2,078 research outputs found
Changes in the Atrial Substrate Alters the Spatiotemporal Organization and Characteristics of Atrial Fibrillation
A Superluminal Subway: The Krasnikov Tube
The ``warp drive'' metric recently presented by Alcubierre has the problem
that an observer at the center of the warp bubble is causally separated from
the outer edge of the bubble wall. Hence such an observer can neither create a
warp bubble on demand nor control one once it has been created. In addition,
such a bubble requires negative energy densities. One might hope that
elimination of the first problem might ameliorate the second as well. We
analyze and generalize a metric, originally proposed by Krasnikov for two
spacetime dimensions, which does not suffer from the first difficulty. As a
consequence, the Krasnikov metric has the interesting property that although
the time for a one-way trip to a distant star cannot be shortened, the time for
a round trip, as measured by clocks on Earth, can be made arbitrarily short. In
our four dimensional extension of this metric, a ``tube'' is constructed along
the path of an outbound spaceship, which connects the Earth and the star.
Inside the tube spacetime is flat, but the light cones are opened out so as to
allow superluminal travel in one direction. We show that, although a single
Krasnikov tube does not involve closed timelike curves, a time machine can be
constructed with a system of two non-overlapping tubes. Furthermore, it is
demonstrated that Krasnikov tubes, like warp bubbles and traversable wormholes,
also involve unphysically thin layers of negative energy density, as well as
large total negative energies, and therefore probably cannot be realized in
practice.Comment: 20 pages, LATEX, 5 eps figures, uses \eps
Ganglionated plexi as neuromodulation targets for atrial fibrillation
The autonomic nervous system plays an important role in the genesis of atrial fibrillation and is one of the candidate targets for atrial fibrillation therapy. This review focuses on the role of the autonomic nervous system in atrial fibrillation development and discusses the results of the ganglionated plexi catheter and surgical ablation in preclinical and clinical studies. The heart is innervated by the extrinsic and intrinsic autonomic nervous systems. The intrinsic autonomic nervous system consists of multiple ganglionated plexi and axons, which innervate the neighboring atrial myocardium and control their electrophysiological properties. Abnormal autonomic innervation has been observed in an animal model of atrial fibrillation and in humans. Direct recordings of autonomic nerve activity in canine models showed that atrial tachyarrhythmia episodes were invariably preceded by intrinsic cardiac autonomic nerve activity, thus supporting the importance of intrinsic cardiac autonomic nerve activity as the triggers for atrial tachyarrhythmia. Targeting ganglionated plexi with catheter ablation improves the outcomes of paroxysmal atrial fibrillation ablation in addition to pulmonary vein antrum isolation. Ablation of ganglionated plexi alone without pulmonary vein isolation is also useful in controlling paroxysmal atrial fibrillation in some patients. However, surgical ganglionated plexi ablation in patients with a large left atrium, persistent atrial fibrillation, and/or a history of prior catheter ablation does not result in additional benefits. These different outcomes suggest that ganglionated plexi ablation is effective in managing patients with paroxysmal atrial fibrillation, but its effects in patients with persistent atrial fibrillation and advanced atrial diseases might be limited
Recording sympathetic nerve activity from the skin
Sympathetic tone is important in cardiac arrhythmogenesis; however, methods to estimate sympathetic tone are either invasive or require proper sinus node function that may be abnormal in disease states. Because of the direct and extensive connections among various nerve structures, it is possible for the sympathetic nerves in the various structures to activate simultaneously. Therefore, we hypothesized that nerve activity can be recorded from the skin and it can be used to estimate the cardiac sympathetic tone. Preclinical studies in canines demonstrated that nerve activity is detectable using conventional ECG electrodes and can be used to estimate cardiac sympathetic tone. Subsequent clinical studies further supported this concept. In addition to studying the autonomic mechanisms of cardiac arrhythmia, these new methods may have broad application in studying both cardiac and non-cardiac diseases
Antiarrhythmic and proarrhythmic effects of subcutaneous nerve stimulation in ambulatory dogs
Background
High output subcutaneous nerve stimulation (ScNS) remodels the stellate ganglia and suppresses cardiac arrhythmia.
Objective
To test the hypothesis that long duration low output ScNS causes cardiac nerve sprouting, increases plasma norepinephrine concentration and the durations of paroxysmal atrial tachycardia (PAT) in ambulatory dogs.
Methods
We prospectively randomized 22 dogs (11 males and 11 females) into 5 different output groups for 2 months of ScNS: 0 mA (sham) (N=6), 0.25 mA (N=4), 1.5 mA (N=4), 2.5 mA (N=4) and 3.5 mA (N=4).
Results
As compared with baseline, the changes of the durations of PAT episodes per 48 hours were significantly different among different groups (sham, -5.0±9.5 s; 0.25 mA 95.5±71.0 s; 1.5 mA, -99.3±39.6 s; 2.5 mA, -155.3±87.8 s and 3.5 mA, -76.3±44.8 s, p<0.001). The 3.5 mA group had greater reduction of sinus heart rate than the sham group (-29.8±15.0 bpm vs -14.5±3.0 bpm, p=0.038). Immunohistochemical studies showed that the 0.25 mA group had a significantly increased while 2.5 mA and 3.5 mA stimulation had a significantly reduced growth-associated protein 43 nerve densities in both atria and ventricles. The plasma Norepinephrine concentrations in 0.25 mA group was 5063.0±4366.0 pg/ml, which was significantly higher than other groups of dogs (739.3±946.3, p=0.009). There were no significant differences in the effects of simulation between males and females.
Conclusions
In ambulatory dogs, low output ScNS causes cardiac nerve sprouting, increases plasma norepinephrine concentration and the duration of PAT episodes while high output ScNS is antiarrhythmic
Spatially Averaged Quantum Inequalities Do Not Exist in Four-Dimensional Spacetime
We construct a particular class of quantum states for a massless, minimally
coupled free scalar field which are of the form of a superposition of the
vacuum and multi-mode two-particle states. These states can exhibit local
negative energy densities. Furthermore, they can produce an arbitrarily large
amount of negative energy in a given region of space at a fixed time. This
class of states thus provides an explicit counterexample to the existence of a
spatially averaged quantum inequality in four-dimensional spacetime.Comment: 13 pages, 1 figure, minor corrections and added comment
Sexâspecific activation of SK current by isoproterenol facilitates action potential triangulation and arrhythmogenesis in rabbit ventricles
Sex has a large influence on cardiac electrophysiological properties. Whether sex differences exist in apaminâsensitive small conductance Ca2+âactivated K+ (SK) current (IKAS) remains unknown. We performed optical mapping, transmembrane potential, patch clamp, western blot and immunostaining in 62 normal rabbit ventricles, including 32 females and 30 males. IKAS blockade by apamin only minimally prolonged action potential (AP) duration (APD) in the basal condition for both sexes, but significantly prolonged APD in the presence of isoproterenol in females. Apamin prolonged APD at the level of 25% repolarization (APD25) more prominently than APD at the level of 80% repolarization (APD80), consequently reversing isoproterenolâinduced AP triangulation in females. In comparison, apamin prolonged APD to a significantly lesser extent in males and failed to restore the AP plateau during isoproterenol infusion. IKAS in males did not respond to the Lâtype calcium current agonist BayK8644, but was amplified by the casein kinase 2 (CK2) inhibitor 4,5,6,7âtetrabromobenzotriazole. In addition, wholeâcell outward IKAS densities in ventricular cardiomyocytes were significantly larger in females than in males. SK channel subtype 2 (SK2) protein expression was higher and the CK2/SK2 ratio was lower in females than in males. IKAS activation in females induced negative intracellular Ca2+âvoltage coupling, promoted electromechanically discordant phase 2 repolarization alternans and facilitated ventricular fibrillation (VF). Apamin eliminated the negative Ca2+âvoltage coupling, attenuated alternans and reduced VF inducibility, phase singularities and dominant frequencies in females, but not in males. We conclude that ÎČâadrenergic stimulation activates ventricular IKAS in females to a much greater extent than in males. IKAS activation plays an important role in ventricular arrhythmogenesis in females during sympathetic stimulation
A note on entropic uncertainty relations of position and momentum
We consider two entropic uncertainty relations of position and momentum
recently discussed in literature. By a suitable rescaling of one of them, we
obtain a smooth interpolation of both for high-resolution and low-resolution
measurements respectively. Because our interpolation has never been mentioned
in literature before, we propose it as a candidate for an improved entropic
uncertainty relation of position and momentum. Up to now, the author has
neither been able to falsify nor prove the new inequality. In our opinion it is
a challenge to do either one.Comment: 2 pages, 2 figures, 2 references adde
The effects of remodeling with heart failure on mode of initiation of ventricular fibrillation and its spatiotemporal organization
Purpose
The effect of the heart failure substrate on the initiation of ventricular fibrillation (VF) and its resulting mechanism is not known. The objective of this study was to determine the effects of substrate on VF initiation and its spatiotemporal organization in the heart failure model.
Methods
Optical action potentials were recorded from LV wedge preparations either from structurally normal hearts (control, nâ=â11) or from congestive heart failure (CHF; nâ=â7), at the epicardial surface, endocardial surface which included a papillary muscle, and a transmural cross section. Action potential duration (APD80) was determined, and VF was initiated. A fast Fourier transform was calculated, and the dominant frequency (DF) was determined.
Results
The CHF group showed increased VF vulnerability (69 vs 26 %, pâ<â0.03), and every mapped surface showed an APD80 gradient which included islands of higher APDs on the transmural surface (M cells) which was not observed in controls. VF in the CHF group was characterized by stable, discrete, high-DF areas that correlated to either foci or spiral waves located on the transmural surface at the site of the papillary muscle. Overall, the top 10 % of DFs correlated to an APD of 101 ms while the bottom 10 % of DFs correlated to an APD of 126 ms (pâ<â0.01).
Conclusions
In the CHF model, APD gradients correlated with an increased vulnerability to VF, and the highest stable DFs were located on the transmural surface which was not seen in controls. This indicates that the CHF substrate creates unique APD and DF characteristics
Quantum Inequalities and Singular Energy Densities
There has been much recent work on quantum inequalities to constrain negative
energy. These are uncertainty principle-type restrictions on the magnitude and
duration of negative energy densities or fluxes. We consider several examples
of apparent failures of the quantum inequalities, which involve passage of an
observer through regions where the negative energy density becomes singular. We
argue that this type of situation requires one to formulate quantum
inequalities using sampling functions with compact support. We discuss such
inequalities, and argue that they remain valid even in the presence of singular
energy densities.Comment: 18 pages, LaTex, 2 figures, uses eps
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