Fragment Potential Research Articles

Management of a Fragmented Angiocatheter During Central Venous Cannulation: A Case Report and Important Lessons

Complications during central venous catheter (CVC) insertion are infrequent with an incidence of 0.1%-1%. We experienced a rare CVC complication with fragmentation of the angiocatheter at its hub during central venous cannulation while utilizing the modified Seldinger technique (ie, wire through the catheter technique). Vascular surgery was emergently required to remove the catheter fragment from the neck. Clinicians must remain vigilant during all aspects of CVC insertion, including awareness of the potential for fragmentation of the angiocatheter during its removal over the in situ guidewire. Prompt recognition and appropriate management included leaving the guidewire in place (to stabilize the distal fragmented segment) and promptly consulting vascular surgery for removal before potential vascular embolization of the angiocatheter fragment. We further recommend that all components of the insertion kit be inspected before and after patient use.

Non-Aggregating Amylin Fragments as an Inhibitors of the Aggregation Process of Susceptible to Aggregation Fragments 18-22, 23-27, and 33-37 of Hormone.

Amylin aggregation is one of the factors in the development of diabetes mellitus, which is classified as a civilization disease. The aim of this research was to find whether non-aggregating fragments 1-7, 8-12, 13-17 and 28-32 of amylin would inhibit the aggregation of the amyloidogenic cores 18-22, 23-27, 33-37 of hormone. In the study of the inhibitory potential of non-aggregating amylin fragments, a set of independent methods were used to study aggregation properties (spectroscopic and fluorescence studies with the use of indicators, microscopic studies, circular dichroism studies) and the method of prediction of aggregation properties. The performed research allowed to select the cyclic fragment (1-7) H-KCNTATC-OH with disulfide bond as an inhibitor capable of inhibiting the aggregation of all amyloidogenic cores 18-22, 23-27, 33-37 of the hormone. Additionally, it was found that this peptide inhibits insulin hot spot aggregation, which may indicate its universal utility in inhibiting the process of aggregation of hormones regulating carbohydrate metabolism directly related to the development of diabetes. Research on the possibility of the extensive use of the cyclic fragment (1-7) of H-KCNTATC-OH as a peptide inhibitor of the polypeptide/protein aggregation process is ongoing.

Modeling solvation effects on absorption and fluorescence spectra of indole in aqueous solution.

Modeling the optical spectra of molecules in solution presents a challenge, so it is important to understand which of the solvation effects (i.e., electrostatics, mutual polarization, and hydrogen bonding interactions between solute and solvent molecules) are crucial in reproducing the various features of the absorption and fluorescence spectra and to identify a sufficient theoretical model that accurately captures these effects with minimal computational cost. In this study, we use various implicit and explicit solvation models, such as molecular dynamics coupled with non-polarizable and polarizable force fields, as well as Car-Parrinello molecular dynamics, to model the absorption and fluorescence spectra of indole in aqueous solution. The excited states are computed using the equation of motion coupled cluster with single and double excitations combined with the effective fragment potential to represent water molecules, which we found to be a computationally efficient approach for modeling large solute-solvent clusters at a high level of quantum theory. We find that modeling mutual polarization, compared to other solvation effects, is a dominating factor for accurately reproducing the position of the peaks and spectral line shape of the absorption spectrum of indole in solution. We present an in-depth analysis of the influence that different solvation models have on the electronic excited states responsible for the features of the absorption spectra. Modeling fluorescence is more challenging since it is hard to reproduce even the correct emitting state, and force field parameters need to be re-evaluated.

Tied to a star: the Green Party of Aotearoa New Zealand and the 2020 election

ABSTRACT In the 2020 General Election, the Green Party of Aotearoa New Zealand appeared ideally positioned to capitalise on its association with the Labour-NZ First coalition, led by Jacinda Ardern. Leading up to the election campaign, the Green Party presented itself as a progressive partner for the dominant Labour Party against weak opposition from the National Party. During the campaign, polls suggested that there was a risk the party would not pass the threshold for representation in Parliament, leading to the vigorous targeting of the Auckland City electorate seat. The strategy was successful, as the Green Party slightly increased its representation and won the electorate seat. Securing an agreement with the Labour Party could ensure continued policy influence but does raise concerns about the potential for fragmentation, in view of the party’s non-conformist roots and the urgency of the environmental challenges ahead.

Cover Image

The cover image is based on the Full Paper Ab initio effective one-electron potential operators: Applications for charge-transfer energy in effective fragment potentials by Bartosz Błasiak et al., https://doi.org/10.1002/jcc.26462

Systematic study of alpha-decay of super-heavy isotopes withZ= 120–126

Alpha-decay half-lives of the even–even superheavy isotopes with proton numbers [Formula: see text] have been calculated within the cluster model. The alpha-daughter potential was constructed by employing the density-dependent double-folding model with a realistic nucleon–nucleon interaction whose exchange part has a finite range approximation. The half-lives were calculated using Wentzel–Kramers–Brillouin (WKB) approximation with the alpha preformation factor. The results have shown that the computed alpha-decay half-lives were in good agreement with their counterpart calculated by different semi-empirical approaches. The obtained results have also shown a negative linear relationship between the logarithm of the preformation factor and the fragmentation potential for the understudy isotopes. Also, the calculated results have shown that isotopes [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] had longer half-lives than their adjacent isotopes, which indicates that the corresponding neutron or proton numbers have a magical or semi-magical properties. Furthermore, we have studied the competition between alpha-decay and spontaneous fission to predict possible decay modes from the even–even isotopes [Formula: see text]. The results revealed that the isotopes [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] had alpha-decay as a predominant mode of decay and the nuclei [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] could not survive from the spontaneous fission. We hope that the theoretical prediction could be helpful for future investigation in this field.

Effect of autologous platelet-rich plasma on human sperm quality during cryopreservation

As a source of growth factors, platelet-rich plasma (PRP) has been widely used in the repair of various injuries due to its cytoprotective properties in regenerative medicine. The objective of the present study was to investigate the effect of autologous PRP supplementation on the quality of frozen-thawed human sperm. Twelve normozoospermic semen samples were collected, and each sample was divided into 4 aliquots and added with different proportions of PRP (0%, 2%, 5%, and 10%) separately, followed by cryopreservation. Sperm motility, viability, membrane integrity, DNA fragmentation index (DFI), reactive oxygen species (ROS) levels and mitochondrial membrane potential were measured and analyzed. The results showed that the addition of 5% PRP improved sperm progressive motility (30.3 ± 2.7 VS. 28.1 ± 2.6), viability (65.5 ± 4.2 VS. 59.6 ± 3.9), and membrane integrity (52.4 ± 3.6 VS. 49.2 ± 3.4) after cryopreservation (P < 0.05). Slight attenuation of ROS generation, restoration of mitochondrial membrane potential and reduction of DNA fragments were also observed in post-thawed sperm supplemented with PRP, but there was no significant (P > 0.05). In conclusion, autologous PRP has a partial protective effect on cryopreservation of human spermatozoa, and the combined application with other high-efficiency cryoprotectant is worthy of further study.

Incidence of outflow tract ventricular tachycardia long after surgical aortic valve replacement.

BackgroundThe peri‐outflow tract region could be the origin of ventricular tachycardia (VT) after aortic valve replacement (AVR). However, the clinical characteristics of outflow tract ventricular tachycardias (OTVTs) after AVR are yet to be clarified. This study investigated the incidence, risk factors, and clinical characteristics of patients with OTVTs after AVR.MethodsWe retrospectively analyzed the clinical course of 120 patients who had undergone surgical AVR (SAVR) between April 1980 and October 2018. The patients had no ischemic or diagnosed cardiomyopathies other than primary aortic valve diseases.ResultsSix patients (5.0%) developed OTVTs after SAVR. The average onset was at 10.8 ± 5.7 years after SAVR. All cases of VT arose from the inferior axis and included left and right bundle branch block configuration. Two patients who underwent cardiac magnetic resonance imaging (MRI) had late gadolinium enhancement (LGE) in the midlayer of the left ventricle basal anteroseptal wall. Patients with periaortic VTs had significantly larger left ventricular (LV) diameter at systole, lower LV ejection fraction, higher positive rates of signal‐averaged electrocardiogram (SAECG), and nonsustained VTs on Holter monitoring. On ablation, local fragmented potentials with low voltage zones were observed in accordance with the LGE distribution. Multiple VTs originating from the periaortic region were provoked in the sessions.ConclusionsAcute OTVT was found in 5% of patients after SAVR. Arrhythmia risk stratification by SAECG, Holter ECG, and cardiac MRI should be considered for a long period in patients after SAVR.

Novel approach to evaluate rock mass fragmentation in block caving using unascertained measurement model and information entropy with flexible credible identification criterion

In recent years, block caving has drawn the attention of many mine enterprises due to the admired extraction rate and lower cost, which can exploit the materials via gravity inflow. At the same time, the limitation of this advanced method cannot be underestimated easily, such as surface subsidence and boulder, usually, the latter leads to the frequent secondary blast and damage of bottom structure. Thus, it is significant and crucial to evaluate the fragmentation before the implement of this method. But, traditional fragmentation assessment model suffers from the complex process of modeling and simulation. In this study, a hybrid model consists of unascertained measurement theory and information entropy was constructed to meet the requirements of this prospective mining method. Considering the influence of various parameters on rock fragmentation at the same time, twenty-three factors (i.e., uniaxial compressive strength, modulus ratio, fracture frequency, aperture, persistence, joint orientation, roughness, infilling, weathering, in situ stresses, stress orientation, stress ratio, underground water, fine ratio, hydraulic radius, undercut height, draw column height, draw points geometry, draw rate, multiple draw interaction, air gap height, broken ore density and undercut direction) were chosen to extract the main characteristics of rock mass samples from the two different mines, namely Reserve North (Chile), Diablo Regimiento (Chile) and Kemess mine (Canada). A new membership function (logarithm curve) was added to eliminate uncertainty results from the low level of knowledge about rock mass properties. Then, information entropy was performed to quantify the impacts of individual index. A credible degree identification criterion (Rη) was also applied to review the sample attributes qualitatively. Ultimately, degree of fragmentation of the three samples was judged easily on the basis of a composite measurement vectors and Rη. The evaluation results showed that the fragmentation grades of Reserve North, Diablo Regimiento and Kemess mine, separately, were “Good”, “Medium” and “Good”. With regard to the excellent performance of this hybrid model, it can be seen as a reliable approach to describe the fragmentation potential during the ore extraction using block caving mining method.

Anxiogenic Potential of Experimental Sleep Fragmentation Is Duration-Dependent and Mediated via Oxidative Stress State.

Sleep architecture alterations, among which sleep fragmentation is highly prevalent, represent risk factors for a variety of diseases, ranging from cardiovascular to brain disorders, including anxiety. What mediates anxiety occurrence upon sleep fragmentation is still a matter of debate. We hypothesized that the sleep fragmentation effects on anxiety are dependent on its duration and mediated by increased oxidative stress and alterations in the number of parvalbumin (PV+) interneurons in the hippocampus. Sleep was fragmented in rats by the treadmill method during a period of 14 days (SF group). Rats with undisturbed sleep in the treadmill (TC group) and those receiving equal amounts of treadmill belt motion (EC group) served as controls. To assess anxiety, we subjected rats to the open field, elevated plus maze, and light-dark tests on the 0, 7th, and 14th day. Upon the last test, brain structures were sampled for oxidative stress assessment and PV+ interneuron immunohistochemistry. The results of ethological tests of anxiety-linked behavior suggested duration-dependent anxiogenic potential of sleep fragmentation. Rats' anxiety-linked behavior upon sleep fragmentation significantly correlated with oxidative stress. The rats with fragmented sleep (SF) showed significantly higher oxidative stress in the hippocampus, thalamus, and cortex, compared to controls (TC and EC), while the antioxidant enzymes' activity was significantly decreased. No significant differences were observed in hippocampal PV+ interneurons among these groups. Our results showed that duration of sleep fragmentation is a significant determinant of anxiety-linked behavior, and these effects are mediated through oxidative distress in the brain. Herein, it is revealed that the sleep fragmentation-oxidative stress-anxiety axis contributes to our better understanding of pathophysiological processes, occurring due to disrupted sleep patterns.

The underestimated role of small fragments for carnivore dispersal in the Atlantic Forest

Designing protected areas capable of supporting organism flow is critical for species persistence across wide scales. Here, we evaluated the capacity and protection level of forest fragments to sustain connectivity for carnivores in the Atlantic Forest. We simulated potential dispersal considering species spatial demands and quantified the importance of patches with different sizes in sustaining species movement. We found that patches smaller than species home-range size represented more than 95% of the patches used during species dispersal. These small remnants play a key role in upholding connectivity for carnivores, especially for species capable of moving long distances. Although the forest structure did support most species movements, our results showed that some species must cross matrices composed by crops and pasture to complete their trajectories. Moreover, between 29% and 70% of the area around the species' movement paths, which could act as potential corridors, overlap with human activities. Current established protected areas – mainly targeted for sustainable use – cover only 15% of the entire extension of small remnants enrolled in species dispersal. We reinforce that conservation efforts should not overlook the potential of small forest fragments to improve connectivity. Integrating key fragments with forest restoration and matrix management would benefit long-term species persistence.

The potentials of short fragments of human anti-microbial peptide LL-37 as a novel therapeutic modality for diseases.

Human cathelicidin antimicrobial peptide LL-37 (LL-37) is an antimicrobial peptide derived from its precursor protein hCAP18, which is an only cathelicidin in human. LL-37 not only serves as a mediator of innate immune defense against invading microorganisms, but it also plays an essential role in tissue homeostasis, regenerative processes, regulation of proinflammatory responses, and inhibition of cancer progression. Therefore, LL-37 has been considered as a drug lead for diseases. However, high levels of LL-37 may reduce cell viability and promote apoptosis of osteoblasts, vascular smooth muscle cells, periodontal ligament cells, neutrophils, airway epithelial cells and T cells. Recent evidence reveals that LL-37-derived short peptides possess similar biological activities as the whole LL-37 with reduced cytotoxicity. Thus, such small molecules constitute a pool of potential therapeutic agents for diseases.

Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility.

The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×106/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential. The presence of leukocytes and pathogens in the semen may be a sign of infection and/or localized inflammatory response in the male genital tract and the accessory glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia coli can cause epididymitis, epididymo-orchitis, or prostatitis. The relationship between leukocytospermia and infection is unclear. Therefore, we describe the pathogens responsible for male genital tract infections and their association with leukocytospermia. The review also examines the diagnostic tests available to identify seminal leukocytes. The role of leukocytospermia in male infertility and its management is also discussed.

Impact of different hydrodynamical mass transfer approaches in the spontaneous fission of Cf isotopes

Theoretical possibilities for the spontaneous emission of fission fragments from [Formula: see text]Cf parents are investigated within the framework of preformed cluster decay model (PCM). The fragmentation potential exhibits a modification from dominated asymmetric fission profile to symmetric splitting with the rise in the N/Z ratio of parent nuclei. The calculated spontaneous fission (SF) half-life times of Cf isotopes find nice agreement with the experimental data, except for [Formula: see text]Cf nucleus. Within the PCM, the hydrodynamical mass transfer among the outgoing binary fragments occurs through a cylindrical vessel connecting them. For the overlapping configuration [Formula: see text]), the two classical models namely Model A and Model B (differ in the way the radius of the connecting cylinder is controlled) are used to estimate mass transfer flow of binary fragmentation. It is observed that with change in the overlapping distance, the radius of the cylindrical vessel changes in Model A, whereas the same remains fixed in Model B. In case of Model B, the effect of cylindrical radii parameter ([Formula: see text]) is also analyzed for [Formula: see text]Cf parents at optimum neck-length ([Formula: see text]R) in view of different observable such as most probable SF fragments, preformation probability, mass transfer, the SF half-lives and the results are compared with Model A calculations. The magnitude of mass transfer, preformation probability, and hence the SF half-lives gets significantly modified on switching from Model A to Model B. Further, a large amount of mass is transferred between the asymmetric fragments as compared to the symmetric ones. The SF half-lives are shown to depend strongly on the choice of classical models as well as on the cylindrical radius parameter, [Formula: see text]. The study infers the importance of classical models to spread further light in the understanding of the dynamical behavior of fragment formation in the fission process.

Investigation of the cold valley paths for the synthesis of isotopes of Ubh in optimum orientations

Cold valley paths have been investigated for the synthesis of isotopes of superheavy element Unbihexium using quantum mechanical fragmentation theory, which suggests the fusion of fission fragments belonging to the cold valleys in the potential energy surfaces with at least one spherical closed shell nucleus as the reaction partner for the nuclear synthesis. For the suitability of the cold valley fission fragments for the synthesis of isotopes of Ubh, first the fragmentation potentials, preformation probabilities and fission barriers of the fission fragments of 314Ubh and 326Ubh compound systems in their ground states have been compared by keeping the fragments either in hot or cold optimum orientations. The comparison suggests 138Ba + 176Yb and 132Sn + 194Os reactions in hot optimum orientations for the synthesis of isotopes of Ubh due to their highest values of preformation probabilities, lowest values of the fragmentation potentials and relatively good values of the fission barriers. Also, the reactions 68Ni + 246Cf and 70Ni + 256Cf have been considered for the comparison with 138Ba + 176Yb and 132Sn + 194Os reactions due to their relatively smaller values of the Coulomb potential, higher mass-asymmetry and fission barrier, and shell closures next to 48Ca which has been used in most of the experiments for the synthesis of superheavy elements. Finally, the excitation functions for the neutron evaporation from the compound systems formed in these reactions, the probabilities of the formation and survival of the compound nuclei have been compared to suggest the suitable cold valley paths energies for the synthesis of the isotopes of Ubh.

Ab initio effective one‐electron potential operators: Applications for charge‐transfer energy in effective fragment potentials

The concept of effective one-electron potentials (EOPs) has proven to be extremely useful in efficient description of electronic structure of chemical systems, especially extended molecular aggregates such as interacting molecules in condensed phases. Here, a general method for EOP-based elimination of electron repulsion integrals is presented, that is tuned toward the fragment-based calculation methodologies such as the second generation of the effective fragment potentials (EFP2) method. Two general types of the EOP operator matrix elements are distinguished and treated either via the distributed multipole expansion or the extended density fitting (DF) schemes developed in this work. The EOP technique is then applied to reduce the high computational costs of the effective fragment charge-transfer (CT) terms being the bottleneck of EFP2 potentials. The alternative EOP-based CT energy model is proposed, derived within the framework of intermolecular perturbation theory with Hartree-Fock noninteracting reference wavefunctions, compatible with the original EFP2 formulation. It is found that the computational cost of the EFP2 total interaction energy calculation can be reduced by up to 38 times when using the EOP-based formulation of CT energy, as compared to the original EFP2 scheme, without compromising the accuracy for a wide range of weakly interacting neutral and ionic molecular fragments. The proposed model can thus be used routinely within the EFP2 framework.

Analysis of various competing binary and ternary decay processes of the Es253 nucleus

The ground state binary and ternary decays of the $^{253}\mathrm{Es}$ radioactive nucleus are investigated using the quantum mechanical fragmentation theory (QMFT) based cluster decay models. First, the relative fragmentation of $^{253}\mathrm{Es}$ is analyzed within the framework of the preformed cluster model (PCM). The PCM-calculated binary fragmentation structure is explored for two types of nuclear potential, i.e., Yukawa plus exponential and proximity potentials. The structure of the fragmentation potential and the location of potential minima are found to be independent of the choice of nuclear potential. It is observed from binary fragmentation structures that $\ensuremath{\alpha}$ $(^{4}\mathrm{He})$ decay, cluster $(^{46}\mathrm{Ar})$ emission, heavy particle $(^{82}\mathrm{Ge})$ radioactivity, and spontaneous fission fragmentation $(^{125}\mathrm{In})$ are the possible ground state decay modes of the $^{253}\mathrm{Es}$ nucleus. The competitive emergence of these decay channels is explored by studying the preformation probability ${P}_{0}$, penetrability $P$, and half-lives ${T}_{1/2}$. The calculated half-lives of $\ensuremath{\alpha}$ and spontaneous fission match nicely with the experimental measurements. Also, the half-lives are predicted for cluster and heavy particle radioactivity, for which experimental verification would be of further interest. Further, an effort is made to explore the possibility of ternary fission (particle accompanied fission) for the decay of the $^{253}\mathrm{Es}$ nucleus using the three-cluster model (TCM), where $^{4}\mathrm{He}$ is observed to be the third fragment along with two binary fission fragments. A comparison of relative yields of binary and ternary fission confirm that the probability of the binary fission decay mode is larger than that of ternary fission. Moreover, closed shell effects play a significant role in the symmetric and asymmetric fission of binary and ternary fission, respectively.

Role of higher order deformations in fission fragment mass distribution of Astatine isotopes within collective clusterization approach

The fission fragment mass distribution is used as an investigation tool which assists to disentangle between different modes of fission (symmetric fission and asymmetric fission). In the present work, the fission dynamics of various ‘At*’ isotopes with mass number A=191 to 220 formed in 19F-induced reactions at common centre-of-mass energy Ec.m .=78.5 MeV is explored. The calculations are made within the dynamical cluster-decay model (DCM) using three type of fragmentation such as spherical, (β 2-deformed and (β 2 – β 2-deformed with hot compact optimized orientations. The structural effects come into picture when deformation effects are included in the fragmentation potential. The mass distributions of ‘At*’ isotopes gets significantly modified after inclusion of deformation effects of decaying fragments. The preformation yield shows a drift from symmetric to asymmetric fission with increase in mass of compound nuclei from ACN =191 to 220. The clear signature of fine-structure effects is evident in view of single humped to double humped preformation structure in the fissioning region. However, the mass division of At isotopes is symmetric for spherical choice of fragments. Finally, the analysis of hot (compact) and cold (elongated) configurations of β 2-deformed and oriented fragments is also carried out.

Impact of metabolic syndrome on sex hormones and reproductive function: a meta-analysis of 2923 cases and 14062 controls.

Current evidence is inconsistent regarding the impact of metabolic syndrome (MetS) on sex hormones and reproductive function, and this meta-analysis aimed to illuminate the association. A literature search was conducted in public databases to identify all relevant studies, and study-specific standardized mean differences (SMD) and 95% confidence intervals (CI) were pooled using a random-effects model. Finally, 21 studies were identified with a total of 2923 MetS cases and 14062 controls. In males, MetS cases had a lower level of testosterone, inhibin B, total sperm count, sperm concentration, sperm normal morphology, sperm total motility, sperm progressive motility and sperm vitality, and a higher level of DNA fragmentation and mitochondrial membrane potential. In females, MetS cases had a higher level of testosterone. No significant difference was detected for follicle-stimulating hormone, luteinizing hormone, oestradiol, prolactin, anti-Müllerian hormone and semen volume in males, and for oestradiol, follicle-stimulating hormone, luteinizing hormone and progesterone in females. In conclusion, this meta-analysis indicated the impact of MetS on sex hormones and reproductive function, and MetS cases had a potential risk of infertility.

Re-entrant ventricular tachycardia as a complication of ablation of idiopathic ventricular premature beats from the right outflow tract: a case report.

BackgroundWe report an unusual case of non-sustained ventricular tachycardia (NSVT) from the epicardial part of the right ventricular outflow tract (RVOT).Case summaryA 37-year-old woman who underwent in 2006 an ablation for idiopathic ventricular premature beats (VPBs) from the RVOT presented with pre-syncopal NSVT in 2016. A cardiac workup showed no coronary disease, normal biventricular function, and no enhancement on cardiac magnetic resonance imaging. A metabolic positron emission tomography scan excluded inflammation. Biopsies revealed normal desmosomal proteins. An endocardial mapping revealed an area of low voltage potential (<0.5 mV) at the antero-septal aspect of the RVOT corresponding to the initial site of ablation from 2006. Activation mapping revealed poor prematurity and pace-mapping showed unsatisfactory morphologies in the RVOT, the left ventricle outflow tract and the right coronary cusp. An epicardial map revealed a low voltage area at the antero-septal aspect of the RVOT with fragmented potentials opposite to the endocardial scar. Pace-mapping demonstrated perfect match. An NSVT was induced and local electrocardiogram showed mid-diastolic potentials. Ablation was applied epicardially and endocardially without any complication. The patient was arrhythmia free at 4-year follow-up.DiscussionCardiac workup allowed to exclude specific conditions such as arrhythmogenic cardiomyopathy, tetralogy of Fallot, sarcoidosis, or myocarditis as a cause for NSVT from the RVOT. The epi and endocardial map showed residual scar subsequent to the first ablation which served as substrate for the re-entrant NSVT. This is the first case which describes NSVT from the epicardial RVOT as a complication from a previous endocardial ablation for idiopathic VPB.