Fasciculoventricular accessory pathway: A misleading and unusual bypass tract

We present the case of a 25 year-old man referred for an electrophysiological study due to suspected pre-excitation as the cause of two recent syncopal episodes. The admission electrocardiogram (ECG) showed a borderline PR interval of 120 ms and apparently small delta waves visible in leads V2-V4. Intracardiac recordings showed a short HV interval of 18 ms that was stable despite decremental atrioventricular conduction. A fasciculoventricular accessory pathway was diagnosed. Administration of ajmaline normalized ECG and HV interval. We discuss electrocardiographical features of this rare bypass tract. (Cardiol J 2010; 17, 1: 83-87

Fasciculoventricular accessory pathway : a misleading and unusual bypass tract

We present the case of a 25 year-old man referred for an electrophysiological study due to suspected pre-excitation as the cause of two recent syncopal episodes. The admission electrocardiogram (ECG) showed a borderline PR interval of 120 ms and apparently small delta waves visible in leads V2–V4. Intracardiac recordings showed a short HV interval of 18 ms that was stable despite decremental atrioventricular conduction. A fasciculoventricular accessory pathway was diagnosed. Administration of ajmaline normalized ECG and HV interval. We discuss electrocardiographical features of this rare bypass tract

His bundle capture proximal to the site of bundle branch block : a novel pitfall of the para-Hisian pacing maneuver

The para-Hisian pacing maneuver is useful in determining whether retrograde conduction is dependent on atrioventricular (AV) nodal conduction. Loss of direct His bundle capture results in a longer route for the depolarization wave to reach the AV node and the atrium, as it has to travel through the working myocardium to engage the distal Purkinje fibers. Thus, loss of direct His bundle capture results in obligatory ventriculoatrial (VA) interval prolongation unless a nonphysiological retrograde conduction route (an accessory pathway [AP]) is present. Consequently, a stable VA interval with loss of His bundle capture is considered diagnostic of the presence of an AP. This concept has been regarded as useful, especially when concentric retrograde atrial activation is present.1 Subsequently, however, potential important pitfalls in the interpretation of this differentiating maneuver were described. These include the recognition of inadvertent atrial capture, pure His bundle capture, the presence of fasciculoventricular pathways, and the impact of retrograde dual AV nodal physiolog

Effects of Changing Drive Control Method of Idling Wood Size Reduction Machines on Fuel Consumption and Exhaust Emissions

Operating conditions often fluctuate during processing of branches and sawmill offcuts using low-power wood size reduction machines (WSRMs), mainly due to changes in wood supply frequency. This results in relatively high proportions of idling time. Fuel consumption and associated exhaust emissions of WSRMs with combustion engines can be reduced by using innovative drive unit control systems during idling. The objective of the research was to determine the effects of two speed control systems on the fuel consumption and exhaust emissions of a WSRM with a two-cylinder cutting mechanisms driven by a small 9.5 kW spark ignition engine. Speed control system A (commercially available) had a substantially higher rotational speed than system B (an innovative, adaptive solution subject to patent application No. P433586). Pine (Pinus sylvestris L.) wood sawmill offcuts (average cross-sectional area, length and water content: 25×40 mm, 3000 mm and ca. 12, respectively) were used in system tests at a feed rate of ca. 5 pieces min-1. Material of this size is typically processed by such machines. Operating conditions were monitored by recording the rotational speed and torque. Emissions of harmful exhaust compounds–carbon monoxide (CO), carbon dioxide (CO2), hydrocarbons (HC), and nitrogen oxides (NOx) – were recorded using a portable emission measurement system. Fuel consumption values were also calculated from the data. The following effects were observed: application of innovative system B resulted in 33% lower fuel consumption, as well as 30%, 37% and 33% lower CO, CO2 and NOx emissions, respectively, than system A, but at the same time 290% higher HC emissions were registered. In operating conditions with higher proportions of idling time, solution B provides even higher reductions in fuel consumption and exhaust emissions

Reply With: Proactive Recommendation of Email Attachments

Email responses often contain items-such as a file or a hyperlink to an external document-that are attached to or included inline in the body of the message. Analysis of an enterprise email corpus reveals that 35% of the time when users include these items as part of their response, the attachable item is already present in their inbox or sent folder. A modern email client can proactively retrieve relevant attachable items from the user's past emails based on the context of the current conversation, and recommend them for inclusion, to reduce the time and effort involved in composing the response. In this paper, we propose a weakly supervised learning framework for recommending attachable items to the user. As email search systems are commonly available, we constrain the recommendation task to formulating effective search queries from the context of the conversations. The query is submitted to an existing IR system to retrieve relevant items for attachment. We also present a novel strategy for generating labels from an email corpus---without the need for manual annotations---that can be used to train and evaluate the query formulation model. In addition, we describe a deep convolutional neural network that demonstrates satisfactory performance on this query formulation task when evaluated on the publicly available Avocado dataset and a proprietary dataset of internal emails obtained through an employee participation program.Comment: CIKM2017. Proceedings of the 26th ACM International Conference on Information and Knowledge Management. 201

Częstoskurcz nadkomorowy z szerokimi zespołami QRS i rozkojarzeniem przedsionkowo-komorowym — czy to możliwe?

We present a case of broad QRS complex tachycardia and atrioventricular (AV) dissociation that was documented duringelectrophysiological study to be a supraventricular rather than a ventricular tachycardia. Ablation of AV nodal slow pathwayeliminated the arrhythmia confirming the diagnosis of atypical AV nodal reentrant tachycardia

Szmer skurczowo−rozkurczowy nad sercem u chorej po urazie komunikacyjnym klatki piersiowej

A case of a 33 year-old female with continuous murmur was admitted to the hospital for diagnostic purposes. TEE was inconclusive. Coronary angiography revealed an aneurysm of left anterior descending with the fistula to the right ventricle. The patient underwent implantation of inset of left internal mammary artery graft and ligation of fistula during open heart surgery