1) Radiofrequency energy induces thermal lesions in cardiac tissue through resistive heating. Tissue temperatures above 50°C are required for irreversible injury. Lesion size increases with power, temperature, electrode size, and contact pressure.
2) Three-dimensional mapping systems and intracardiac echocardiography help locate arrhythmia origins and guide ablation, such as for crista terminalis tachycardias.
3) Intracardiac echocardiography assists with visualizing anatomy, ensuring electrode contact, monitoring lesion formation, and identifying complications of ablation procedures.
A talk for general practitioners on the role of CT coronary angiography in cardiology practice in Australia.
To see more from dr alistair begg visit his website at www.dralistairbegg.com or visit the cardiac dvd dvd website at www.whatswrongwithmyheart.com
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
A talk for general practitioners on the role of CT coronary angiography in cardiology practice in Australia.
To see more from dr alistair begg visit his website at www.dralistairbegg.com or visit the cardiac dvd dvd website at www.whatswrongwithmyheart.com
A detailed description of ct coronary angiography and calcium scoring with various aspects regarding the preparation, procedure, limitations and a short review regarding post CABG imaging.
Anomalous coronary arteries are a rare but recognized cause of myocardial ischemia and sudden death. Identification currently requires x-ray angiography, which may have difficulty defining the three-dimensional course of the anomalous vessel. Magnetic resonance coronary angiography (MRCA) has been shown to image coronary artery anatomy noninvasively
Surgery for aneurysmal right coronary fistula and constrictive pericarditis Abdulsalam Taha
CRCM, March 2014
View on scirp.org
Abstract:
Coronary artery fistula (CAF) is a direct communication between a coronary artery and the lumen of any of the cardiac chambers, the coronary sinus, the pulmonary artery, the superior vena cava or the proximal pulmonary veins. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. Congenital CAF is a rare anomaly and aneurysmal formation in the fistula is even rarer. Majority of CAF are isolated lesions, however, congenital or acquired heart diseases may coexist. Herein, we report a case of huge congenital aneurysmal right CAF connected to the right atrium in an Iraqi man of 62 associated with tuberculous effusive-constrictive pericarditis to whom off pump pericardiectomy was performed followed by ligation of right coronary artery and vein graft implantation to its posterior descending branch under cardiopulmonary bypass. To the best of our knowledge, such association was not previously reported. CAF can be repaired surgically with minimum risk and excellent outcome. Surgery is advised whenever coronary fistula is diagnosed unless it is very small to avoid the potential complications.
Key words: coronary artery fistula, ectasia, aneurysm, pericarditis, pericardiectomy
Role of MDCT MULTISCLICE in coronary artery part 5 (non atherosclerotic coron...AHMED ESAWY
Role of mdc tin coronary artery part 5 (non atherosclerotic coronary abnormalities) dr ahmed esawy
Role of mdc tin coronary artery part 4 (anomalous coronary arteries) dr ahmed esawy
Anomalous coronary arteries are a rare but recognized cause of myocardial ischemia and sudden death. Identification currently requires x-ray angiography, which may have difficulty defining the three-dimensional course of the anomalous vessel. Magnetic resonance coronary angiography (MRCA) has been shown to image coronary artery anatomy noninvasively
Surgery for aneurysmal right coronary fistula and constrictive pericarditis Abdulsalam Taha
CRCM, March 2014
View on scirp.org
Abstract:
Coronary artery fistula (CAF) is a direct communication between a coronary artery and the lumen of any of the cardiac chambers, the coronary sinus, the pulmonary artery, the superior vena cava or the proximal pulmonary veins. The majority of these fistulas are congenital in origin although they may occasionally be detected after cardiac surgery. Congenital CAF is a rare anomaly and aneurysmal formation in the fistula is even rarer. Majority of CAF are isolated lesions, however, congenital or acquired heart diseases may coexist. Herein, we report a case of huge congenital aneurysmal right CAF connected to the right atrium in an Iraqi man of 62 associated with tuberculous effusive-constrictive pericarditis to whom off pump pericardiectomy was performed followed by ligation of right coronary artery and vein graft implantation to its posterior descending branch under cardiopulmonary bypass. To the best of our knowledge, such association was not previously reported. CAF can be repaired surgically with minimum risk and excellent outcome. Surgery is advised whenever coronary fistula is diagnosed unless it is very small to avoid the potential complications.
Key words: coronary artery fistula, ectasia, aneurysm, pericarditis, pericardiectomy
Role of MDCT MULTISCLICE in coronary artery part 5 (non atherosclerotic coron...AHMED ESAWY
Role of mdc tin coronary artery part 5 (non atherosclerotic coronary abnormalities) dr ahmed esawy
Role of mdc tin coronary artery part 4 (anomalous coronary arteries) dr ahmed esawy
Loops Around the Heart – A Giant Snakelike Right Coronary Artery Ectasia with...komalicarol
Coronary artery dilatation is an uncommon finding and is incidentally found during diagnostic coronary angiography or at necropsy.
The pathogenesis of dilatation of coronary arteries is still not very
well understood and therapeutic strategies are not clear. It is useful to know the difference between aneurysm and ectasia. In this
report we demonstrate the diagnostic workup of an asymptomatic
patient with a remarkable snakelike dilatation of the right coronary
artery with unique convolute. For the first time we used intracoronary injection and simultaneous echocardiographic visualization
of contrast agent (Sonovue) to proof a fistula to the coronary sinus.
Like our patient, most of the patients are asymptomatic in absence
of coronary artery disease and we decided on a conservative approach because of his very complex anatomy
To every girl and every woman, this word is provided: You are princess, You’re ambassador to the king , You’re a servant of the King, Jesus Christ is the king, Jesus is in your heart, You can befriend Jesus
A beautiful paper published by Eugene Braunwald
European Heart Journal, Volume 42, Issue 24, 21 June 2021, Pages 2327–2328, https://doi.org/10.1093/eurheartj/ehab264
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Cambridge International AS A Level Biology Coursebook - EBook (MaryFosbery J...
Samir rafla lecture of Electrophysiology- part one-Catheter ablation of cardiac arrhythmias
1. Samir Rafla-Lecture of Electrophysiology- Part one
Source: Book of Catheter ablation of cardiac arrhythmias / edited by Shoei K. Stephen Huang, Mark A. Wood. – 2nd ed. 2010
Radiofrequency (RF) energy induces thermal lesion formation through resistive heating of myocardial tissue. Tissue
temperatures of 50˚C or higher are necessary for irreversible injury. Under controlled conditions, RF lesion size is directly
proportional to delivered power, electrode-tissue interface temperature, electrode diameter, and contact pressure.
FIGURE. Typical appearance of radiofrequency catheter ablation lesion. There is a small central depression with volume loss,
surrounded by an area of pallor, then a hemorrhagic border zone. The specimen has been stained with nitro blue tetrazolium to
differentiate viable from nonviable tissue.
3. FIGURE 6-3. A,A 12-lead echocardiogram (ECG) from a patient with Wolff-Parkinson-White syndrome due to an inferior
paraseptal accessory pathway. B,Leads III and V6 from the surface ECG are simultaneously displayed with bipolar intracardiac
recording from the high right atrium (HRA), and bipolar and unipolar recordings from the probing electrode (PE) at the site of
ablation of the accessory pathway. In the filtered bipolar recording from the distal pair of electrodes of the ablation catheter (PE
2-1), a fast deflection preceding the onset of the delta wave was registered that most likely represents the so-called accessory
pathway potential (APP). This potential was also present at the near-DC (0.1 to 500 Hz) unfiltered unipolar recording from the
4. distal ablating electrode (PE 1) and the filtered (30 to 500 Hz) distal unipolar recording (PE 1F). C,Left anterior oblique (LAO)
fluorographic projection showing the ablation catheter at the site of block of the accessory pathway during the application of the
radiofrequency current. A coronary sinus venogram has also been obtained, which retrogradely fills a diverticular formation in
the middle cardiac vein. D,Venous phase of a left coronary artery angiography depicting the coronary sinus diverticulum and an
inferior left ventricular venous branch ending at the neck of the diverticulum. This was the site of ablation of the accessory
pathway. E,Anatomic slice in an LAO projection showing the entry into the coronary sinus and the middle cardiac vein as well as
the ending of an inferior left ventricular venous affluent (red arrow).
FIGURE 6-15. Ablation of an inferior paraseptal accessory pathway within the mid-cardiac vein (MCV). A, The accessory pathway
is blocked 1016 msec after the onset of the application of radiofrequency current (RF). B,Right anterior oblique (RAO) and left
5. anterior oblique (LAO) fluorographic images displaying the position of the ablation catheter (RF). The injection of contrast in the
RAO projection enables one to determine that the ablation catheter is outside the outlines of the right atrium as defined by the
angiographic contrast. This is indeed true because the catheter is inside the mid-cardiac vein. C,RAO and LAO slice of the heart.
The MCV drains in the proximal coronary sinus (CS) running an inferior course before bending anteriorly along the epicardial
surface of the muscular ventricular septum (MVS). Ao, aorta; LA, left atrium; RA, right atrium; RVA, right ventricular apex; RVOT,
right ventricular outflow tract.
Fundamentals of Intracardiac Mapping
Activation Sequence Mapping
Endocardial Mapping Techniques
FIGURE 7-8.Late potential mapping in the right ventricle. In a patient with arrhythmogenic right ventricular (RV) dysplasia, many
of the electrograms were abnormal, especially at the RV inflow, the RV apex, and the RV outflow tract. The figure shows late
potentials during sinus rhythm in the region of the RV apex on the ablation (ABL) catheter (arrows). HRA, high right atrium.
Pace Mapping
Entrainment Mapping
6. FIGURE 7-14. Progressive fusion with demonstration of (manifest) entrainment. The figure shows activation around the tricuspid
annulus during attempted entrainment of what appeared to be typical, counterclockwise atrial flutter in a patient with a normal
heart.
Advanced Catheter Three-Dimensional Mapping Systems (Carto Advanced Mapping System)
7.
8. FIGURE 8-4. Carto activation map of focal ventricular tachycardia is shown. The earliest activation site (shown in red) is
surrounded by the later activation.
10 Role of Intracardiac Echocardiography in Clinical Electrophysiology
11 Ablation of Focal Atrial Tachycardias
The mechanism of focal atrial tachycardia (AT) can be automatic, triggered, or reentry.
The P-wave morphology on a 12-lead electrocardiogram gives a general idea of the site of origin of the focal AT. Mapping
techniques include determining the earliest atrial activation during tachycardia and pace mapping of the P-wave morphology.
Ablation targets comprise abnormal atrial tissue from which the tachycardia originates, as identified by the site of earliest atrial
activation and abnormal local atrial electrograms.
Three-dimensional mapping systems are often useful, and intracardiac echocardiography can be helpful, especially for crista
terminalis tachycardias. Difficulty arises when the tachycardia is not inducible or is not sustained.
9. Troubleshooting difficult cases includes the unusual location of the tachycardia focus arising from the coronary sinus, superior
or inferior vena cava, ligament of Marshall, appendages, or aortic cusps. Mapping of the left atrium and pulmonary veins is
often needed when a leftsided tachycardia is suspected.
10 Role of Intracardiac Echocardiography in Clinical Electrophysiology
CartoSound three-dimensional reconstruction of the images obtained by intracardiac echocardiography (ICE) and integration
with electroanatomic mapping system helps to identify atrial endocardial structures and to characterize the role of anatomy
in arrhythmia mechanism (e.g., crista terminalis, pulmonary veins).
For guidance of radiofrequency (RF) ablation, ICE is used to identify the anatomic location of the catheter tip and to ensure
tissue contact (distal tip electrode or linear ablation catheter).
For monitoring RF lesions, ICE is used for real-time assessment of lesion formation and size (mural swelling and increased tissue
echodensity).
For AF ablation, ICE assists with transseptal puncture, defines pulmonary vein (PV) anatomy, allows accurate positioning of
the lasso catheter at the PV ostium, monitors lesion formation, monitors for complications (e.g., tamponade, thrombus,
atrioesophageal fistula), and identifies and possibly predict PV stenosis.
Other uses of ICE include atrial flutter ablation (imaging cavotricuspid isthmus anatomy), ventricular tachycardia (imaging
scar border, identifying coronary cusps and left ventricular outflow tract), guidance of transseptal puncture in difficult cases,
assessment of left atrial and appendage mechanical function and thrombus, and guidance of atrial septal defect device
closure.
10. FIGURE 10-14. A,Two-dimensional view of the left side of the heart with the intracardiac echocardiography catheter positioned
in the right atrium (RA). The imaging frequency was 7.5 MHz. Visible are the interatrial septum (IAS), left atrium (LA), proximal
coronary sinus in cross section (CS), mitral valve (MiV), left ventricle (LV), and left atrial appendage (LAA).