Effect of Epicardial Fat on Electroanatomical Mapping and Epicardial Catheter Ablation

ObjectivesThe purpose of this study was to correlate 3-dimensional distribution of epicardial fat on computed tomography (CT) with electroanatomical (EA) voltage maps obtained during percutaneous epicardial mapping in order to determine the fat thickness cut-off that results in voltage attenuation and to establish normal ventricular epicardial voltage criteria in the absence of fat.BackgroundEpicardial fat can mimic scar tissue when epicardial voltage mapping is performed, as both result in low epicardial voltage. Cardiac CT can differentiate epicardial fat from scar or muscle on the basis of their distinct attenuations.MethodsTranscutaneous epicardial mapping was performed in a consecutive series of 14 patients. A cardiac CT was performed before the procedure and a 3-dimensional image of the epicardial fat was generated and registered with the epicardial EA voltage map.ResultsIn patients without cardiomyopathy (n = 8), a voltage ≥1.5 mV best correlated with the absence of epicardial fat. A fat thickness ≥2.8 mm resulted in voltage attenuation and best separated low voltage (<1.5 mV) from normal voltage (≥1.5 mV; sensitivity 81%, specificity 81%, area under the curve 0.85). In patients without cardiomyopathy, the low-voltage area matched well with the area of epicardial fat. In the 6 patients with nonischemic cardiomyopathy, the low-voltage area by far exceeded the area accounted for by epicardial fat; this corresponded with the presence of scar tissue. Epicardial ablations at sites with >10 mm of fat were ineffective.ConclusionsCardiac CT identifies epicardial fat that can mimic scar tissue during epicardial EA voltage mapping, which is important during epicardial mapping and ablation

Poisson Models with Employer-Employee Unobserved Heterogeneity: An Application to Absence Data

We propose a parametric model based on the Poisson distribution that permits to take into account both unobserved worker and workplace heterogeneity as long as both effects are nested. By assuming that workplace and worker unobserved heterogeneity components follow a gamma and a Dirichlet distribution respectively, we obtain a closed form the unconditional density function. We estimate the model to obtain the determinants of absenteeism using linked employer-employee Canadian data from the Workplace and Employee Survey (2003). Coefficient estimates are interpreted in the framework of the typical labor-leisure model. We show that omitting unobserved heterogeneity on either side of the employment relationship leads to notable biases in the estimated coefficients. In particular, the impact of wages on absences is underestimated in simpler models.Absenteeism, Linked Employer-Employee Data, Employer-Employee Unobserved Heterogeneity, Count Data Models, Dirichlet Distribution

Poisson Models with Employer-Employee Unobserved Heterogeneity: An Application to Absence Data

We propose a parametric model based on the Poisson distribution that permits to take into account both unobserved worker and workplace heterogeneity as long as both effects are nested. By assuming that workplace and worker unobserved heterogeneity components follow a gamma and a Dirichlet distribution respectively, we obtain a closed form for the unconditional density function. We estimate the model to obtain the determinants of absenteeism using linked employer-employee Canadian data from the Workplace and Employee Survey (2003). Coefficient estimates are interpreted in the framework of the typical labor-leisure model. We show that omitting unobserved heterogeneity on either side of the employement relationship leads to notable biases in the estimated coefficients. In particular, the impact of wages on absences is underestimated in simpler models.Absenteeism; Linked Employer-Employee Data; Employer- Employee Unobserved Heterogeneity; Count Data Models; Dirichlet Distribution

Normal mode decomposition and dispersive and nonlinear mixing in stratified fluids

Motivated by the analysis of the propagation of internal waves in a stratified ocean, we consider in this article the incompressible Euler equations with variable density in a flat strip, and we study the evolution of perturbations of the hydrostatic equilibrium corresponding to a stable vertical strati-fication of the density. We show the local well-posedness of the equations in this configuration and provide a detailed study of their linear approximation. Performing a modal decomposition according to a Sturm-Liouville problem associated to the background stratification, we show that the linear approximation can be described by a series of dispersive perturbations of linear wave equations. When the so called Brunt-Vais{\"a}l{\"a} frequency is not constant, we show that these equations are coupled, hereby exhibiting a phenomenon of dispersive mixing. We then consider more specifically shallow water configurations (when the horizontal scale is much larger than the depth); under the Boussinesq approximation (i.e. neglecting the density variations in the momentum equation), we provide a well-posedness theorem for which we are able to control the existence time in terms of the relevant physical scales. We can then extend the modal decomposition to the nonlinear case and exhibit a non-linear mixing of different nature than the dispersive mixing mentioned above. Finally, we discuss some perspectives such as the sharp stratification limit that is expected to converge towards two-fluids systems

Singular ordinary differential equations homogeneous of degree 0 near a codimension 2 set

This work deals with an example of class of ordinary differential equations which are singular near a codimension 2 set, with an homogeneous singularity of degree 0. Under some structural assumptions, we prove that for almost all initial data there exists a unique global solution and study the evolution of the Lebesgue measure of a transported set of initial data. The analysis is motivated by the Low Mach number asymptotics of compressible fluid models in the case of non isentropic flows, which involves such dynamical systems

Le FORUM, Vol. 32 Nos. 3 & 4

https://digitalcommons.library.umaine.edu/francoamericain_forum/1021/thumbnail.jp