Electrical Propagation Research Articles

Electrical breakdown dynamics in an argon bubble submerged in conductive liquid for nanosecond pulsed discharges

This study delves into the dynamics of cold atmospheric plasma and their interaction within conductive solutions under the unique conditions of nanosecond pulsed discharges (22 kV peak voltage, 10 ns FWHM, 4.5 kV ns−1 rate-of-rise). The research focuses on the electrical response, breakdown, and discharge propagation in an argon bubble, submerged in a NaCl solution of varying conductivity. Full or partial discharges were observed at conductivities of 1.5 µS cm−1 (deionized water) to 1.6 mS cm−1, but no breakdown was observed at 11.0 mS cm−1 when reducing the electrode gap. It is demonstrated that at higher conductivity electric breakdown is observed only when the gas bubble comes into direct contact with the electrode and multiple emission nodes were observed at different timescales. These nodes expanded in the central region of the bubble over timescales longer than the initial high-voltage pulse. This work offers a temporal resolution of 2 ns exposure times over the first 30 ns of the initial voltage pulse, and insight into plasma formation over decaying reflected voltage oscillations over 200 ns.

Reordering and synchronization of electrical turbulence in cardiac tissue through global and partial optogenetical illumination.

Electrical turbulence in the heart is considered the culprit of cardiac disease, including the fatal ventricular fibrillation. Optogenetics is an emerging technology that has the capability to produce action potentials of cardiomyocytes to affect the electric wave propagation in cardiac tissue, thereby possessing the potential to control the turbulence, by shining a rotating spiral pattern onto the tissue. In this paper, we present a method to reorder and synchronize electrical turbulence through optogenetics. A generic two-variable reaction-diffusion model and a simplified three-variable ionic cardiac model are used. We discuss cases involving either global or partial illumination.

Scattering and Attenuation in 5G Electromagnetic Propagation (5 GHz and 25 GHz) in the Presence of Rainfall: A Numerical Study

Rainfall has always been a concern for wireless communications systems. As 5G technology relies on high-frequency bands, it is fundamental to model and simulate the interaction of such radio waves with rainfall, as the deployment of large-scale infrastructure for 5G is highly expensive. This research presents a reformulation of the Maxwell equations for a bi-dimensional space in a transverse electric propagation mode, for a linear, inhomogeneous, and isotropic propagation medium with its magnetic and electric properties dependent on time. This reformulation was solved using the Finite Differences in Time Domain (FDTD) method with the Convolutional Perfectly Matched Layer (CPML) boundary condition. Two main frequency propagation scenarios were studied: 5 GHz (corresponding to Wi-Fi in the 802.11n standard as well as to the lowest bands of 5G) and 25 GHz (corresponding to 5G), within a 10m×3m rectangular domain in air and with rain. The rainfall was simulated using a parallel Ziggurat algorithm. According to the findings, while 5 GHz waves experience scattering processes, 25 GHz waves experience substantial dispersion and attenuation throughout the domain in low- to moderate-intensity rain.

Model of ultrashort-pulse laser excitation of bulk and thin film dielectrics: Coupling material excitation and electric field propagation

Model of ultrashort-pulse laser excitation of bulk and thin film dielectrics: Coupling material excitation and electric field propagation

An analysis of the spread of electric field within the cochlea for different devices including custom-made electrodes for subtotal cochleoectomy.

Cochlear implants (CIs) can restore hearing not only in patients with profound hearing loss and deafness, but also in patients following tumour removal of intra-cochlear schwannomas. In such cases, design and placement differ from conventional electrode insertion, in which the cochlea remains filled with fluid. Despite these technical and surgical differences, previous studies have tended to show positive results in speech perception in tumour patients. The purpose of this study is to retrospectively evaluate the ability to predict speech recognition outcomes using individual electric field spreads and to investigate worldwide unique tumour cases. In a retrospective analysis in a university tertiary center electric field spreads were compared between two groups of electrode designs implanted between 2009 and 2020 i.e., between lateral wall electrodes and custom-made perimodiolar electrode carriers from the same company. The voltage gradients were analysed and grouped with speech recognition results. Differences in electrical field spreads were found between lateral wall electrodes and the custom-made perimodiolar electrodes, whereas a significant influence of electric fields on scores in speech recognition cannot be demonstrated. Prediction of speech recognition outcome based on electric field propagation results seems not feasible. Significant differences in field spread between electrode arrays can be clearly demonstrated. This observation and its relevance to hearing treatment and speech recognition should therefore be further investigated in upcoming studies.

Simulation-Driven Enhancement of an Alkaline CO2 Capture Electrochemical Cell

Electrochemical cells using anion exchange membranes (AEM) have been previously demonstrated to regenerate aqueous K2CO3 solutions obtained via CO2 absorption from air with aqueous KOH [1]. Preliminary results suggest this technique might significantly outperform currently employed methods in terms of specific energy expenditure (MJ/kgCO2). In order to accomplish this, we propose a computational study of an electrochemical cell designed and operated at the Paul Scherrer Institut. A multi-phase multi-component model has been developed and implemented via appropriate customization of the commercial CFD software Ansys Fluent. The model accounts for all the physical and chemical phenomena relevant to the electrochemical process, i.e. fluid flow mechanics, heat and mass transfer, electrical potential propagation and chemical and electrochemical reactions. The results of the simulations suggest two possible causes of cell overpotential. Firstly, the formation of hydrogen bubbles by the hydrogen evolution reaction in the cathode electrode, which partially cover the liquid-solid interface where the electrochemical reaction occurs. This is clearly shown by direct comparison with idealized single-phase simulations. Secondly, the flow structure of the catholyte is not optimized to favor the diffusion/migration of carbonate rather than hydroxide anions towards the membrane. This requires increasing the gap between the electrode and the membrane in order to maximize the faradaic efficiency, but it also increases the cell specific resistance. Although we show that there exists an optimal ratio of electrode-membrane gap to cell height, our simulations indicate that a topological optimization of the electrode fine structure might be beneficial to eliminate the undesired effects mentioned above. [1] Muroyama, A. P., & Gubler, L. (2022). Carbonate Regeneration Using a Membrane Electrochemical Cell for Efficient CO2 Capture. ACS Sustainable Chemistry & Engineering.

Epidemiology and Outcomes Associated with PR Prolongation.

PR prolongation is defined primarily as delayed conduction through the AV node, but can also signify delayed electrical impulse propagation through any part of the conduction system. The prevalence of PR prolongation ranges from 1% to 5% in patients younger than 50 years, with increasing prevalence, after the sixth decade of life and in patients with organic heart disease. Contemporary studies have documented increased risk of atrial arrhythmias, heart failure, and mortality in patients with PR prolongation. Future studies are needed to more accurately risk stratify elderly patients with PR prolongation who may be at increased risk of adverse outcomes.

Materials and Design Approaches for a Fully Bioresorbable, Electrically Conductive and Mechanically Compliant Cardiac Patch Technology.

Myocardial infarction (MI) is one of the leading causes of death and disability. Recently developed cardiac patches provide mechanical support and additional conductive paths to promote electrical signal propagation in the MI area to synchronize cardiac excitation and contraction. Cardiac patches based on conductive polymers offer attractive features; however, the modest levels of elasticity and high impedance interfaces limit their mechanical and electrical performance. These structures also operate as permanent implants, even in cases where their utility is limited to the healing period of tissue damaged by the MI. The work presented here introduces a highly conductive cardiac patch that combines bioresorbable metals and polymers together in a hybrid material structure configured in a thin serpentine geometry that yields elastic mechanical properties. Finite element analysis guides optimized choices of layouts in these systems. Regular and synchronous contraction of human induced pluripotent stem cell-derived cardiomyocytes on the cardiac patch and ex vivo studies offer insights into the essential properties and the bio-interface. These results provide additional options in the design of cardiac patches to treat MI and other cardiac disorders.

Micromotion Derived Fluid Shear Stress Mediates Peri-Electrode Gliosis through Mechanosensitive Ion Channels.

The development of bioelectronic neural implant technologies has advanced significantly over the past 5 years, particularlyin brain-machine interfaces and electronic medicine. However, neuroelectrode-based therapies require invasive neurosurgery and can subject neural tissues to micromotion-induced mechanical shear, leading to chronic inflammation, the formation of a peri-electrode void and the deposition of reactive glial scar tissue. These structures act as physical barriers, hindering electrical signal propagation and reducing neural implant functionality. Although well documented, the mechanisms behind the initiation and progression of these processes are poorly understood. Herein, in silico analysis of micromotion-induced peri-electrode void progression and gliosis is described. Subsequently, ventral mesencephalic cells exposed to milliscale fluid shear stress in vitro exhibited increased expression of gliosis-associated proteins and overexpression of mechanosensitive ion channels PIEZO1 (piezo-type mechanosensitive ion channel component 1) and TRPA1 (transient receptor potential ankyrin 1), effects further confirmed in vivo in a rat model of peri-electrode gliosis. Furthermore, in vitro analysis indicates that chemical inhibition/activation of PIEZO1 affects fluid shear stress mediated astrocyte reactivity in a mitochondrial-dependent manner. Together, the results suggest that mechanosensitive ion channels play a major role in the development of a peri-electrode void and micromotion-induced glial scarring at the peri-electrode region.

Unraveling Impacts of Chamber-Specific Differences in Intercalated Disc Ultrastructure and Molecular Organization on Cardiac Conduction

BackgroundPropagation of action potentials through the heart coordinates the heartbeat. Thus, intercalated discs, specialized cell–cell contact sites that provide electrical and mechanical coupling between cardiomyocytes, are an important target for study. Impaired propagation leads to arrhythmias in many pathologies, where intercalated disc remodeling is a common finding, hence the importance and urgency of understanding propagation dependence on intercalated disc structure. Conventional modeling approaches cannot predict changes in propagation elicited by perturbations that alter intercalated disc ultrastructure or molecular organization, because of lack of quantitative structural data at subcellular through nano scales. ObjectivesThis study sought to quantify intercalated disc structure at these spatial scales in the healthy adult mouse heart and relate them to chamber-specific properties of propagation as a precursor to understanding the effects of pathological intercalated disc remodeling. MethodsUsing super-resolution light microscopy, electron microscopy, and computational image analysis, we provide here the first ever systematic, multiscale quantification of intercalated disc ultrastructure and molecular organization. ResultsBy incorporating these data into a rule-based model of cardiac tissue with realistic intercalated disc structure, and comparing model predictions of electrical propagation with experimental measures of conduction velocity, we reveal that atrial intercalated discs can support faster conduction than their ventricular counterparts, which is normally masked by interchamber differences in myocyte geometry. Further, we identify key ultrastructural and molecular organization features underpinning the ability of atrial intercalated discs to support faster conduction. ConclusionsThese data provide the first stepping stone to elucidating chamber-specific effects of pathological intercalated disc remodeling, as occurs in many arrhythmic diseases.

Propagation in Superconducting Niobium Rectangular Waveguide in the 100 GHz band

Rectangular waveguides that use superconducting materials for walls are expected to reduce transmission loss compared to normal metal waveguides. However, research on superconducting waveguides has been limited, particularly on the fabrication and measurement of physical models in the mm/sub-mm band. We attempted to fabricate a niobium (Nb) waveguide and measure its propagation. Because Nb is known to be a difficult-to-machine material, we searched for the best cutting tools and machining conditions. Consequently, we fabricated a waveguide with a surface accuracy of 0.3 µm rms using an end mill with a diameter of 1 mm. For the measurement of waveguide propagation, the resonator method was adopted, and the resonance characteristics were measured at room (298 K) and cryogenic (4.8 K) temperatures in the 100 GHz band. The resonance property at 298 K is consistent with the shapes predicted from literature-based conductivity. However, at 4.8 K, that of superconducting Nb is significantly changed. We used electromagnetic analysis to reproduce these properties, and the electrical conductivity and propagation loss were calculated. The conductivity and loss were computed as 1.8×1011 S/m and 0.05 dB/m, respectively. We observed a slight transmission loss and verified the effectiveness of the superconducting waveguides.

Non-Oxidative Ethane Dehydrogenation in a Packed-Bed DBD Plasma Reactor

Plasma-assisted conversion of ethane (C2H6) can produce value-added chemical building blocks using green electricity. Here we employ a simple packed-bed coaxial dielectric barrier discharge (DBD) reactor to convert C2H6 at mild operating conditions unattainable by conventional thermocatalysis. Ethylene (C2H4), acetylene (C2H2), and methane (CH4) are the main products along with small fractions of C3 and C4 hydrocarbons. Interestingly, the C2H4 selectivity is primarily correlated to C2H6 conversion, dominated by electron dissociation and recombination reactions irrespective of the dielectric properties of the packed bed material (SiO2, Al2O3, ZrO2, TiO2, and BaTiO3), packing material size, supplied power, and C2H6 concentration. While a distortion of the electric field and discharge propagation results in varying dissipated power as materials change, the C2H4 energy yield remains constant. The particle size appears to affect conversion mainly due to pressure alterations. Pd/SiO2 catalyst can change the selectivity, favoring saturated species by expending hydrogen.

Traveling-Wave Mach-Zehnder Modulator Integrated With Electro-Optic Frequency-Domain Equalizer for Broadband Modulation

Broadband modulator is a key component of future high-capacity and high-baud-rate optical fiber communication. An electro-optic (EO) frequency-domain equalizer is proposed and investigated to increase the 3-dB bandwidth of optical modulators. The equalizer can be integrated with conventional traveling-wave modulators using a crossing waveguide, U-turn waveguide, or ferroelectric-domain-inversion. The 3-dB bandwidth of the modulator can be doubled by integrating the equalizer. As a theoretical consideration, we modeled several types of EO equalizers and investigated the function and parameter dependency of the equalizers in detail. For the experimental demonstration, a titanium-diffused lithium niobate optical waveguide modulator integrated with the EO equalizer was fabricated. The optical loss including fiber-coupling was as low as 5.4 dB, and the half-wave voltage was 3.7 V. The measured electro-optic response at 110 GHz is –0.4 dB, and that of the 3-dB bandwidth is larger than 110 GHz, which is the upper frequency limit of our measurement equipment. The 3-dB bandwidth of the modulator estimated using the fitting curve obtained from the measured electrical propagation loss of the modulator electrode was approximately 200 GHz.

Electrographic flow mapping guided catheter ablation offers advantages for patients with persistent atrial fibrillation.

Catheter ablation (CA) remains challenging due to suboptimal success rates in persistent atrial fibrillation (AF). Existing mapping technologies cannot reliably distinguish sources in this patient population. Recently, the novel electrographic flow (EGF) mapping system was developed using a modified Horn-Schunk optical flow algorithm to detect and quantify patterns of electrical wavefront propagation in the atria. To test the hypothesis that targeted source ablation based on EGF mapping is superior to empiric AF ablation. We included all consecutive patients undergoing EGF guided ablation for persistent AF. All patients underwent pulmonary vein isolation (PVI) and were treated with the same EAM system (CARTO). The outcome of PVI+EGF guided CA was compared with data of PVI-only procedures (PVI-only group) and PVI plus additional empiric adjunctive linear and substrate ablations (PVI+LINES group). 12-months outcome as freedom from AF and atrial tachycardia/flutter (AT/AFL), procedural safety and efficiency characterized by procedure duration, fluoroscopy use, radiofrequency applications and duration, were analyzed. Both intention-to-treat and per protocol analysis were conducted. A total number of 70 patients (39 in PVI+EGF, 16 in PVI-only and 15 patients in PVI+LINES group) were enrolled. Intention-to-treat analysis showed fewer AF recurrences in PVI+EGF as compared with the PVI-only or PVI+LINES groups at 12 months (25.6%vs. 62.5%vs. 53.3%, p=.02). There were no differences in AT/AFL recurrence (17.9%vs. 37.5%vs. 20.0%, p=.37). Procedure times were longer in PVI+EGF group (p<.01), and there were no differences in fluoroscopy use (p=.67). Our data suggest that patients treated with EGF-guided CA developed fewer AF recurrences. Although the procedure times are longer, it seems to be safe and offers a more targeted, patient-specific ablation strategy beyond PVI than adjunctive empiric lines and substrate ablation in this complex group of patients.

DISTINCT CARDIAC CONNEXIN-43 EXPRESSION IN HEMODYNAMICALLY UPLOADED AND UNLOADED HEART MAY IMPACT VULNERABILITY TO MALIGNANT ARRHYTHMIAS

Objective: Experimental and clinical studies suggest that myocardial hypertrophy in response to hypertension and hyperthyroidism increases propensity to cardiac arrhythmias. While these are rare in conditions resulting in myocardial atrophy, such as hypothyroidism or type-1 diabetes mellitus (T1DM). One of the crucial factors impacting the susceptibility of the heart to life-threatening arrhythmias is gap junction channel protein connexin-43 (Cx43), which ensure cardiac cell-to-cell coupling for electrical signal propagation that induce contraction. We aimed to explore abundance of Cx43 protein and its cardiomyocyte topology in hemodynamically uploaded hypertrophied versus unloaded hypotrophic cardiac phenotype. Design and method: Analysis were performed in left ventricular tissue of adult male rats of following groups: 1. spontaneously hypertensive rat (SHR); 2. normotensive Wistar Kyoto rats (WKY) treated for 8-weeks with L-thyroxine (0.15 μg/kg, i.v.) to induce hyperthyroid status; 3. WKY rats treated with methimazol (0.05% solution, p.o.) to induce hypothyroid status; 4. WKY rats treated with strepotozotocin (50mg/kg, i.p.) to induce T1DM. Animals were compared with non-treated normotensive control rats. Results: Comparing to healthy non-treated rats there was a decrease of total myocardial Cx43 protein and its variant phosphorylated at serine368 in SHR and hyperthyroid rats. Besides, enhanced abnormal localisation of Cx43 was demonstrated on lateral sides of hypertrophied cardiomyocytes. In contrast, total Cx43 protein and its serine368 variant were increased in atrophied left ventricle of hypothyroid and T1DM rats. It was associated with less pronounced alterations in Cx43 topology. In parallel, the abundance of PKC epsilon, which phosphorylates Cx43 at serine368 that stabilize Cx43 function and distribution was reduced in hypertrophied heart while enhanced in atrophied once. Conclusions: Findings suggest that differences in the abundance of cardiac Cx43, its variant phosphorylated at serine368 and Cx43 topology may explain, in part, distinct propensity of uploaded and unloaded heart to malignant arrhythmias. It suggests that hemodynamically overloaded heart might benefit from interventions promoting unloading. This research was supported by VEGA grants 2/0002/20, 2/0006/23, Slovak Research and Development Agency under the Contract no. 21-0410

NON-PHARMACOLOGICAL INTERVENTIONS UP-REGULATE MYOCARDIAL CONNEXIN-43 AND DECREASE A RISK OF MALIGNANT ARRHYTHMIAS IN EXPERIMENTAL MODEL OF ESSENTIAL HYPERTENSION

Objective: Available data suggest that meta-inflammation and oxidative stress as well as endogenous deficiency of omega-3 and melatonin may be involved in hypertension-induced myocardial abnormalities that increase propensity to cardiac arrhythmias. We aimed to explore whether supplementation with omega-3 and melatonin as well as cold acclimation may affect arrhythmogenicity of rats suffering from essential hypertension. We focused on myocardial connexin-43(Cx43) channel protein, which ensures cardiac cell-cell coupling for electrical signal propagation, thereby is crucial factor impacting susceptibility of the heart malignant arrhythmias. Design and method: Experiments were performed using adult, male, spontaneously hypertensive rats (SHR, wild type), hairless SHR (mutant strain) and normotensive Wistar rats. SHR were treated for two-month with omega-3 (Omacor,200mg/day) or melatonin (400ug/day) and compared with untreated rats. Hairless SHR adapted to cold were compared with wild type SHR and normotensive Wistar rats. Biometrical parameters were registered and left ventricular heart tissue was taken for analysis of Cx43 and PKC↙, which via phosphorylation affects Cx43 channel function. Isolated perfused heart was used for the examination of its susceptibility to electrically-induced sustained ventricular fibrillation (VF). Results: Supplementation with omega-3 or melatonin and cold acclimation did not affect significantly blood pressure as well as heart or left ventricular weights of SHR or hairless SHR. However, the electrical threshold to induce VF was significantly lower (∼20mA) in non-treated compared with treated SHR (∼35mA) as well as in wild type SHR compared to hairless SHR (∼40mA). Antiarrhythmic effect was associated with increased protein levels of Cx43 and its functional phosphorylated forms in left ventricles of treated SHR and hairless SHR compared to untreated wild type SHR. Moreover, pro-arrhythmic myocardial Cx43 distribution on lateral sides of the cardiomyocytes was attenuated by treatment or cold acclimation. In parallel, there was an increase of PKC↙ expression that may enhance cardio-protective Cx43 phosphorylation. Conclusions: In conclusion, findings indicate that non-pharmacological interventions can protect hypertensive rat heart from malignant arrhythmias, at least in part, by targeting myocardial Cx43. It is challenging to pay attention to non-pharmacological approaches in humans suffering from primary hypertension.

Distinct Cardiac Connexin-43 Expression in Hypertrophied and Atrophied Myocardium May Impact the Vulnerability of the Heart to Malignant Arrhythmias. A Pilot Study.

Our and other studies suggest that myocardial hypertrophy in response to hypertension and hyperthyroidism increases propensity of the heart to malignant arrhythmias, while these are rare in conditions of hypothyroidism or type-1 diabetes mellitus associated with myocardial atrophy. One of the crucial factors impacting the susceptibility of the heart to life-threatening arrhythmias is gap junction channel protein connexin-43 (Cx43), which ensure cell-to-cell coupling for electrical signal propagation. Therefore, we aimed to explore Cx43 protein abundance and its topology in hypertrophic and hypotrophic cardiac phenotype. Analysis were performed in left ventricular tissue of adult male spontaneously hypertensive rat (SHR), Wistar Kyoto rats treated for 8-weeks with L-thyroxine, methimazol or strepotozotocin to induce hyperthyroid, hypothyroid and type-1 diabetic status as well as non-treated animals. Results showed that comparing to healthy rats there was a decrease of total myocardial Cx43 and its variant phosphorylated at serine368 in SHR and hyperthyroid rats. Besides, enhanced localization of Cx43 was demonstrated on lateral sides of hypertrophied cardiomyocytes. In contrast, total Cx43 protein and its serine368 variant were increased in atrophied left ventricle of hypothyroid and type-1 diabetic rats. It was associated with less pronounced alterations in Cx43 topology. In parallel, the abundance of PKCepsilon, which phosphorylates Cx43 at serine368 that stabilize Cx43 function and distribution was reduced in hypertrophied heart while enhanced in atrophied once. Findings suggest that differences in the abundance of cardiac Cx43, its variant phosphorylated at serine368 and Cx43 topology may explain, in part, distinct propensity of hypertrophied and atrophied heart to malignant arrhythmias.

Impact of effective refractory period personalization on prediction of atrial fibrillation vulnerability

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska- Curie grant agreement Introduction Although the effective refractory period (ERP) is one of the main electrophysiological properties governing atrial tachycardia (AT) maintenance, ERP personalization is rarely performed when creating patient-specific computer models of the atria to inform clinical decision making. State-of-the-art models usually do not consider physiological ERP gradients but assume a homogeneous ERP distribution. This assumption might have an influence on the ability to induce reentries in the model. Aim To evaluate the impact of incorporating clinical ERP measurements when creating in silico personalized models to predict vulnerability to atrial fibrillation (AF). Methods Clinical ERP measurements were obtained from three patients from multiple locations in the atria. The protocol for ERP identification consisted of trains of 7 S1 stimuli with a basic cycle length of 500ms followed by an S2 stimulus with a coupling interval between 300 and 200ms in decrements of 10ms until loss of capture. The atrial geometries from the electroanatomical mapping system were used to generate personalized atrial models. To reproduce patient-specific ERP, the established Courtemanche cellular model was gradually reparameterized from control conditions to a setup representing AF-induced remodeling. Three different approaches were studied: 1) a control scenario with no ERP personalization 2) a discrete split where each region had a single ERP value and 3) a continuous ERP distribution by interpolation of measured ERP data (Fig. 1). Arrhythmia vulnerability was assessed by virtual S1S2 pacing from different locations separated by 3cm. The number and location of inducing points and type of arrhythmia were determined for the three approaches. The mean conduction velocity was set to 0.7 m/s and the electrical propagation in the atria was modeled by the monodomain equation and solved with openCARP. Results Incorporating patient-specific ERP as a continuous distribution did not induce any reentrant activity. A summary of induced ATs is shown in Table 1. For patient A, AF was induced from 3 different locations with the control setup, whereas 9 ATs were induced with the regional method, of which 4 were AF and 5 macro reentries. For patient B, AF was induced from 1 point with the control setup; whereas with the regional approach, AF was induced at 4 points. For patient C, only one macro reentry was induced with the regional method. Conclusion Incorporation of patient-specific ERP values has an impact on the assessment of AF vulnerability. Furthermore, the type of personalization affects the likelihood of AF inducibility. The incorporation of more detailed ERP distributions may lead to a more accurate prediction of AF trigger points and could in the future inform patient-specific therapy planning. Larger cohorts need to follow to demonstrate the role of incorporating clinical patient-specific ERP values into personalized models for predicting AF vulnerability.

A new workflow including Coherent algorithm in sinus rhythm for the treatment of Ventricular Tachycardia in patients with scar related heart disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation is a well establish therapy in patients with structural heart disease (SHD) and sustain ventricular tachycardia (VT). Scar substrate modification is one of the two endpoint of a VT ablation procedure. Dechanneling is one of the described successful techniques that shown to be effective for substrate modification Aim This is a pilot study aiming to evaluate the feasibility and the acute efficacy of a new mapping approach for VT ablation with the combination of high density (HD) mapping and Coherent mapping algorithm. Methods All enrolled patients underwent radio frequency catheter ablation (RFCA) for drug-refractory VT or VT storm. Before mapping, programmed ventricular stimulation was performed in all patients for the induction of clinical VT or any other ventricular arrhythmias (VA), if VA was inducible, then electrical cardioversion was conducted to restore sinus rhythm. After transseptal puncture, left ventricular (LV) HD mapping was conducted using a 3D mapping system aiming &amp;gt;5000 mapping points during sinus rhythm, intrinsic atrial rhythm, or ventricular pacing with a multielectrode catheter. During HD mapping, all late potentials (LPs) were tagged as double potentials (DP) and all potentials below 0,2 mV were tagged as scar. Then, Coherent mapping was used to visualize electrical propagation through the LV, based on velocity vector identification, highlighting how the electrical signal enters the scar and identifying the "entrance points" (EP). RFCA was delivered in a power-controlled mode on all the individuated EPs using an open, irrigated-tip ablation catheter with contact force sensor. After RFCA, a second remap was conducted to evaluate the LPs abolition. Then, a programmed ventricular stimulation was performed to validate non inducibility of any VAs. Results 10 consecutive patients (age 71,25±10,32 years, 100% male) undergoing RFCA for drug-refractory VT or VT storm (50%). Acute procedural end-point were: abolition of the LPs and non-inducibility of any VA at the end of the procedure. Abolition of LPs was reached in all cases while non inducibility was reached in 9 patients (90%). Mean procedural time was 214±33,81 min, mean mapping time was 89±15,40 min with mean number of acquired points of 5218±359,56. Mean fluoroscopy time and dose were 15±33,81 min and 5218±7149,8 µGm2, respectively. Mean entrance points identified was 2,6±0,84. In 5 patents (50%), after ablation a modification in the refractory period of the left ventricular myocardium was observed. Mean RF time was 1216±565,46 seconds, with mean number of Visitag of 33±29,98. No acute complication were reported. Conclusion High-density mapping in sinus rhythm combined with Coherent algorithm facilitates the understanding of the substrate and provides targets for effective ablation. This approach has been proven safe and with high acute success rates.

PO-01-207 VERNIX CASEOSA DISTRIBUTION MODULATES NON-INVASIVE FETAL ECG SIGNAL: A COMPUTATIONAL STUDY

Non-invasive fetal ECG (FECG) shows promise as a diagnostic method to monitor fetal health. However, extracting the fetal cardiac signal remains a challenge due to low signal-to-noise ratio. An important factor is a low-conducting layer which forms around the fetus from week 28 of gestation called the vernix caseosa (VC). We developed an anatomically detailed and biophysically accurate computational model of a pregnant torso to investigate the effects of the VC on the FECG. The model was constructed by combining geometries of a pregnant woman with a 24 week infant and a torso with ventricles (a). Ionic current properties of the maternal heart is modelled using the Ten Tusscher human ventricular cardiomyocyte model, while a modified version adapted to match fetal electrophysiology is used for the fetal heart. 22 distribution patterns of the VC was generated using combinations of 3 regions and 4 thickness. No VC case was used as control. Electrical propagation was simulated using the pseudo-bidomain formulation. Sinus rhythm was simulated with a baseline cycle of 500 ms and 450 ms for the maternal and fetal hearts, respectively. When VC was represented as homogeneous, changing the VC thickness from 0.5 mm to 3 mm resulted in reduction of QRS maximum amplitude from 6 x 10-5 to 6 x 10-6 mV (c). However, in the heterogeneous VC models, there is no significant difference in signal as thickness was changed (d). The location of the VC significantly affected the signal (e). VC only covering the head was almost identical to control with a relative difference measure of only 1.35%. However, introduction of VC on the back resulted in greatest difference in potential distribution with a relative difference measure ranging between 34.5 and 49%. We have developed a novel, highly-detailed computational model of a pregnant torso that shows how VC distribution affects the FECG. This model can be used to improve techniques in extracting FECG at different gestational stages.