Prospective evaluation of the learning curve and electrical characteristics of left bundle branch area pacing

Background Left bundle branch area pacing (LBBAP) has recently been introduced as a physiological pacing technique with a synchronous ventricular activation. Objective To prospectively evaluate the feasibility and learning curve, as well as the electrical characteristics of LBBAP. Methods In 80 consecutive LBBAP pacemaker patients, ECG characteristics during intrinsic rhythm, RV septum pacing (RVSP) and LBBAP were evaluated. From the ECG's QRS duration and LVAT (stimulus to V6 R-wave peak time, RWPT) were measured. Also, the left bundle branch potential (LBBpot) to V6 RWPT interval was measured and compared to the LVAT. After conversion of the ECG into VCG (Kors conversion matrix), QRS area, as measurement for electrical dyssynchrony, was calculated. Results Permanent lead implantation was successful in 77/80 patients (96%) undergoing an attempt at LBBAP. LBBAP lead implantation time as well as fluoroscopy time were significantly shorter during last 25% of implantation compared to first 25% of implantations (17±5 min vs. 33±16 min and 12±7 min vs. 21±13 min, respectively, panel A and B). LBB capture was obtained in 54/80 patients (68%). In 36/45 patients (80%) with intact AV conduction and narrow QRS an LBBpot was present. The mean interval between the LBBpot and the onset of QRS was 22±6 ms. In the patients with narrow QRS (n=45), QRS duration increased significantly during both RVSP (139±24 ms) and LBBAP (123±21 ms), compared to intrinsic rhythm (95±13 ms). QRS area on the other hand, increased during both RVSP (73±20 μVs) but decreased during LBBAP (41±15 μVs), to values close to intrinsic rhythm (32±16 μVs, panel C). For all patients, QRS area was significantly lower in patients with LBB capture compared to patients without capture (43±18 μVs vs 54±21 μVs, respectively). In patients with LBB capture (n=54), LVAT was significantly shorter compared to patients without LBB capture (75±14 vs. 88±9 ms, respectively). In the patients with LBB capture, there was a significant correlation between the LBBpot – V6 RWPT and S – V6 RWPT intervals (Pearson correlation 0.739, P<0.001). Conclusion LBBAP is a safe and feasible technique, with a clear learning curve that seems obtained after ± 40–60 implantations. LBB capture is obtained in two-thirds of patients. Although QRS duration remains prolonged, LBBAP largely restores ventricular electrical synchrony to values close to intrinsic (narrow QRS) rhythm. FUNDunding Acknowledgement Type of funding sources: None.

High-Precision Angle Prediction of Sun for Space Remote Sensing Instrument

In order to grasp the timing of sun calibration in advance, this paper introduces a high-precision method to predict the solar angle by using the current broadcast time and orbital instantaneous root of the satellite platform. By calculating the sun’s apparent right ascension and apparent declination, the conversion matrix from the geocentric inertial coordinate system to the orbital coordinate system, and the satellite attitude correction matrix, the sun vector in the satellite body coordinate system is obtained. This method is used to predict the sun angle of a sun synchronous orbit in the satellite coordinate system, and the prediction results are compared with the STK simulation results. The results show that the sun angle prediction error of this method is less than ±0.003°. It can meet the requirements of on-orbit solar calibration. The main error sources in the prediction method are analysed.

Comparison of QRSarea and left ventricular activation time during left bundle branch pacing and left ventricular septal pacing

Funding Acknowledgements Type of funding sources: None. Background Left bundle branch area pacing (LBBAP) has recently been introduced as a novel physiological pacing strategy. Within LBBAP, distinction is made between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP, no left bundle capture). Objective To compare acute electrocardiographic (ECG) and vectorcardiographic (VCG) effects of LBBP and LVSP as compared to intrinsic conduction. Methods In 50 patients with normal cardiac function and pacemaker indication for bradycardia, ECG characteristics of LBBP and LVSP were evaluated during RVSP and pacing at various depths in the septum: starting at the RV side of the septum: the last position with QS morphology, the first position with r’ morphology, LVSP and – in patients where LBB capture was achieved – LBBP. From the ECG’s QRS duration and QRS morphology in V1, and the stimulus-LVAT interval were measured. After conversion of the ECG into VCG (Kors conversion matrix), QRS area was calculated. Results In LVSP, QRS area significantly decreased from 82 ± 29 µVs during RVSP to 46 ± 12 µVs during LVSP. In patients where LBB capture was achieved QRS area significantly decreased from 78 ± 23 µVs to 38 ± 15 µVs in LBBP. In patients with LBB capture, QRS area was significantly smaller during LBBP compared to LVSP (figure A), but LVAT was not significantly different (figure B, p = 0.138). In patients with normal ventricular activation where LBBP was achieved (n = 20), QRS area was significantly larger during LVSP (48 ± 17) compared to LBBP (37 ± 16), the latter being not significantly different from normal intrinsic ventricular activation (35 ± 19 µVs). Conclusions ECG and VCG indices demonstrate that ventricular dyssynchrony is comparable but slightly more synchronous during LBBP compared to LVSP. Abstract Figure. QRS area and S-LVAT in LVSP and LBBP

Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients

Background: Left bundle branch area pacing (LBBAP) has recently been introduced as a novel physiological pacing strategy. Within LBBAP, distinction is made between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP, no left bundle capture). Objective: To investigate acute electrophysiological effects of LBBP and LVSP as compared to intrinsic ventricular conduction. Methods: Fifty patients with normal cardiac function and pacemaker indication for bradycardia underwent LBBAP. Electrocardiography (ECG) characteristics were evaluated during pacing at various depths within the septum: starting at the right ventricular (RV) side of the septum: the last position with QS morphology, the first position with r’ morphology, LVSP and—in patients where left bundle branch (LBB) capture was achieved—LBBP. From the ECG’s QRS duration and QRS morphology in lead V1, the stimulus- left ventricular activation time left ventricular activation time (LVAT) interval were measured. After conversion of the ECG into vectorcardiogram (VCG) (Kors conversion matrix), QRS area and QRS vector in transverse plane (Azimuth) were determined. Results: QRS area significantly decreased from 82 ± 29 µVs during RV septal pacing (RVSP) to 46 ± 12 µVs during LVSP. In the subgroup where LBB capture was achieved (n = 31), QRS area significantly decreased from 46 ± 17 µVs during LVSP to 38 ± 15 µVs during LBBP, while LVAT was not significantly different between LVSP and LBBP. In patients with normal ventricular activation and narrow QRS, QRS area during LBBP was not significantly different from that during intrinsic activation (37 ± 16 vs. 35 ± 19 µVs, respectively). The Azimuth significantly changed from RVSP (−46 ± 33°) to LVSP (19 ± 16°) and LBBP (−22 ± 14°). The Azimuth during both LVSP and LBBP were not significantly different from normal ventricular activation. QRS area and LVAT correlated moderately (Spearman’s R = 0.58). Conclusions: ECG and VCG indices demonstrate that both LVSP and LBBP improve ventricular dyssynchrony considerably as compared to RVSP, to values close to normal ventricular activation. LBBP seems to result in a small, but significant, improvement in ventricular synchrony as compared to LVSP.

A Lagrange Multiplier-based Technique within the Nonlinear Finite Element Method in Cracked Columns

In this research, two energy-based techniques, called Lagrange multiplier and conversion matrix, are applied to involve crack parameters into the non-linear finite element relations of Euler-Bernoulli beams made of functionally graded materials. The two techniques, which divide a cracked element into three parts, are implemented to enrich the secant and tangent stiffness matrices. The Lagrange multiplier technique is originally proposed according to the establishment of a modified total potential energy equation by adding continuity conditions equations of the crack point. The limitation of the conversion matrix in involving the relevant non-linear equations is the main motivation in representing the Lagrange multiplier. The presented Lagrange multiplier is a problem-solving technique in the cracked structures, where both geometrical nonlinearity and material inhomogeneity areas are considered in the analysis like the post-buckling problem of cracked functionally graded material columns. Accordingly, some case-studies regarding the post-buckling analysis of cracked functionally graded material columns under mechanical and thermal loads are used to evaluate the results.

EEG-Based Epilepsy Recognition via Multiple Kernel Learning

In the field of brain-computer interfaces, it is very common to use EEG signals for disease diagnosis. In this study, a style regularized least squares support vector machine based on multikernel learning is proposed and applied to the recognition of epilepsy abnormal signals. The algorithm uses the style conversion matrix to represent the style information contained in the sample, regularizes it in the objective function, optimizes the objective function through the commonly used alternative optimization method, and simultaneously updates the style conversion matrix and classifier during the iteration process parameter. In order to use the learned style information in the prediction process, two new rules are added to the traditional prediction method, and the style conversion matrix is used to standardize the sample style before classification.

Nuclear structure dependence of the coherent (μ-,e-) conversion matrix elements

Coherent rates for the neutrinoless muon to electron conversion. (μ-, e-) in the presence of nuclei, are studied throughout the periodic table. The relevant ground state to ground state transition matrix elements are obtained in the context of the quasi-particle RPA. The results are discussed in view of the existing experimental data extracted at TRIUMF and PSI for 48Ti and 208Pb nuclei and compared with: (i) the single particle shell model results calculated with a determinantal ground state wave function and (ii) the results deduced in a local density approximation.

Bio-inspired SiO2-hard-template reconstructed g-C3N4 nanosheets for enhanced photocatalytic hydrogen evolution

Building architectures to manipulate light propagation using a light-conversion matrix is one of the most competitive strategies to enhance photocatalytic performance.