scholarly journals Atrial fibrillation is associated with large beat-to-beat variability in mitral and tricuspid annulus dimensions

2021 ◽  
Author(s):  
Jwan A Naser ◽  
Hilal Olgun Kucuk ◽  
Andrea O Ciobanu ◽  
Hayan Jouni ◽  
Didem Oguz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Tricuspid Valve ◽  
Mitral Annulus ◽  
Absolute Difference ◽  
Time Interval ◽  
Tricuspid Annulus ◽  
Maximal Size ◽  
Valve Diseases ◽  
Median Absolute Difference ◽  
Selection Of

Abstract Aims Beat-to-beat variability in cycle length is well-known in atrial fibrillation (Afib); whether this also translates to variability in annulus size remains unknown. Defining annulus maximal size in Afib is critical for accurate selection of percutaneous devices given the frequent association with mitral and tricuspid valve diseases. Methods and results Images were obtained from 170 patients undergoing 3D echocardiography [100 (50 sinus rhythm (SR) and 50 Afib) for mitral annulus (MA) and 70 (35 SR and 35 Afib) for tricuspid annulus (TA)]. Images were analysed for differences in annular dynamics with a commercially available software. Number of cardiac cycles analysed was 567 in mitral valve and 346 in tricuspid valve. Median absolute difference in maximal MA area over four to six cycles was 1.8 cm2 (range 0.5–5.2 cm2) in Afib vs. 0.8 cm2 (range 0.1–2.9 cm2) in SR, P < 0.001. Maximal MA area was observed within 30–70% of the R-R interval in 81% of cardiac cycles in SR and in 73% of cycles in Afib. Median absolute difference in maximal TA area over four to six cycles was 1.4 cm2 (range 0.5–3.6 cm2) in Afib vs. 0.7 cm2 (range 0.3–1.7 cm2) in SR, P < 0.001. Maximal TA area was observed within 60–100% of the R-R interval in 81% of cardiac cycles in SR, but only in 49% of cycles in Afib. Conclusion MA and TA reach maximal size within a broad time interval centred around end-systole and end-diastole, respectively, with significant beat-to-beat variability. Afib leads to a larger beat-to-beat variability in both timing of occurrence and values of annulus size than in SR.

Beat-to-beat variability in the tricuspid annulus dimensions and dynamics is markedly increased in atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Naser ◽  
A Ciobanu ◽  
S Wen ◽  
J Thaden ◽  
V Nkomo ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Tricuspid Valve ◽  
Cycle Length ◽  
Cardiac Cycle ◽  
Absolute Difference ◽  
Funding Source ◽  
Accurate Assessment ◽  
Tricuspid Annulus ◽  
Median Absolute Difference

Abstract Background Atrial fibrillation (Afib) leads to beat-to-beat variability in cycle length; however, whether there is associated beat-to-beat variability in the tricuspid annulus (TA) dimensions or variability in the time in cardiac cycle when TA reaches maximal size is unknown. Purpose We aim to assess the beat-to-beat variability in the TA dimensions in Afib compared with sinus rhythm (SR). Methods Images were obtained from 58 patients (29 in Afib, 29 in SR) undergoing either 3D TTE or TEE examination. We measured TA in 3–6 cardiac cycles per patient using commercially available software (TomTec 4MV). Results Median absolute difference in maximal TA area over 3–6 cardiac cycles was 1.60 cm2 (range 0.35 cm2 to 4.08 cm2) in Afib vs. 1.17 cm2 (range 0.32 cm2 to 2.19 cm2) in SR, p=0.0063. Median absolute difference in the maximal circumference was 0.79 cm (range 0.09 cm to 2.2 cm) in Afib vs 0.54 cm (range 0.12 cm to 1.43 cm) in SR, p=0.0175. A total of 118 cardiac cycles were analyzed in patients in SR and 147 in Afib. Timing of maximal TA area was most commonly recorded at end-diastole (80–100% of the R-R interval) in 62% of cycles in SR; however, it was distributed over a broad range in Afib, p<0.0001, [Figure]. Conclusion Afib leads to significant beat-to-beat variability in the maximal TA area, minimal TA area, maximal TA circumference, and in the time of maximal TA area. These findings suggest that accurate assessment of TA dimensions should be based on continuous tracking of the TA over several cardiac cycles, especially in patients with Afib. These observations have significant implications for device sizing in percutaneous tricuspid valve interventions. Timing of Maximal TA Area Funding Acknowledgement Type of funding source: None

Selection of Medications to Prevent Stroke Among Individuals With Atrial Fibrillation

2013 ◽  
Vol 15 (5) ◽  
pp. 583-592
Author(s):  
Luca Testa ◽  
Alfonso Fasano ◽  
Valerio De Sanctis ◽  
Roberto Adriano Latini ◽  
Azeem Latib ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Selection Of

scholarly journals Evaluation of point-of-care glucose testing accuracy using locally-smoothed median absolute difference curves

2008 ◽  
Vol 389 (1-2) ◽  
pp. 31-39 ◽  
Author(s):  
Gerald J. Kost ◽  
Nam K. Tran ◽  
Victor J. Abad ◽  
Richard F. Louie
Keyword(s):  
Point Of Care ◽  
Absolute Difference ◽  
Glucose Testing ◽  
Testing Accuracy ◽  
Median Absolute Difference

Sample selection of prognostics validation test based on multi-stage Wiener process

2018 ◽  
Vol 233 (4) ◽  
pp. 605-614
Author(s):  
Zhiao Zhao ◽  
Yong Zhang ◽  
Guanjun Liu ◽  
Jing Qiu
Keyword(s):  
Wiener Process ◽  
Process Model ◽  
Failure Modes ◽  
Early Stage ◽  
Sample Selection ◽  
Degradation Process ◽  
Time Interval ◽  
Degradation Data ◽  
Multi Stage ◽  
Selection Of

Sample allocation and selection technology is of great significance in the test plan design of prognostics validation. Considering the existing researches, the importance of prognostics samples of different moments is not considered in the degradation process of a single failure. Normally, prognostics samples are generated under the same time interval mechanism. However, a prognostics system may have low prognostics accuracy because of the small quantity of failure degradation and measurement randomness in the early stage of a failure degradation process. Historical degradation data onto equipment failure modes are collected, and the degradation process model based on the multi-stage Wiener process is established. Based on the multi-stage Wiener process model, we choose four parameters to describe different degradation stages in a degradation process. According to four parameters, the sample selection weight of each degradation stage is calculated and the weight of each degradation stage is used to select prognostics samples. Taking a bearing wear fault of a helicopter transmission device as an example, its degradation process is established and sample selection weights are calculated. According to the sample selection weight of each degradation process, we accomplish the prognostics sample selection of the bearing wear fault. The results show that the prognostics sample selection method proposed in this article has good applicability.

scholarly journals Subjective study on potts spine with therapeutic yoga intervention

2020 ◽  
Vol 1 (2) ◽  
pp. 32
Author(s):  
Amudha Rani Narayanan
Keyword(s):  
Pain Management ◽  
Complete Relief ◽  
Single Subject ◽  
Time Interval ◽  
Yoga Therapy ◽  
Yoga Intervention ◽  
Subjective Study ◽  
Personalized Approach ◽  
Reduced Time ◽  
Selection Of

This is a qualitative single subject intervention assessment involving the treatment of a 58 year old man, diagnosed with para-vertebral abscess due to tubercular pott’s spine with Diabetes since 2008, administered with neuro anaesthesia for pain management, which could not succeed in providing complete relief and hence a parallel attempt was made to treat the same through an integrative mind-body approach to resolving pain. Basic challenges in this process were to conceptualize a personalized approach based on the constitution and personality of the seeker and selection of specific tools of yoga therapy to suit the individual’s requirement. Adoption of yoga therapy involving synergized techniques resulted in holistic cure in a significantly reduced time interval. However, more studies are required to be adopted in the same manner to strengthen the line of the efficacy of such therapies in similar cases.

Abstract 16289: Deformation of Tricuspid Annulus After Tricuspid Ring Annuloplasty: A Three-dimensional Transesophageal Echocardiography Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Atsushi Hayashi ◽  
Jun Akashi ◽  
Yosuke Nabeshima ◽  
Mai Iwataki ◽  
Yutaka Otsuji
Keyword(s):  
Transesophageal Echocardiography ◽  
Tricuspid Valve ◽  
Heart Surgery ◽  
Three Dimensional ◽  
Tricuspid Annulus ◽  
Annuloplasty Ring ◽  
Functional Tricuspid Regurgitation ◽  
Ring Annuloplasty ◽  
Percent Area ◽  
The Impact

Background: Tricuspid ring annuloplasty (TAP) is usually performed for patients with mild or greater functional tricuspid regurgitation (TR) at the time of left-sided valve surgery. However, there were limited data regarding the shape of tricuspid annulus after TAP. The aim of this study was using three-dimensional (3D) transesophageal echocardiography to investigate the impact of the ring annuloplasty on the tricuspid annulus after TAP. Methods: 3D tricuspid valve was retrospectively analyzed in 20 patients who underwent concomitant left-sided heart surgery and TAP for functional TR. 3D data of tricuspid valve were acquired before TAP, immediate after surgery (intraoperative), and before discharge (15±5 days after TAP). TAP was performed by one surgeon using a Carpentier-Edwards Physio Tricuspid annuloplasty ring. The ring size was determined by measuring the distance from anteroseptal to posteroseptal commissures. 3D tricuspid annular area was measured. The area protruded outside the annuloplasty ring was obtained by subtracting the ring area from the annular area (Figure). Results: All 20 patients underwent successfully TAP with less than mild residual TR. Annuloplasty rings size 28mm, 30mm, 32mm, and 34mm were used in 6 (30%), 4 (20%), 5 (25%), and 5 (25%) patients, respectively. Median annular area decreased from 1074 (interquartile rage 893-1276) mm 2 before TAP to 591 (519-706) mm 2 immediate after TAP, but showed significant increase to 645 (501-766) mm 2 at the time of discharge (P<0.001). Percent area protruded outside the annuloplasty ring was 14% immediate after TAP and increased to 24% before discharge (P<0.001). Before discharge, there were 9 patients with more than mild residual TR (2 had moderate TR). Percent area protruded outside the annuloplasty ring was associated with mild or more residual TR at the discharge. Conclusion: Tricuspid annular shape after TAP was not always round. Deformation of tricuspid annulus may be associated with residual TR.

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