralogy of Fallot repair. Neural stimulation of the right inferior FP was used to control the ventricular response to supraventricular arrhythmias. Right inferior FP stimulation decreased baseline AV nodal conduction without altering sinus cycle length. AV node Wenckebach cycle length prolonged from 270±33 to 352±89 ms, P=0.02. Atrial fibrillation occurred in 7 animals, simulating a rapid atrial tachyarrhythmias. FP stimulation slowed the ventricular response rate from 166±58 to 63±29 beats per minute, P<0.001. Postoperative JET occurred in 7 dogs. FP stimulation slowed the ventricular rate during postoperative JET from 148±31 to 106±32 beats per minute, P<0.001, and restored sinus rhythm in 7/7 dogs. Right inferior FP stimulation had a selective effect on the AV node, and slowed the ventricular rate during postoperative JET and atrial tachyarrhythmias in our young canine open heart surgery model. FP stimulation may be a useful new technique for managing children with JET and atrial tachyarrhythmias.

Multiclass Classification of Cardiac Arrhythmia Using Improved Feature Selection and SVM Invariants.

PubMed

Mustaqeem, Anam; Anwar, Syed Muhammad; Majid, Muahammad

2018-01-01

Arrhythmia is considered a life-threatening disease causing serious health issues in patients, when left untreated. An early diagnosis of arrhythmias would be helpful in saving lives. This study is conducted to classify patients into one of the sixteen subclasses, among which one class represents absence of disease and the other fifteen classes represent electrocardiogram records of various subtypes of arrhythmias. The research is carried out on the dataset taken from the University of California at Irvine Machine Learning Data Repository. The dataset contains a large volume of feature dimensions which are reduced using wrapper based feature selection technique. For multiclass classification, support vector machine (SVM) based approaches including one-against-one (OAO), one-against-all (OAA), and error-correction code (ECC) are employed to detect the presence and absence of arrhythmias. The SVM method results are compared with other standard machine learning classifiers using varying parameters and the performance of the classifiers is evaluated using accuracy, kappa statistics, and root mean square error. The results show that OAO method of SVM outperforms all other classifiers by achieving an accuracy rate of 81.11% when used with 80/20 data split and 92.07% using 90/10 data split option.

31 CFR 8.5 - Records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Records. 8.5 Section 8.5 Money and... AND FIREARMS General Requirements § 8.5 Records. (a) Availability. Registers of all persons admitted... inspection at the Office of the Director. Other records may be disclosed upon specific request in accordance...

Human ex-vivo action potential model for pro-arrhythmia risk assessment.

PubMed

Page, Guy; Ratchada, Phachareeya; Miron, Yannick; Steiner, Guido; Ghetti, Andre; Miller, Paul E; Reynolds, Jack A; Wang, Ken; Greiter-Wilke, Andrea; Polonchuk, Liudmila; Traebert, Martin; Gintant, Gary A; Abi-Gerges, Najah

2016-01-01

While current S7B/E14 guidelines have succeeded in protecting patients from QT-prolonging drugs, the absence of a predictive paradigm identifying pro-arrhythmic risks has limited the development of valuable drug programs. We investigated if a human ex-vivo action potential (AP)-based model could provide a more predictive approach for assessing pro-arrhythmic risk in man. Human ventricular trabeculae from ethically consented organ donors were used to evaluate the effects of dofetilide, d,l-sotalol, quinidine, paracetamol and verapamil on AP duration (APD) and recognized pro-arrhythmia predictors (short-term variability of APD at 90% repolarization (STV(APD90)), triangulation (ADP90-APD30) and incidence of early afterdepolarizations at 1 and 2Hz to quantitatively identify the pro-arrhythmic risk. Each drug was blinded and tested separately with 3 concentrations in triplicate trabeculae from 5 hearts, with one vehicle time control per heart. Electrophysiological stability of the model was not affected by sequential applications of vehicle (0.1% dimethyl sulfoxide). Paracetamol and verapamil did not significantly alter anyone of the AP parameters and were classified as devoid of pro-arrhythmic risk. Dofetilide, d,l-sotalol and quinidine exhibited an increase in the manifestation of pro-arrhythmia markers. The model provided quantitative and actionable activity flags and the relatively low total variability in tissue response allowed for the identification of pro-arrhythmic signals. Power analysis indicated that a total of 6 trabeculae derived from 2 hearts are sufficient to identify drug-induced pro-arrhythmia. Thus, the human ex-vivo AP-based model provides an integrative translational assay assisting in shaping clinical development plans that could be used in conjunction with the new CiPA-proposed approach. Copyright © 2016 Elsevier Inc. All rights reserved.

Human ex-vivo action potential model for pro-arrhythmia risk assessment

PubMed Central

Page, Guy; Ratchada, Phachareeya; Miron, Yannick; Steiner, Guido; Ghetti, Andre; Miller, Paul E; Reynolds, Jack A; Wang, Ken; Greiter-Wilke, Andrea; Polonchuk, Liudmila; Traebert, Martin; Gintant, Gary A; Abi-Gerges, Najah

2016-01-01

While current S7B/E14 guidelines have succeeded in protecting patients from QT-prolonging drugs, the absence of a predictive paradigm identifying pro-arrhythmic risks has limited the development of valuable drug programs. We investigated if a human ex-vivo action potential (AP)-based model could provide a more predictive approach for assessing pro-arrhythmic risk in man. Human ventricular trabeculae from ethically consented organ donors were used to evaluate the effects of dofetilide, d,l-sotalol, quinidine, paracetamol and verapamil on AP duration (APD) and recognized pro-arrhythmia predictors (short-term variability of APD at 90% repolarization (STV(APD90)), triangulation (ADP90-APD30) and incidence of early afterdepolarizations at 1 and 2 Hz to quantitatively identify the pro-arrhythmic risk. Each drug was blinded and tested separately with 3 concentrations in triplicate trabeculae from 5 hearts, with one vehicle time control per heart. Electrophysiological stability of the model was not affected by sequential applications of vehicle (0.1% dimethyl sulfoxide). Paracetamol and verapamil did not significantly alter anyone of the AP parameters and were classified as devoid of pro-arrhythmic risk. Dofetilide, d,l-sotalol and quinidine exhibited an increase in the manifestation of pro-arrhythmia markers. The model provided quantitative and actionable activity flags and the relatively low total variability in tissue response allowed for the identification of pro-arrhythmic signals. Power analysis indicated that a total of 6 trabeculae derived from 2 hearts are sufficient to identify drug-induced pro-arrhythmia. Thus, the human ex-vivo AP-based model provides an integrative translational assay assisting in shaping clinical development plans that could be used in conjunction with the new CiPA-proposed approach. PMID:27235787

Voluntary exercise does not affect stress-induced tachycardia, but improves resistance to cardiac arrhythmias in rats.

PubMed

Beig, Mirza I; Callister, Robin; Saint, David A; Bondarenko, Eugene; Walker, Frederick R; Day, Trevor A; Nalivaiko, Eugene

2011-01-01

1. It is currently unknown whether long-term voluntary exercise has enduring cardioprotective effects in animal models. 2. The present study was conducted in three groups of rats: (i) sedentary controls (n = 6); (ii) 24 h runners (n = 8; unlimited access to running wheels); and (iii) 2 h runners (n = 8; access to running wheels limited to 2 h daily). After termination of the 6 week exercise protocol, all rats were implanted with the telemetric electrocardiogram transmitters and were studied 1 week later. 3. Resting heart rate (HR) values in the control rats, 24 h runners and 2 h runners were 372 ± 7, 361 ± 9 and 298 ± 5 b.p.m., respectively (P < 0.05 for 2 h runners vs controls). The high-frequency spectral power in the control rats, 24 h runners and 2 h runners was 3.9 ± 0.2, 4.3 ± 0.3 and 5.3 ± 0.3 s², respectively (P < 0.05 for 2 h runners vs controls), whereas intrinsic HR was 383 ± 3, 377 ± 2 and 346 ± 3 b.p.m., respectively (P < 0.001 for 2 h runners vs controls). Restraint stress provoked tachycardia of similar magnitude in all groups. 4. After completion of telemetric studies, haemodynamic indices and susceptibility to cardiac arrhythmias were assessed in anaesthetized animals, there were no major between-group differences in HR, arterial pressure, contractility indices or sensitivity to β-adrenoceptor stimulation (dobutamine) or blockade (atenolol). The effective refractory period in the control rats, 24 h runners and 2 h runners was 49 ± 2, 55 ± 2 and 60 ± 4 ms, respectively (P = 0.054 for 2 h runners vs controls). A significantly higher dose of aconitine was required to provoke ventricular arrhythmias in the 24 h and 2 h running groups compared with controls (489 ± 76, 505 ± 88 and 173 ± 33 μg, respectively; P < 0.05). 5. We conclude that, in rats, long-term voluntary exercise has enduring cardioprotective effects mediated at the level of both the central nervous system and the heart. © 2010 The Authors. Clinical and Experimental

ECG Signal Analysis and Arrhythmia Detection using Wavelet Transform

NASA Astrophysics Data System (ADS)

Kaur, Inderbir; Rajni, Rajni; Marwaha, Anupma

2016-12-01

Electrocardiogram (ECG) is used to record the electrical activity of the heart. The ECG signal being non-stationary in nature, makes the analysis and interpretation of the signal very difficult. Hence accurate analysis of ECG signal with a powerful tool like discrete wavelet transform (DWT) becomes imperative. In this paper, ECG signal is denoised to remove the artifacts and analyzed using Wavelet Transform to detect the QRS complex and arrhythmia. This work is implemented in MATLAB software for MIT/BIH Arrhythmia database and yields the sensitivity of 99.85 %, positive predictivity of 99.92 % and detection error rate of 0.221 % with wavelet transform. It is also inferred that DWT outperforms principle component analysis technique in detection of ECG signal.

Surgical outcome of Fontan conversion and arrhythmia surgery: Need a pacemaker?

PubMed

Terada, Takafumi; Sakurai, Hajime; Nonaka, Toshimichi; Sakurai, Takahisa; Sugiura, Junya; Taneichi, Tetsuyoshi; Ohtsuka, Ryohei

2014-07-01

Atrial tachyarrhythmias are frequent complications in the late period after the Fontan procedure, and important risk factors for a poor prognosis. The impact of Fontan conversion and arrhythmia surgery in failed Fontan patients has been described in many reports. We evaluated our experience with Fontan conversion procedures, concomitant arrhythmia surgery, and pacemaker implantation. We reviewed the hospital records of 25 consecutive patients who underwent a Fontan conversion procedure from January 2004 to March 2012. Twenty-four patients had arrhythmia surgery using cryoablation and radiofrequency ablation at the time of conversion. A bilateral atrial maze procedure was performed in 6 patients, right-side maze in 15, and isthmus block in 3. Three patients with a diagnosis of corrected transposition of the great arteries underwent simultaneous pacemaker implantation electively. There was no early death and one late death during a mean follow-up period of 21.2 months. Three tachyarrhythmia recurrences developed, and there were 4 occurrences of sinus bradycardia. Five of these patients required postoperative pacemaker implantation. The mid-term results of Fontan conversion and arrhythmia surgery in our institute were satisfactory. The occurrence of unexpected postoperative pacemaker requirement was high in the patients who underwent a right atrial or bilateral atrial maze procedure. Pacemaker or lead implantation is recommended for patients planned to undergo a right-side or full maze procedure. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Geraniol blocks calcium and potassium channels in the mammalian myocardium: useful effects to treat arrhythmias.

PubMed

de Menezes-Filho, José Evaldo Rodrigues; Gondim, Antônio Nei Santana; Cruz, Jader Santos; de Souza, Américo Azevedo; Santos, José Nilson Andrade Dos; Conde-Garcia, Eduardo Antônio; de Sousa, Damião Pergentino; Santos, Michel Santana; de Oliveira, Evaleide Diniz; de Vasconcelos, Carla Maria Lins

2014-12-01

Geraniol is a monoterpene present in several essential oils, and it is known to have a plethora of pharmacological activities. In this study, we explored the contractile and electrophysiological properties of geraniol and its antiarrhythmic effects in the heart. The geraniol effects on atrial contractility, L-type Ca(2+) current, K(+) currents, action potential (AP) parameters, ECG profile and on the arrhythmia induced by ouabain were evaluated. In the atrium, geraniol reduced the contractile force (~98%, EC = 1,510 ± 160 μM) and diminished the positive inotropism of CaCl2 and BAY K8644. In cardiomyocytes, the IC a,L was reduced by 50.7% (n = 5) after perfusion with 300 μM geraniol. Moreover, geraniol prolonged the AP duration (APD) measured at 50% (n = 5) after repolarization, without changing the resting potential. The increased APD could be attributed to the blockade of the transient outward K(+) current (Ito ) (59.7%, n = 4), the non-inactivation K(+) current (Iss ) (39.2%, n = 4) and the inward rectifier K(+) current (IK 1 ) (33.7%, n = 4). In isolated hearts, geraniol increased PRi and QTi without affecting the QRS complex (n = 6), and it reduced both the left ventricular pressure (83%) and heart rate (16.5%). Geraniol delayed the time to onset of ouabain-induced arrhythmias by 128%, preventing 30% of the increase in resting tension (n = 6). Geraniol exerts its negative inotropic and chronotropic responses in the heart by decreasing both L-type Ca(2+) and voltage-gated K(+) currents, ultimately acting against ouabain-induced arrhythmias. © 2014 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

Atmospheric bulk deposition to the Lagoon of Venice Part II. Source apportionment analysis near the industrial zone of Porto Marghera, Italy.

PubMed

Guerzoni, S; Rampazzo, G; Molinaroli, E; Rossini, P

2005-09-01

Multivariate statistical analyses were applied to measurements of atmospheric deposition of total particulate (TSP), inorganic elements (Al, Ca, Na, K, Mg, Si, Mn, Fe, Zn, Ni, Cr, Cu, Pb, Cd, As, Hg, V and S) and organic compounds (PAH, PCB, HCB and PCDD/F) collected in four stations, all located in the Lagoon of Venice. Aerosols at the scale of the basin (i.e., within a distance of 20 km) were mainly characterised by two end-members, one natural (composed of mineral particulate and marine spray) and one anthropogenic (with at least two different source components), affecting the sites in various ways. Variability at the two distant (>20 km) sites (Valle Dogà, Valle Figheri) was mainly due to natural components, whereas the other two stations (city of Venice, Dogaletto, approximately 5 km) were mainly impacted by industrial (and urban) sources. Total annual inputs were compared with the limits recently set by law (maximum allowed discharge=MAD). In the year of study, MAD values were exceeded for total As, Cd, Hg, Pb, dissolved Zn, PAH and PCDD/F. These results indicate that industrial sources gave rise to a quasi-permanent compositional (background) effect near the industrial area. The risk associated with atmospheric deposition should be quantified within the DSPIR framework to avoid future negative consequences in populations living in the vicinity of Porto Marghera.

Recurrent ventricular arrhythmias complicating myocardial infarction in the presence of phaeochromocytoma.

PubMed Central

McNeill, A J; Adgey, A A; Wilson, C

1992-01-01

After an acute myocardial infarction a 49 year old man developed late recurrent severe ventricular arrhythmias coincident with transient hypertensive episodes. A phaeochromocytoma was diagnosed on the basis of the urinary concentration of catecholamines and computerised tomography of the adrenal glands. After stabilisation of his cardiac rhythm and blood pressure with alpha and beta adrenergic blockade and anti-arrhythmic treatment the right adrenal gland, which contained the tumour, was successfully resected. The diagnosis of a phaeochromocytoma should be considered when recurrent ventricular arrhythmias are associated with intermittent hypertension after myocardial infarction. PMID:1739535

Ambient particulate air pollution and cardiac arrhythmia in a panel of older adults in Steubenville, Ohio

PubMed Central

Sarnat, S E; Suh, H H; Coull, B A; Schwartz, J; Stone, P H; Gold, D R

2006-01-01

Objectives Ambient particulate air pollution has been associated with increased risk of cardiovascular morbidity and mortality. Pathways by which particles may act involve autonomic nervous system dysfunction or inflammation, which can affect cardiac rate and rhythm. The importance of these pathways may vary by particle component or source. In an eastern US location with significant regional pollution, the authors examined the association of air pollution and odds of cardiac arrhythmia in older adults. Methods Thirty two non‐smoking older adults were evaluated on a weekly basis for 24 weeks during the summer and autumn of 2000 with a standardised 30 minute protocol that included continuous electrocardiogram measurements. A central ambient monitoring station provided daily concentrations of fine particles (PM2.5, sulfate, elemental carbon) and gases. Sulfate was used as a marker of regional pollution. The authors used logistic mixed effects regression to examine the odds of having any supraventricular ectopy (SVE) or ventricular ectopy (VE) in association with increases in air pollution for moving average pollutant concentrations up to 10 days before the health assessment. Results Participant specific mean counts of arrhythmia over the protocol varied between 0.1–363 for SVE and 0–350 for VE. The authors observed odds ratios for having SVE over the length of the protocol of 1.42 (95% CI 0.99 to 2.04), 1.70 (95% CI 1.12 to 2.57), and 1.78 (95% CI 0.95 to 3.35) for 10.0 μg/m3, 4.2 μg/m3, and 14.9 ppb increases in five day moving average PM2.5, sulfate, and ozone concentrations respectively. The other pollutants, including elemental carbon, showed no effect on arrhythmia. Participants reporting cardiovascular conditions (for example, previous myocardial infarction or hypertension) were the most susceptible to pollution induced SVE. The authors found no association of pollution with VE. Conclusion Increased levels of ambient sulfate and ozone may increase

Selective heart rate reduction with ivabradine slows ischaemia-induced electrophysiological changes and reduces ischaemia–reperfusion-induced ventricular arrhythmias

PubMed Central

Ng, Fu Siong; Shadi, Iqbal T.; Peters, Nicholas S.; Lyon, Alexander R.

2013-01-01

Heart rates during ischaemia and reperfusion are possible determinants of reperfusion arrhythmias. We used ivabradine, a selective If current inhibitor, to assess the effects of heart rate reduction (HRR) during ischaemia–reperfusion on reperfusion ventricular arrhythmias and assessed potential anti-arrhythmic mechanisms by optical mapping. Five groups of rat hearts were subjected to regional ischaemia by left anterior descending artery occlusion for 8 min followed by 10 min of reperfusion: (1) Control n = 10; (2) 1 μM of ivabradine perfusion n = 10; (3) 1 μM of ivabradine + 5 Hz atrial pacing throughout ischaemia–reperfusion n = 5; (4) 1 μM of ivabradine + 5 Hz pacing only at reperfusion; (5) 100 μM of ivabradine was used as a 1 ml bolus upon reperfusion. For optical mapping, 10 hearts (ivabradine n = 5; 5 Hz pacing n = 5) were subjected to global ischaemia whilst transmembrane voltage transients were recorded. Epicardial activation was mapped, and the rate of development of ischaemia-induced electrophysiological changes was assessed. HRR observed in the ivabradine group during both ischaemia (195 ± 11 bpm vs. control 272 ± 14 bpm, p < 0.05) and at reperfusion (168 ± 13 bpm vs. 276 ± 14 bpm, p < 0.05) was associated with reduced reperfusion ventricular fibrillation (VF) incidence (20% vs. 90%, p < 0.05). Pacing throughout ischaemia–reperfusion abolished the protective effects of ivabradine (100% VF), whereas pacing at reperfusion only partially attenuated this effect (40% VF). Ivabradine, given as a bolus at reperfusion, did not significantly affect VF incidence (80% VF). Optical mapping experiments showed a delay to ischaemia-induced conduction slowing (time to 50% conduction slowing: 10.2 ± 1.3 min vs. 5.1 ± 0.7 min, p < 0.05) and to loss of electrical excitability in ivabradine-perfused hearts (27.7 ± 4.3 min vs. 14.5 ± 0.6 min, p < 0.05). Ivabradine administered throughout ischaemia

Gout and arrhythmias: In search for causation beyond association.

PubMed

Giannopoulos, Georgios; Angelidis, Christos; Deftereos, Spyridon

2018-06-13

Gout is a systemic disease, characterized by the formation and deposition of crystals in tissues (mainly in and around the joints) of individuals with elevated serum uric acid levels. Lately, a considerable number of reports relating elevated uric acid and/or gout with rhythm disorders, such as atrial fibrillation, have been published. This review summarizes evidence linking common arrhythmias and hyperuricemia/gout and discusses questions or controversies that surround it. Overall, existing evidence may not be overwhelming, but strongly suggests a positive correlation between uric acid levels and common rhythm disorders. Needless to say that such a link - as a univariate association between the two - is to be expected, given the extensive overlap of risk factors and comorbidities of hyperuricemia/gout and arrhythmias. However, the observed associations seem to persist - in most studies - after extensive adjustment for potential confounders. Still, multivariable analyses of epidemiologically collected data cannot substitute for proof coming from basic and clinical studies. There is obviously a need for further basic research to establish a causal relationship between uric acid effects and arrhythmias, as well as translational studies and clinical trials to investigate the therapeutic implications of such a relationship. Simply put, we are fairly certain that there is association, but proof of causation is what we are still in want of. Copyright © 2018. Published by Elsevier Inc.

Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals.

PubMed

Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa

2016-04-01

Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support

"I Could Teach You How to Choose Right": Using Holocaust Memoir to Teach Shakespeare's "The Merchant of Venice"

ERIC Educational Resources Information Center

Whaley, Annemarie Koning

2011-01-01

The article examines the problems of teaching William Shakespeare's "The Merchant of Venice" after the Holocaust, arguing that even though the play is anti-Semitic, it can become a valuable teaching tool when placed in the context of the Holocaust memoirs "Dry Tears" by Nechama Tec and "The Nazi Officer's Wife" by…

A Real-Time Cardiac Arrhythmia Classification System with Wearable Sensor Networks

PubMed Central

Hu, Sheng; Wei, Hongxing; Chen, Youdong; Tan, Jindong

2012-01-01

Long term continuous monitoring of electrocardiogram (ECG) in a free living environment provides valuable information for prevention on the heart attack and other high risk diseases. This paper presents the design of a real-time wearable ECG monitoring system with associated cardiac arrhythmia classification algorithms. One of the striking advantages is that ECG analog front-end and on-node digital processing are designed to remove most of the noise and bias. In addition, the wearable sensor node is able to monitor the patient's ECG and motion signal in an unobstructive way. To realize the real-time medical analysis, the ECG is digitalized and transmitted to a smart phone via Bluetooth. On the smart phone, the ECG waveform is visualized and a novel layered hidden Markov model is seamlessly integrated to classify multiple cardiac arrhythmias in real time. Experimental results demonstrate that the clean and reliable ECG waveform can be captured in multiple stressed conditions and the real-time classification on cardiac arrhythmia is competent to other workbenches. PMID:23112746

Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform.

PubMed

Tripathy, Rajesh K; Zamora-Mendez, Alejandro; de la O Serna, José A; Paternina, Mario R Arrieta; Arrieta, Juan G; Naik, Ganesh R

2018-01-01

Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform

PubMed Central

Tripathy, Rajesh K.; Zamora-Mendez, Alejandro; de la O Serna, José A.; Paternina, Mario R. Arrieta; Arrieta, Juan G.; Naik, Ganesh R.

2018-01-01

Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

Simulation of Cardiac Arrhythmias Using a 2D Heterogeneous Whole Heart Model

PubMed Central

Balakrishnan, Minimol; Chakravarthy, V. Srinivasa; Guhathakurta, Soma

2015-01-01

Simulation studies of cardiac arrhythmias at the whole heart level with electrocardiogram (ECG) gives an understanding of how the underlying cell and tissue level changes manifest as rhythm disturbances in the ECG. We present a 2D whole heart model (WHM2D) which can accommodate variations at the cellular level and can generate the ECG waveform. It is shown that, by varying cellular-level parameters like the gap junction conductance (GJC), excitability, action potential duration (APD) and frequency of oscillations of the auto-rhythmic cell in WHM2D a large variety of cardiac arrhythmias can be generated including sinus tachycardia, sinus bradycardia, sinus arrhythmia, sinus pause, junctional rhythm, Wolf Parkinson White syndrome and all types of AV conduction blocks. WHM2D includes key components of the electrical conduction system of the heart like the SA (Sino atrial) node cells, fast conducting intranodal pathways, slow conducting atriovenctricular (AV) node, bundle of His cells, Purkinje network, atrial, and ventricular myocardial cells. SA nodal cells, AV nodal cells, bundle of His cells, and Purkinje cells are represented by the Fitzhugh-Nagumo (FN) model which is a reduced model of the Hodgkin-Huxley neuron model. The atrial and ventricular myocardial cells are modeled by the Aliev-Panfilov (AP) two-variable model proposed for cardiac excitation. WHM2D can prove to be a valuable clinical tool for understanding cardiac arrhythmias. PMID:26733873

ECG signal quality during arrhythmia and its application to false alarm reduction.

PubMed

Behar, Joachim; Oster, Julien; Li, Qiao; Clifford, Gari D

2013-06-01

An automated algorithm to assess electrocardiogram (ECG) quality for both normal and abnormal rhythms is presented for false arrhythmia alarm suppression of intensive care unit (ICU) monitors. A particular focus is given to the quality assessment of a wide variety of arrhythmias. Data from three databases were used: the Physionet Challenge 2011 dataset, the MIT-BIH arrhythmia database, and the MIMIC II database. The quality of more than 33 000 single-lead 10 s ECG segments were manually assessed and another 12 000 bad-quality single-lead ECG segments were generated using the Physionet noise stress test database. Signal quality indices (SQIs) were derived from the ECGs segments and used as the inputs to a support vector machine classifier with a Gaussian kernel. This classifier was trained to estimate the quality of an ECG segment. Classification accuracies of up to 99% on the training and test set were obtained for normal sinus rhythm and up to 95% for arrhythmias, although performance varied greatly depending on the type of rhythm. Additionally, the association between 4050 ICU alarms from the MIMIC II database and the signal quality, as evaluated by the classifier, was studied. Results suggest that the SQIs should be rhythm specific and that the classifier should be trained for each rhythm call independently. This would require a substantially increased set of labeled data in order to train an accurate algorithm.

Toxic metals in Venics lagoon sediments: Model, observation, an possible removal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Basu, A.; Molinaroli, E.

1994-11-01

We have modeled the distribution of nine toxic metals in the surface sediments from 163 stations in the Venice lagoon using published data. Three entrances from the Adriatic Sea control the circulation in the lagoon and divide it into three basins. We assume, for purposes of modeling, that Porto Marghera at the head of the Industrial Zone area is the single source of toxic metals in the Venice lagoon. In a standing body of lagoon water, concentration of pollutants at distance x from the source (C{sub 0}) may be given by C=C{sub 0}e{sup -kx} where k is the rate constantmore » of dispersal. We calculated k empirically using concentrations at the source, and those farthest from it, that is the end points of the lagoon. Average k values (ppm/km) in the lagoon are: Zn 0.165, Cd 0.116, Hg 0.110, Cu 0.105, Co 0.072, Pb 0.058, Ni 0.008, Cr (0.011) and Fe (0.018 percent/km), and they have complex distributions. Given the k values, concentration at source (C{sub 0}), and the distance x of any point in the lagoon from the source, we have calculated the model concentrations of the nine metals at each sampling station. Tides, currents, floor morphology, additional sources, and continued dumping perturb model distributions causing anomalies (observed minus model concentrations). Positive anomalies are found near the source, where continued dumping perturbs initial boundary conditions, and in areas of sluggish circulation. Negative anomalies are found in areas with strong currents that may flush sediments out of the lagoon. We have thus identified areas in the lagoon where higher rate of sediment removal and exchange may lesson pollution. 41 refs., 4 figs., 3 tabs.« less

Radiological impact of phosphogypsum discharged into the Venice lagoon: 222Rn

NASA Astrophysics Data System (ADS)

Cantaluppi, C.; Ceccotto, F.; Cianchi, A.; Fasson, A.; Degetto, S.

2012-04-01

For about 20 years, between the 60 's and the 80 's of the last century, in the Passo a Campalto area (Lagoon of Venice - Italy) about 400,000 m3 of phosphogypsum (PG) were deposited at the border of the lagoon and next to urban areas without any environmental control. These materials are a by-product formed during the wet processing of phosphate rocks by sulphuric acid and have a significant environmental impact due to their abundance and their chemical-physical and radiochemical characteristics. The PG contains both chemical elements, which are considered dangerous for the ecosystems and natural radionuclides whose concentrations are much higher if compared to those typical for the Earth's crust. These discarded materials caused for many years the dispersion of radionuclides in the environment due to the tidal erosion, the re-suspension of radioactive inhalable dusts, the uncontrolled radon exhalation and the bioaccumulation of some radionuclides in the lagoon environment. After a decision of the appointed authorities, the Venice Water Authority (Ministry of Infrastructure and Transport), planned a permanent safety control of the site resulting in the complete isolation of the entire volume of contaminated materials from the environmental system. The entire project was specific for the particular features of the site and it required the improvement of analytical, sampling and measurement techniques in order to verify the effectiveness of the safety action. The radon assessment, in particular the check of the effectiveness of the inhibition of radon exhalation, is part of a more complex study, covering many other aspects of the management of a permanent disposal; they will be the object of further notes. The ultimate results of this study prove the efficacy of the intervention: radon concentrations in air and exhalation values from the restored area, measured during surveys, have been proved to be well in agreement with those of non contaminated soils.

Remote Navigation for Complex Arrhythmia

PubMed Central

Suman-Horduna, Irina; Babu-Narayan, Sonya V; Ernst, Sabine

2013-01-01

Magnetic navigation has been established as an alternative to conventional, manual catheter navigation for invasive electrophysiology interventions about a decade ago. Besides the obvious advantage of radiation protection for the operator who is positioned remotely from the patient, there are additional benefits of steering the tip of a very floppy catheter. This manuscript reviews the published evidence from simple arrhythmias in patients with normal cardiac anatomy to the most complex congenital heart disease. This progress was made possible by the introduction of improved catheters and most importantly irrigated-tip electrodes. PMID:26835041

Statins as anti-arrhythmics: a systematic review part II: effects on risk of ventricular arrhythmias.

PubMed

Abuissa, Hussam; O'Keefe, James H; Bybee, Kevin A

2009-10-01

Recent studies have demonstrated that statins may possess anti-arrhythmic properties in addition to their lipid-lowering effects. Studies which reported the association of statins with the incidence of ventricular arrhythmias were identified through a systematic review of the published literature. Statins have been associated with a significant reductions in ventricular arrhythmia in cardiomyopathy patients with an implantable cardioverter defibrillator, although randomized trials have not been completed. Published data suggests that statins may possess anti-arrhythmic properties that reduce the propensity for ventricular arrhythmias. Most of this data is observational; more randomized, placebo-controlled trials are needed.

Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

PubMed

Xu, Mingzhu; Yang, Xiangjun

2015-01-01

Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated. Copyright © 2015 Elsevier Inc. All rights reserved.

Abolition of reperfusion-induced arrhythmias in hearts from thiamine-deficient rats.

PubMed

Oliveira, Fernando A; Guatimosim, Silvia; Castro, Carlos H; Galan, Diogo T; Lauton-Santos, Sandra; Ribeiro, Angela M; Almeida, Alvair P; Cruz, Jader S

2007-07-01

Extensive work has been done regarding the impact of thiamine deprivation on the nervous system. In cardiac tissue, chronic thiamine deficiency is described to cause changes in the myocardium that can be associated with arrhythmias. However, compared with the brain, very little is known about the effects of thiamine deficiency on the heart. Thus this study was undertaken to explore whether thiamine deprivation has a role in cardiac arrhythmogenesis. We examined hearts isolated from thiamine-deprived and control rats. We measured heart rate, diastolic and systolic tension, and contraction and relaxation rates. Whole cell voltage clamp was performed in rat isolated cardiac myocytes to measure L-type Ca(2+) current. In addition, we investigated the global intracellular calcium transients by using confocal microscopy in the line-scan mode. The hearts from thiamine-deficient rats did not degenerate into ventricular fibrillation during 30 min of reperfusion after 15 min of coronary occlusion. The antiarrhythmogenic effects were characterized by the arrhythmia severity index. Our results suggest that hearts from thiamine-deficient rats did not experience irreversible arrhythmias. There was no change in L-type Ca(2+) current density. Inactivation kinetics of this current in Ca(2+)-buffered cells was retarded in thiamine-deficient cardiac myocytes. The global Ca(2+) release was significantly reduced in thiamine-deficient cardiac myocytes. The amplitude of caffeine-releasable Ca(2+) was lower in thiamine-deficient myocytes. In summary, we have found that thiamine deprivation attenuates the incidence and severity of postischemic arrhythmias, possibly through a mechanism involving a decrease in global Ca(2+) release.

Clinical Profile of Cardiac Arrhythmias in Children Attending the Out Patient Department of a Tertiary Paediatric Care Centre in Chennai

PubMed Central

Sundararajan, Premkumar; Sangaralingam, Thangavelu

2016-01-01

Introduction The presentation of symptoms of paediatric arrhythmias vary depending on the age and underlying heart disease. Physical examination of children with important arrhythmias may be entirely normal. Aim Aim is to study the characteristics of cardiac arrhythmias in paediatric patients in a tertiary paediatric care centre in Chennai, India. Materials and Methods The participants (n=60) were from birth to 12 years of age. Patients with sinus arrhythmias, sinus tachycardia and sinus bradycardia were excluded. Proportions of various parameters of interest like clinical features, age and sex distribution and underlying heart disease of children presenting with cardiac arrhythmias were arrived. Statistical analysis was performed using SPSS version 16.0. Results Ventricular ectopics were the most common type of arrhythmias observed in the present study followed by Sinus Node Dysfunction (SND). The most common type of SND was sino atrial arrest. Supra ventricular tachycardia was the most frequently sustained tachyarrhythmia in the present study. An increased association of WPW (Wolf Parkinson White Syndrome) with specific congenital cardiac defects was noted. Conclusion Cardiac arrhythmias in children can present at anytime from fetal life to adolescence and their recognition requires high index of suspicion. While majority of children with arrhythmias have structurally normal heart, they are frequently encountered in children with underlying heart disease. Treatment of paediatric arrhythmias should be guided by the severity of the patient, the structure and function of the heart. PMID:28208963

Testing lagoonal sediments with early life stages of the copepod Acartia tonsa (Dana): An approach to assess sediment toxicity in the Venice Lagoon.

PubMed

Picone, Marco; Bergamin, Martina; Delaney, Eugenia; Ghirardini, Annamaria Volpi; Kusk, Kresten Ole

2018-01-01

The early-life stages of development of the calanoid copepod Acartia tonsa from egg to copepodite I is proposed as an endpoint for assessing sediment toxicity by exposing newly released eggs directly onto the sediment-water interface. A preliminary study of 5 sediment samples collected in the lagoon of Venice highlighted that the larval development rate (LDR) and the early-life stages (ELS) mortality endpoints with A. tonsa are more sensitive than the standard amphipod mortality test; moreover LDR resulted in a more reliable endpoint than ELS mortality, due to the interference of the sediment with the recovery of unhatched eggs and dead larvae. The LDR data collected in a definitive study of 48 sediment samples from the Venice Lagoon has been analysed together with the preliminary data to evaluate the statistical performances of the bioassay (among replicate variance and minimum significant difference between samples and control) and to investigate the possible correlation with sediment chemistry and physical properties. The results showed that statistical performances of the LDR test with A. tonsa correspond with the outcomes of other tests applied to the sediment-water interface (Strongylocentrotus purpuratus embryotoxicity test), sediments (Neanthes arenaceodentata survival and growth test) and porewater (S. purpuratus); the LDR endpoint did, however, show a slightly higher variance as compared with other tests used in the Lagoon of Venice, such as 10-d amphipod lethality test and larval development with sea urchin and bivalves embryos. Sediment toxicity data highlighted the high sensitivity and the clear ability of the larval development to discriminate among sediments characterized by different levels of contamination. The data of the definitive study evidenced that inhibition of the larval development was not affected by grain-size and the organic carbon content of the sediment; in contrast, a strong correlation between inhibition of the larval development

[Clinical aspects of reperfusion arrhythmia following intravenous thrombolysis in acute myocardial infarct].

PubMed

Kettner, W; Klein, E; Schulz, W; Götze, C

1987-05-15

In accordance with the majority of the reports in the literature reperfusion arrhythmias were observed in more than 30% of the patients with acute myocardial infarction (n = 25) under or immediately after a highly dosed short-term infusion with streptokinase. With reference to indirect signs the recanalisation rate was assumed with 75%. Only one third of the reperfusion arrhythmias had haemodynamically significant characteristics and required an influence. Though in literature from animal experimental findings directive conclusions for the therapy are to be derived, the procedure in practice is still vastly empirical. In the ventricular tachycardia lidocaine, procainamide and ajmalin may be recommended. In ineffectiveness or particularly threatening situations the electrotherapy (cardioversion, DC-shock) is to be preferred. The concept inaugurated by Corr and Witkowski apply alpha-adrenoreceptor blockers has not yet entered the clinical practice. Possible problems in the treatment of reperfusion arrhythmias in the prehospital phase should at present still be a reason not to antedate the thrombolytic therapy into this phase.

Ubiquitous health monitoring and real-time cardiac arrhythmias detection: a case study.

PubMed

Li, Jian; Zhou, Haiying; Zuo, Decheng; Hou, Kun-Mean; De Vaulx, Christophe

2014-01-01

As the symptoms and signs of heart diseases that cause sudden cardiac death, cardiac arrhythmia has attracted great attention. Due to limitations in time and space, traditional approaches to cardiac arrhythmias detection fail to provide a real-time continuous monitoring and testing service applicable in different environmental conditions. Integrated with the latest technologies in ECG (electrocardiograph) analysis and medical care, the pervasive computing technology makes possible the ubiquitous cardiac care services, and thus brings about new technical challenges, especially in the formation of cardiac care architecture and realization of the real-time automatic ECG detection algorithm dedicated to care devices. In this paper, a ubiquitous cardiac care prototype system is presented with its architecture framework well elaborated. This prototype system has been tested and evaluated in all the clinical-/home-/outdoor-care modes with a satisfactory performance in providing real-time continuous cardiac arrhythmias monitoring service unlimitedly adaptable in time and space.

Metabolic Syndrome Remodels Electrical Activity of the Sinoatrial Node and Produces Arrhythmias in Rats

PubMed Central

Albarado-Ibañez, Alondra; Avelino-Cruz, José Everardo; Velasco, Myrian; Torres-Jácome, Julián; Hiriart, Marcia

2013-01-01

In the last ten years, the incidences of metabolic syndrome and supraventricular arrhythmias have greatly increased. The metabolic syndrome is a cluster of alterations, which include obesity, hypertension, hypertriglyceridemia, glucose intolerance and insulin resistance, that increase the risk of developing, among others, atrial and nodal arrhythmias. The aim of this study is to demonstrate that metabolic syndrome induces electrical remodeling of the sinus node and produces arrhythmias. We induced metabolic syndrome in 2-month-old male Wistar rats by administering 20% sucrose in the drinking water. Eight weeks later, the rats were anesthetized and the electrocardiogram was recorded, revealing the presence of arrhythmias only in treated rats. Using conventional microelectrode and voltage clamp techniques, we analyzed the electrical activity of the sinoatrial node. We observed that in the sinoatrial node of “metabolic syndrome rats”, compared to controls, the spontaneous firing of all cells decreased, while the slope of the diastolic depolarization increased only in latent pacemaker cells. Accordingly, the pacemaker currents If and Ist increased. Furthermore, histological analysis showed a large amount of fat surrounding nodal cardiomyocytes and a rise in the sympathetic innervation. Finally, Poincaré plot denoted irregularity in the R-R and P-P ECG intervals, in agreement with the variability of nodal firing potential recorded in metabolic syndrome rats. We conclude that metabolic syndrome produces a dysfunction SA node by disrupting normal architecture and the electrical activity, which could explain the onset of arrhythmias in rats. PMID:24250786

Metabolic syndrome remodels electrical activity of the sinoatrial node and produces arrhythmias in rats.

PubMed

Albarado-Ibañez, Alondra; Avelino-Cruz, José Everardo; Velasco, Myrian; Torres-Jácome, Julián; Hiriart, Marcia

2013-01-01

In the last ten years, the incidences of metabolic syndrome and supraventricular arrhythmias have greatly increased. The metabolic syndrome is a cluster of alterations, which include obesity, hypertension, hypertriglyceridemia, glucose intolerance and insulin resistance, that increase the risk of developing, among others, atrial and nodal arrhythmias. The aim of this study is to demonstrate that metabolic syndrome induces electrical remodeling of the sinus node and produces arrhythmias. We induced metabolic syndrome in 2-month-old male Wistar rats by administering 20% sucrose in the drinking water. Eight weeks later, the rats were anesthetized and the electrocardiogram was recorded, revealing the presence of arrhythmias only in treated rats. Using conventional microelectrode and voltage clamp techniques, we analyzed the electrical activity of the sinoatrial node. We observed that in the sinoatrial node of "metabolic syndrome rats", compared to controls, the spontaneous firing of all cells decreased, while the slope of the diastolic depolarization increased only in latent pacemaker cells. Accordingly, the pacemaker currents If and Ist increased. Furthermore, histological analysis showed a large amount of fat surrounding nodal cardiomyocytes and a rise in the sympathetic innervation. Finally, Poincaré plot denoted irregularity in the R-R and P-P ECG intervals, in agreement with the variability of nodal firing potential recorded in metabolic syndrome rats. We conclude that metabolic syndrome produces a dysfunction SA node by disrupting normal architecture and the electrical activity, which could explain the onset of arrhythmias in rats.

Excessive exercise habits of runners as new signs of hypertension and arrhythmia.

PubMed

Kim, Young-Joo; Kim, Chul-Hyun; Park, Kyoung-Min

2016-08-15

Excessive exercise may induce arrhythmia, and this risk is higher in middle-aged people. The study aim was to compare the exercise characteristics of middle-aged runners participating in excessive endurance exercise. The subjects of this study were 552 runners (mean age; 49.0±7.4years) without structural heart disease who performed exercise at least twice per week, had consistently exercised for at least three years, and had finished at least five marathons. The arrhythmia runner group (ARG, n=14) and normal runner group (NRG, n=538) were compared with regard to hemodynamic response, cardiorespiratory fitness level, training history, number of finished races, finishing times, and exercise habits. The mean resting systolic (134.0±15.8mmHg) and diastolic (85.8±10.9mmHg) blood pressure values indicated pre-hypertension, while the mean maximal SBP (213.7±27.4mmHg) values indicated exercise-induced hypertension. The VO2max was significantly higher and the maximal DBP was significantly lower in the ARG than in the NRG (p<0.05). Training history was significantly longer in the ARG than in the NRG (p<0.05), while the number of finished marathons, the finishing times in marathons and the exercise frequency per week didn't differ significantly between the two groups. Exercise intensity was significantly higher in the ARG than in the NRG (p<0.01). Middle-aged long-distance runners showed pre-hypertension and exercise-induced hypertension, and the ARG had higher VO2max values, greater exercise intensities, and longer training histories than the NRG. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Impact of arrhythmia on diagnostic performance of adenosine stress CMR in patients with suspected or known coronary artery disease.

PubMed

Greulich, Simon; Steubing, Hannah; Birkmeier, Stefan; Grün, Stefan; Bentz, Kerstin; Sechtem, Udo; Mahrholdt, Heiko

2015-11-05

The diagnostic performance of adenosine stress cardiovascular magnetic resonance (CMR) in patients with arrhythmias presenting for work-up of suspected or known CAD is largely unknown, since most CMR studies currently available exclude arrhythmic patients from analysis fearing gating problems, or other artifacts will impair image quality. The primary aim of our study was to evaluate the diagnostic performance of adenosine stress CMR for detection of significant coronary stenosis in patients with arrhythmia presenting for 1) work-up of suspected coronary artery disease (CAD), or 2) work-up of ischemia in known CAD. Patients with arrhythmia referred for work-up of suspected CAD or work-up of ischemia in known CAD undergoing adenosine stress CMR were included if they had coronary angiography within four weeks of CMR. One hundred fifty-nine patients were included (n = 64 atrial fibrillation, n = 87 frequent ventricular extrasystoles, n = 8 frequent supraventricular extrasystoles). Of these, n = 72 had suspected CAD, and n = 87 had known CAD. Diagnostic accuracy of the adenosine stress CMR for detection of significant CAD was 73 % for the entire population (sensitivity 72 %, specificity 76 %). Diagnostic accuracy was 75 % (sensitivity 80 %, specificity 74 %) in patients with suspected CAD, and 74 % (sensitivity 71 %, specificity 79 %) in the group with known CAD. For different types of arrhythmia, diagnostic accuracy of CMR was 70 % in the atrial fibrillation group, and 79 % in patients with ventricular extrasystoles. On a per coronary territory analysis, diagnostic accuracy of CMR was 77 % for stenosis of the left and 82 % for stenosis of the right coronary artery. The present data demonstrates good diagnostic performance of adenosine stress CMR for detection of significant coronary stenosis in patients with arrhythmia presenting for work-up of suspected CAD, or work-up of ischemia in known CAD. This holds true for a per patient, as

Ship traffic and shoreline erosion in the Lagoon of Venice

NASA Astrophysics Data System (ADS)

Scarpa, Gian Marco; Zaggia, Luca; Lorenzetti, Giuliano; Manfè, Giorgia; Parnell, Kevin; Molinaroli, Emanuela; Rapaglia, John; Gionta, Sofia

2016-04-01

A study based on the analysis of a historical sequence of aerial photographs and satellite images combined with in situ measurements revealed an unprecedented shoreline regression on the side of a major waterway in the Venice Lagoon, Italy. The study considered long and short-term recession rates caused by ship-induced depression wakes in an area which was reclaimed at the end of the '60 for the expansion of the nearby Porto Marghera Industrial Zone and never used since then. The GIS analysis performed with the available imagery shows an average retreat of about 4 m yr-1 in the period between 1965 and 2015. Field measurements carried out between April 2014 and January 2015 also revealed that the shoreline's regression still proceed with a speed comparable to the long-term average regardless of the distance from the navigation channel and is not constant through time. Periods of high water levels determined by astronomical tide or storm surges, more common in the winter season, are characterized by faster regression rates. The retreat proceeds by collapse of slabs of the reclaimed muddy soil after erosion and removal of the underlying original salt marsh sediments and is a discontinuous process in time and space depending on morphology, intrinsic propertiesand vegetation cover of the artificial deposits. Digitalization of historical maps and new bathymetric surveys made in April 2015 allowed for the reconstruction of two digital terrain models for both past and present situations. The two models have been used to calculate the total volume of sediment lost during the period between 1970 and 2015. The results of this study shows as ship-channel interactions can dominate the morphodynamics of a waterway and its margins and permitted to better understand how this part of the Venice Lagoon reacted to the pressure of human activities in the post-industrial period. Evaluation of the temporal and spatial variation of shoreline position is also crucial to predict future

Ursodeoxycholic acid prevents ventricular conduction slowing and arrhythmia by restoring T-type calcium current in fetuses during cholestasis.

PubMed

Adeyemi, Oladipupo; Alvarez-Laviada, Anita; Schultz, Francisca; Ibrahim, Effendi; Trauner, Michael; Williamson, Catherine; Glukhov, Alexey V; Gorelik, Julia

2017-01-01

Increased maternal serum bile acid concentrations in intrahepatic cholestasis of pregnancy (ICP) are associated with fetal cardiac arrhythmias. Ursodeoxycholic acid (UDCA) has been shown to demonstrate anti-arrhythmic properties via preventing ICP-associated cardiac conduction slowing and development of reentrant arrhythmias, although the cellular mechanism is still being elucidated. High-resolution fluorescent optical mapping of electrical activity and electrocardiogram measurements were used to characterize effects of UDCA on one-day-old neonatal and adult female Langendorff-perfused rat hearts. ICP was modelled by perfusion of taurocholic acid (TC, 400μM). Whole-cell calcium currents were recorded from neonatal rat and human fetal cardiomyocytes. TC significantly prolonged the PR interval by 11.0±3.5% (P<0.05) and slowed ventricular conduction velocity (CV) by 38.9±5.1% (P<0.05) exclusively in neonatal and not in maternal hearts. A similar CV decline was observed with the selective T-type calcium current (ICa,T) blocker mibefradil 1μM (23.0±6.2%, P<0.05), but not with the L-type calcium current (ICa,L) blocker nifedipine 1μM (6.9±6.6%, NS). The sodium channel blocker lidocaine (30μM) reduced CV by 60.4±4.5% (P<0.05). UDCA co-treatment was protective against CV slowing induced by TC and mibefradil, but not against lidocaine. UDCA prevented the TC-induced reduction in the ICa,T density in both isolated human fetal (-10.2±1.5 versus -5.5±0.9 pA/pF, P<0.05) and neonatal rat ventricular myocytes (-22.3±1.1 versus -9.6±0.8 pA/pF, P<0.0001), whereas UDCA had limited efficacy on the ICa,L. Our findings demonstrate that ICa,T plays a significant role in ICP-associated fetal cardiac conduction slowing and arrhythmogenesis, and is an important component of the fetus-specific anti-arrhythmic activity of UDCA.

Ursodeoxycholic acid prevents ventricular conduction slowing and arrhythmia by restoring T-type calcium current in fetuses during cholestasis

PubMed Central

Adeyemi, Oladipupo; Alvarez-Laviada, Anita; Schultz, Francisca; Ibrahim, Effendi; Trauner, Michael; Williamson, Catherine; Glukhov, Alexey V.

2017-01-01

Background Increased maternal serum bile acid concentrations in intrahepatic cholestasis of pregnancy (ICP) are associated with fetal cardiac arrhythmias. Ursodeoxycholic acid (UDCA) has been shown to demonstrate anti-arrhythmic properties via preventing ICP-associated cardiac conduction slowing and development of reentrant arrhythmias, although the cellular mechanism is still being elucidated. Methods High-resolution fluorescent optical mapping of electrical activity and electrocardiogram measurements were used to characterize effects of UDCA on one-day-old neonatal and adult female Langendorff-perfused rat hearts. ICP was modelled by perfusion of taurocholic acid (TC, 400μM). Whole-cell calcium currents were recorded from neonatal rat and human fetal cardiomyocytes. Results TC significantly prolonged the PR interval by 11.0±3.5% (P<0.05) and slowed ventricular conduction velocity (CV) by 38.9±5.1% (P<0.05) exclusively in neonatal and not in maternal hearts. A similar CV decline was observed with the selective T-type calcium current (ICa,T) blocker mibefradil 1μM (23.0±6.2%, P<0.05), but not with the L-type calcium current (ICa,L) blocker nifedipine 1μM (6.9±6.6%, NS). The sodium channel blocker lidocaine (30μM) reduced CV by 60.4±4.5% (P<0.05). UDCA co-treatment was protective against CV slowing induced by TC and mibefradil, but not against lidocaine. UDCA prevented the TC-induced reduction in the ICa,T density in both isolated human fetal (−10.2±1.5 versus −5.5±0.9 pA/pF, P<0.05) and neonatal rat ventricular myocytes (−22.3±1.1 versus −9.6±0.8 pA/pF, P<0.0001), whereas UDCA had limited efficacy on the ICa,L. Conclusion Our findings demonstrate that ICa,T plays a significant role in ICP-associated fetal cardiac conduction slowing and arrhythmogenesis, and is an important component of the fetus-specific anti-arrhythmic activity of UDCA. PMID:28934223

Noninvasive cardiac activation imaging of ventricular arrhythmias during drug-induced QT prolongation in the rabbit heart.

PubMed

Han, Chengzong; Pogwizd, Steven M; Killingsworth, Cheryl R; Zhou, Zhaoye; He, Bin

2013-10-01

Imaging myocardial activation from noninvasive body surface potentials promises to aid in both cardiovascular research and clinical medicine. To investigate the ability of a noninvasive 3-dimensional cardiac electrical imaging technique for characterizing the activation patterns of dynamically changing ventricular arrhythmias during drug-induced QT prolongation in rabbits. Simultaneous body surface potential mapping and 3-dimensional intracardiac mapping were performed in a closed-chest condition in 8 rabbits. Data analysis was performed on premature ventricular complexes, couplets, and torsades de pointes (TdP) induced during intravenous administration of clofilium and phenylephrine with combinations of various infusion rates. The drug infusion led to a significant increase in the QT interval (from 175 ± 7 to 274 ± 31 ms) and rate-corrected QT interval (from 183 ± 5 to 262 ± 21 ms) during the first dose cycle. All the ectopic beats initiated by a focal activation pattern. The initial beat of TdPs arose at the focal site, whereas the subsequent beats were due to focal activity from different sites or 2 competing focal sites. The imaged results captured the dynamic shift of activation patterns and were in good correlation with the simultaneous measurements, with a correlation coefficient of 0.65 ± 0.02 averaged over 111 ectopic beats. Sites of initial activation were localized to be ~5 mm from the directly measured initiation sites. The 3-dimensional cardiac electrical imaging technique could localize the origin of activation and image activation sequence of TdP during QT prolongation induced by clofilium and phenylephrine in rabbits. It offers the potential to noninvasively investigate the proarrhythmic effects of drug infusion and assess the mechanisms of arrhythmias on a beat-to-beat basis. © 2013 Heart Rhythm Society. All rights reserved.

8 CFR 100.5 - Regulations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Regulations. 100.5 Section 100.5 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS STATEMENT OF ORGANIZATION § 100.5 Regulations. The regulations of the Department of Homeland Security, published as chapter I of title 8 of the...

8 CFR 100.5 - Regulations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Regulations. 100.5 Section 100.5 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS STATEMENT OF ORGANIZATION § 100.5 Regulations. The regulations of the Department of Homeland Security, published as chapter I of title 8 of the...

The eSurge-Venice project: altimeter and scatterometer satellite data to improve the storm surge forecasting in the city of Venice

NASA Astrophysics Data System (ADS)

Zecchetto, Stefano; De Biasio, Francesco; Umgiesser, Georg; Bajo, Marco; Vignudelli, Stefano; Papa, Alvise; Donlon, Craig; Bellafiore, Debora

2013-04-01

On the framework of the Data User Element (DUE) program, the European Space Agency is funding a project to use altimeter Total Water Level Envelope (TWLE) and scatterometer wind data to improve the storm surge forecasting in the Adriatic Sea and in the city of Venice. The project will: a) Select a number of Storm Surge Events occurred in the Venice lagoon in the period 1999-present day b) Provide the available satellite Earth Observation (EO) data related to the Storm Surge Events, mainly satellite winds and altimeter data, as well as all the available in-situ data and model forecasts c) Provide a demonstration Near Real Time service of EO data products and services in support of operational and experimental forecasting and warning services d) Run a number of re-analysis cases, both for historical and contemporary storm surge events, to demonstrate the usefulness of EO data The re-analysis experiments, based on hindcasts performed by the finite element 2-D oceanographic model SHYFEM (https://sites.google.com/site/shyfem/), will 1. use different forcing wind fields (calibrated and not calibrated with satellite wind data) 2. use Storm Surge Model initial conditions determined from altimeter TWLE data. The experience gained working with scatterometer and Numerical Weather Prediction (NWP) winds in the Adriatic Sea tells us that the bias NWP-Scatt wind is negative and spatially and temporally not uniform. In particular, a well established point is that the bias is higher close to coasts then offshore. Therefore, NWP wind speed calibration will be carried out on each single grid point in the Adriatic Sea domain over the period of a Storm Surge Event, taking into account of existing published methods. Point #2 considers two different methodologies to be used in re-analysis tests. One is based on the use of the TWLE values from altimeter data in the Storm Surge Model (SSM), applying data assimilation methodologies and trying to optimize the initial conditions of the

Intracoronary infusion of catecholamines causes focal arrhythmias in pigs.

PubMed

Doppalapudi, Harish; Jin, Qi; Dosdall, Derek J; Qin, Hao; Walcott, Gregory P; Killingsworth, Cheryl R; Smith, William M; Ideker, Raymond E; Huang, Jian

2008-09-01

Acute ischemia causes myriad changes including increased catecholamines. We tested the hypothesis that elevated catecholamines alone are arrhythmogenic. A 504 electrode sock was placed over both ventricles in six open-chest pigs. During control infusion of saline through a catheter in the left anterior descending coronary artery (LAD), no sustained arrhythmias occurred, and the refractory period estimated by the activation recovery interval (ARI) was 175 +/- 14 ms in the LAD bed below the catheter. After infusion of isoproterenol at 0.1 microg/kg/min through the catheter, the ARI in this bed was significantly reduced to 109 +/- 10 ms. A sharp gradient of refractoriness of 43 +/- 10 ms was at the border of the perfused bed. Sustained monomorphic ventricular tachycardia occurred after drug infusion in the perfused bed or near its boundary in all animals with a cycle length of 329 +/- 26 ms and a focal origin. The maximum slope of the ARI restitution curve at the focal origins of the tachyarrhythmias was always <1 (0.62 +/- 0.15). Similar results with a focal arrhythmia origin occurred in two additional pigs in which intramural mapping was performed with 36 plunge needle electrodes in the left ventricular perfused bed. Regional elevation of a catecholamine, which is one of the alterations produced by acute ischemia, can by itself cause tachyarrhythmias. These arrhythmias are closely associated with a shortened refractory period and a large gradient of the spatial distribution of refractoriness but not with a steep restitution curve.

Intracardiac echo-facilitated 3D electroanatomical mapping of ventricular arrhythmias from the papillary muscles: assessing the 'fourth dimension' during ablation.

PubMed

Proietti, Riccardo; Rivera, Santiago; Dussault, Charles; Essebag, Vidal; Bernier, Martin L; Ayala-Paredes, Felix; Badra-Verdu, Mariano; Roux, Jean-François

2017-01-01

Ventricular arrhythmias (VA) originating from a papillary muscle (PM) have recently been described as a distinct clinical entity with peculiar features that make its treatment with catheter ablation challenging. Here, we report our experience using an intracardiac echo-facilitated 3D electroanatomical mapping approach in a case series of patients undergoing ablation for PM VA. Sixteen patients who underwent catheter ablation for ventricular tachycardia (VT) or symptomatic premature ventricular contractions originating from left ventricular PMs were included in the study. A total of 24 procedures (mean 1.5 per patient) were performed: 15 using a retrograde aortic approach and 9 using a transseptal approach. Integrated intracardiac ultrasound for 3D electroanatomical mapping was used in 15 of the 24 procedures. The posteromedial PM was the most frequent culprit for the clinical arrhythmia, and the body was the part of the PM most likely to be the successful site for ablation. The site of ablation was identified based on the best pace map matching the clinical arrhythmia and the site of earliest the activation. At a mean follow-up of 10.5 ± 7 months, only two patients had recurrent arrhythmias following a repeat ablation procedure. An echo-facilitated 3D electroanatomical mapping allows for real-time creation of precise geometries of cardiac chambers and endocavitary structures. This is useful during procedures such as catheter ablation of VAs originating from PMs, which require detailed representation of anatomical landmarks. Routine adoption of this technique should be considered to improve outcomes of PM VA ablation. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Genome-wide association of implantable cardioverter-defibrillator activation with life-threatening arrhythmias.

PubMed

Murray, Sarah S; Smith, Erin N; Villarasa, Nikki; Nahey, Tara; Lande, Jeff; Goldberg, Harold; Shaw, Marian; Rosenthal, Lawrence; Ramza, Brian; Alaeddini, Jamshid; Han, Xinqiang; Damani, Samir; Soykan, Orhan; Kowal, Robert C; Topol, Eric J

2012-01-01

To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD), we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases) vs. those who did not over at least a 3-year period (controls). Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10⁻⁶. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram) were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. ClinicalTrials.gov NCT00664807.

Evaluation of oxidative stress biomarkers in Zosterisessor ophiocephalus from the Venice Lagoon, Italy.

PubMed

Pascoli, Francesco; Negrato, Elena; Di Giancamillo, Alessia; Bertotto, Daniela; Domeneghini, Cinzia; Simontacchi, Claudia; Mutinelli, Franco; Radaelli, Giuseppe

2011-02-01

Several studies carried out in the last years have demonstrated the presence of a wide range of contaminants in some areas of the Venice Lagoon. Many of these contaminants are able to drive free radical reactions, which lead to oxidative stress and can potentially affect fish health. In the present study, oxidative stress biomarkers were examined in three different sites (Porto Marghera, Val di Brenta and Caroman) of the Venice Lagoon and their levels monitored in Zosterisessor ophiocephalus, one of the most common fish species present in the lagoon. Schmorl's staining revealed the presence of melanomacrophage centres in spleen and head kidney, and the highest number of melanomacrophage centres was observed in the animals sampled at the Porto Marghera (Porto Marghera vs Val di brenta and Caroman: p<0.01). The cellular localization of HNE and NT, investigated through an immunohistochemical approach, showed that immunopositivity was mainly localized in melanomacrophage centres of spleen and kidney. It is relevant that the animals of the detoxified control group did not exhibit any immunoreactivity. By Western blot, the antibodies against HNE and NT recognized in the liver polypeptides damaged by oxidative stress with molecular weights under 66kDa. Comparing the relative densities, animals from the Val di Brenta site exhibited the lowest levels of HNE adducts (p<0.05), whereas animals from the Porto Marghera site exhibited the highest levels of NT adducts (p<0.05). MDA levels, measured spectrophotometrically by TBARS assay did not exhibit any statistical difference among sites. Copyright © 2010 Elsevier B.V. All rights reserved.

The current state of introduction of HPV vaccination into national immunisation schedules in Europe: results of the VENICE 2008 survey.

PubMed

Lévy-Bruhl, D; Bousquet, V; King, L A; O'Flanagan, D; Bacci, S; Lopalco, P L; Salmaso, S

2009-10-01

Three surveys have been undertaken in European Union (EU) member states since January 2007, within the European Commission funded Vaccine European New Integrated Collaboration Effort (VENICE) project, to monitor the decision status regarding the introduction of human papillomavirus (HPV) vaccination into national immunisation schedules. A web-based questionnaire was developed and completed online by the 28 countries participating in VENICE. According to the last update (31st December 2008), 15 countries have decided to introduce HPV vaccination into their national immunisation schedule, while another six have started the decision-making process with a recommendation favouring introduction. Varying target populations have been selected by the countries which have introduced vaccination. The number of countries which have made a decision or recommendation has increased from 12 to 21 between October 2007 and December 2008. This survey demonstrates the rapidly evolving nature of HPV vaccine introduction in Europe. A further update should be available in the second half of 2009.

On the Lateral Retreat of Salt Marshes: Field Monitoring in the Venice Lagoon (Italy)

NASA Astrophysics Data System (ADS)

Solari, L.; Bendoni, M.; Mel, R.; Oumeraci, H.; Francalanci, S.; Lanzoni, S.

2014-12-01

Salt marshes are geomorphic structures located in ecotone environments such as lagoon and estuaries, providing lot of ecosystem services to local population. In the last decades they are disappearing due to several factors such as sea level rise, subsidence and edge erosion due to surface waves. The latter is likely the chief mechanism modeling marsh boundaries and leading to the loss of wide marsh areas. In the case of the Venice Lagoon, from the beginning of the last century, the whole salt marsh surface has more than halved and trends indicate that the salt marshes might completely disappear over the next 50 years. Here, we present a field monitoring activity that we are currently carrying out on a retreating salt marsh located in the north part of the Lagoon of Venice (Italy). The marsh is subject to North-East (Bora) wind. Marsh area loss during the last decades has been documented through the comparison of georeferenced aerial photographs showing a retreat rate of the order of 1 m/year. Field measurements started by the end of November 2013 and consist of: salt marsh bank geometry at different cross-sections and wave climate in the lagoon about 30 m in front of the salt marsh. Erosion data are obtained by means of erosion pins located horizontally on the marsh scarp; at higher banks (about 0.9 m), two pins are located along the same vertical direction, for lower banks (about 0.4m), only one pin is employed. Significant wave height has been measured during three storm surges by means of pressure transducers (Pts). The measured wave climate in front of the bank was then put into relationship with the offshore wave climate estimated using wind data (intensity and direction) and bathymetric data. Wind intensity and direction is measured hourly by several measurement stations located in the Lagoon of Venice. In this way, it is possible to extrapolate wave climate hourly at the monitored marsh and calculate the wave power that acted on the bank in a given time

An Approach to Remove the Systematic Bias from the Storm Surge forecasts in the Venice Lagoon

NASA Astrophysics Data System (ADS)

Canestrelli, A.

2017-12-01

In this work a novel approach is proposed for removing the systematic bias from the storm surge forecast computed by a two-dimensional shallow-water model. The model covers both the Adriatic and Mediterranean seas and provides the forecast at the entrance of the Venice Lagoon. The wind drag coefficient at the water-air interface is treated as a calibration parameter, with a different value for each range of wind velocities and wind directions. This sums up to a total of 16-64 parameters to be calibrated, depending on the chosen resolution. The best set of parameters is determined by means of an optimization procedure, which minimizes the RMS error between measured and modeled water level in Venice for the period 2011-2015. It is shown that a bias is present, for which the peaks of wind velocities provided by the weather forecast are largely underestimated, and that the calibration procedure removes this bias. When the calibrated model is used to reproduce events not included in the calibration dataset, the forecast error is strongly reduced, thus confirming the quality of our procedure. The proposed approach it is not site-specific and could be applied to different situations, such as storm surges caused by intense hurricanes.

Evaluation of heart rhythm variability and arrhythmia in children with systemic and localized scleroderma.

PubMed

Wozniak, Jacek; Dabrowski, Rafal; Luczak, Dariusz; Kwiatkowska, Malgorzata; Musiej-Nowakowska, Elzbieta; Kowalik, Ilona; Szwed, Hanna

2009-01-01

To evaluate possible disturbances in autonomic regulation and cardiac arrhythmias in children with localized and systemic scleroderma. There were 40 children included in the study: 20 with systemic and 20 with localized scleroderma. The control group comprised 20 healthy children. In 24-hour Holter recording, the average rate of sinus rhythm was significantly higher in the groups with systemic and localized scleroderma than in the control group, but there was no significant difference between them. The variability of heart rhythm in both groups was significantly decreased. In the group with systemic scleroderma, single supraventricular ectopic beats were observed in 20% and runs were seen in 40% of patients. In the group with localized scleroderma, supraventricular single ectopic beats occurred in 35% of patients and runs in 45% of those studied. Ventricular arrhythmia occurred in 2 children with systemic scleroderma, but in 1 child, it was complex. The most frequent cardiac arrhythmias in both types of scleroderma in children were of supraventricular origin, whereas ventricular arrhythmias did not occur very often. There were no significant differences in autonomic disturbances manifesting as a higher heart rate and decreased heart rate variability between localized and systemic scleroderma.

Sedimentological, archeological and historical evidences of paleoclimatic changes during the holocene in the lagoon of Venice (Italy)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bonardi, M.; Canal, E.; Cavazzoni, S.

1997-12-31

Sedimentological investigations and archeological and historical information have allowed to correlate paleoenvironmental and coastline variations, in the Lagoon of Venice, to climatic changes during the Holocene. In particular, we report the results of a detailed study of Holocene sediments, from salt marshes and small islands, taken above and below a level with well dated archeological findings that gave a good indication of the mean sea level.

Temporal abstraction and inductive logic programming for arrhythmia recognition from electrocardiograms.

PubMed

Carrault, G; Cordier, M-O; Quiniou, R; Wang, F

2003-07-01

This paper proposes a novel approach to cardiac arrhythmia recognition from electrocardiograms (ECGs). ECGs record the electrical activity of the heart and are used to diagnose many heart disorders. The numerical ECG is first temporally abstracted into series of time-stamped events. Temporal abstraction makes use of artificial neural networks to extract interesting waves and their features from the input signals. A temporal reasoner called a chronicle recogniser processes such series in order to discover temporal patterns called chronicles which can be related to cardiac arrhythmias. Generally, it is difficult to elicit an accurate set of chronicles from a doctor. Thus, we propose to learn automatically from symbolic ECG examples the chronicles discriminating the arrhythmias belonging to some specific subset. Since temporal relationships are of major importance, inductive logic programming (ILP) is the tool of choice as it enables first-order relational learning. The approach has been evaluated on real ECGs taken from the MIT-BIH database. The performance of the different modules as well as the efficiency of the whole system is presented. The results are rather good and demonstrate that integrating numerical techniques for low level perception and symbolic techniques for high level classification is very valuable.

Sedimentation rate and lateral migration of tidal channels in the Lagoon of Venice (Northern Italy)

NASA Astrophysics Data System (ADS)

Donnici, Sandra; Madricardo, Fantina; Serandrei-Barbero, Rossana

2017-11-01

Tidal channels are crucial for the functioning of highly valuable coastal environments, such as estuaries and lagoons. Their properties, however, are currently less understood than those of river systems. To elucidate their past behaviour, an extensive geophysical investigation was performed to reconstruct the evolution of channels and tidal surfaces in the central part of the Lagoon of Venice (Italy) over the past 5000 years. Comparing high-spatial-resolution acoustic data and sedimentary facies analyses of 41 cores, 29 of which were radiocarbon dated, revealed the sedimentation rates in different lagoonal environments and allowed the migration of two large meanders to be reconstructed. The average sedimentation rate of the study succession in the different sedimentary environments was 1.27 mm yr-1. The lateral migration rates were 13-23 m/century. This estimate is consistent with the lateral migration rates determined by comparing aerial photographs of recent channels. Comparing the buried channels with historical and current maps showed that, in general, the number of active channels is now reduced. Their morphology was sometimes simplified by artificial interventions. An understanding of the impact of the artificial interventions over time is useful for the management and conservation of tidal environments, particularly for the Lagoon of Venice, where management authorities are currently debating the possible deepening and rectification of large navigation channels.

Resting respiratory sinus arrhythmia is associated with tonic positive emotionality.

PubMed

Oveis, Christopher; Cohen, Adam B; Gruber, June; Shiota, Michelle N; Haidt, Jonathan; Keltner, Dacher

2009-04-01

Resting respiratory sinus arrhythmia (RSAREST) indexes important aspects of individual differences in emotionality. In the present investigation, the authors address whether RSAREST is associated with tonic positive or negative emotionality, and whether RSAREST relates to phasic emotional responding to discrete positive emotion-eliciting stimuli. Across an 8-month, multiassessment study of first-year university students (n = 80), individual differences in RSAREST were associated with positive but not negative tonic emotionality, assessed at the level of personality traits, long-term moods, the disposition toward optimism, and baseline reports of current emotional states. RSAREST was not related to increased positive emotion, or stimulus-specific emotion, in response to compassion-, awe-, or pride-inducing stimuli. These findings suggest that resting RSA indexes aspects of a person's tonic positive emotionality. (c) 2009 APA, all rights reserved.

Controversies in Cardiovascular Research: Induced pluripotent stem cell-derived cardiomyocytes – boutique science or valuable arrhythmia model?

PubMed Central

Knollmann, Björn C

2013-01-01

As part of the series on Controversies in Cardiovascular Research, the article reviews the strengths and limitations of induced pluripotent stem cell-derived cardiomyocytes (iPSC-CM) as models of cardiac arrhythmias. Specifically, the article attempts to answer the following questions: Which clinical arrhythmias can be modeled by iPSC-CM? How well can iPSC-CM model adult ventricular myocytes? What are the strengths and limitations of published iPSC-CM arrhythmia models? What new mechanistic insight has been gained? What is the evidence that would support using iPSC-CM to personalize anti-arrhythmic drug therapy? The review also discusses the pros and cons of using the iPSC-CM technology for modeling specific genetic arrhythmia disorders such as long QT syndrome, Brugada Syndrome or Catecholaminergic Polymorphic Ventricular Tachycardia. PMID:23569106

Periodic Limb Movements during Sleep and Cardiac Arrhythmia in Older Men (MrOS Sleep)

PubMed Central

Koo, Brian B.; Mehra, Reena; Blackwell, Terri; Ancoli-Israel, Sonia; Stone, Katie L.; Redline, Susan

2014-01-01

Study Objectives: To determine if periodic limb movements during sleep (PLMS) are associated with nocturnal cardiac arrhythmia. Methods: 2,793 community-dwelling older men underwent polysomnography with measurement of limb movements and EKG. Logistic regression assessed association of periodic limb movement index and periodic limb movement arousal index with arrhythmia including atrial fibrillation and non-sustained ventricular tachycardia detected by polysomnography. Models were adjusted for age, race, cardiovascular risk factors, and clinic site. Secondary analyses were subset to men without calcium channel/β-adrenergic medication usage, and stratified by congestive heart failure or myocardial infarction history. Results: In the overall cohort, periodic limb movement index, and periodic limb movement arousal index were not associated with ventricular or atrial arrhythmia after considering potential confounders. In men not taking calcium channel/β-blocking medication, increased adjusted odds of non-sustained ventricular tachycardia were observed for periodic limb movement index (OR = 1.30 per SD increase; 95% CI 1.00, 1.68) and periodic limb movement arousal index (OR = 1.29 per SD increase; 95% CI 1.03, 1.62). In men with CHF or MI, there was a suggested association of atrial fibrillation with periodic limb movement index (OR = 1.29, 95% CI 0.96, 1.73 per SD increase; p = 0.09) or periodic limb movement arousal index (OR = 1.21, 95% CI 0.94, 1.57 per SD increase; p = 0.14), although results were not statistically significant. Conclusions: There is not an association between PLMS and cardiac arrhythmia in all older men but in subsets of men, particularly those with structural heart disease and not on calcium channel or β-adrenergic medication, cardiac arrhythmia does associate with PLMS. Citation: Koo BB; Mehra R; Blackwell T; Ancoli-Israel S; Stone KL; Redline S; for the Osteoporotic Fractures in Men (MrOS) Study Group. Periodic limb movements during sleep and

Atrial Arrhythmia in Ageing Spontaneously Hypertensive Rats: Unraveling the Substrate in Hypertension and Ageing

PubMed Central

Lau, Dennis H.; Shipp, Nicholas J.; Kelly, Darren J.; Thanigaimani, Shivshankar; Neo, Melissa; Kuklik, Pawel; Lim, Han S.; Zhang, Yuan; Drury, Karen; Wong, Christopher X.; Chia, Nicholas H.; Brooks, Anthony G.; Dimitri, Hany; Saint, David A.; Brown, Lindsay; Sanders, Prashanthan

2013-01-01

Background Both ageing and hypertension are known risk factors for atrial fibrillation (AF) although the pathophysiological contribution or interaction of the individual factors remains poorly understood. Here we aim to delineate the arrhythmogenic atrial substrate in mature spontaneously hypertensive rats (SHR). Methods SHR were studied at 12 and 15 months of age (n = 8 per group) together with equal numbers of age-matched normotensive Wistar-Kyoto control rats (WKY). Electrophysiologic study was performed on superfused isolated right and left atrial preparations using a custom built high-density multiple-electrode array to determine effective refractory periods (ERP), atrial conduction and atrial arrhythmia inducibility. Tissue specimens were harvested for structural analysis. Results Compared to WKY controls, the SHR demonstrated: Higher systolic blood pressure (p<0.0001), bi-atrial enlargement (p<0.05), bi-ventricular hypertrophy (p<0.05), lower atrial ERP (p = 0.008), increased atrial conduction heterogeneity (p = 0.001) and increased atrial interstitial fibrosis (p = 0.006) & CD68-positive macrophages infiltration (p<0.0001). These changes resulted in higher atrial arrhythmia inducibility (p = 0.01) and longer induced AF episodes (p = 0.02) in 15-month old SHR. Ageing contributed to incremental bi-atrial hypertrophy (p<0.01) and atrial conduction heterogeneity (p<0.01) without affecting atrial ERP, fibrosis and arrhythmia inducibility. The limited effect of ageing on the atrial substrate may be secondary to the reduction in CD68-positive macrophages. Conclusions Significant atrial electrical and structural remodeling is evident in the ageing spontaneously hypertensive rat atria. Concomitant hypertension appears to play a greater pathophysiological role than ageing despite their compounding effect on the atrial substrate. Inflammation is pathophysiologically linked to the pro-fibrotic changes in the hypertensive atria. PMID:24013508

Use of self-gated radial cardiovascular magnetic resonance to detect and classify arrhythmias (atrial fibrillation and premature ventricular contraction).

PubMed

Piekarski, Eve; Chitiboi, Teodora; Ramb, Rebecca; Feng, Li; Axel, Leon

2016-11-25

Arrhythmia can significantly alter the image quality of cardiovascular magnetic resonance (CMR); automatic detection and sorting of the most frequent types of arrhythmias during the CMR acquisition could potentially improve image quality. New CMR techniques, such as non-Cartesian CMR, can allow self-gating: from cardiac motion-related signal changes, we can detect cardiac cycles without an electrocardiogram. We can further use this data to obtain a surrogate for RR intervals (valley intervals: VV). Our purpose was to evaluate the feasibility of an automated method for classification of non-arrhythmic (NA) (regular cycles) and arrhythmic patients (A) (irregular cycles), and for sorting of common arrhythmia patterns between atrial fibrillation (AF) and premature ventricular contraction (PVC), using the cardiac motion-related signal obtained during self-gated free-breathing radial cardiac cine CMR with compressed sensing reconstruction (XD-GRASP). One hundred eleven patients underwent cardiac XD-GRASP CMR between October 2015 and February 2016; 33 were included for retrospective analysis with the proposed method (6 AF, 8 PVC, 19 NA; by recent ECG). We analyzed the VV, using pooled statistics (histograms) and sequential analysis (Poincaré plots), including the median (medVV), the weighted mean (meanVV), the total number of VV values (VVval), and the total range (VVTR) and half range (VVHR) of the cumulative frequency distribution of VV, including the median to half range (medVV/VVHR) and the half range to total range (VVHR/VVTR) ratios. We designed a simple algorithm for using the VV results to differentiate A from NA, and AF from PVC. Between NA and A, meanVV, VVval, VVTR, VVHR, medVV/VVHR and VVHR/VVTR ratios were significantly different (p values = 0.00014, 0.0027, 0.000028, 5×10 -9 , 0.002, respectively). Between AF and PVC, meanVV, VVval and medVV/VVHR ratio were significantly different (p values = 0.018, 0.007, 0.044, respectively). Using our algorithm

Symmetrical compression distance for arrhythmia discrimination in cloud-based big-data services.

PubMed

Lillo-Castellano, J M; Mora-Jiménez, I; Santiago-Mozos, R; Chavarría-Asso, F; Cano-González, A; García-Alberola, A; Rojo-Álvarez, J L

2015-07-01

The current development of cloud computing is completely changing the paradigm of data knowledge extraction in huge databases. An example of this technology in the cardiac arrhythmia field is the SCOOP platform, a national-level scientific cloud-based big data service for implantable cardioverter defibrillators. In this scenario, we here propose a new methodology for automatic classification of intracardiac electrograms (EGMs) in a cloud computing system, designed for minimal signal preprocessing. A new compression-based similarity measure (CSM) is created for low computational burden, so-called weighted fast compression distance, which provides better performance when compared with other CSMs in the literature. Using simple machine learning techniques, a set of 6848 EGMs extracted from SCOOP platform were classified into seven cardiac arrhythmia classes and one noise class, reaching near to 90% accuracy when previous patient arrhythmia information was available and 63% otherwise, hence overcoming in all cases the classification provided by the majority class. Results show that this methodology can be used as a high-quality service of cloud computing, providing support to physicians for improving the knowledge on patient diagnosis.

6 CFR 5.8 - Business information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 6 Domestic Security 1 2014-01-01 2014-01-01 false Business information. 5.8 Section 5.8 Domestic... Freedom of Information Act § 5.8 Business information. (a) In general. Business information obtained by... this section. (b) Definitions. For purposes of this section: (1) Business information means commercial...

6 CFR 5.8 - Business information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 6 Domestic Security 1 2013-01-01 2013-01-01 false Business information. 5.8 Section 5.8 Domestic... Freedom of Information Act § 5.8 Business information. (a) In general. Business information obtained by... this section. (b) Definitions. For purposes of this section: (1) Business information means commercial...

6 CFR 5.8 - Business information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 6 Domestic Security 1 2012-01-01 2012-01-01 false Business information. 5.8 Section 5.8 Domestic... Freedom of Information Act § 5.8 Business information. (a) In general. Business information obtained by... this section. (b) Definitions. For purposes of this section: (1) Business information means commercial...

6 CFR 5.8 - Business information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 6 Domestic Security 1 2011-01-01 2011-01-01 false Business information. 5.8 Section 5.8 Domestic... Freedom of Information Act § 5.8 Business information. (a) In general. Business information obtained by... this section. (b) Definitions. For purposes of this section: (1) Business information means commercial...

6 CFR 5.8 - Business information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 6 Domestic Security 1 2010-01-01 2010-01-01 false Business information. 5.8 Section 5.8 Domestic... Freedom of Information Act § 5.8 Business information. (a) In general. Business information obtained by... this section. (b) Definitions. For purposes of this section: (1) Business information means commercial...

Heterotaxy syndrome and associated arrhythmias in pediatric patients.

PubMed

Niu, Mary C; Dickerson, Heather A; Moore, Judson A; de la Uz, Caridad; Valdés, Santiago O; Kim, Jeffrey J; Bard, David E; Morris, Shaine A; Miyake, Christina Y

2018-04-01

Heterotaxy syndrome (HS) is a rare disorder with complex anatomy involving misarrangements of the cardiac conduction system. Arrhythmias may be related to anatomic variations and contribute to morbidity. The purpose of this study was to investigate the associations between arrhythmias, anatomy, and outcomes in a large HS cohort. A single-center retrospective review of patients ≤21 years of age diagnosed with HS was performed. A total of 337 patients were included in the study. During median follow-up of 7 years (interquartile range 2-16 years), 129 patients (38%) had ≥1 clinically significant rhythm disturbance: tachyarrhythmias in 75 (22%), bradyarrhythmias in 29 (9%), and both in 25 (7%). Factors associated with tachyarrhythmia by multivariate analysis were at least moderate atrioventricular valve regurgitation (hazard ratio [HR] 1.66; 95% confidence interval [CI] 1.11-2.50), single ventricle anatomy (HR 2.30; 95% CI 1.09-4.85), and pulmonary venous obstruction (HR 2.33; 95% CI 1.45-3.76). Isomerism subtype was not associated with tachyarrhythmias. In adjusted and unadjusted analyses, bradyarrhythmias (symptomatic sinus/atrial bradycardia and high-grade or complete heart block) were associated with left atrial isomerism (LAI) compared to right atrial isomerism (HR 7.12; 95% CI 3.01-16.9). The overall transplant-free survival of the cohort was 66%. Tachyarrhythmias, but not bradyarrhythmias, were associated with mortality or need for transplant (HR 2.24; 95% CI 1.45-3.46). Clinically significant arrhythmias are common in HS. Although bradyarrhythmias are associated with LAI, tachyarrhythmia occurrence may depend more on hemodynamic and anatomic factors than isomerism subtype. Tachyarrhythmias, but not bradyarrhythmias, are associated with death or need for transplant. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Cholinergic stimulation with pyridostigmine protects myocardial infarcted rats against ischemic-induced arrhythmias and preserves connexin43 protein.

PubMed

Santos-Almeida, Fernanda Machado; Girão, Henrique; da Silva, Carlos Alberto Aguiar; Salgado, Helio Cesar; Fazan, Rubens

2015-01-15

We investigated the effects of acute pyridostigmine (PYR) treatment, an acetylcholinesterase inhibitor, on arterial pressure (AP), heart rate (HR), cardiac sympathovagal balance, and the incidence of arrhythmias during the first 4 h after myocardial infarction (MI) in anesthetized rats. Male Wistar rats were implanted with catheters into the femoral artery and vein for AP recordings and drug administration. Rats received the autonomic receptor blockers methyl-atropine (1 mg/kg iv) and propranolol (2 mg/kg iv) at intervals of 15 min, 1 h after saline (n=16) or PYR (0.25 mg/kg iv, n=18), to indirectly assess sympathovagal balance. Acute treatment with PYR increased cardiac vagal (86±7 vs. 44±5 beats/min) and decreased sympathetic tone (-31±8 vs. -69±7 beats/min). Different animals were implanted with ECG electrodes and catheters. A large MI was induced via left coronary artery ligation after basal recordings. Rats received PYR (n=14) or saline (n=14) 10-15 min after MI, and the recordings lasted up to 4 h. In part of the animals, hearts were removed for connexin43 quantification after all procedures. MI elicited a fall in AP (-45±5 mmHg), a progressive rise in HR (26±14 beats/min), and an increase in corrected QT interval (33±13 ms). PYR elicited a prompt bradycardia (-50±14 beats/min) that returned to basal levels over time, and it prevented the lengthening of the corrected QT interval. Treatment with PYR increased by ∼20% the occurrence of rats free of arrhythmias after MI. MI markedly decreased connexin43 in left ventricles, and PYR treatment partially prevented this decrease. Copyright © 2015 the American Physiological Society.

Effects of angiotensin-neprilysin inhibition compared to angiotensin inhibition on ventricular arrhythmias in reduced ejection fraction patients under continuous remote monitoring of implantable defibrillator devices.

PubMed

de Diego, Carlos; González-Torres, Luis; Núñez, José María; Centurión Inda, Raúl; Martin-Langerwerf, David A; Sangio, Antonio D; Chochowski, Piotr; Casasnovas, Pilar; Blazquéz, Julio C; Almendral, Jesús

2018-03-01

Angiotensin-neprilysin inhibition compared to angiotensin inhibition decreased sudden cardiac death in patients with reduced ejection fraction heart failure (rEFHF). The precise mechanism remains unclear. The purpose of this study was to explore the effect of angiotensin-neprilysin inhibition on ventricular arrhythmias compared to angiotensin inhibition in rEFHF patients with an implantable cardioverter-defibrillator (ICD) and remote monitoring. We prospectively included 120 patients with ICD and (1) New York Heart Association functional class ≥II; (2) left ventricular ejection fraction ≤40%; and (3) remote monitoring. For 9 months, patients received 100% angiotensin inhibition with angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB), beta-blockers, and mineraloid antagonist. Subsequently, ACEi or ARB was changed to sacubitril-valsartan in all patients, who were followed for 9 months. Appropriate shocks, nonsustained ventricular tachycardia (NSVT), premature ventricular contraction (PVC) burden, and biventricular pacing percentage were analyzed. Patients were an average age of 69 ± 8 years and had mean left ventricular ejection fraction of 30.4% ± 4% (82% ischemic). Use of beta-blockers (98%), mineraloid antagonist (97%) and antiarrhythmic drugs was similar before and after sacubitril-valsartan. Sacubitril-valsartan significantly decreased NSVT episodes (5.4 ± 0.5 vs 15 ± 1.7 in angiotensin inhibition; P <.002), sustained ventricular tachycardia, and appropriate ICD shocks (0.8% vs 6.7% in angiotensin inhibition; P <.02). PVCs per hour decreased after sacubitril-valsartan (33 ± 12 vs 78 ± 15 in angiotensin inhibition; P <.0003) and was associated with increased biventricular pacing percentage (from 95% ± 6% to 98.8% ± 1.3%; P <.02). Angiotensin-neprilysin inhibition decreased ventricular arrhythmias and appropriate ICD shocks in rEFHF patients under home monitoring compared to angiotensin inhibition. Copyright © 2017

43 CFR 8.5 - Mineral rights.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Mineral rights. 8.5 Section 8.5 Public... INTERIOR AND OF THE ARMY RELATIVE TO RESERVOIR PROJECT LANDS § 8.5 Mineral rights. Mineral, oil and gas rights will not be acquired except where the development thereof would interfere with project purposes...

43 CFR 8.5 - Mineral rights.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Mineral rights. 8.5 Section 8.5 Public... INTERIOR AND OF THE ARMY RELATIVE TO RESERVOIR PROJECT LANDS § 8.5 Mineral rights. Mineral, oil and gas..., but mineral rights not acquired will be subordinated to the Government's right to regulate their...

43 CFR 8.5 - Mineral rights.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Mineral rights. 8.5 Section 8.5 Public... INTERIOR AND OF THE ARMY RELATIVE TO RESERVOIR PROJECT LANDS § 8.5 Mineral rights. Mineral, oil and gas..., but mineral rights not acquired will be subordinated to the Government's right to regulate their...

43 CFR 8.5 - Mineral rights.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Mineral rights. 8.5 Section 8.5 Public... INTERIOR AND OF THE ARMY RELATIVE TO RESERVOIR PROJECT LANDS § 8.5 Mineral rights. Mineral, oil and gas..., but mineral rights not acquired will be subordinated to the Government's right to regulate their...

43 CFR 8.5 - Mineral rights.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Mineral rights. 8.5 Section 8.5 Public... INTERIOR AND OF THE ARMY RELATIVE TO RESERVOIR PROJECT LANDS § 8.5 Mineral rights. Mineral, oil and gas..., but mineral rights not acquired will be subordinated to the Government's right to regulate their...

Random forests ensemble classifier trained with data resampling strategy to improve cardiac arrhythmia diagnosis.

PubMed

Ozçift, Akin

2011-05-01

Supervised classification algorithms are commonly used in the designing of computer-aided diagnosis systems. In this study, we present a resampling strategy based Random Forests (RF) ensemble classifier to improve diagnosis of cardiac arrhythmia. Random forests is an ensemble classifier that consists of many decision trees and outputs the class that is the mode of the class's output by individual trees. In this way, an RF ensemble classifier performs better than a single tree from classification performance point of view. In general, multiclass datasets having unbalanced distribution of sample sizes are difficult to analyze in terms of class discrimination. Cardiac arrhythmia is such a dataset that has multiple classes with small sample sizes and it is therefore adequate to test our resampling based training strategy. The dataset contains 452 samples in fourteen types of arrhythmias and eleven of these classes have sample sizes less than 15. Our diagnosis strategy consists of two parts: (i) a correlation based feature selection algorithm is used to select relevant features from cardiac arrhythmia dataset. (ii) RF machine learning algorithm is used to evaluate the performance of selected features with and without simple random sampling to evaluate the efficiency of proposed training strategy. The resultant accuracy of the classifier is found to be 90.0% and this is a quite high diagnosis performance for cardiac arrhythmia. Furthermore, three case studies, i.e., thyroid, cardiotocography and audiology, are used to benchmark the effectiveness of the proposed method. The results of experiments demonstrated the efficiency of random sampling strategy in training RF ensemble classification algorithm. Copyright © 2011 Elsevier Ltd. All rights reserved.

Biomarker responses and contamination levels in crabs (Carcinus aestuarii) from the Lagoon of Venice: An integrated approach in biomonitoring estuarine environments.

PubMed

Ricciardi, Francesco; Matozzo, Valerio; Binelli, Andrea; Marin, Maria Gabriella

2010-03-01

An integrated biological-chemical approach is necessary to evaluate correctly the environmental status of bodies of water, as suggested by the EU Water Framework Directive. The shore crab Carcinus aestuarii, sampled in the Lagoon of Venice (NE Italy), was used as a biomonitor species, and the chemical concentrations of 42 organic pollutants (HCHs, PAHs, PCBs, DDTs, PBDEs), biological responses related to neurotoxicity (AChE inhibition), detoxification mechanisms (CYP450 induction) and endocrine alterations (vitellogenin-like protein induction) were measured at the same time. The responsiveness of biomarkers as predictors (or descriptors) of chemical contamination was evaluated by multivariate regression analysis, revealing good predictor potential for the selected biomarkers. Biomonitoring in the Lagoon of Venice revealed a predominance of DDT and PCB compounds, especially near industrial sites or large cities. Endocrine alterations, not always correlated with the presence of measured compounds, were also detected in many areas, suggesting exposure to compounds able to interfere with the crab endocrine system. Copyright 2009 Elsevier Ltd. All rights reserved.

Microbial deterioration of artistic tiles from the façade of the Grande Albergo Ausonia & Hungaria (Venice, Italy).

PubMed

Giacomucci, Lucia; Bertoncello, Renzo; Salvadori, Ornella; Martini, Ilaria; Favaro, Monica; Villa, Federica; Sorlini, Claudia; Cappitelli, Francesca

2011-08-01

The Grande Albergo Ausonia & Hungaria (Venice Lido, Italy) has an Art Nouveau polychrome ceramic coating on its façade, which was restored in 2007. Soon after the conservation treatment, many tiles of the façade decoration showed coloured alterations putatively attributed to the presence of microbial communities. To confirm the presence of the biological deposit and the stratigraphy of the Hungaria tiles, stereomicroscope, optical and environmental scanning electron microscope observations were made. The characterisation of the microbial community was performed using a PCR-DGGE approach. This study reported the first use of a culture-independent approach to identify the total community present in biodeteriorated artistic tiles. The case study examined here reveals that the coloured alterations on the tiles were mainly due to the presence of cryptoendolithic cyanobacteria. In addition, we proved that the microflora present on the tiles was generally greatly influenced by the environment of the Hungaria hotel. We found several microorganisms related to the alkaline environment, which is in the range of the tile pH, and related to the aquatic environment, the presence of the acrylic resin Paraloid B72® used during the 2007 treatment and the pollutants of the Venice lagoon.

Present and future challenges of urban systems affected by seawater and its intrusion: the case of Venice, Italy

NASA Astrophysics Data System (ADS)

di Sipio, Eloisa; Zezza, Fulvio

2011-11-01

In lagoonal and marine environments, both historic monuments and recent buildings suffer from severe salt damage caused by sea flooding, sea-level rise and frequent storm events. Salt-water contamination of groundwater systems, a widespread phenomenon typical of coastal areas, can lead to a deterioration not only of the quality of fresh groundwater resources, but also of building materials in urban settlements. A general overview is given of the hydrogeological configuration of the subsoil of Venice (Italy), with particular reference to the shallow groundwater circulation. The relationship between the seawater in the subsoil and salt decay processes, due to salt crystallization, is highlighted. These processes affect civil constructions in Venice's historic center. Perched aquifers, influenced by tide variations and characterized by salt-water intrusion, favor the transport of salts within masonry walls through the action of rising damp. In fact, foundations, in direct contact with the aquifers, may become a preferential vehicle for the transportation of salt within buildings. Decay patterns of different building materials can be detected through non-destructive techniques, which can identify sea-salt damage and therefore assist in the preservation of cultural heritage in coastal areas.

COSMO-SkyMed vs RADARSAT-2 for Monitoring Natural and Anthropogenic Components of the Land Movement in Venice

NASA Astrophysics Data System (ADS)

Tosi, Luigi; Da Lio, Cristina; Strozzi, Tazio; Teatini, Pietro

2016-08-01

We present the result of a test aimed at evaluating the capability of RADARSAT-2 and COSMO-SkyMed to map the natural subsidence and ground movements induced by anthropogenic activities in the historical center of Venice. Firstly, ground movements have been retrieved at quite long- and short-term by the Persistent Scattered Interferometry (PSI) on 2008-2015 RADARSA T-2 and 2013-2015 COSMO-SkyMed image stacks, respectively. Secondly, PSI has been calibrated at regional scale using the records of permanent GPS stations. Thirdly, considering that over the last two decades "in the historical center of Venice" natural land movements are primarily ascribed to long- term processes, and those induced by human activities act at short-term, we have properly resampled 83-month RADARSA T-2 C-band and 27-month COSMO- SkyMed X-band interferometric products by a common grid and processed the outcome to estimate the two components of the displacements. Results show that the average natural subsidence is generally in the range of 0.9 - 1.1 mm/yr and the anthropogenic ground movements are up to 2 mm/yr.

[Sedation and anesthesia in dogs and cats with cardiovascular disease. II. Anesthesia planning with respect to pathophysiology, heart arrhythmia].

PubMed

Skarda, R T; Muir, W W; Bednarski, R M; Hubbell, J A; Mason, D E

1995-01-01

The purpose of this study was to review the incidence of cardiac arrhythmias in 137 anesthetized dogs and 13 anesthetized cats with congenital or acquired heart disease that were referred for correction of following procedures: patent ductus arteriosus (PDA-ligation, 28%), cardiac catheterization with angiogram and angioplasty (22%), pacemaker implantation (18%), exploratory lateral thoracotomy (8.7%), correction of right aortic arch (ring anomaly, 3.3%), correction of subvalvular aortic stenosis (2.7%), correction of PDA with coil in patients with mitral regurgitation and congestive heart failure (2%), pericardectomy and removal of heart base tumor (2%), and palliative surgery for ventricular septal defect (VSD, 0.7%). The anesthetic plan considered the risks of anesthesia based upon the pathophysiology of cardiac lesions and the anesthetic drug effects on the cardiovascular system. Recommendations are made for dogs with decreased cardiac contractility, cardiac disease with volume overload, cardiac disease with pressure overload, and pericardial tamponade. The percentages of animals and their associated cardiac arrhythmias after premedication and during and after anesthesia were: sinus bradycardia (15.3%), sinus tachycardia (3.3%), atrial flutter (0.7%), atrial fibrillation (0.7%), premature ventricular contraction (14%), and ventricular tachycardia (1.3%). Prompt therapy was given to a percentage of animals in order to control arrhythmia and support cardiovascular system, by using atropine or glycopyrrolate (14%), lidocaine (17.3%), and dopamine (14.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Gas-particle distributions, sources and health effects of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and polychlorinated naphthalenes (PCNs) in Venice aerosols.

PubMed

Gregoris, Elena; Argiriadis, Elena; Vecchiato, Marco; Zambon, Stefano; De Pieri, Silvia; Donateo, Antonio; Contini, Daniele; Piazza, Rossano; Barbante, Carlo; Gambaro, Andrea

2014-04-01

Air samples were collected in Venice during summer 2009 and 2012 to measure gas and particulate concentrations of polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and polychlorinated naphthalenes (PCNs). PCB-11, considered a marker for non-Aroclor contamination of the environment, was found for the first time in the Venetian lagoon and in Europe. An investigation on sources has been conducted, evidencing traffic as the major source of PAHs, whereas PCBs have a similar composition to Aroclor 1248 and 1254; in 2009 a release of PCN-42 has been hypothesized. Toxicological evaluation by TCA and TEQ methods, conducted for the first time in Venice air samples, identified BaP, PCB-126 and PCB-169 as the most important contributors to the total carcinogenic activity of PAHs and the total dioxin-like activity of PCBs and PCNs. Copyright © 2014 Elsevier B.V. All rights reserved.

1 CFR 8.5 - Ancillaries.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1 General Provisions 1 2011-01-01 2011-01-01 false Ancillaries. 8.5 Section 8.5 General Provisions... been affected by documents published during the period January 1, 1949, to December 31, 1963, and January 1, 1964, to December 31, 1972, respectively.) 1 Listings shall refer to Federal Register pages and...

1 CFR 8.5 - Ancillaries.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1 General Provisions 1 2010-01-01 2010-01-01 false Ancillaries. 8.5 Section 8.5 General Provisions... been affected by documents published during the period January 1, 1949, to December 31, 1963, and January 1, 1964, to December 31, 1972, respectively.) 1 Listings shall refer to Federal Register pages and...

1 CFR 8.5 - Ancillaries.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1 General Provisions 1 2012-01-01 2012-01-01 false Ancillaries. 8.5 Section 8.5 General Provisions... been affected by documents published during the period January 1, 1949, to December 31, 1963, and January 1, 1964, to December 31, 1972, respectively.) 1 Listings shall refer to Federal Register pages and...

78 FR 54564 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-05

... Linder Rgnl, Takeoff Minimums and Obstacle DP, Amdt 1 Venice, FL, Venice Muni, RNAV (GPS) RWY 5, Orig Venice, FL, Venice Muni, RNAV (GPS) RWY 23, Orig Venice, FL, Venice Muni, Takeoff Minimums and Obstacle...

Hereditary arrhythmias and cardiomyopathies: decision-making about genetic testing.

PubMed

Louis, Clauden; Calamaro, Emily; Vinocur, Jeffrey M

2018-01-01

The modern field of clinical genetics has advanced beyond the traditional teachings familiar to most practicing cardiologists. Increased understanding of the roles of genetic testing may improve uptake and appropriateness of use. Clinical genetics has become integral to the management of patients with hereditary arrhythmia and cardiomyopathy diagnoses. Depending on the condition, genetic testing may be useful for diagnosis, prognosis, treatment, family screening, and reproductive planning. However, genetic testing is a powerful tool with potential for underuse, overuse, and misuse. In the absence of a substantial body of literature on how these guidelines are applied in clinical practice, we use a case-based approach to highlight key lessons and pitfalls. Importantly, in many scenarios genetic testing has become the standard of care supported by numerous class I recommendations; genetic counselors can improve accessibility to and appropriate use and application of testing. Optimal management of hereditary arrhythmias and cardiomyopathies incorporates genetic testing, applied as per consensus guidelines, with involvement of a multidisciplinary team.

Benthic foraminifera and trace element distribution: a case-study from the heavily polluted lagoon of Venice (Italy).

PubMed

Coccioni, Rodolfo; Frontalini, Fabrizio; Marsili, Andrea; Mana, Davide

2009-01-01

Living benthic foraminiferal assemblages were studied in surface samples collected from the lagoon of Venice (Italy) in order to investigate the relationship between these sensitive microorganisms and trace element pollution. Geochemical analysis of sediments shows that the lagoon is affected by trace element pollution (Cd, Cu, Ni, Pb, Zn and Hg) with the highest concentrations in its inner part, which corresponds to the Porto Marghera industrial area. The biocenosis are largely dominated by Ammonia tepida, Haynesina germanica and Cribroelphidium oceanensis and, subordinately, by Aubignyna perlucida, Ammonia parkinsoniana and Bolivina striatula. Biotic and abiotic factors were statistically analyzed with multivariate technique of cluster analysis and principal component analysis. The statistical analysis reveals a strong relationship between trace elements (in particular Mn, Pb and Hg) and the occurrence of abnormalities in foraminiferal tests. Remarkably, greater proportions of abnormal specimens are usually found at stations located close to the heaviest polluted industrial zone of Porto Marghera. This paper shows that benthic foraminifera can be used as useful and relatively speedy and inexpensive bio-indicators in monitoring the health quality of the lagoon of Venice. It also provides a basis for future investigations aimed at unraveling the benthic foraminiferal response to human-induced pollution in marine and transitional marine environments.

Arrhythmia-induced cardiomyopathies: the riddle of the chicken and the egg still unanswered?

PubMed

Simantirakis, Emmanuel N; Koutalas, Emmanuel P; Vardas, Panos E

2012-04-01

The hypothesis testing of inappropriate fast, irregular, or asynchronous myocardial contraction provoking cardiomyopathy has been the primary focus of numerous research efforts, especially during the last few decades. Rapid ventricular rates resulting from supraventricular arrhythmias and atrial fibrillation (AF), irregularity of heart rhythm-basic element of AF-and asynchrony, as a consequence of right ventricular pacing, bundle branch block, or frequent premature ventricular complexes, have been established as primary causes of arrhythmia-induced cardiomyopathy. The main pathophysiological pathways involved have been clarified, including neurohumoral activation, energy stores depletion, and abnormalities in stress and strain. Unfortunately, from a clinical point of view, patients usually seek medical advice only when symptoms develop, while the causative arrhythmia may be present for months or years, resulting in myocardial remodelling, diastolic, and systolic dysfunction. In some cases, making a definite diagnosis may become a strenuous exercise for the treating physician, as the arrhythmia may not be present and, additionally, therapy must be applied for the diagnosis to be confirmed retrospectively. The diagnostic process is also hardened due to the fact that strict diagnosing criteria are still a matter of discrepancy. Therapy options include pharmaceutical agents trials, catheter-based therapies and, in the context of chronic ventricular pacing, resynchronization. For the majority of patients, partial or complete recovery is expected, although they have to be followed up thoroughly due to the risk of recurrence. Large, randomized controlled trials are more than necessary to optimize patients' stratification and therapeutic strategy choices.

Assessment of cumulative evidence for the association between glutathione S-transferase polymorphisms and lung cancer: application of the Venice interim guidelines

PubMed Central

Langevin, Scott M.; Ioannidis, John P.A.; Vineis, Paolo; Taioli, Emanuela

2010-01-01

There is an overwhelming abundance of genetic association studies available in the literature, which often can be collectively difficult to interpret. To address this issue, the Venice interim guidelines were established for determining the credibility of the cumulative evidence. The objective of this report is to evaluate the literature on the association of common GST variants (GSTM1 null, GSTT1 null and GSTP1 Ile105Val polymorphism) and lung cancer, and to assess the credibility of the associations using the newly proposed cumulative evidence guidelines. Information from the literature was enriched with an updated meta-analysis and a pooled analysis using data from the Genetic Susceptibility to Environmental Carcinogens (GSEC) database. There was a significant association between GSTM1 null and lung cancer for the meta- (meta OR = 1.17, 95% CI: 1.10–1.25) and pooled analysis (adjusted OR = 1.10, 95% CI: 1.04–1.16), although substantial heterogeneity was present. No overall association between lung cancer and GSTT1 null or GSTP1 Ile105Val was found. When the Venice criteria was applied, cumulative evidence for all associations were considered “weak”, with the exception of East Asian carriers of the G allele of GSTP1 Ile105Val, which was graded as “moderate” evidence. In spite of large amounts of studies, and several statistically significant summary estimates produced by meta-analyses, the application of the Venice criteria suggests extensive heterogeneity and susceptibility to bias for the studies on association of common genetic polymorphisms, such as with GST variants and lung cancer. PMID:20729793

Assessment of cumulative evidence for the association between glutathione S-transferase polymorphisms and lung cancer: application of the Venice interim guidelines.

PubMed

Langevin, Scott M; Ioannidis, John P A; Vineis, Paolo; Taioli, Emanuela

2010-10-01

There is an overwhelming abundance of genetic association studies available in the literature, which can often be collectively difficult to interpret. To address this issue, the Venice interim guidelines were established for determining the credibility of the cumulative evidence. The objective of this report is to evaluate the literature on the association of common glutathione S-transferase (GST) variants (GSTM1 null, GSTT1 null and GSTP1 Ile105Val polymorphism) and lung cancer, and to assess the credibility of the associations using the newly proposed cumulative evidence guidelines. Information from the literature was enriched with an updated meta-analysis and a pooled analysis using data from the Genetic Susceptibility to Environmental Carcinogens database. There was a significant association between GSTM1 null and lung cancer for the meta-analysis (meta odds ratio=1.17, 95% confidence interval: 1.10-1.25) and pooled analysis (adjusted odds ratio=1.10, 95% confidence interval: 1.04-1.16), although substantial heterogeneity was present. No overall association between lung cancer and GSTT1 null or GSTP1 Ile105Val was found. When the Venice criteria was applied, cumulative evidence for all associations were considered 'weak', with the exception of East Asian carriers of the G allele of GSTP1 Ile105Val, which was graded as 'moderate' evidence. Despite the large amounts of studies, and several statistically significant summary estimates produced by meta-analyses, the application of the Venice criteria suggests extensive heterogeneity and susceptibility to bias for the studies on association of common genetic polymorphisms, such as with GST variants and lung cancer.

Arctigenin, a potential anti-arrhythmic agent, inhibits aconitine-induced arrhythmia by regulating multi-ion channels.

PubMed

Zhao, Zhenying; Yin, Yongqiang; Wu, Hong; Jiang, Min; Lou, Jianshi; Bai, Gang; Luo, Guo'an

2013-01-01

Arctigenin possesses biological activities, but its underlying mechanisms at the cellular and ion channel levels are not completely understood. Therefore, the present study was designed to identify the anti-arrhythmia effect of arctigenin in vivo, as well as its cellular targets and mechanisms. A rat arrhythmia model was established via continuous aconitine infusion, and the onset times of ventricular premature contraction, ventricular tachycardia and death were recorded. The Action Potential Duration (APD), sodium current (I(Na)), L-type calcium current (I(Ca, L)) and transient outward potassium current (I(to)) were measured and analysed using a patch-clamp recording technique in normal rat cardiomyocytes and myocytes of arrhythmia aconitine-induced by. Arctigenin significantly delayed the arrhythmia onset in the aconitine-induced rat model. The 50% and 90% repolarisations (APD50 and APD90) were shortened by 100 µM arctigenin; the arctigenin dose also inhibited the prolongation of APD50 and APD90 caused by 1 µM aconitine. Arctigenin inhibited I(Na) and I(Ca,L) and attenuated the aconitine-increased I(Na) and I(Ca,L) by accelerating the activation process and delaying the inactivation process. Arctigenin enhanced Ito by facilitating the activation process and delaying the inactivation process, and recoverd the decreased Ito induced by aconitine. Arctigenin has displayed anti-arrhythmia effects, both in vivo and in vitro. In the context of electrophysiology, I(Na), I(Ca, L), and I(to) may be multiple targets of arctigenin, leading to its antiarrhythmic effect. © 2013 S. Karger AG, Basel.

The effect of Cardiac Arrhythmias Simulation Software on the nurses' learning and professional development.

PubMed

Bazrafkan, Leila; Hemmati, Mehdi

2018-04-01

One of the important tasks of nurses in intensive care unit is interpretation of ECG. The use of training simulator is a new paradigm in the age of computers. This study was performed to evaluate the impact of cardiac arrhythmias simulator software on nurses' learning in the subspecialty Vali-Asr Hospital in 2016. This study was conducted by quasi-experimental randomized Salomon four group design with the participation of 120 nurses in subspecialty Vali-Asr Hospital in Tehran, Iran in 2016 that were selected purposefully and allocated in 4 groups. By this design other confounding factors such as the prior information, maturation and the role of sex and age were controlled by Solomon 4 design. The valid and reliable multiple choice test tools were used to gather information; the validity of the test was approved by experts and its reliability was obtained by Cronbach's alpha coefficient 0.89. At first, the knowledge and skills of the participants were assessed by a pre-test; following the educational intervention with cardiac arrhythmias simulator software during 14 days in ICUs, the mentioned factors were measured for the two groups again by a post-test in the four groups. Data were analyzed using the two way ANOVA. The significance level was considered as p<0.05. Based on randomized four-group Solomon designs and our test results, using cardiac arrhythmias simulator software as an intervention was effective in the nurses' learning since a significant difference was found between pre-test and post-test in the first group (p<0.05). Also, other comparisons by ANOVA test showed that there was no interaction between pre-test and intervention in all of the three knowledge areas of cardiac arrhythmias, their treatments and their diagnosis (P>0.05). The use of software-based simulator for cardiac arrhythmias was effective in nurses' learning in light of its attractive components and interactive method. This intervention increased the knowledge of the nurses in cognitive

Possible influence of the polarity reversal of the solar magnetic field on the various types of arrhythmias

NASA Astrophysics Data System (ADS)

Giannaropoulou, E.; Papailiou, M.; Mavromichalaki, H.; Gigolashvili, M.; Tvildiani, L.; Janashia, K.; Preka-Papadema, P.; Papadima, Th

2013-02-01

Over the last few years various researches have reached the conclusion that cosmic ray variations and geomagnetic disturbances are related to the condition of the human physiological state. In this study medical data concerning the number of incidents of different types of cardiac arrhythmias for the time period 1983 - 1992 which refer to 1902 patients in Tbilisi, Georgia were used. The smoothing method and the Pearson r-coefficients were used to examine the possible effect of different solar and geomagnetic activity parameters and cosmic ray intensity variations on the different types of arrhythmias. The time interval under examination was separated into two different time periods which coincided with the polarity reversal of the solar magnetic field that occurred in the years 1989-1990 and as a result a different behavior of all the above mentioned parameters as well as of the different types of arrhythmias was noticed during the two time intervals. In addition, changing of polarity sign of the solar magnetic field was found to affect the sign of correlation between the incidence of arrhythmias and the aforementioned parameters. The primary and secondary maxima observed in the solar parameters during the solar cycle 22, also appeared in several types of arrhythmias with a time lag of about five months.

Association of ventricular arrhythmia and in-hospital mortality in stroke patients in Florida: A nonconcurrent prospective study.

PubMed

Dahlin, Arielle A; Parsons, Chase C; Barengo, Noël C; Ruiz, Juan Gabriel; Ward-Peterson, Melissa; Zevallos, Juan Carlos

2017-07-01

Stroke remains one of the leading causes of death in the United States. Current evidence identified electrocardiographic abnormalities and cardiac arrhythmias in 50% of patients with an acute stroke. The purpose of this study was to assess whether the presence of ventricular arrhythmia (VA) in adult patients hospitalized in Florida with acute stroke increased the risk of in-hospital mortality.Secondary data analysis of 215,150 patients with ischemic and hemorrhagic stroke hospitalized in the state of Florida collected by the Florida Agency for Healthcare Administration from 2008 to 2012. The main outcome for this study was in-hospital mortality. The main exposure of this study was defined as the presence of VA. VA included the ICD-9 CM codes: paroxysmal ventricular tachycardia (427.1), ventricular fibrillation (427.41), ventricular flutter (427.42), ventricular fibrillation and flutter (427.4), and other - includes premature ventricular beats, contractions, or systoles (427.69). Differences in demographic and clinical characteristics and hospital outcomes were assessed between patients who developed versus did not develop VA during hospitalization (χ and t tests). Binary logistic regression was used to estimate unadjusted and adjusted odds ratios and 95% confidence intervals (CIs) between VA and in-hospital mortality.VA was associated with an increased risk of in-hospital mortality after adjusting for all covariates (odds ratio [OR]: 1.75; 95% CI: 1.6-1.2). There was an increased in-hospital mortality in women compared to men (OR: 1.1; 95% CI: 1.1-1.14), age greater than 85 years (OR: 3.9, 95% CI: 3.5-4.3), African Americans compared to Whites (OR: 1.1; 95% CI: 1.04-1.2), diagnosis of congestive heart failure (OR: 2.1; 95% CI: 2.0-2.3), and atrial arrhythmias (OR: 2.1, 95% CI: 2.0-2.2). Patients with hemorrhagic stroke had increased odds of in-hospital mortality (OR: 9.0; 95% CI: 8.6-9.4) compared to ischemic stroke.Identifying VAs in stroke patients may help in

Cardiac arrhythmia mechanisms in rats with heart failure induced by pulmonary hypertension

PubMed Central

Benoist, David; Stones, Rachel; Drinkhill, Mark J.; Benson, Alan P.; Yang, Zhaokang; Cassan, Cecile; Gilbert, Stephen H.; Saint, David A.; Cazorla, Olivier; Steele, Derek S.; Bernus, Olivier

2012-01-01

Pulmonary hypertension provokes right heart failure and arrhythmias. Better understanding of the mechanisms underlying these arrhythmias is needed to facilitate new therapeutic approaches for the hypertensive, failing right ventricle (RV). The aim of our study was to identify the mechanisms generating arrhythmias in a model of RV failure induced by pulmonary hypertension. Rats were injected with monocrotaline to induce either RV hypertrophy or failure or with saline (control). ECGs were measured in conscious, unrestrained animals by telemetry. In isolated hearts, electrical activity was measured by optical mapping and myofiber orientation by diffusion tensor-MRI. Sarcoplasmic reticular Ca2+ handling was studied in single myocytes. Compared with control animals, the T-wave of the ECG was prolonged and in three of seven heart failure animals, prominent T-wave alternans occurred. Discordant action potential (AP) alternans occurred in isolated failing hearts and Ca2+ transient alternans in failing myocytes. In failing hearts, AP duration and dispersion were increased; conduction velocity and AP restitution were steeper. The latter was intrinsic to failing single myocytes. Failing hearts had greater fiber angle disarray; this correlated with AP duration. Failing myocytes had reduced sarco(endo)plasmic reticular Ca2+-ATPase activity, increased sarcoplasmic reticular Ca2+-release fraction, and increased Ca2+ spark leak. In hypertrophied hearts and myocytes, dysfunctional adaptation had begun, but alternans did not develop. We conclude that increased electrical and structural heterogeneity and dysfunctional sarcoplasmic reticular Ca2+ handling increased the probability of alternans, a proarrhythmic predictor of sudden cardiac death. These mechanisms are potential therapeutic targets for the correction of arrhythmias in hypertensive, failing RVs. PMID:22427523

An electrocardiographic scoring system for distinguishing right ventricular outflow tract arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy from idiopathic ventricular tachycardia.

PubMed

Hoffmayer, Kurt S; Bhave, Prashant D; Marcus, Gregory M; James, Cynthia A; Tichnell, Crystal; Chopra, Nagesh; Moxey, Laura; Krahn, Andrew D; Dixit, Sanjay; Stevenson, William; Calkins, Hugh; Badhwar, Nitish; Gerstenfeld, Edward P; Scheinman, Melvin M

2013-04-01

Ventricular arrhythmias in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and idiopathic ventricular tachycardia (VT) can share a left bundle branch block/inferior axis morphology. We previously reported electrocardiogram characteristics during outflow tract ventricular arrhythmias that helped distinguish VT related to ARVD/C from idiopathic VT. To prospectively validate these criteria. We created a risk score by using a derivation cohort. Two experienced electrophysiologists blinded to the diagnosis prospectively scored patients with VT/premature ventricular contractions (PVCs) with left bundle branch block/inferior axis pattern in a validation cohort of 37 ARVD/C tracings and 49 idiopathic VT tracings. All patients with ARVD/C had their diagnosis confirmed based on the revised task force criteria. Patients with idiopathic VT were selected based on structurally normal hearts with documented right ventricular outflow tract VT successfully treated with ablation. The scoring system provides 3 points for sinus rhythm anterior T-wave inversions in leads V1-V3 and during ventricular arrhythmia: 2 points for QRS duration in lead I≥120 ms, 2 points for QRS notching, and 1 point for precordial transition at lead V5 or later. A score of 5 or greater was able to correctly distinguish ARVD/C from idiopathic VT 93% of the time, with a sensitivity of 84%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 91%. We describe a simple scoring algorithm that uses 12-lead electrocardiogram characteristics to effectively distinguish right ventricular outflow tract arrhythmias originating from patients with ARVD/C versus patients with idiopathic VT. Copyright © 2013 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Use of sodium bicarbonate to treat tricyclic antidepressant-induced arrhythmias in a patient with alkalosis.

PubMed Central

Molloy, D W; Penner, S B; Rabson, J; Hall, K W

1984-01-01

Sodium bicarbonate has been recommended for the treatment of arrhythmias induced by tricyclic antidepressants. It is unclear, however, whether this therapy is effective only in the presence of acidosis. A case is presented in which there was an immediate response to sodium bicarbonate in three episodes of ventricular tachycardia despite the presence of alkalosis on two of the three occasions. Given the poor response to conventional therapy of arrhythmias induced by tricyclic antidepressants the use of sodium bicarbonate may be reasonable even in the presence of alkalosis. However, in the presence of pre-existing respiratory or metabolic alkalosis, such therapy is not without risk, and it is suggested that it be reserved for life-threatening situations when the arrhythmia has failed to respond to hyperventilation or antiarrhythmics or both. PMID:6329501

Short-term Effects of High-Dose Caffeine on Cardiac Arrhythmias in Patients With Heart Failure: A Randomized Clinical Trial.

PubMed

Zuchinali, Priccila; Souza, Gabriela C; Pimentel, Maurício; Chemello, Diego; Zimerman, André; Giaretta, Vanessa; Salamoni, Joyce; Fracasso, Bianca; Zimerman, Leandro I; Rohde, Luis E

2016-12-01

The presumed proarrhythmic action of caffeine is controversial. Few studies have assessed the effect of high doses of caffeine in patients with heart failure due to left ventricular systolic dysfunction at high risk for ventricular arrhythmias. To compare the effect of high-dose caffeine or placebo on the frequency of supraventricular and ventricular arrhythmias, both at rest and during a symptom-limited exercise test. Double-blinded randomized clinical trial with a crossover design conducted at the heart failure and cardiac transplant clinic of a tertiary-care university hospital. The trial included patients with chronic heart failure with moderate-to-severe systolic dysfunction (left ventricular ejection fraction <45%) and New York Heart Association functional class I to III between March 5, 2013, and October 2, 2015. Caffeine (100 mg) or lactose capsules, in addition to 5 doses of 100 mL decaffeinated coffee at 1-hour intervals, for a total of 500 mg of caffeine or placebo during a 5-hour protocol. After a 1-week washout period, the protocol was repeated. Number and percentage of ventricular and supraventricular premature beats assessed by continuous electrocardiographic monitoring. We enrolled 51 patients (37 [74%] male; mean [SD] age, 60.6 [10.9] years) with predominantly moderate-to-severe left ventricular systolic dysfunction (mean [SD] left ventricular ejection fraction, 29% [7%]); 31 [61%] had an implantable cardioverter-defibrillator device. No significant differences between the caffeine and placebo groups were observed in the number of ventricular (185 vs 239 beats, respectively; P = .47) and supraventricular premature beats (6 vs 6 beats, respectively; P = .44), as well as in couplets, bigeminal cycles, or nonsustained tachycardia during continuous electrocardiographic monitoring. Exercise test-derived variables, such as ventricular and supraventricular premature beats, duration of exercise, estimated peak oxygen consumption, and heart rate

Unique Association of Rare Cardiovascular Disease in an Athlete With Ventricular Arrhythmias.

PubMed

Santomauro, V; Contursi, M; Dellegrottaglie, S; Borsellino, G

2015-01-01

Ventricular arrhythmias are a leading cause of non-elegibility to competitive sport. The failure to detect a significant organic substrate in the initial stage of screening does not preclude the identification of structural pathologies in the follow-up by using advanced imaging techniques. Here we report the case of a senior athlete judged not elegible because an arrhythmia with the morphology consistent with the origin of the left ventricle, in which subsequent execution of a cardiac MR and a thoracic CT scan has allowed the identification of an unique association between an area of myocardial damage, probable site of origine of the arrhythma, and a rare aortic malformation.

A Report To The Superintendent Regarding the Progress of Venice Junior High School Towards Flexible Instructional Organization (F10), or Staff Differentiation.

ERIC Educational Resources Information Center

English, Fenwick W.

This report determined the results of the implementation of flexible instructional organization (F10) or staff differentiation at Venice Junior High School, Sarasota, Florida. The introductory portion concerns the report purpose, procedures and scope as well as background material. Results of interviews, conferences, surveys, observations, and…

Genome-Wide Association of Implantable Cardioverter-Defibrillator Activation With Life-Threatening Arrhythmias

PubMed Central

Murray, Sarah S.; Smith, Erin N.; Villarasa, Nikki; Nahey, Tara; Lande, Jeff; Goldberg, Harold; Shaw, Marian; Rosenthal, Lawrence; Ramza, Brian; Alaeddini, Jamshid; Han, Xinqiang; Damani, Samir; Soykan, Orhan; Kowal, Robert C.; Topol, Eric J.

2012-01-01

Objectives To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD), we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases) vs. those who did not over at least a 3-year period (controls). Background Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. Methods Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. Results and Conclusions We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10−6. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram) were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. Trial Registration ClinicalTrials.gov NCT00664807 PMID:22247754

Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection.

PubMed

Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

2017-06-12

Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan-Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities.

Postoperative administration of landiolol hydrochloride for patients with supraventricular arrhythmia: the efficacy of sustained intravenous infusion at a low dose.

PubMed

Wariishi, Seiichiro; Yamashita, Koichi; Nishimori, Hideaki; Fukutomi, Takashi; Yamamoto, Masaki; Radhakrishnan, Geethalakshmi; Sasaguri, Shiro

2009-11-01

The purpose of this study was to investigate the efficacy of landiolol hydrochloride, a short-acting beta(1) blocker, by initiating its administration at a low dose (5 microg kg(-1) min(-1)) in patients with postoperative supraventricular arrhythmia. The efficacy of landiolol was evaluated in 38 patients who, after developing postoperative atrial flutter or fibrillation, with sinus tachycardia and two patients who had a history of paroxysmal atrial fibrillation with frequent atrial extrasystole. The heart rate and blood pressure before and 2 h after the administration of landiolol were compared. A return to the sinus rhythm from supraventricular arrhythmia was noted in 89%. The heart rate was reduced from 137+/-26 bpm (before landiolol administration) to 93+/-18 bpm (2 h after the start of the medication, P<0.01). As an agent to correct an arrhythmic condition, landiolol successfully raised the systolic blood pressure from 108+/-24 mmHg (before medication) to 120+/-19 mmHg (2 h after the medication was started, P<0.05). Continuous intravenous infusion of landiolol at a low dose was found to be effective for postoperative supraventricular arrhythmia.

5 CFR 1315.8 - Rebates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Rebates. 1315.8 Section 1315.8 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES PROMPT PAYMENT § 1315.8 Rebates. Agencies shall determine governmentwide commercial purchase card payment dates based on an analysis of the total...

Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study.

PubMed

Haeusler, Karl Georg; Herm, Juliane; Kunze, Claudia; Krüll, Matthias; Brechtel, Lars; Lock, Jürgen; Hohenhaus, Marc; Heuschmann, Peter U; Fiebach, Jochen B; Haverkamp, Wilhelm; Endres, Matthias; Jungehulsing, Gerhard Jan

2012-08-31

Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing. In the prospective observational "Berlin Beat of Running" study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2%) Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Findings from the "Berlin Beats of Running" study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress and brain damage. clinicaltrials.gov NCT01428778.

Fragrances as new contaminants in the Venice lagoon.

PubMed

Vecchiato, Marco; Cremonese, Simone; Gregoris, Elena; Barbaro, Elena; Gambaro, Andrea; Barbante, Carlo

2016-10-01

Fragrance Materials (FMs) are omnipresent components of household and Personal Care Products (PCPs). In spite of their widespread use, little is known about their environmental occurrence. We selected 17 among the longest-lasting and most stable fragrance ingredients that are commercially available, namely: Amberketal, Ambrofix, Amyl Salicylate, Benzyl Salicylate, Bourgeonal, Dupical, Hexyl Salicylate, Isobutavan, Lemonile, Mefranal, Myraldene, Okoumal, Oranger Crystals, Pelargene, Peonile, Tridecene-2-Nitrile, Ultravanil. A new analytical method was developed to quantify FMs in water samples and it was applied to perform the first study about the distribution of these compounds in the surface waters of the city of Venice and its lagoon. Total FMs concentrations range from about 30ngL(-1) to more than 10μgL(-1) in polluted canals during the low tide. Sewage discharges were supposed to be the main sources of the selected FMs in the environment. Salicylates, oestrogenic and allergenic compounds, were in general the most abundant and widespread components. This study reports for the first time the detection of most of the selected FMs in surface waters and represent the first step to understand their environmental fate. Copyright © 2016 Elsevier B.V. All rights reserved.

Arrhythmia Evaluation in Wearable ECG Devices

PubMed Central

Sadrawi, Muammar; Lin, Chien-Hung; Hsieh, Yita; Kuo, Chia-Chun; Chien, Jen Chien; Haraikawa, Koichi; Abbod, Maysam F.; Shieh, Jiann-Shing

2017-01-01

This study evaluates four databases from PhysioNet: The American Heart Association database (AHADB), Creighton University Ventricular Tachyarrhythmia database (CUDB), MIT-BIH Arrhythmia database (MITDB), and MIT-BIH Noise Stress Test database (NSTDB). The ANSI/AAMI EC57:2012 is used for the evaluation of the algorithms for the supraventricular ectopic beat (SVEB), ventricular ectopic beat (VEB), atrial fibrillation (AF), and ventricular fibrillation (VF) via the evaluation of the sensitivity, positive predictivity and false positive rate. Sample entropy, fast Fourier transform (FFT), and multilayer perceptron neural network with backpropagation training algorithm are selected for the integrated detection algorithms. For this study, the result for SVEB has some improvements compared to a previous study that also utilized ANSI/AAMI EC57. In further, VEB sensitivity and positive predictivity gross evaluations have greater than 80%, except for the positive predictivity of the NSTDB database. For AF gross evaluation of MITDB database, the results show very good classification, excluding the episode sensitivity. In advanced, for VF gross evaluation, the episode sensitivity and positive predictivity for the AHADB, MITDB, and CUDB, have greater than 80%, except for MITDB episode positive predictivity, which is 75%. The achieved results show that the proposed integrated SVEB, VEB, AF, and VF detection algorithm has an accurate classification according to ANSI/AAMI EC57:2012. In conclusion, the proposed integrated detection algorithm can achieve good accuracy in comparison with other previous studies. Furthermore, more advanced algorithms and hardware devices should be performed in future for arrhythmia detection and evaluation. PMID:29068369

In vivo and in vitro antiarrhythmic effects of SSR149744C in animal models of atrial fibrillation and ventricular arrhythmias.

PubMed

Gautier, Patrick; Serre, Martine; Cosnier-Pucheu, Sylvie; Djandjighian, Laurent; Roccon, Alain; Herbert, Jean-Marc; Nisato, Dino

2005-02-01

SSR149744C (2-butyl-3-{4-[3-(dibutylamino)propyl]benzoyl}-1-benzofuran-5-carboxylate isopropyl fumarate) is a new noniodinated benzofuran derivative structurally related to amiodarone and dronedarone that is currently undergoing clinical trials as an antiarrhythmic agent. As SSR149744C exhibits electrophysiological and hemodynamic properties of class I, II, III, and IV antiarrhythmic agents, the aim of this study was to evaluate its acute intravenous (IV) or oral (PO) antiarrhythmic activities in in vitro and in vivo animal models of atrial and ventricular arrhythmias. In vagally induced atrial fibrillation (AF) in anesthetized dogs, SSR149744C (3 and 10 mg/kg IV) terminated AF in all 7 dogs and prevented reinduction in 4 out of 7 dogs; effective refractory periods of right atrium were dose-dependently and frequency-independently lengthened. In low-K+ medium-induced AF models, SSR149744C (0.1 to 1 microM) prevented AF in isolated guinea pig hearts in a concentration-dependent manner. At the ventricular level, SSR149744C (0.1 to 10 mg/kg IV and 3 to 90 mg/kg PO) prevented reperfusion-induced arrhythmias in anesthetized rats with a dose-effect relationship, and, at doses of 30 to 90 mg/kg PO, it reduced early (0-24 hours) mortality following permanent left coronary artery ligature in conscious rats. The present results show that SSR149744C is an effective antiarrhythmic agent in atrial fibrillation and in ventricular arrhythmias. Like amiodarone and dronedarone, its efficiency in these animal models of arrhythmias is likely be related to its multifactorial mechanism of action.

Respiratory sinus arrhythmia in Chagas disease.

PubMed

Neves, Victor Ribeiro; Peltola, Mirja; Huikuri, Heikki; Rocha, Manoel Otávio da Costa; Ribeiro, Antonio Luiz

2014-10-01

We applied the respiratory sinus arrhythmia (RSA) quantification algorithm to 24-hour ECG recordings of Chagas disease (ChD) patients with (G1, n=148) and without left ventricular dysfunction (LVD) (G2, n=33), and in control subjects (G0, n=28). Both ChD groups displayed a reduced RSA index; G1=299 (144-812); G2=335 (162-667), p=0.011, which was correlated with vagal indexes of heart rate variability analysis. RSA index is a marker of vagal modulation in ChD patients. Copyright © 2014 Elsevier B.V. All rights reserved.

[Arrhythmias and heart blocks in flying personnel with mitral valve prolapses].

PubMed

Zakharov, V P; Karlov, V N; Bondareva, S V; Vlasov, V D

1999-01-01

Investigated were 76 pilots with ECG-verified mitral valve prolapses (MVP) of the 1st and 2nd degree (w/o profound regurgitation). There were various heart blocks and ECG repolarization changes in 35 cases. Comparison of results of the cardiovascular functional investigations of flyers with MVP displayed non-specific cardiac rhythm and conductance disturbances that were registered more often during ECG-monitoring or test loading. According to the data of this study, bicycle and treadmill ergometry revealed "pseudoischemic" shifts in ECG. Literary indications of a significant loss in human endurance of physical loads due to MVP combined with the strain-induced arrhythmia received the experimental confirmation. Probably, arrhythmias in flyers with diagnosed MVP are predominantly associated with electric instability of the myocardium against the autonomous dysfunction with prevailing adrenergic effects.

Exercise capacity and muscle strength and risk of vascular disease and arrhythmia in 1.1 million young Swedish men: cohort study.

PubMed

Andersen, Kasper; Rasmussen, Finn; Held, Claes; Neovius, Martin; Tynelius, Per; Sundström, Johan

2015-09-16

To investigate the associations of exercise capacity and muscle strength in late adolescence with risk of vascular disease and arrhythmia. Cohort study. General population in Sweden. 1.1 million men who participated in mandatory military conscription between 1 August 1972 and 31 December 1995, at a median age of 18.2 years. Participants were followed until 31 December 2010. Associations between exercise capacity and muscle strength with risk of vascular disease and subgroups (ischaemic heart disease, heart failure, stroke, and cardiovascular death) and risk of arrhythmia and subgroups (atrial fibrillation or flutter, bradyarrhythmia, supraventricular tachycardia, and ventricular arrhythmia or sudden cardiac death). Maximum exercise capacity was estimated by the ergometer bicycle test, and muscle strength was measured as handgrip strength by a hand dynamometer. High exercise capacity or muscle strength was deemed as above the median level. During a median follow-up of 26.3 years, 26 088 vascular disease events and 17 312 arrhythmia events were recorded. Exercise capacity was inversely associated with risk of vascular disease and its subgroups. Muscle strength was also inversely associated with vascular disease risk, driven by associations of higher muscle strength with lower risk of heart failure and cardiovascular death. Exercise capacity had a U shaped association with risk of arrhythmia, driven by a direct association with risk of atrial fibrillation and a U shaped association with bradyarrhythmia. Higher muscle strength was associated with lower risk of arrhythmia (specifically, lower risk of bradyarrhythmia and ventricular arrhythmia). The combination of high exercise capacity and high muscle strength was associated with a hazard ratio of 0.67 (95% confidence interval 0.65 to 0.70) for vascular events and 0.92 (0.88 to 0.97) for arrhythmia compared with the combination of low exercise capacity and low muscle strength. Exercise capacity and muscle strength

Aconitine "challenge" test reveals a single whole-body exposure to diesel exhaust increases cardiac arrhythmia risk in hypertensive rats

EPA Science Inventory

Epidemiological studies demonstrate a significant association between cardiac electrical dysfunction, arrhythmias and air pollution exposure. Sensitivity to aconitine-induced arrhythmia has been used repeatedly to examine the factors that increase the risk of such cardiac electri...

Evidence of reversible bradycardia and arrhythmias caused by immunogenic proteins secreted by T. cruzi in isolated rat hearts.

PubMed

Rodríguez-Angulo, Héctor O; Toro-Mendoza, Jhoan; Marques, Juan A; Concepción, Juan L; Bonfante-Cabarcas, Rafael; Higuerey, Yoliver; Thomas, Luz E; Balzano-Nogueira, Leandro; López, José R; Mijares, Alfredo

2015-02-01

Chagas cardiomyopathy, caused by the protozoan Trypanosoma cruzi, is characterized by alterations in intracellular ion, heart failure and arrhythmias. Arrhythmias have been related to sudden death, even in asymptomatic patients, and their molecular mechanisms have not been fully elucidated. The aim of this study is to demonstrate the effect of proteins secreted by T. cruzi on healthy, isolated beating rat heart model under a non-damage-inducing protocol. We established a non-damage-inducing recirculation-reoxygenation model where ultrafiltrate fractions of conditioned medium control or conditioned infected medium were perfused at a standard flow rate and under partial oxygenation. Western blotting with chagasic patient serum was performed to determine the antigenicity of the conditioned infected medium fractions. We observed bradycardia, ventricular fibrillation and complete atrioventricular block in hearts during perfusion with >50 kDa conditioned infected culture medium. The preincubation of conditioned infected medium with chagasic serum abolished the bradycardia and arrhythmias. The proteins present in the conditioned infected culture medium of >50 kDa fractions were recognized by the chagasic patient sera associated with arrhythmias. These results suggest that proteins secreted by T. cruzi are involved in Chagas disease arrhythmias and may be a potential biomarker in chagasic patients.

Evidence of Reversible Bradycardia and Arrhythmias Caused by Immunogenic Proteins Secreted by T. cruzi in Isolated Rat Hearts

PubMed Central

Rodríguez-Angulo, Héctor O.; Toro-Mendoza, Jhoan; Marques, Juan A.; Concepción, Juan L.; Bonfante-Cabarcas, Rafael; Higuerey, Yoliver; Thomas, Luz E.; Balzano-Nogueira, Leandro; López, José R.; Mijares, Alfredo

2015-01-01

Rationale Chagas cardiomyopathy, caused by the protozoan Trypanosoma cruzi, is characterized by alterations in intracellular ion, heart failure and arrhythmias. Arrhythmias have been related to sudden death, even in asymptomatic patients, and their molecular mechanisms have not been fully elucidated. Objective The aim of this study is to demonstrate the effect of proteins secreted by T. cruzi on healthy, isolated beating rat heart model under a non-damage-inducing protocol. Methods and Results We established a non-damage-inducing recirculation-reoxygenation model where ultrafiltrate fractions of conditioned medium control or conditioned infected medium were perfused at a standard flow rate and under partial oxygenation. Western blotting with chagasic patient serum was performed to determine the antigenicity of the conditioned infected medium fractions. We observed bradycardia, ventricular fibrillation and complete atrioventricular block in hearts during perfusion with >50 kDa conditioned infected culture medium. The preincubation of conditioned infected medium with chagasic serum abolished the bradycardia and arrhythmias. The proteins present in the conditioned infected culture medium of >50 kDa fractions were recognized by the chagasic patient sera associated with arrhythmias. Conclusions These results suggest that proteins secreted by T. cruzi are involved in Chagas disease arrhythmias and may be a potential biomarker in chagasic patients. PMID:25647069

Disproportionality analysis of buprenorphine transdermal system and cardiac arrhythmia using FDA and WHO postmarketing reporting system data.

PubMed

Sessler, Nelson E; Walker, Ekaterina; Chickballapur, Harsha; Kacholakalayil, James; Coplan, Paul M

2017-01-01

Positive-controlled clinical studies have shown a dose dependent effect of buprenorphine transdermal system on QTc interval prolongation. This study provides assessment of the buprenorphine transdermal system and cardiac arrhythmia using US FDA and WHO postmarketing reporting databases. Disproportionality analysis of spontaneously reported adverse events to assess whether the reporting rate of cardiac arrhythmia events was disproportionately elevated relative to expected rates of reporting in both FDA and WHO databases. Cardiac arrhythmia events were identified using the standardized Medical Dictionary for Regulatory Activities query for torsade de pointes and/or QT prolongation (TdP/QTP). The threshold for a signal of disproportionate adverse event reporting was defined as the lower 90% confidence limit ≥ 2 of the Empiric Bayes geometric mean in FDA database and as the lower 95% confidence limit of the Informational Component >0 in WHO database. There were 124 (<1%) and 77 (2%) cardiac arrhythmia event cases associated with buprenorphine transdermal as compared to 3206 (12%) and 2913 (14%) involving methadone in the FDA and WHO databases, respectively. In the FDA database methadone was associated with a signal of disproportionate reporting for TdP/QTP (EB05 3.26); however, buprenorphine transdermal was not (EB05 0.33). In the WHO database methadone was associated with a signal of disproportionate reporting for TdP/QTP (IC025 2.66); however, buprenorphine transdermal was not (IC025 -0.88). Similar trends were observed in sensitivity analyses by age, gender, and specific terms related to ventricular arrhythmia. The signal identified in the transdermal buprenorphine thorough QTc study, which led to a dose limitation in its US label, does not translate into a signal of increased risk for cardiac arrhythmia in real world use, as assessed by this method of analyzing post-market surveillance data.

Aconitine Challenge Test Reveals a Single Exposure to Air Pollution Causes Increased Cardiac Arrhythmia Risk in Hypertensive Rats - Abstract

EPA Science Inventory

Epidemiological studies demonstrate a significant association between arrhythmias and air pollution exposure. Sensitivity to aconitine-induced arrhythmia has been used repeatedly to examine the factors that increase the risk of such cardiac electrical dysfunction. In this study, ...

Macroalgae, nutrient cycles, and pollutants in the lagoon of Venice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sfriso, A.; Pavoni, B.; Marcomini, A.

1992-12-01

The Lagoon of Venice is a wide, shallow coastal basin that extends for about 50 km along the northwest coast of the Adriatic Sea. The lagoon has been substantially modified through the actions of man over the last century through the artificial control of the hydraulic dynamics of the lagoon including the construction of channels to facilitate navigation. The lagoon is subjected to considerable pollutant loading through the drainage of land under cultivation, municipal sewage, and industrial effluents. In this paper are reported the results of observations designed to document recent changes in macroalgal species composition, seasonal cycles of primarymore » producers and nutrient levels, and the effects of the macroalgal community on concentrations of organic and inorganic pollutants. The dominant macroalgae in the lagoon was Ulva rigida, and the levels of plant nutrients and pollutants were influenced by the seasonal cycles of the macroalgal community. 44 refs., 11 figs., 2 tabs.« less

An arrhythmia classification algorithm using a dedicated wavelet adapted to different subjects.

PubMed

Kim, Jinkwon; Min, Se Dong; Lee, Myoungho

2011-06-27

Numerous studies have been conducted regarding a heartbeat classification algorithm over the past several decades. However, many algorithms have also been studied to acquire robust performance, as biosignals have a large amount of variation among individuals. Various methods have been proposed to reduce the differences coming from personal characteristics, but these expand the differences caused by arrhythmia. In this paper, an arrhythmia classification algorithm using a dedicated wavelet adapted to individual subjects is proposed. We reduced the performance variation using dedicated wavelets, as in the ECG morphologies of the subjects. The proposed algorithm utilizes morphological filtering and a continuous wavelet transform with a dedicated wavelet. A principal component analysis and linear discriminant analysis were utilized to compress the morphological data transformed by the dedicated wavelets. An extreme learning machine was used as a classifier in the proposed algorithm. A performance evaluation was conducted with the MIT-BIH arrhythmia database. The results showed a high sensitivity of 97.51%, specificity of 85.07%, accuracy of 97.94%, and a positive predictive value of 97.26%. The proposed algorithm achieves better accuracy than other state-of-the-art algorithms with no intrasubject between the training and evaluation datasets. And it significantly reduces the amount of intervention needed by physicians.

An arrhythmia classification algorithm using a dedicated wavelet adapted to different subjects

PubMed Central

2011-01-01

Background Numerous studies have been conducted regarding a heartbeat classification algorithm over the past several decades. However, many algorithms have also been studied to acquire robust performance, as biosignals have a large amount of variation among individuals. Various methods have been proposed to reduce the differences coming from personal characteristics, but these expand the differences caused by arrhythmia. Methods In this paper, an arrhythmia classification algorithm using a dedicated wavelet adapted to individual subjects is proposed. We reduced the performance variation using dedicated wavelets, as in the ECG morphologies of the subjects. The proposed algorithm utilizes morphological filtering and a continuous wavelet transform with a dedicated wavelet. A principal component analysis and linear discriminant analysis were utilized to compress the morphological data transformed by the dedicated wavelets. An extreme learning machine was used as a classifier in the proposed algorithm. Results A performance evaluation was conducted with the MIT-BIH arrhythmia database. The results showed a high sensitivity of 97.51%, specificity of 85.07%, accuracy of 97.94%, and a positive predictive value of 97.26%. Conclusions The proposed algorithm achieves better accuracy than other state-of-the-art algorithms with no intrasubject between the training and evaluation datasets. And it significantly reduces the amount of intervention needed by physicians. PMID:21707989

Anatomy of the Holocene succession of the southern Venice lagoon revealed by very high-resolution seismic data

NASA Astrophysics Data System (ADS)

Zecchin, Massimo; Brancolini, Giuliano; Tosi, Luigi; Rizzetto, Federica; Caffau, Mauro; Baradello, Luca

2009-05-01

The southern portion of the Venice lagoon contains a relatively thick (up to 20 m) Holocene sedimentary body that represents a detailed record of the formation and evolution of the lagoon. New very high-resolution (VHR) seismic profiles provided a detailed investigation on depositional geometries, internal bounding surfaces and stratal relationships. These informations, combined with core analysis, allowed the identification of large- to medium-scale sedimentary structures (e.g. dunes, point bars), the corresponding sedimentary environment, and of retrogradational and progradational trends. In addition, the availability of dense seismic network produced a 3D reconstruction of the southern lagoon and the recognition of the along-strike and dip variability of the stratal architecture. Three main seismic units (H1-H3), separated by key stratal surfaces (S1-S3), form the Holocene succession in the southern Venice lagoon. This succession is bounded at the base by the Pleistocene/Holocene boundary (the surface S1), which consists of a surface of subaerial exposure locally subjected to river incision. The lower part of the Holocene succession (up to 13 m thick) consists of incised valley fills passing upward into lagoon and then shallow-marine sediments (Unit H1), and therefore shows a deepening-upward trend and a retrogradational stacking pattern. A prograding delta and adjacent shorelines, showing internal clinoforms downlapping onto the top of Unit H1 (the surface S2), form the middle part of the Holocene succession (Unit H2, up to 7.5 m thick). Unit H2 is interpreted as a result of a regressive phase started about 6 kyr BP and continued until recent time. The upper part of the Holocene succession (Unit H3) consists of lagoonal deposits, including tidal channel and tidal and subtidal flat sediments, that abruptly overlie Unit H2. Unit H3 is thought to represent a drowning of the area primarily due to human interventions that created rivers diversion and consequent

Circulating microRNAs in arrhythmogenic right ventricular cardiomyopathy with ventricular arrhythmia.

PubMed

Yamada, Shinya; Hsiao, Ya-Wen; Chang, Shih-Lin; Lin, Yenn-Jiang; Lo, Li-Wei; Chung, Fa-Po; Chiang, Shuo-Ju; Hu, Yu-Feng; Tuan, Ta-Chuan; Chao, Tze-Fan; Liao, Jo-Nan; Lin, Chin-Yu; Chang, Yao-Ting; Te, Abigail Louise D; Tsai, Yung-Nan; Chen, Shih-Ann

2018-06-01

MicroRNAs (miRNAs) have been implicated in cardiac diseases. This study aimed to characterize the circulating miRNAs in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and correlate the miRNAs with the clinical outcomes of ARVC. This study included 62 patients with ventricular arrhythmia (VA): 28 patients (45%) had definite ARVC, 11 (18%) had borderline or possible ARVC, and 23 (37%) had idiopathic ventricular tachycardia (VT). In addition, 33 age- and sex-matched healthy subjects were enrolled as normal control subjects. The expression of selected miRNAs was analysed in all study subjects. The clinical outcomes of patients with definite ARVC after catheter ablation were further investigated. On the basis of the miRNA polymerase chain reaction array, we selected 11 miRNAs for analysis of their expression in the plasma of all subjects. Definite ARVC patients had significantly higher expression of circulating miR-144-3p, 145-5p, 185-5p, and 494 than the three other groups. Out of 25 definite ARVC patients who underwent radiofrequency catheter ablation, recurrent VA occurred in 8 patients (32%) during the follow-up period (45 ± 20 months). Definite ARVC patients with recurrent VA had a higher level of circulating miR-494 than did those without recurrence. Receiver operating characteristic analysis showed miR-494 to be a predictive factor of recurrent VA (area under the curve: 0.832). Plasma levels of miR-144-3p, 145-5p, 185-5p, and 494 were significantly elevated in definite ARVC patients with VA. An increased plasma level of miR-494 was associated with the recurrence of VA after ablation in definite ARVC patients.

Effects of chronic omega-3 polyunsaturated fatty acid supplementation on human atrial mechanical function after reversion of atrial arrhythmias to sinus rhythm: reversal of tachycardia-mediated atrial cardiomyopathy with fish oils.

PubMed

Kumar, Saurabh; Sutherland, Fiona; Wheeler, Miriam; Heck, Patrick M; Lee, Geoffrey; Teh, Andrew W; Garg, Manohar L; Morgan, John G; Sparks, Paul B

2011-05-01

Atrial mechanical stunning is a form of tachycardia-mediated atrial cardiomyopathy that manifests after reversion of persistent atrial arrhythmias to sinus rhythm. This study sought to examine whether chronic omega-3 polyunsaturated fatty acid supplementation with fish oils can reverse atrial mechanical stunning. Patients undergoing reversion of persistent atrial fibrillation (AF) or atrial flutter (AFL) to sinus rhythm were randomized to a control group (n = 26) or an omega-3 group (n = 23). The latter were prescribed 6 g/day of fish oil for ≥1 month prior to the procedure. Parameters of left atrial appendage function were compared immediately before and immediately after reversion. After fish oil intake for a mean of 70 days, the following were noted favoring the omega-3 group among both AF and AFL patients: (1) 2-fold higher serum omega-3 levels (P < .001), (2) less mean decrease in emptying velocity (e.g., AF: 8% vs. 32%, P = .02), (3) less mean decrease in appendage emptying fraction (e.g., AFL: 7% vs. 60%, P = .002), (4) lower incidence of new or increased spontaneous echocardiographic contrast (e.g., AF: 11% vs. 62.5%, P = .003), and (5) lower incidence of atrial mechanical stunning (e.g., AFL: 20% vs. 100%, P = .001). Omega-3 intake conferred protection against stunning in a multivariable analysis (odds ratio 0.18, P = .02). Chronic fish oil ingestion in humans attenuates atrial mechanical stunning after reversion of atrial arrhythmias to sinus rhythm. This suggests that fish oils may target or even reverse underlying cellular and/or structural remodeling that occurs in response to persistent atrial arrhythmias. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

Epac2-Rap1 Signaling Regulates Reactive Oxygen Species Production and Susceptibility to Cardiac Arrhythmias

PubMed Central

Yang, Zhaokang; Kirton, Hannah M.; Al-Owais, Moza; Thireau, Jérôme; Richard, Sylvain; Peers, Chris

2017-01-01

Abstract Aims: In the heart, β1-adrenergic signaling involves cyclic adenosine monophosphate (cAMP) acting via both protein kinase-A (PKA) and exchange protein directly activated by cAMP (Epac): a guanine nucleotide exchange factor for the small GTPase Rap1. Inhibition of Epac-Rap1 signaling has been proposed as a therapeutic strategy for both cancer and cardiovascular disease. However, previous work suggests that impaired Rap1 signaling may have detrimental effects on cardiac function. The aim of the present study was to investigate the influence of Epac2-Rap1 signaling on the heart using both in vivo and in vitro approaches. Results: Inhibition of Epac2 signaling induced early afterdepolarization arrhythmias in ventricular myocytes. The underlying mechanism involved an increase in mitochondrial reactive oxygen species (ROS) and activation of the late sodium current (INalate). Arrhythmias were blocked by inhibition of INalate or the mitochondria-targeted antioxidant, mitoTEMPO. In vivo, inhibition of Epac2 caused ventricular tachycardia, torsades de pointes, and sudden death. The in vitro and in vivo effects of Epac2 inhibition were mimicked by inhibition of geranylgeranyltransferase-1, which blocks interaction of Rap1 with downstream targets. Innovation: Our findings show for the first time that Rap1 acts as a negative regulator of mitochondrial ROS production in the heart and that impaired Epac2-Rap1 signaling causes arrhythmias due to ROS-dependent activation of INalate. This has implications for the use of chemotherapeutics that target Epac2-Rap1 signaling. However, selective inhibition of INalate provides a promising strategy to prevent arrhythmias caused by impaired Epac2-Rap1 signaling. Conclusion: Epac2-Rap1 signaling attenuates mitochondrial ROS production and reduces myocardial arrhythmia susceptibility. Antioxid. Redox Signal. 27, 117–132. PMID:27649969

Effects of valsartan on ventricular arrhythmia induced by programmed electrical stimulation in rats with myocardial infarction

PubMed Central

Jiao, Kun-Li; Li, Yi-Gang; Zhang, Peng-Pai; Chen, Ren-Hua; Yu, Yi

2012-01-01

Abstract The impact of angiotensin II receptor blockers (ARBs) on electrical remodelling after myocardial infarction (MI) remains unclear. The purpose of the present study was to evaluate the effect of valsartan on incidence of ventricular arrhythmia induced by programmed electrical stimulation (PES) and potential link to changes of myocardial connexins (Cx) 43 expression and distribution in MI rats. Fifty-nine rats were randomly divided into three groups: Sham (n = 20), MI (n = 20) and MI + Val (20 mg/kg/day per gavage, n = 19). After eight weeks, the incidence of PES-induced ventricular tachycardia (VT) and fibrillation (VF) was compared among groups. mRNA and protein expressions of Cx43, angiotensin II type 1 receptor (AT1R) in the LV border zone (BZ) and non-infarct zone (NIZ) were determined by real-time PCR and Western blot, respectively. Connexins 43 protein and collagen distribution were examined by immunohistochemistry in BZ and NIZ sections from MI hearts. Valsartan effectively improved the cardiac function, reduced the prolonged QTc (163.7 ± 3.7 msec. versus 177.8 ± 4.5 msec., P < 0.05) after MI and the incidence of VT or VF evoked by PES (21.1% versus 55%, P < 0.05). Angiotensin II type 1 receptor expression was significantly increased in BZ and NIZ sections after MI, which was down-regulated by valsartan. The mRNA and protein expressions of Cx43 in BZ were significantly reduced after MI and up-regulated by valsartan. Increased collagen deposition and reduced Cx43 expression in BZ after MI could be partly attenuated by Valsartan. Valsartan reduced the incidence of PES-induced ventricular arrhythmia, this effect was possibly through modulating the myocardial AT1R and Cx43 expression. PMID:22128836

Use of whole exome sequencing for the identification of Ito-based arrhythmia mechanism and therapy.

PubMed

Sturm, Amy C; Kline, Crystal F; Glynn, Patric; Johnson, Benjamin L; Curran, Jerry; Kilic, Ahmet; Higgins, Robert S D; Binkley, Philip F; Janssen, Paul M L; Weiss, Raul; Raman, Subha V; Fowler, Steven J; Priori, Silvia G; Hund, Thomas J; Carnes, Cynthia A; Mohler, Peter J

2015-05-26

Identified genetic variants are insufficient to explain all cases of inherited arrhythmia. We tested whether the integration of whole exome sequencing with well-established clinical, translational, and basic science platforms could provide rapid and novel insight into human arrhythmia pathophysiology and disease treatment. We report a proband with recurrent ventricular fibrillation, resistant to standard therapeutic interventions. Using whole-exome sequencing, we identified a variant in a previously unidentified exon of the dipeptidyl aminopeptidase-like protein-6 (DPP6) gene. This variant is the first identified coding mutation in DPP6 and augments cardiac repolarizing current (Ito) causing pathological changes in Ito and action potential morphology. We designed a therapeutic regimen incorporating dalfampridine to target Ito. Dalfampridine, approved for multiple sclerosis, normalized the ECG and reduced arrhythmia burden in the proband by >90-fold. This was combined with cilostazol to accelerate the heart rate to minimize the reverse-rate dependence of augmented Ito. We describe a novel arrhythmia mechanism and therapeutic approach to ameliorate the disease. Specifically, we identify the first coding variant of DPP6 in human ventricular fibrillation. These findings illustrate the power of genetic approaches for the elucidation and treatment of disease when carefully integrated with clinical and basic/translational research teams. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

1 CFR 5.8 - Form of citation.

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2011-01-01

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2014-01-01

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ECG-based 4D-dose reconstruction of cardiac arrhythmia ablation with carbon ion beams: application in a porcine model

NASA Astrophysics Data System (ADS)

Richter, Daniel; Immo Lehmann, H.; Eichhorn, Anna; Constantinescu, Anna M.; Kaderka, Robert; Prall, Matthias; Lugenbiel, Patrick; Takami, Mitsuru; Thomas, Dierk; Bert, Christoph; Durante, Marco; Packer, Douglas L.; Graeff, Christian

2017-09-01

Noninvasive ablation of cardiac arrhythmia by scanned particle radiotherapy is highly promising, but especially challenging due to cardiac and respiratory motion. Irradiations for catheter-free ablation in intact pigs were carried out at the GSI Helmholtz Center in Darmstadt using scanned carbon ions. Here, we present real-time electrocardiogram (ECG) data to estimate time-resolved (4D) delivered dose. For 11 animals, surface ECGs and temporal structure of beam delivery were acquired during irradiation. R waves were automatically detected from surface ECGs. Pre-treatment ECG-triggered 4D-CT phases were synchronized to the R-R interval. 4D-dose calculation was performed using GSI’s in-house 4D treatment planning system. Resulting dose distributions were assessed with respect to coverage (D95 and V95), heterogeneity (HI  =  D5-D95) and normal tissue exposure. Final results shown here were performed offline, but first calculations were started shortly after irradiation The D95 for TV and PTV was above 95% for 10 and 8 out of 11 animals, respectively. HI was reduced for PTV versus TV volumes, especially for some of the animals targeted at the atrioventricular junction, indicating residual interplay effects due to cardiac motion. Risk structure exposure was comparable to static and 4D treatment planning simulations. ECG-based 4D-dose reconstruction is technically feasible in a patient treatment-like setting. Further development of the presented approach, such as real-time dose calculation, may contribute to safe, successful treatments using scanned ion beams for cardiac arrhythmia ablation.

15 CFR 8b.5 - Assurances required.

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2010-01-01

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Mitral valve prolapse and electrolyte abnormality: a dangerous combination for ventricular arrhythmias

PubMed Central

Rajani, Ali Raza; Murugesan, Vagishwari; Baslaib, Fahad Omar; Rafiq, Muhammad Anwer

2014-01-01

A 27-year-old woman with a history of bileaflet mitral valve prolapse and moderate mitral regurgitation presented to our emergency with untractable polymorphic wide complex tachycardia and unstable haemodynamics. After cardiopulmonary resuscitation, return of spontaneous circulation was achieved 30 min later. Her post-resuscitation ECG showed a prolonged QT interval which progressively normalised over the same day. Her laboratory investigations revealed hypocalcaemia while other electrolytes were within normal limits. A diagnosis of ventricular arrhythmia secondary to structural heart disease further precipitated by hypocalcaemia was made. Further hospital stay did not reveal a recurrence of prolonged QT interval or other arrhythmias except for an episode of non-sustained ventricular tachycardia. However, the patient suffered diffuse hypoxic brain encephalopathy secondary to prolonged cardiopulmonary resuscitation. PMID:24827670

A Noninvasive Imaging Modality for Cardiac Arrhythmias

PubMed Central

Burnes, John E.; Taccardi, Bruno; Rudy, Yoram

2007-01-01

Background The last decade witnessed an explosion of information regarding the genetic, molecular, and mechanistic basis of heart disease. Translating this information into clinical practice requires the development of novel functional imaging modalities for diagnosis, localization, and guided intervention. A noninvasive modality for imaging cardiac arrhythmias is not yet available. Present electrocardiographic methods cannot precisely localize a ventricular tachycardia (VT) or its key reentrant circuit components. Recently, we developed a noninvasive electrocardiographic imaging modality (ECGI) that can reconstruct epicardial electrophysiological information from body surface potentials. Here, we extend its application to image reentrant arrhythmias. Methods and Results Epicardial potentials were recorded during VT with a 490 electrode sock during an open chest procedure in 2 dogs with 4-day-old myocardial infarctions. Body surface potentials were generated from these epicardial potentials in a human torso model. Realistic geometry errors and measurement noise were added to the torso data, which were then used to noninvasively reconstruct epicardial isochrones, electrograms, and potentials with excellent accuracy. ECGI reconstructed the reentry pathway and its key components, including (1) the central common pathway, (2) the VT exit site, (3) lines of block, and (4) regions of slow and fast conduction. This allowed for detailed characterization of the reentrant circuit morphology. Conclusions ECGI can noninvasively image arrhythmic activation on the epicardium during VT to identify and localize key components of the arrhythmogenic pathway that can be effective targets for antiarrhythmic intervention. PMID:11044435

Radar-driven High-resolution Hydrometeorological Forecasts of the 26 September 2007 Venice flash flood

NASA Astrophysics Data System (ADS)

Massimo Rossa, Andrea; Laudanna Del Guerra, Franco; Borga, Marco; Zanon, Francesco; Settin, Tommaso; Leuenberger, Daniel

2010-05-01

Space and time scales of flash floods are such that flash flood forecasting and warning systems depend upon the accurate real-time provision of rainfall information, high-resolution numerical weather prediction (NWP) forecasts and the use of hydrological models. Currently available high-resolution NWP model models can potentially provide warning forecasters information on the future evolution of storms and their internal structure, thereby increasing convective-scale warning lead times. However, it is essential that the model be started with a very accurate representation of on-going convection, which calls for assimilation of high-resolution rainfall data. This study aims to assess the feasibility of using carefully checked radar-derived quantitative precipitation estimates (QPE) for assimilation into NWP and hydrological models. The hydrometeorological modeling chain includes the convection-permitting NWP model COSMO-2 and a hydrologic-hydraulic models built upon the concept of geomorphological transport. Radar rainfall observations are assimilated into the NWP model via the latent heat nudging method. The study is focused on 26 September 2007 extreme flash flood event which impacted the coastal area of north-eastern Italy around Venice. The hydro-meteorological modeling system is implemented over the Dese river, a 90 km2 catchment flowing to the Venice lagoon. The radar rainfall observations are carefully checked for artifacts, including beam attenuation, by means of physics-based correction procedures and comparison with a dense network of raingauges. The impact of the radar QPE in the assimilation cycle of the NWP model is very significant, in that the main individual organized convective systems were successfully introduced into the model state, both in terms of timing and localization. Also, incorrectly localized precipitation in the model reference run without rainfall assimilation was correctly reduced to about the observed levels. On the other hand, the

Cardiac arrhythmia beat classification using DOST and PSO tuned SVM.

PubMed

Raj, Sandeep; Ray, Kailash Chandra; Shankar, Om

2016-11-01

The increase in the number of deaths due to cardiovascular diseases (CVDs) has gained significant attention from the study of electrocardiogram (ECG) signals. These ECG signals are studied by the experienced cardiologist for accurate and proper diagnosis, but it becomes difficult and time-consuming for long-term recordings. Various signal processing techniques are studied to analyze the ECG signal, but they bear limitations due to the non-stationary behavior of ECG signals. Hence, this study aims to improve the classification accuracy rate and provide an automated diagnostic solution for the detection of cardiac arrhythmias. The proposed methodology consists of four stages, i.e. filtering, R-peak detection, feature extraction and classification stages. In this study, Wavelet based approach is used to filter the raw ECG signal, whereas Pan-Tompkins algorithm is used for detecting the R-peak inside the ECG signal. In the feature extraction stage, discrete orthogonal Stockwell transform (DOST) approach is presented for an efficient time-frequency representation (i.e. morphological descriptors) of a time domain signal and retains the absolute phase information to distinguish the various non-stationary behavior ECG signals. Moreover, these morphological descriptors are further reduced in lower dimensional space by using principal component analysis and combined with the dynamic features (i.e based on RR-interval of the ECG signals) of the input signal. This combination of two different kinds of descriptors represents each feature set of an input signal that is utilized for classification into subsequent categories by employing PSO tuned support vector machines (SVM). The proposed methodology is validated on the baseline MIT-BIH arrhythmia database and evaluated under two assessment schemes, yielding an improved overall accuracy of 99.18% for sixteen classes in the category-based and 89.10% for five classes (mapped according to AAMI standard) in the patient

15 CFR 8.5 - Nondiscrimination clause.

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2010-01-01

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Sediment texture and metal contamination in the Venice Lagoon (Italy): A snapshot before the installation of the MOSE system

NASA Astrophysics Data System (ADS)

Zonta, Roberto; Botter, Margherita; Cassin, Daniele; Bellucci, Luca Giorgio; Pini, Roberto; Dominik, Janusz

2018-05-01

the top of the cores, reflecting the depletion of fine particles in the upper sediment layer due to winnowing in non-confined lagoon areas. In contrast, partly anthropogenic elements (Cu, Hg, Pb, Zn) increased up to the subsurface sediment layers (5-10 and/or 10-20 cm) as an effect of increasing pollutant inputs until a certain time in the past. Enrichment Factors (EF) were calculated from 9 cores, comparing concentrations in the "pre-industrial" (>100 years ago) and recent (surface layer, 0-5 cm) sediments. The mostly lithogenic elements were not enriched (EF ˜ 1), whereas the partly anthropogenic elements showed slight (Cu and Pb, EF ˜ 1.2) to significant (Hg and Zn, EF ˜ 2) enrichment. The shallow waters on the landward side (particularly close to freshwater inputs), the area nearby the industrial district of Porto Marghera and a small zone adjacent to the city of Chioggia were identified as the main pollutant accumulation sites. Mercury was the only element potentially harmful for aquatic life. Its concentration in the biologically active surface sediment layer (0-5 cm) exceeded the NOAA Effects Range-Median (ERM) value in 27% of samples, corresponding to 20% of the shallow-water surface area. The collected data set represents a valuable reference for monitoring the impact of the construction and operation of the MOSE system on the sediment features of the Venice Lagoon.

8 CFR 1246.5 - Hearing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Hearing. 1246.5 Section 1246.5 Aliens and... OF ADJUSTMENT OF STATUS § 1246.5 Hearing. (a) Service counsel. The Government shall be represented at the hearing by a Service counsel who shall have authority to present evidence, and to interrogate...

The Effects of Nandrolone Decanoate Along with Prolonged Low-Intensity Exercise on Susceptibility to Ventricular Arrhythmias.

PubMed

Binayi, Fateme; Joukar, Siyavash; Najafipour, Hamid; Karimi, Abdolah; Karimi, Ali; Abdollahi, Farzane; Masumi, Yaser

2016-01-01

We examined the influence of chronic administration of nandrolone decanoate with low-intensity endurance swimming exercise on susceptibility to lethal ventricular arrhythmias in rat. The animal groups included the control group, exercise group (EX), nandrolone group (Nan), vehicle group (Arach), trained vehicle group (Arach + Ex) and trained nandrolone group (Nan + Ex) that treated for 8 weeks. Then, arrhythmia induction was performed by intravenous infusion of aconitine and electrocardiogram recorded. Then, malondialdehyde (MDA), hydroxyproline (HYP) and glutathione peroxidase of heart tissue were measured. Chronic administration of nandrolone with low-intensity endurance swimming exercise had no significant effect on blood pressure, heart rate and basal ECG parameters except RR interval that showed increase (P < 0.05). Low-intensity exercise could prevent the incremental effect of nandrolone on MDA and HYP significantly. It also increased the heart hypertrophy index (P < 0.05) and reduced the abating effect of nandrolone on animal weighting. Nandrolone along with exercise significantly increased the duration of VF (P < 0.05) and reduced the VF latency (P < 0.05). The findings suggest that chronic co-administration of nandrolone with low-intensity endurance swimming exercise to some extent facilitates the occurrence of ventricular fibrillation in rat. Complementary studies are needed to elucidate the involved mechanisms of this abnormality.

Treatment of cardiac arrhythmias in a mouse model of Rett syndrome with Na+-channel-blocking antiepileptic drugs

PubMed Central

Herrera, José A.; Ward, Christopher S.; Pitcher, Meagan R.; Percy, Alan K.; Skinner, Steven; Kaufmann, Walter E.; Glaze, Daniel G.; Wehrens, Xander H. T.; Neul, Jeffrey L.

2015-01-01

One quarter of deaths associated with Rett syndrome (RTT), an X-linked neurodevelopmental disorder, are sudden and unexpected. RTT is associated with prolonged QTc interval (LQT), and LQT-associated cardiac arrhythmias are a potential cause of unexpected death. The standard of care for LQT in RTT is treatment with β-adrenergic antagonists; however, recent work indicates that acute treatment of mice with RTT with a β-antagonist, propranolol, does not prevent lethal arrhythmias. In contrast, acute treatment with the Na+ channel blocker phenytoin prevented arrhythmias. Chronic dosing of propranolol may be required for efficacy; therefore, we tested the efficacy of chronic treatment with either propranolol or phenytoin on RTT mice. Phenytoin completely abolished arrhythmias, whereas propranolol showed no benefit. Surprisingly, phenytoin also normalized weight and activity, but worsened breathing patterns. To explore the role of Na+ channel blockers on QT in people with RTT, we performed a retrospective analysis of QT status before and after Na+ channel blocker antiepileptic therapies. Individuals with RTT and LQT significantly improved their QT interval status after being started on Na+ channel blocker antiepileptic therapies. Thus, Na+ channel blockers should be considered for the clinical management of LQT in individuals with RTT. PMID:25713300

Ventricular arrhythmias and changes in heart rate preceding ventricular tachycardia in patients with an implantable cardioverter defibrillator.

PubMed

Lerma, Claudia; Wessel, Niels; Schirdewan, Alexander; Kurths, Jürgen; Glass, Leon

2008-07-01

The objective was to determine the characteristics of heart rate variability and ventricular arrhythmias prior to the onset of ventricular tachycardia (VT) in patients with an implantable cardioverter defibrillator (ICD). Sixty-eight beat-to-beat time series from 13 patients with an ICD were analyzed to quantify heart rate variability and ventricular arrhythmias. The episodes of VT were classified in one of two groups depending on whether the sinus rate in the 1 min preceding the VT was greater or less than 90 beats per minute. In a subset of patients, increased heart rate and reduced heart rate variability was often observed up to 20 min prior to the VT. There was a non-significant trend to higher incidence of premature ventricular complexes (PVCs) before VT compared to control recordings. The patterns of the ventricular arrhythmias were highly heterogeneous among different patients and even within the same patient. Analysis of the changes of heart rate and heart rate variability may have predictive value about the onset of VT in selected patients. The patterns of ventricular arrhythmia could not be used to predict onset of VT in this group of patients.

A comparison of heart function and arrhythmia in clinically asymptomatic patients with beta thalassemia intermedia and beta thalassemia major.

PubMed

Amoozgar, Hamid; Zeighami, Samaneh; Haghpanah, Sezaneh; Karimi, Mehran

2017-01-01

The goal of this study was to compare heart function and arrhythmia in clinically asymptomatic patients with beta thalassemia intermedia and beta thalassemia major. In this cross-sectional study, 60 patients with beta thalassemia major and 60 patients with beta thalassemia intermedia who had clinically no symptoms of arrhythmia and clinically normal heart function were evaluated using 24-hour ambulatory electrocardiogram monitoring and echocardiography. For data analysis SPSS ver.20 software was used. A P-value of less than 0.05 was considered statistically significant. The mean age of the beta thalassemia intermedia patients was 24.18 ± 7.9 years and the mean age in beta thalassemia major was 24.38 ± 7.7 years (P>0.05). Premature atrial contractions (PACs) were observed in 14 (23.3%) patients with beta thalassemia intermedia and in 22 (36.6%) beta thalassemia major patients. Premature ventricular contractions (PVCs) were detected in 8 (13.3%) patients in the beta thalassemia intermediate group and 16 (26.6) patients in the beta thalassemia major group, respectively. The left ventricular diastolic dimension, end-diastolic volume, and stroke volume were significantly higher in beta thalassemia intermedia group (P<0.05). Pulmonary acceleration time as an indicator of pulmonary pressure was lower in beta thalassemia intermedia group. Both atrial and ventricular arrhythmias were more common in the beta thalassemia major group. Higher end-diastolic volume and stroke volume were detected in the beta thalassemia intermedia group. Pulmonary acceleration time was lower in the beta thalassemia intermedia group, which can be an indicator of higher pulmonary pressure.

10-year follow-up after radiofrequency ablation of idiopathic ventricular arrhythmias from right ventricular outflow tract.

PubMed

Rørvik, Synne Dragesund; Chen, Jian; Hoff, Per Ivar; Solheim, Eivind; Schuster, Peter

The aim of this study was to examine the effect of radiofrequency ablation (RFA) of ventricular arrhythmias from right ventricular outflow tract (RVOT) during long-term follow-up. A follow-up analysis was conducted using an in-house questionnaire, as well as a qualitative assessment of the patients' medical records. The study population of 34 patients had a previous diagnosis of idiopathic VT or frequent PVCs from the RVOT, and received RFA treatment between 2002 and 2005. The main symptoms prior to RFA were palpitations (82.4%) and dizziness (76.5%). A reduction in symptoms following RFA was reported by 91.2% of patients (p < 0.001). Furthermore, there was a reduced use of antiarrhythmic medication after RFA (p < 0.001). General health perception classified on a scale of 1 (poor) to 4 (excellent), improved from median class 1 to 3 (p < 0.001) during long-term follow-up. The fitness to work increased from median class 3 to class 5 (1 = incapacitated, 5 = full time employment, p = 0.038), while the rate of patients in full time employment increased from 26.5% to 55.9% after RFA (p = 0.02). A reduction of symptoms and use of antiarrhythmic medication, as well as an improvement in the general health perception and fitness to work after RFA of idiopathic ventricular arrhythmias can be demonstrated at ten-year follow-up. Copyright © 2016 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.

Observer agreement for detection of cardiac arrhythmias on telemetric ECG recordings obtained at rest, during and after exercise in 10 Warmblood horses.

PubMed

Trachsel, D S; Bitschnau, C; Waldern, N; Weishaupt, M A; Schwarzwald, C C

2010-11-01

Frequent supraventricular or ventricular arrhythmias during and after exercise are considered pathological in horses. Prevalence of arrhythmias seen in apparently healthy horses is still a matter of debate and may depend on breed, athletic condition and exercise intensity. To determine intra- and interobserver agreement for detection of arrhythmias at rest, during and after exercise using a telemetric electrocardiography device. The electrocardiogram (ECG) recordings of 10 healthy Warmblood horses (5 of which had an intracardiac catheter in place) undergoing a standardised treadmill exercise test were analysed at rest (R), during warm-up (W), during exercise (E), as well as during 0-5 min (PE(0-5)) and 6-45 min (PE(6-45)) recovery after exercise. The number and time of occurrence of physiological and pathological 'rhythm events' were recorded. Events were classified according to origin and mode of conduction. The agreement of 3 independent, blinded observers with different experience in ECG reading was estimated considering time of occurrence and classification of events. For correct timing and classification, intraobserver agreement for observer 1 was 97% (R), 100% (W), 20% (E), 82% (PE(0-5)) and 100% (PE(6-45)). Interobserver agreement between observer 1 vs. observer 2 and between observer 1 vs. 3, respectively, was 96 and 92.6% (R), 83 and 31% (W), 0 and 13% (E), 23 and 18% (PE(0-5)), and 67 and 55% (PE(6-45)). When including the events with correct timing but disagreement for classification, the intraobserver agreement increased to 94% during PE(0-5) and the interobserver agreement reached 83 and 50% (W), 20 and 50% (E), 41 and 47% (PE(0-5)), and 83.5 and 65% (PE(6-45)). The interobserver agreement increased with observer experience. Intra- and interobserver agreement for recognition and classification of events was good at R, but poor during E and poor-moderate during recovery periods. These results highlight the limitations of stress ECG in horses and the

Detection and Prevention of Cardiac Arrhythmias During Space Flight

NASA Technical Reports Server (NTRS)

Pillai, Dilip; Rosenbaum, David S.; Liszka, Kathy J.; York, David W.; Mackin, Michael A.; Lichter, Michael J.

2004-01-01

There have been reports suggesting that long-duration space flight might lead to an increased risk of potentially serious heart rhythm disturbances. If space flight does, in fact, significantly decrease cardiac electrical stability, the effects could be catastrophic, potentially leading to sudden cardiac death. It will be important to determine the mechanisms underlying this phenomenon in order to prepare for long-term manned lunar and interplanetary missions and to develop appropriate countermeasures. Electrical alternans affecting the ST segment and T-wave have been demonstrated to be common among patients at increased risk for ventricular arrhythmias. Subtle electrical alternans on the ECG may serve as a noninvasive marker of vulnerability to ventricular arrhythmias. We are studying indices of electrical instability in the heart for long term space missions by non-invasively measuring microvolt level T-wave alternans in a reduced gravity environment. In this investigation we are using volunteer subjects on the KC-135 aircraft as an initial study of the effect of electrical adaptation of the heart to microgravity. T-wave alternans will be analyzed for heart rate variability and QT restitution curve plotting will be compared for statistical significance.

Privacy-Preserving Electrocardiogram Monitoring for Intelligent Arrhythmia Detection †

PubMed Central

Son, Junggab; Park, Juyoung; Oh, Heekuck; Bhuiyan, Md Zakirul Alam; Hur, Junbeom; Kang, Kyungtae

2017-01-01

Long-term electrocardiogram (ECG) monitoring, as a representative application of cyber-physical systems, facilitates the early detection of arrhythmia. A considerable number of previous studies has explored monitoring techniques and the automated analysis of sensing data. However, ensuring patient privacy or confidentiality has not been a primary concern in ECG monitoring. First, we propose an intelligent heart monitoring system, which involves a patient-worn ECG sensor (e.g., a smartphone) and a remote monitoring station, as well as a decision support server that interconnects these components. The decision support server analyzes the heart activity, using the Pan–Tompkins algorithm to detect heartbeats and a decision tree to classify them. Our system protects sensing data and user privacy, which is an essential attribute of dependability, by adopting signal scrambling and anonymous identity schemes. We also employ a public key cryptosystem to enable secure communication between the entities. Simulations using data from the MIT-BIH arrhythmia database demonstrate that our system achieves a 95.74% success rate in heartbeat detection and almost a 96.63% accuracy in heartbeat classification, while successfully preserving privacy and securing communications among the involved entities. PMID:28604628

The Ocean Surface Topography Constellation: The Next 15 Years in Satellite Altimetry

DTIC Science & Technology

2012-02-22

global coverage in 2007 - to estimate changes in volume due to the warming of the oceans. 5.2 Ocean State Estimation Regarding ocean climate analyses...Ocean Observations and Information for Society" Conference (Vol. 2), Venice, Italy, 21-25 September 2009, Hall, J., Harrison D.E. and Stammer , D., Eds...Venice, Italy, 21-25 September 2009, Hall, J„ Harrison D.E. and Stammer , D., Eds., ESA Publication WPP-306, 2010. 8. Balmaseda, M., Alves, O

Arrhythmia as a cardiac manifestation in MELAS syndrome.

PubMed

Thomas, Tamara; Craigen, William J; Moore, Ryan; Czosek, Richard; Jefferies, John L

2015-09-01

A 44-year-old female with a diagnosis of mitochondrial myopathy, encephalopathy and stroke-like episodes (MELAS) syndrome had progressive left ventricular hypertrophy (LVH) on echocardiogram. A Holter monitor demonstrated episodes of non-sustained atrial tachycardia, a finding not been previously described in this population. This unique case of MELAS syndrome demonstrates the known associated cardiac manifestation of LVH and the new finding of atrial tachycardia which may represent the potential for subclinical arrhythmia in this population.

Cardiac Arrhythmias in Adults With Congenital Heart Disease: Scope, Specific Problems, and Management.

PubMed

Lindsay, Ian; Moore, Jeremy P

2015-12-01

Progressive advances in the field of congenital heart disease (CHD) have led to a dramatic rise in the number of affected patients surviving well into adulthood. Groundbreaking and innovative achievements in the medical, surgical, and interventional management of these patients have allowed them to lead full adult lives that have included raising families, completing degrees in higher education, and maintaining successful careers. As patients are living longer, arrhythmias have emerged as one of the most significant factors affecting their morbidity, mortality, and quality of life. This article aims to review the current understanding of arrhythmia within the adult congenital heart disease (ACHD) population, emphasizing recent advances and providing recommendations pertaining to the management of these patients.

Classification of ECG signal with Support Vector Machine Method for Arrhythmia Detection

NASA Astrophysics Data System (ADS)

Turnip, Arjon; Ilham Rizqywan, M.; Kusumandari, Dwi E.; Turnip, Mardi; Sihombing, Poltak

2018-03-01

An electrocardiogram is a potential bioelectric record that occurs as a result of cardiac activity. QRS Detection with zero crossing calculation is one method that can precisely determine peak R of QRS wave as part of arrhythmia detection. In this paper, two experimental scheme (2 minutes duration with different activities: relaxed and, typing) were conducted. From the two experiments it were obtained: accuracy, sensitivity, and positive predictivity about 100% each for the first experiment and about 79%, 93%, 83% for the second experiment, respectively. Furthermore, the feature set of MIT-BIH arrhythmia using the support vector machine (SVM) method on the WEKA software is evaluated. By combining the available attributes on the WEKA algorithm, the result is constant since all classes of SVM goes to the normal class with average 88.49% accuracy.

LiteNet: Lightweight Neural Network for Detecting Arrhythmias at Resource-Constrained Mobile Devices.

PubMed

He, Ziyang; Zhang, Xiaoqing; Cao, Yangjie; Liu, Zhi; Zhang, Bo; Wang, Xiaoyan

2018-04-17

By running applications and services closer to the user, edge processing provides many advantages, such as short response time and reduced network traffic. Deep-learning based algorithms provide significantly better performances than traditional algorithms in many fields but demand more resources, such as higher computational power and more memory. Hence, designing deep learning algorithms that are more suitable for resource-constrained mobile devices is vital. In this paper, we build a lightweight neural network, termed LiteNet which uses a deep learning algorithm design to diagnose arrhythmias, as an example to show how we design deep learning schemes for resource-constrained mobile devices. Compare to other deep learning models with an equivalent accuracy, LiteNet has several advantages. It requires less memory, incurs lower computational cost, and is more feasible for deployment on resource-constrained mobile devices. It can be trained faster than other neural network algorithms and requires less communication across different processing units during distributed training. It uses filters of heterogeneous size in a convolutional layer, which contributes to the generation of various feature maps. The algorithm was tested using the MIT-BIH electrocardiogram (ECG) arrhythmia database; the results showed that LiteNet outperforms comparable schemes in diagnosing arrhythmias, and in its feasibility for use at the mobile devices.

LiteNet: Lightweight Neural Network for Detecting Arrhythmias at Resource-Constrained Mobile Devices

PubMed Central

Zhang, Xiaoqing; Cao, Yangjie; Liu, Zhi; Zhang, Bo; Wang, Xiaoyan

2018-01-01

By running applications and services closer to the user, edge processing provides many advantages, such as short response time and reduced network traffic. Deep-learning based algorithms provide significantly better performances than traditional algorithms in many fields but demand more resources, such as higher computational power and more memory. Hence, designing deep learning algorithms that are more suitable for resource-constrained mobile devices is vital. In this paper, we build a lightweight neural network, termed LiteNet which uses a deep learning algorithm design to diagnose arrhythmias, as an example to show how we design deep learning schemes for resource-constrained mobile devices. Compare to other deep learning models with an equivalent accuracy, LiteNet has several advantages. It requires less memory, incurs lower computational cost, and is more feasible for deployment on resource-constrained mobile devices. It can be trained faster than other neural network algorithms and requires less communication across different processing units during distributed training. It uses filters of heterogeneous size in a convolutional layer, which contributes to the generation of various feature maps. The algorithm was tested using the MIT-BIH electrocardiogram (ECG) arrhythmia database; the results showed that LiteNet outperforms comparable schemes in diagnosing arrhythmias, and in its feasibility for use at the mobile devices. PMID:29673171

The size distribution of chemical elements of atmospheric aerosol at a semi-rural coastal site in Venice (Italy). The role of atmospheric circulation.

PubMed

Masiol, Mauro; Squizzato, Stefania; Ceccato, Daniele; Pavoni, Bruno

2015-01-01

The concentrations of selected elemental tracers were determined in the aerosol of a semi-rural coastal site near Venice (Italy). Size-segregated aerosol samples were collected using an 8-stage cascade impactor set at 15m above ground, during the cold season (late autumn and winter), when high levels of many pollutants are known to cause risks for human health. From the experimental data, information was extracted on potential pollutant sources by investigating the relationships between elements in the different size fractions. Moreover, an approach to highlight the importance of local atmospheric circulation and air mass origin in influencing the PM composition and fractional distribution is proposed. Anthropogenic elements are strongly inter-correlated in the submicrometric (<1 μm) (S, K, Mn, Cu, Fe and Zn) and intermediate mode (1-4 μm) (Mn, Cu, Zn, Ni) and their relationships highlight the presence of several sources (combustions, secondary aerosol, road traffic). In the intermediate mode, associations having geochemical significance exist between marine (Na, Cl and Mg) and crustal (Si, Mg, Ca, Al, Ti and K) elements. In the coarse mode (>4 μm) Fe and Zn are well correlated and are probably linked to tire and brake wear emissions. Regarding atmospheric circulation, results show increasing levels of elements related to pollution sources (S, K, Mn, Ni, Cu, Zn) when air masses come from Central and Eastern Europe direction and on the ground wind blows from NWN-N-NE (from mainland Venice). Low wind speed and high percentage of wind calm hours favor element accumulation in the submicrometric and intermediate modes. Furthermore, strong winds favor the formation of sea-spray and the increase of Si in the coarse mode due to the resuspension of sand fine particles. Copyright © 2014 Elsevier Ltd. All rights reserved.

Is exposure to ionising radiation associated with childhood cardiac arrhythmia in the Russian territories contaminated by the Chernobyl fallout? A cross-sectional population-based study

PubMed Central

Clero, Enora; Doroshchenko, Vladimir; Silenok, Aleksandr; Kurnosova, Irina; Butsenin, Andrei; Denjoy, Isabelle; Franck, Didier; Heuze, Jean-Pierre; Gourmelon, Patrick

2018-01-01

Objective To investigate childhood cardiac arrhythmia and chronic exposure to caesium-137 (137Cs) resulting from the Chernobyl accident. Design Prospective cross-sectional study using exposed/unexposed design conducted in the Bryansk region from May 2009 to May 2013 on children selected on the basis of 137Cs soil deposition: control territories ([137Cs]<37 kBq per square metre, where children were considered as unexposed) and contaminated territories ([137Cs]>555 kBq per square metre, where children were considered as exposed). Setting Russian territories affected by the Chernobyl fallout (Bryansk region). Participants This cross-sectional study included 18 152 children aged 2–18 years and living in the Bryansk region (Russia). Main outcome measures All children received three medical examinations (ECG, echocardiography and 137Cs whole-body activity measurement) and some of them were given with a 24-hour Holter monitoring and blood tests. Results Cardiac arrhythmia was diagnosed in 1172 children living in contaminated territories and 1354 children living in control territories. The crude prevalence estimated to 13.3% in contaminated territories was significantly lower than in control territories with 15.2% over the period 2009–2013 (P<0.001). Considering 137Cs whole-body burden as exposure, cardiac arrhythmia was found in 449 contaminated children and 2077 uncontaminated children, corresponding to an estimated crude prevalence of 14.5% and 14.2%, respectively, which does not differ significantly (P=0.74). Also, we investigated the association between territory, exposure to 137Cs and cardiac arrhythmia: the adjusted OR was not significant (0.90 with 95% CI 0.81 to 1.00; P=0.06) for the territory. For 137Cs whole-body burden, the ORs close to 1 did not reach statistical significance (P for trend=0.97). Conclusion This study does not observe an association between cardiac arrhythmia and 137Cs deposition levels in the Bryansk region exposed to Chernobyl

High throughput, multiplexed pathogen detection authenticates plague waves in medieval Venice, Italy.

PubMed

Tran, Thi-Nguyen-Ny; Signoli, Michel; Fozzati, Luigi; Aboudharam, Gérard; Raoult, Didier; Drancourt, Michel

2011-03-10

Historical records suggest that multiple burial sites from the 14th-16th centuries in Venice, Italy, were used during the Black Death and subsequent plague epidemics. High throughput, multiplexed real-time PCR detected DNA of seven highly transmissible pathogens in 173 dental pulp specimens collected from 46 graves. Bartonella quintana DNA was identified in five (2.9%) samples, including three from the 16th century and two from the 15th century, and Yersinia pestis DNA was detected in three (1.7%) samples, including two from the 14th century and one from the 16th century. Partial glpD gene sequencing indicated that the detected Y. pestis was the Orientalis biotype. These data document for the first time successive plague epidemics in the medieval European city where quarantine was first instituted in the 14th century.

8 CFR 246.5 - Hearing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Hearing. 246.5 Section 246.5 Aliens and... Hearing. (a) Service counsel. The Government shall be represented at the hearing by a Service counsel who... attend or remain in attendance at the hearing. ...

Indoor air quality at the Correr Museum, Venice, Italy.

PubMed

Camuffo, D; Brimblecombe, P; Van Grieken, R; Busse, H J; Sturaro, G; Valentino, A; Bernardi, A; Blades, N; Shooter, D; De Bock, L; Gysels, K; Wieser, M; Kim, O

1999-09-15

Two multidisciplinary field surveys, one in winter and the other in summer have monitored the indoor microclimate, air pollution, deposition and origin of the suspended particulate matter and microorganisms of the Correr Museum, Venice. In addition, this study was focused to identify the problems caused by the heating and air conditioning system (HAC) and the effects due to the presence of carpets. Heating and air conditioning systems (HACs), when chiefly designed for human welfare, are not suitable for conservation and can cause dangerous temperature and humidity fluctuations. Improvements at the Correr Museum have been achieved with the assistance of environmental monitoring. The carpet has a negative influence as it retains particles and bacteria which are resuspended each time people walk on it. The indoor/outdoor pollutants ratio is greater in the summertime, when doors and windows are more frequently open to allow for better ventilation, illustrating that this ratio is mainly governed by the free exchange of the air masses. The chemical composition, size and origin of the suspended particulate matter have been identified, as well as the bacteria potentially dangerous to the paintings. Some general suggestions for improving indoor air quality are reported in the conclusions.

"The Root is Hidden and the Material Uncertain": the challenges of prosecuting witchcraft in early modern Venice.

PubMed

Seitz, Jonathan

2009-01-01

The rich archival records of the Holy Office of the Inquisition in Venice have yielded much information about early modern society and culture. The transcripts of witchcraft trials held before the Inquisition reveal the complexities of early modern conceptions of natural and supernatural. The tribunal found itself entirely unable to convict individuals charged with performing harmful magic, or maleficio, as different worldviews clashed in the courtroom. Physicians, exorcists, and inquisitors all had different approaches to distinguishing natural phenomena from supernatural, and without a consensus guilty verdicts could not be obtained.

Arrhythmias and hemodialysis: role of potassium and new diagnostic tools.

PubMed

Buemi, Michele; Coppolino, Giuseppe; Bolignano, Davide; Sturiale, Alessio; Campo, Susanna; Buemi, Antoine; Crascì, Eleonora; Romeo, Adolfo

2009-01-01

Cardiovascular diseases represent the main causes of death in patients affected by renal failure, and arrhythmias are frequently observed in patients undergoing hemodialysis. Dialytic treatment per se can be considered as an arrhythmogenic stimulus; moreover, uraemic patients are characterized by a "pro-arrhythmic substrate" because of the high prevalence of ischaemic heart disease, left ventricular hypertrophy and autonomic neuropathy. One of the most important pathogenetic element involved in the onset of intra-dialytic arrhythmias is the alteration in electrolytes concentration, particularly calcium and potassium. It may be very useful to monitor the patient's cardiac activity during the whole hemodilaytic session. Nevertheless, the application of an extended intradialytic electrocardiographic monitoring is not simple because of several technical and structural impairments. We tried to overcome these difficulties using Whealthy, a wearable system consisting in a t-shirt composed of conductors and piezoresistive materials, integrated to form fibers and threads connected to tissutal sensors, electrodes, and connectors. ECG and pneumographic impedance signals are acquired by the electrodes in the tissue, and the data are registered by a small computer and transmitted via GPRS or Bluetooth.

[Kurschmann-Steinert myotonic dystrophia and Adams-Stoke attacks. Successful treatment of arrhythmia by means of pacemaker implantation].

PubMed

Bieler, M; Sefidpar, M; Engel, U R; Reutter, F W

1976-11-20

The case is reported of a 39-year-old male with Steinert's dystrophia myotonica complicated by cardiac arrhythmias manifested by high-degree a-v block with Stokes-Adams attacks. Implantation of a demand-type cardiac pacemaker brought prompt relief from cardiac symptoms and the patient was able to resume work. The pathologico-anatomical findings in dystrophia myotonica are discussed, together with their possible connection with the type of arrhythmias described.

5 CFR 1820.8 - Business information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Business information. 1820.8 Section 1820.8 Administrative Personnel OFFICE OF SPECIAL COUNSEL FREEDOM OF INFORMATION ACT REQUESTS; PRODUCTION OF RECORDS OR TESTIMONY § 1820.8 Business information. (a) In general. Business information obtained...

Are 8-oxoguanine (8-oxoGua) and 5-hydroxymethyluracil (5-hmUra) oxidatively damaged DNA bases or transcription (epigenetic) marks?

PubMed

Zarakowska, Ewelina; Gackowski, Daniel; Foksinski, Marek; Olinski, Ryszard

2014-04-01

The oxidatively modified DNA base 8-oxo-7,8-dihydroguanine (8-oxoGua) is nontoxic and weakly mutagenic. Here we report on new data suggesting a potential for 8-oxoGua to affect the expression of several genes via epigenetic changes resulting in chromatin relaxation. Using pig thymus extract, we analyzed the distribution of 8-oxoGua among different nuclei fractions representative of transcriptionally active and silenced regions. The levels of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) found in transcriptionally active euchromatin (4.37/10(6) nucleotides) and in the matrix fraction (4.16/10(6) nucleotides) were about 5 times higher than in transcriptionally silenced heterochromatin (0.91/10(6) nucleotides). Other experimental data are presented which suggest that 8-oxoGua present in specific DNA sequences may be widely used for transcription regulation. Like 8-oxoGua, 5-hydroxymethyluracil (5-hmUra) is another oxidatively modified DNA base (the derivative is formed by thymine oxidation). Recent experimental evidence supports the notion that 5-hmUra plays an important role in active DNA demethylation. This involves overexpression of activation-induced cytidine deaminase (AID) and ten-eleven translocation 1 (TET1) protein (the key proteins involved in active demethylation), which leads to global accumulation of 5-hmUra. Our preliminary data demonstrate a significant increase of the 5-hmUra levels in pig brain extract when compared with liver extract. The lack of 5-hmUra in Escherichia coli DNA also speaks for a role of this modification in the active demethylation process. It is concluded that 8-oxodG and 5-hmUra in DNA may be considered as epigenetic marks. Copyright © 2013 Elsevier B.V. All rights reserved.

Current Interventional and Surgical Management of Congenital Heart Disease: Specific Focus on Valvular Disease and Cardiac Arrhythmias.

PubMed

Holst, Kimberly A; Said, Sameh M; Nelson, Timothy J; Cannon, Bryan C; Dearani, Joseph A

2017-03-17

Successful outcome in the care of patients with congenital heart disease depends on a comprehensive multidisciplinary team. Surgery is offered for almost every heart defect, despite complexity. Early mortality for cardiac surgery in the neonatal period is ≈10% and beyond infancy is <5%, with 90% to 95% of patients surviving with a good quality of life into the adult years. Advances in imaging have facilitated accurate diagnosis and planning of interventions and surgical procedures. Similarly, advances in the perioperative medical management of patients, particularly with intensive care, has also contributed to improving outcomes. Arrhythmias and heart failure are the most common late complications for the majority of defects, and reoperation for valvar problems is common. Lifelong surveillance for monitoring of recurrent or residual structural heart defects, as well as periodic assessment of cardiac function and arrhythmia monitoring, is essential for all patients. The field of congenital heart surgery is poised to incorporate new innovations such as bioengineered cells and scaffolds that will iteratively move toward bioengineered patches, conduits, valves, and even whole organs. © 2017 American Heart Association, Inc.

Genetic testing in heritable cardiac arrhythmia syndromes: differentiating pathogenic mutations from background genetic noise.

PubMed

Giudicessi, John R; Ackerman, Michael J

2013-01-01

In this review, we summarize the basic principles governing rare variant interpretation in the heritable cardiac arrhythmia syndromes, focusing on recent advances that have led to disease-specific approaches to the interpretation of positive genetic testing results. Elucidation of the genetic substrates underlying heritable cardiac arrhythmia syndromes has unearthed new arrhythmogenic mechanisms and given rise to a number of clinically meaningful genotype-phenotype correlations. As such, genetic testing for these disorders now carries important diagnostic, prognostic, and therapeutic implications. Recent large-scale systematic studies designed to explore the background genetic 'noise' rate associated with these genetic tests have provided important insights and enhanced how positive genetic testing results are interpreted for these potentially lethal, yet highly treatable, cardiovascular disorders. Clinically available genetic tests for heritable cardiac arrhythmia syndromes allow the identification of potentially at-risk family members and contribute to the risk-stratification and selection of therapeutic interventions in affected individuals. The systematic evaluation of the 'signal-to-noise' ratio associated with these genetic tests has proven critical and essential to assessing the probability that a given variant represents a rare pathogenic mutation or an equally rare, yet innocuous, genetic bystander.

High-throughput cardiac safety evaluation and multi-parameter arrhythmia profiling of cardiomyocytes using microelectrode arrays.

PubMed

Gilchrist, Kristin H; Lewis, Gregory F; Gay, Elaine A; Sellgren, Katelyn L; Grego, Sonia

2015-10-15

Microelectrode arrays (MEAs) recording extracellular field potentials of human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) provide a rich data set for functional assessment of drug response. The aim of this work is the development of a method for a systematic analysis of arrhythmia using MEAs, with emphasis on the development of six parameters accounting for different types of cardiomyocyte signal irregularities. We describe a software approach to carry out such analysis automatically including generation of a heat map that enables quick visualization of arrhythmic liability of compounds. We also implemented signal processing techniques for reliable extraction of the repolarization peak for field potential duration (FPD) measurement even from recordings with low signal to noise ratios. We measured hiPS-CM's on a 48 well MEA system with 5minute recordings at multiple time points (0.5, 1, 2 and 4h) after drug exposure. We evaluated concentration responses for seven compounds with a combination of hERG, QT and clinical proarrhythmia properties: Verapamil, Ranolazine, Flecainide, Amiodarone, Ouabain, Cisapride, and Terfenadine. The predictive utility of MEA parameters as surrogates of these clinical effects were examined. The beat rate and FPD results exhibited good correlations with previous MEA studies in stem cell derived cardiomyocytes and clinical data. The six-parameter arrhythmia assessment exhibited excellent predictive agreement with the known arrhythmogenic potential of the tested compounds, and holds promise as a new method to predict arrhythmic liability. Copyright © 2015 Elsevier Inc. All rights reserved.

Mercury in the food chain of the Lagoon of Venice, Italy.

PubMed

Dominik, Janusz; Tagliapietra, Davide; Bravo, Andrea G; Sigovini, Marco; Spangenberg, Jorge E; Amouroux, David; Zonta, Roberto

2014-11-15

Sediments and biota samples were collected in a restricted area of the Lagoon of Venice and analysed for total mercury, monomethyl mercury (MMHg), and nitrogen and carbon isotopes. Results were used to examine mercury biomagnification in a complex food chain. Sedimentary organic matter (SOM) proved to be a major source of nutrients and mercury to primary consumers. Contrary to inorganic mercury, MMHg was strongly biomagnified along the food chain, although the lognormal relationship between MMHg and δ(15)N was less constrained than generally reported from lakes or coastal marine ecosystems. The relationship improved when logMMHg concentrations were plotted against trophic positions derived from baseline δ(15)N estimate for primary consumers. From the regression slope a mean MMHg trophic magnification factor of 10 was obtained. Filter-feeding benthic bivalves accumulated more MMHg than other primary consumers and were probably important in MMHg transfer from sediments to higher levels of the food chain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Occurrence and use of ground water in the Venice-Englewood area, Sarasota and Charlotte counties, Florida

USGS Publications Warehouse

Sutcliffe, Horace; Thompson, Thomas H.

1983-01-01

In a 75-square-mile area of coastal Sarasota and Charlotte Counties, demand for water is increasing. Groundwater, the principal source of supply, is distributed largely by public water systems. Principal water-bearing formations in descending order, include the surficial aquifer, artesian zone 1 in the Tamiami Formation, zone 2 in the upper part of the Hawthorn Formation, zone 3 in the lower part of the Hawthorn Formation and upper part of the Tampa Limestone, and zones 4 and 5 which comprise the Floridan aquifer. The surficial aquifer, except near tidewater, provides limited supplies of freshwater to wells. Artesian zone 1 is the major aquifer for public supply. It is contaminated by saline water in some areas, either as a result of inundation by storm-driven tides or by upwar leakage of mineralized water from underlying aquifers through uncased or improperly constructed wells. The city of Venice obtains some water from zone 2, but the water is brackish in much of the area. The water is suitable for irrigation in parts of the area. Except for local use of water for watering livestock and maintaining ponds, the water from zones 3, 4, and 5 is little used because of its poor quality. (USGS)

5 CFR 1604.8 - Death benefits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Death benefits. 1604.8 Section 1604.8 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD UNIFORMED SERVICES ACCOUNTS § 1604.8 Death..., with the following exceptions: (a) Separate accounts. To designate a beneficiary for a TSP death...

5 CFR 1604.8 - Death benefits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Death benefits. 1604.8 Section 1604.8 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD UNIFORMED SERVICES ACCOUNTS § 1604.8 Death... a service member account contains combat zone contributions, the death benefit payment will be made...

5 CFR 1604.8 - Death benefits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Death benefits. 1604.8 Section 1604.8 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD UNIFORMED SERVICES ACCOUNTS § 1604.8 Death... a service member account contains combat zone contributions, the death benefit payment will be made...

Implantable Defibrillators for Secondary Prevention of Sudden Cardiac Death in Cardiac Surgery Patients With Perioperative Ventricular Arrhythmias

PubMed Central

Nageh, Maged F.; Kim, John J.; Chen, Lie‐Hong; Yao, Janis F.

2014-01-01

Background Randomized studies of implantable cardioverter defibrillators (ICD) have excluded sudden cardiac death survivors who had revascularization before or after an arrhythmic event. To evaluate the role of ICD and the effects of clinical variables including degree of revascularization, we studied cardiac surgery patients who had an ICD implanted for sustained perioperative ventricular arrhythmias. Methods and Results The electronic database for Southern California Kaiser Foundation hospitals was searched for patients who had cardiac surgery between 1999 and 2005 and an ICD implanted within 3 months of surgery. One hundred sixty‐four patients were identified; 93/164 had an ICD for sustained pre‐ or postoperative ventricular tachycardia or fibrillation requiring resuscitation. Records were reviewed for the following: presenting arrhythmia, ejection fraction, and degree of revascularization. The primary end point was total mortality (TM) and/or appropriate ICD therapy (ICD‐T), and secondary end points are TM and ICD‐T. During the mean follow up of 49 months, the primary endpoint of TM+ICD‐T and individual end points of TM and ICD‐T were observed in 52 (56%), 35 (38%), and 28 (30%) patients, respectively, with 55% of TM, and 23% of ICD‐T occurring within 2 years of implant. In multivariate risk analysis, none of the following was associated with any of the end points: incomplete revascularization, presenting ventricular arrhythmia, and timing of arrhythmias. Conclusion Our data supports the recent guidelines for ICD in this cohort of patients, as the presence of irreversible substrate and triggers of ventricular arrhythmias, cannot be reliably excluded even with complete revascularization. Further studies are needed to understand this complex group of patients. PMID:25146702

Genetic testing and genetic counseling in patients with sudden death risk due to heritable arrhythmias.

PubMed

Spoonamore, Katherine G; Ware, Stephanie M

2016-03-01

Sudden cardiac death due to heritable ventricular arrhythmias is an important cause of mortality, especially in young healthy individuals. The identification of the genetic basis of Mendelian diseases associated with arrhythmia has allowed the integration of this information into the diagnosis and clinical management of patients and at-risk family members. The rapid expansion of genetic testing options and the increasing complexity involved in the interpretation of results creates unique opportunities and challenges. There is a need for competency to incorporate genetics into clinical management and to provide appropriate family-based risk assessment and information. In addition, disease-specific genetic knowledge is required to order and correctly interpret and apply genetic testing results. Importantly, genetic diagnosis has a critical role in the risk stratification and clinical management of family members. This review summarizes the approach to genetic counseling and genetic testing for inherited arrhythmias and highlights specific genetic principles that apply to long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Cardiovascular safety of prokinetic agents: A focus on drug-induced arrhythmias.

PubMed

Giudicessi, J R; Ackerman, M J; Camilleri, M

2018-02-14

Gastrointestinal sensorimotor dysfunction underlies a wide range of esophageal, gastric, and intestinal motility and functional disorders that collectively constitute nearly half of all referrals to gastroenterologists. As a result, substantial effort has been dedicated toward the development of prokinetic agents intended to augment or restore normal gastrointestinal motility. However, the use of several clinically efficacious gastroprokinetic agents, such as cisapride, domperidone, erythromycin, and tegaserod, is associated with unfavorable cardiovascular safety profiles, leading to restrictions in their use. The purpose of this review is to detail the cellular and molecular mechanisms that lead commonly to drug-induced cardiac arrhythmias, specifically drug-induced long QT syndrome, torsades de pointes, and ventricular fibrillation, to examine the cardiovascular safety profiles of several classes of prokinetic agents currently in clinical use, and to explore potential strategies by which the risk of drug-induced cardiac arrhythmia associated with prokinetic agents and other QT interval prolonging medications can be mitigated successfully. © 2018 John Wiley & Sons Ltd.

Repetitive nonreentrant ventriculoatrial synchrony: An underrecognized cause of pacemaker-related arrhythmia.

PubMed

Sharma, Parikshit S; Kaszala, Karoly; Tan, Alex Y; Koneru, Jayanthi N; Shepard, Richard; Ellenbogen, Kenneth A; Huizar, Jose F

2016-08-01

Similar to endless loop tachycardia (ELT), repetitive nonreentrant ventriculoatrial synchrony (RNRVAS) is a ventriculoatrial (VA) synchrony pacemaker-mediated arrhythmia. RNRVAS was first described in 1990 and can only occur in the presence of retrograde VA conduction and dual-chamber or cardiac resynchronization devices with tracking (P-synchronous ventricular pacing such as DDD, DDDR) or nontracking pacing modes that allow AV-sequential pacing (DDI, DDIR). RNRVAS is promoted by (1) high lower rate limit or any feature that allows rapid pacing, (2) long AV intervals, or (3) long postventricular atrial refractory period (PVARP). In contrast to ELT, RNRVAS is a less well-recognized form of pacemaker-mediated arrhythmia; thus, unlike ELT, there are no specific device algorithms to prevent, recognize, and terminate RNRVAS. However, RNRVAS has been recently shown to occur frequently. We present a series of cases, some of which were found fortuitously. Owing to its clinical implications, we propose that algorithms should be developed to prevent, identify, and terminate RNRVAS. Published by Elsevier Inc.

Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

PubMed Central

2012-01-01

Background Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent) brain lesions during and after marathon running are missing. Methods/ Design In the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE), 3 Tesla brain magnetic resonance imaging (MRI), carotid ultrasound imaging (CUI) and serial blood sampling (BS) within 2-3 days prior (CE, MRI, CUI, BS), directly after (CE, BS) and within 2 days after (CE, MRI, BS) the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG)-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2%) Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Discussion Findings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link between physical stress

Recommendations regarding dietary intake and caffeine and alcohol consumption in patients with cardiac arrhythmias: what do you tell your patients to do or not to do?

PubMed

Glatter, Kathryn A; Myers, Richard; Chiamvimonvat, Nipavan

2012-10-01

The etiology of arrhythmias including atrial fibrillation is multifactorial. Most arrhythmias are associated with comorbid illnesses like hypertension, diabetes, thyroid disease, or advanced age. Although it is tempting to blame a stimulant like caffeine as a trigger for arrhythmias, the literature does not support this idea. There is no real benefit to having patients with arrhythmias limit their caffeine intake. Caffeine is a vasoactive substance that also may promote the release of norepinephrine and epinephrine. However, acute ingestion of caffeine (as coffee or tea) does not cause atrial fibrillation. Even patients suffering a myocardial infarction do not have an increased incidence of ventricular or other arrhythmias after ingesting several cups of coffee. Large epidemiologic studies have also failed to find a connection between the amount of coffee/caffeine used and the development of arrhythmias. As such, it does not make sense to suggest that patients with palpitations, paroxysmal atrial fibrillation, or supraventricular tachycardia, abstain from caffeine use. Energy drinks are a new phenomenon on the beverage market, with 30-50 % of young adults and teens using them regularly. Energy drinks are loaded with caffeine, sugar, and other chemicals that can stimulate the cardiac system. There is an increasing body of mainly anecdotal case reports describing arrhythmias or even sudden death triggered by exercise plus using energy drinks. Clearly, there must be more study in this area, but it is wise to either limit or avoid their use in patients with arrhythmias. Moderate to heavy alcohol use seems to be associated with the development of atrial fibrillation. The term "holiday heart" was coined back in 1978, to describe patients who had atrial fibrillation following binge alcohol use. Thus, it is reasonable to recommend to patients with arrhythmias that they limit their alcohol use, although unfortunately this treatment will likely not completely resolve their

Congenital Deafness with Cardiac Arrhythmias: The Jervell and Lange-Nielsen Syndrome.

ERIC Educational Resources Information Center

Wahl, Richard A.; Macdonald, Dick, II

1980-01-01

The Jervell and Lange-Nielsen syndrome, affecting 0.3 percent of congenitally deaf persons, consists of severe cardiac arrhythmias and sensorineural hearing loss. The authors recommend that every congenitally deaf child with suspicious symptoms receive an electrocardiogram and that professionals who work with deaf children not only inform…

Screening women for cervical cancer carcinoma with a HPV mRNA test: first results from the Venice pilot program.

PubMed

Maggino, Tiziano; Sciarrone, Rocco; Murer, Bruno; Dei Rossi, Maria Rosa; Fedato, Chiara; Maran, Michela; Lorio, Melania; Soldà, Marika; Zago, Fiorella; Giorgi Rossi, Paolo; Zorzi, Manuel

2016-08-23

HPV DNA-based screening is more effective than a Pap test in preventing cervical cancer, but the test is less specific. New HPV tests have been proposed for primary screening. The HPV mRNA test showed a similar or slightly lower sensitivity than the HPV DNA tests but with a higher specificity. We report the results of an organised HPV mRNA-based screening pilot program in Venice, Italy. From October 2011 to May 2014, women aged 25-64 years were invited to undergo a HPV mRNA test (Aptima). Those testing positive underwent cytological triage. Women with positive cytology were referred to colposcopy, whereas those with negative cytology were referred to repeat the HPV mRNA test 1 year later. The results of the HPV mRNA test program were compared with both the local historical cytology-based program and with four neighbouring DNA HPV-based pilot projects. Overall, 23 211 women underwent a HPV mRNA test. The age-standardised positivity rate was 7.0%, higher than in HPV DNA programs (6.8%; relative rate (RR) 1.11, 95% confidence interval (CI) 1.05-1.17). The total colposcopy referral was 5.1%, double than with cytology (2.6%; RR 2.02, 95% CI 1.82-2.25) but similar to the HPV DNA programs (4.8%; RR 1.02; 95% CI 0.96-1.08). The cervical intraepithelial neoplasia grade 2+ detection rate with HPV mRNA was greater than in the HPV DNA programs at baseline (RR 1.50; 95% CI 1.19-1.88) and not significantly lower at the 1-year repeat (RR 0.70; 95% CI 0.40-1.16). The overall RR was 1.29 (95% CI 1.05-1.59), which was much higher than with cytology (detection rate 5.5‰ vs 2.1‰; RR 2.50, 95% CI 1.76-3.62). A screening programme based on the HPV mRNA obtained results similar to those observed with the HPV DNA test. In routine screening programmes, even a limited increase in HPV prevalence may conceal the advantage represented by the higher specificity of HPV mRNA.

17 CFR 5.8 - Aggregate retail forex assets.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Aggregate retail forex assets. 5.8 Section 5.8 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFF-EXCHANGE FOREIGN CURRENCY TRANSACTIONS § 5.8 Aggregate retail forex assets. (a) Each retail foreign exchange dealer...

High Throughput, Multiplexed Pathogen Detection Authenticates Plague Waves in Medieval Venice, Italy

PubMed Central

Tran, Thi-Nguyen-Ny; Signoli, Michel; Fozzati, Luigi; Aboudharam, Gérard; Raoult, Didier; Drancourt, Michel

2011-01-01

Background Historical records suggest that multiple burial sites from the 14th–16th centuries in Venice, Italy, were used during the Black Death and subsequent plague epidemics. Methodology/Principal Findings High throughput, multiplexed real-time PCR detected DNA of seven highly transmissible pathogens in 173 dental pulp specimens collected from 46 graves. Bartonella quintana DNA was identified in five (2.9%) samples, including three from the 16th century and two from the 15th century, and Yersinia pestis DNA was detected in three (1.7%) samples, including two from the 14th century and one from the 16th century. Partial glpD gene sequencing indicated that the detected Y. pestis was the Orientalis biotype. Conclusions These data document for the first time successive plague epidemics in the medieval European city where quarantine was first instituted in the 14th century. PMID:21423736

Cardiac Arrhythmia: In vivo screening in the zebrafish to overcome complexity in drug discovery.

PubMed

Macrae, Calum A

2010-07-01

IMPORTANCE OF THE FIELD: Cardiac arrhythmias remain a major challenge for modern drug discovery. Clinical events are paroxysmal, often rare and may be asymptomatic until a highly morbid complication. Target selection is often based on limited information and though highly specific agents are identified in screening, the final efficacy is often compromised by unanticipated systemic responses, a narrow therapeutic index and substantial toxicities. AREAS COVERED IN THIS REVIEW: Our understanding of complexity of arrhythmogenesis has grown dramatically over the last two decades, and the range of potential disease mechanisms now includes pathways previously thought only tangentially involved in arrhythmia. This review surveys the literature on arrhythmia mechanisms from 1965 to the present day, outlines the complex biology underlying potentially each and every rhythm disturbance, and highlights the problems for rational target identification. The rationale for in vivo screening is described and the utility of the zebrafish for this approach and for complementary work in functional genomics is discussed. Current limitations of the model in this setting and the need for careful validation in new disease areas are also described. WHAT THE READER WILL GAIN: An overview of the complex mechanisms underlying most clinical arrhythmias, and insight into the limits of ion channel conductances as drug targets. An introduction to the zebrafish as a model organism, in particular for cardiovascular biology. Potential approaches to overcoming the hurdles to drug discovery in the face of complex biology including in vivo screening of zebrafish genetic disease models. TAKE HOME MESSAGE: In vivo screening in faithful disease models allows the effects of drugs on integrative physiology and disease biology to be captured during the screening process, in a manner agnostic to potential drug target or targets. This systematic strategy bypasses current gaps in our understanding of disease

Variation in adult vaccination policies across Europe: an overview from VENICE network on vaccine recommendations, funding and coverage.

PubMed

Kanitz, Elisabeth E; Wu, Lauren A; Giambi, Cristina; Strikas, Raymond A; Levy-Bruhl, Daniel; Stefanoff, Pawel; Mereckiene, Jolita; Appelgren, Eva; D'Ancona, Fortunato

2012-07-27

In 2010-2011, in the framework of the VENICE project, we surveyed European Union (EU) and Economic Area (EEA) countries to fill the gap of information regarding vaccination policies in adults. This project was carried out in collaboration with the United States National Vaccine Program Office, who conducted a similar survey in all developed countries. VENICE representatives of all 29 EU/EEA-countries received an online questionnaire including vaccination schedule, recommendations, funding and coverage in adults for 17 vaccine-preventable diseases. The response rate was 100%. The definition of age threshold for adulthood for the purpose of vaccination ranged from 15 to 19 years (median=18 years). EU/EEA-countries recommend between 4 and 16 vaccines for adults (median=11 vaccines). Tetanus and diphtheria vaccines are recommended to all adults in 22 and 21 countries respectively. The other vaccines are mostly recommended to specific risk groups; recommendations for seasonal influenza and hepatitis B exist in all surveyed countries. Six countries have a comprehensive summary document or schedule describing all vaccines which are recommended for adults. None of the surveyed countries was able to provide coverage estimates for all the recommended adult vaccines. Vaccination policies for adults are not consistent across Europe, including the meaning of "recommended vaccine" which is not comparable among countries. Coverage data for adults should be collected routinely like for children vaccination. Copyright © 2012 Elsevier Ltd. All rights reserved.

Assess the environmental health status of macrophyte ecosystems using an oxidative stress biomarker. Case studies: The Gulf of Aqaba and the Lagoon of Venice

NASA Astrophysics Data System (ADS)

Wahsha, Mohammad; Juhmani, Abdul-Salam; Buosi, Alessandro; Sfriso, Andrea; Sfriso, Adriano

2017-04-01

Macrophytes play a fundamental role in structuring communities in aquatic environments. They contribute to maintaining the ecosystem services. Unfortunately, nowadays, they are threatened by different sources of pollution. The release of such potentially toxic elements (PTEs) to the environment may influence negatively the ecosystem health, which often limits and sometimes disqualifies the ecosystem biodiversity. Indeed, the increasing concentration and distribution of PTEs in the marine ecosystem by mismanagement of industrial activities, overuse of agrochemicals, and waste disposal are causing worldwide concern. The aim of this work is to describe the developing of an innovative early warning tool, based on the implementation of the lipid peroxidation oxidative stress biomarker for the assessment and monitoring of ecological status in response to PTEs in different marine environments. Six sites were selected along the Jordanian coastline of the Gulf of Aqaba and the lagoon of Venice in Italy according to different morphological, ecological conditions and anthropogenic impact. Our results indicated that the effect of PTEs causes oxidative stress to macrophytes; in particular: Ulva fasciata and Ulva lactuca collected from the lagoon of Venice and Gulf of Aqaba respectively. The oxidative stress by PTEs alters the biochemical processes, as it stimulates the generation of reactive oxygen species (ROS) and accordingly the oxidative degradation of lipids (LPO). The by-products of LPO, the organic compound malondialdehyde (MDA) is significantly correlated (p<0.05) to the levels of PTEs in the environment. We can conclude that despite the numerous analytical methods available, the determination of isolated substances by traditional chemo- physical analysis has a limited environmental application. Thus, the implementation of MDA assay as an alternative diagnostic biomarker tool could be more effectively to recognize changes in the environment at an early stage. Keywords

Atrial arrhythmias and autonomic dysfunction in rats exposed to chronic intermittent hypoxia.

PubMed

Bober, Sara L; Ciriello, John; Jones, Douglas L

2018-06-01

Obstructive sleep apnea, which involves chronic intermittent hypoxia (CIH), is a major risk factor for developing atrial fibrillation (AF). Whether or not CIH alone alters cardiac mechanisms to support AF is unknown. This study investigated the effects of CIH on atrial electrophysiology and arrhythmia vulnerability and evaluated the role of autonomics in CIH promotion of AF. Adult male Sprague-Dawley rats were exposed to 8 h/day of CIH or normoxia for 7 days. After exposure, rats were anesthetized for intracardiac electrophysiological experiments. Atrial effective refractory periods (AERPs) and AF inducibility were determined using programmed electrical stimulation and burst pacing in the absence and presence of autonomic receptor agonists and antagonists. Western blot analysis measured atrial protein expression of muscarinic M2, M3, and β 1 -adrenergic receptors. Compared with normoxia-exposed control rats, CIH-exposed rats had enhanced AF vulnerability using both programmed electrical stimulation and burst pacing, accompanied by greater AERP responses to carbachol and propranolol, lesser responses to isoproterenol, and higher atrial M2 receptor protein levels. Enhanced atrial vulnerability was accentuated by carbachol and abolished by atropine, indicating that the AF-promoting effects of CIH depended principally on parasympathetic activation. Enhancement of atrial vulnerability and AERP shortening with cholinergic agonists in CIH-exposed rats is consistent with sensitivity to parasympathetic activation. Higher responses to adrenergic receptor blockade in CIH-exposed rats is consistent with sympathetic potentiation. These findings implicate CIH as an important mediator of enhanced AF susceptibility in obstructive sleep apnea and provide novel insights into the underlying mechanisms. NEW & NOTEWORTHY Our study demonstrates, for the first time, that chronic intermittent hypoxia alone enhances vulnerability to atrial arrhythmia induction, which depends principally

22 CFR 8.5 - Creation of a committee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Creation of a committee. 8.5 Section 8.5 Foreign Relations DEPARTMENT OF STATE GENERAL ADVISORY COMMITTEE MANAGEMENT § 8.5 Creation of a committee. (a) A bureau or an office designated or desiring to sponsor an advisory committee will prepare a...

22 CFR 8.5 - Creation of a committee.