CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Demonstration of posterior fascicle to myocardial conduction block during ablation of idiopathic left ventricular tachycardia: An electrophysiological predictor of long-term success

Idiopathic left ventricular tachycardia (ILVT) is a common form of ventricular tachycardia (VT) in structurally normal heart. Different methods have been proposed for radiofrequency ablation (RFA) of ILVT that have good short-term results but recurrence is higher. Termination of tachycardia during RFA and/or noninduciblity has been the procedural end point. To describe electrophysiological markers that add to long-term freedom from recurrences. Fifteen patients with ILVT underwent RFA guided by 3-dimensional electroanatomical mapping. After creating a 3-dimensional geometry of the left ventricle (LV), the conduction system of the LV was mapped by tracing from His recording from the left ventricular outflow tract and distally till the fascicles and perifascicular myocardium. VT was induced by using programmed electrical stimulation. Ablation was done targeting the distal posterior fascicle and extended linearly to the surrounding myocardium till conduction block was achieved between the fascicle-Purkinje network and the left ventricular myocardium. All patients (13 men; mean age 32±9 years) had inducible VTs. The mean tachycardia cycle length was 320±28 ms. Radiofrequency energy was given to the distal posterior fascicle and the myocardium, with an aim to achieve a myocardial-fascicular conduction block in addition to the termination of VT and noninducibility. Ablation was successful in all. No recurrence of tachycardia was seen in any patient on follow-up (20.8±8.5 months). Distal posterior fascicle and Purkinje-myocardial junction is an effective target site for ILVT ablation. The demonstration of myocardial to fascicle conduction block serves as an important electrophysiological marker of successful ablation and improved long-term success

Modified Transseptal Puncture Technique in Challenging Septa: A Randomized Comparison to Conventional Technique

Background. Transseptal puncture (TSP) can be challenging. We compared safety and efficacy of a modified TSP technique (“mosquito” technique, MOSQ-TSP) to conventional TSP (CONV-TSP). Method. Patients undergoing AF ablation in whom first attempt of TSP did not result in left atrial (LA) pressure (failure to cross, FTC) were randomized to MOSQ-TSP (i.e., puncture of the fossa via a wafer-thin inner stylet) or CONV-TSP (i.e., additional punctures at different positions). Primary endpoint was LA access. Secondary endpoints were safety, time, fluoroscopic dose (dose-area product, DAP), and number of additional punctures from FTC to final LA access. Result. Of 384 patients, 68 had FTC (MOSQ-TSP, n=34 versus CONV-TSP, n=34). No complications were reported. In MOSQ-TSP, primary endpoint was 100% (versus 73.5%, p<0.002), median time to LA access was 72 s [from 37 to 384 s] (versus 326 s [from 75 s to 1936 s], p<0.002), mean DAP to LA access was 1778±2315 mGy/cm2 (versus 9347±10690 mGy/cm2, p<0.002), and median number of additional punctures was 2 [1 to 3] (versus 0, p<0.002). Conclusion. In AF patients in whom the first attempt of TSP fails, the “mosquito” technique allows effective, safe, and time sparing LA access. This approach might facilitate TSP in elastic, aneurysmatic, or fibrosed septa

Remote Magnetic versus Manual Navigation for Radiofrequency Ablation of Paroxysmal Atrial Fibrillation: Long-Term, Controlled Data in a Large Cohort

Purpose. We aimed to study long-term outcome after pulmonary vein isolation (PVI) guided by remote magnetic navigation (RMN) and provided comparative data to outcome after manual navigation (MAN). Methods. Three hundred thirty-six patients with symptomatic paroxysmal AF underwent PVI by irrigated point-by-point radiofrequency (RF) ablation (RMN, n=114 versus MAN, n=222). Patients were followed up with symptom guided rhythm monitoring for a period up to 43 months. The end point of the study was freedom from repeat ablation after a single procedure and without antiarrhythmic drug treatment (ADT). Results. At the end of follow-up (median 26.3 months), freedom from repeat ablation was comparable between RMN and MAN (70.9% versus 69.5%, p=0.61). At repeat, mean number of reconnected veins was 2.4 ± 1.2 in RMN versus 2.6 ± 1.0 in MAN (p=0.08). The majority of repeat procedures occurred during the first year (82.1% in RMN versus 78.5% in MAN; p=0.74). Conclusion. On the long term (up to 3 years) and in a large cohort of patients with paroxysmal AF, RMN-guided PVI is as effective as MAN guided PVI. In both strategies the majority of repeat procedures occurred during the first year after index procedure

Polymorphism in Exon-40 of FASN Gene in Lesser known Buffalo breeds of India

Present study was aimed to discover the single nucleotide variation present in exon 40 region of the Fatty Acid Synthase (FASN) gene. FASN plays a central role in de novo lipogenesis in mammals and variation in this enzyme may affect economic traits including fatty acid composition of buffalo milk. A total of 80 DNA samples in two riverine buffalo breeds namely, Gojri and Chhattisgarhi were screened using Restriction Fragment Length Polymorphism (RFLP). FASN gene was found to be polymorphic with an adenine to guanine transition. Three types of genotypes, viz. AA, AG and GG were observed in the studied breeds. Allele A was found to be more frequent than G allele. All the genotypes showed almost the same frequency across the breeds, indicating that there is absence of selection for FASN gene in lesser known buffalo breeds of India. The study will augment the information available and can be applied in future studies to determine the role of bovine FASN gene as a candidate gene marker for a milk-fat content

Diversity assessment of a lesser known buffalo population from Central India and its comparative evaluation reveals presence of sufficient genetic variation and absence of selection

Planned breeding and conservation strategies for a lesser-known population require an assessment of complete genetic diversity and population structure analysis in addition to its morphometric characteristics. In the present study, a comparative analysis of the genetic structure of a rare buffalo population, namely Chhattisgarhi, was extensively studied using a panel of FAO-recommended microsatellite markers along with well-established breeds namely Murrah, Nili-Ravi, Gojri, Kalahandi, and Nagpuri. Mode shift analysis indicated the absence of genetic bottleneck in the recent past. Assessment of genetic diversity indices across all loci indicated the presence of sufficient genetic variation within and between populations. Analysis of molecular variance between the six different buffalo populations attributed 19.05% of the variations to between-population differentiation. Cluster analyses using DAPC and Bayesian approach along with the phylogenetic tree based on UPGMA grouped six populations into three groups. The Chhattisgarhi population was revealed to be genetically closer to Nagpuri and Kalahandi populations. The study reveals the presence of sufficient genetic diversity within the Chhattisgarhi population and indicates the absence of a systematic selection program. We suggest improvement and conservation programs should be planned for this breed in the near future through short-term selection.</p