bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Right Ventricular Pacing Site from the Perspective of QRS Duration, Heart Function and the Configuration of 12‐lead Electrocardiogram
Authors: Noro Mahito , Kujime Shingo , Ito Naoshi , Enomoto Yoshinari , Moriyama Akiyoshi , Nakae Takeshi , Numata Ayaka , Sakai Tuyoshi , Tezuka Naoki , Sakata Takao , Sugi Kaoru
Published: August 2012

Introduction: It has become clear that the onset of heart failure is closely linked to right apex pacing, which lengthens the QRS duration and evokes discoordinate contraction of the left ventricle (LV). Currently, it is thought that the site inducing the shortest QRS duration is optimal for pacing.

Objectives: The purpose of this study was to ascertain the pacing site inducing the shortest QRS duration and to examine the configuration of the 12‐lead electrocardiogram and heart function while pacing at this site.

Methods: Nine patients with normal heart function were enrolled. Pacing at right ventricular outflow, mid‐interventricular septum (MS), and right ventricular apex was performed. QRS duration was measured and the configuration of the 12‐lead electrocardiogram changed by pacing was studied. Output and LV dp/dt were calculated at each pacing site.

Results: QRS duration became shorter with MS pacing and the pacing lead situated at the periphery of the coronary sinus and turned in a posterior direction. The configuration of the 12‐lead electrocardiogram showed an Rs or rS pattern with II, III, and aVF leads. Output and LV dp/dt showed a tendency to increase with MS pacing.

Conclusion: It is thought that mid‐interventricular septum pacing shortens the QRS duration.
Prevalence and QT Interval of Early Repolarization in a Hospital‐based Population
Authors: Hayashi Hideki , Miyamoto Akashi , Ishida Katsuya , Yoshino Tomohide , Sugimoto Yoshihisa , Ito Makoto , Horie Minoru
Published: August 2012

Background: Early repolarization, which was regarded as benign, has recently been associated with malignant arrhythmia. Despite the newly emerged importance of early repolarization, little is known about prevalence and QT interval of early repolarization. Methods: Early repolarization (defined as an elevation at the junction between QRS complex and ST segment ≥ 0.1 mV in at least 2 leads) was assessed in database containing 308,391 ECGs consisting of 102,065 patients (52,779 males and 49,286 females).

Results: A total of 1,775 patients (mean age, 49 ± 30 years) with early repolarization were chosen (1.7% of total population). The prevalence of early repolarization was about 11‐times higher in male patients (n = 1,623) than in female patients (n = 152). The prevalence of early repolarization was 1.4% at the age of 0‐9 years, peaked (5.0%) at the age of 10‐19 years, and progressively decreased with advancing age from 20 to 79 years (3.3, 2.1, 1.6, 0.9, 0.5, and 0.3% at the age of 20‐29, 30‐39, 40‐49, 50‐59, 60‐69, and 70‐79 years, respectively). Bazett's QTc interval of patients with early repolarization did not significantly differ among groups of each decade and between genders.

Conclusion: The prevalence of early repolarization was both age‐ and gender‐dependent in a hospital‐based population. Yet, there was no association between QTc interval and age and between QTc interval and gender.
Catheter Ablation for Electrical Storm as Polymorphic Ventricular Tachycardia in a Case with Ischemic Cardiomyopathy after Coronary Artery Bypass Graft
Authors: Yoshiga Yasuhiro , Shimizu Akihiko , Suzuki Shinsuke , Sugi Naoki , Omiya Toshihide , Ono Makoto , Yoshida Masaaki , Matsuzaki Masunori
Published: August 2012

We report a case involving a patient with ischemic cardiomyopathy who developed polymorphic ventricular tachycardia (PVT) and ventricular fibrillation storm after coronary artery bypass graft. Because PVT was initiated by various right bundle branch type premature ventricular contractions (PVCs), we assessed the relatively monomorphic ventricular tachycardia (MVT) during PVT. Electroanatomical mapping revealed that the earliest ventricular activation of the MVT was located in the scar border zone at the posterior septum of the left ventricle. Stable potentials which preceded the MVT were observed. Catheter ablation for the preceding potential suppressed the maintenance of the PVT, although triggered PVCs appeared frequently. Catheter ablation was effective as a bailout therapy in a patient with PVT‐induced cardiomyopathy after cardiac operation.
The Importance of the Spatial Relationship between the Position of the Non‐contact Mapping Balloon Array and the Arrhythmogenic Target Sites for Successful Catheter Ablation
Authors: Aoyagi Hideshi , Okishige Kaoru , Sugiyama Koji , Maeda Minetaka , Kurabayashi Manabu , Shimura Tsukasa , Ueshima Daisuke , Yoshimura Koujirou , Azegami Koji
Published: August 2012

Back ground: Three‐dimensional mapping systems such as the non‐contact mapping system (EnSite) have been utilized for radiofrequency catheter ablation (RFCA) in cases with various kinds of arrhythmias.

Methods: An EnSite system was utilized for RFCA in 12 patients with right‐sided atrial tachycardia (AT). The patients were classified into two groups according to the focus of the AT in the right atrium (RA). The patients in whom the EnSite array was positioned near the focus of the AT were defined as group A, whereas those patients in whom the EnSite array was located less near the focus were defined as group B. RF energy was applied under the guidance of the mapping with the EnSite array. We investigated the relationship between the position of the EnSite array and the focus of the AT in terms of the mapping accuracy in both groups.

Results: Even though the accuracy of the mapping of the breakout site and arrhythmia origin was comparable between groups A and B, the distance between the successful CA sites and the presumed AT focus according to the EnSite mapping was significantly shorter in group A than group B.

Conclusions: As the location of the focus of the AT becomes closer to the proximal and distal ends of the ESB, the mapping accuracy deteriorates.
Preventive Effect of Amiodarone on VT/VF Events in ICD Patients with Structural Heart Diseases
Authors: Kiryu Michiro , Niwano Shinichi , Kishihara Jun , Aoyama Yuya , Ishikawa Shoko , Murakami Masami , Kurokawa Sayaka , Yumoto Yoshihiro , Imaki Ryuta , Fukaya Hidehira , Niwano Hiroe , Izumi Tohru
Published: August 2012

Background: Although amiodarone (AMD) is applied for implantable cardioverterdefibrillator (ICD) patients to reduce VT/VF events, its actual benefit and long‐term efficacy are unclear. In the present study, we retrospectively evaluated the incidence of VT/VF events in ICD patients with and without AMD.

Methods and results: The study population consisted of 77 consecutive patients with ICD therapy and structural heart diseases. They were followed up for 24 ± 3 months, and the incidences of VT/VF events or hospitalization were evaluated. When they were divided into two groups with and without VT/VF events (42:35), univariate analysis indicated a higher incidence of cardiomyopathy as the basic disease, VT as the initial arrhythmic diagnosis, higher levels of total bilirubin, and a lower incidence of AMD use in patients with VT/VF events. When they were divided by AMD use (24/53), VT/VF events were observed in 8/24 in patients with AMD (33.3%) and 34/53 without AMD (64.2%, p = 0:012). In sub‐group analysis based on left ventricular ejection function (LVEF), the VT/VF event rate was lower in the AMD group in patients with LVEF < 40% (p = 0:007).

Conclusions: AMD was considered to reduce VT/VF events in ICD patients, especially in the population with structural heart disease and lower LVEF.
Comparison of the Effects of Na+ and K+ Channel Blockers on the Electrophysiological Properties of the Pulmonary Veins in Patients with Atrial Fibrillation
Authors: Yasuda Tomoo , Kumagai Koichiro , Ogawa Masahiro , Nakashima Hideko , Zhang Bo , Miura Shin‐ichiro , Saku Keijiro
Published: August 2012

Introduction: We assessed the effects of pilsicainide, a pure Na+ channel blocker, and nifekalant, a pure rapid delayed rectifier potassium current (IKr) blocker, on the electrophysiological characteristics within the pulmonary vein (PV) and at the PV‐left atrial (LA) junction.

Methods and Results: We used a basket catheter for PV mapping in 38 patients with paroxysmal atrial fibrillation (AF). Programmed stimulation was performed in the distal PV and PV‐LA junction before and after the infusion of pilsicainide (1 mg/kg; n = 24) or nifekalant (0.3 mg/kg; n = 14). Both drugs significantly prolonged the effective refractory period (ERP) of the distal PV and PV‐LA junction. Pilsicainide significantly decreased the ERP heterogeneity of the PV and PV‐LA junction (36 ± 43 vs. 9 ± 60 ms, P < 0:05). In contrast, nifekalant significantly increased the ERP heterogeneity of the PV and PV‐LA junction (from 38 ± 34 to 60 ± 46 ms, P < 0:01). Pilsicainide significantly prolonged the conduction time (S1‐A1) from the distal PV to the PV‐LA junction (from 42 ± 12 to 63 ± 26 ms, P < 0:001), whereas this did not change with nifekalant.

Conclusions: In AF patients, pilsicainide has antiarrhythmic effects mainly on the distal PV by modifying the ERP and conduction properties. In contrast, nifekalant has antiarrhythmic effects mainly on the PV‐LA junction by modifying the ERP.
Effect of Cigarette Smoking on the Risk of Atrial Fibrillation Recurrence after Pulmonary Vein Isolation
Authors: Fukamizu Seiji , Sakurada Harumizu , Takano Makoto , Hojo Rintarou , Nakai Mori , Yuba Takao , Komiyama Kota , Tatsumoto Akiko , Maeno Kenichi , Mizusawa Yuka , Tanabe Yasuhiro , Suzuki Makoto , Tejima Tamotsu , Nishizaki Mitsuhiro , Kobayashi Youichi , Hiraoka Masayasu
Published: August 2012

Introduction: Previous studies have shown that atrial fibrillation (AF) recurrence after pulmonary vein (PV) isolation depends on various factors; however, the effect of cigarette smoking on AF recurrence after PV isolation has not been investigated.

Methods and Results: Fifty‐nine consecutive patients with drug‐refractory AF (48 men and 11 women, mean age: 60 ± 11 years) who underwent PV isolation were included. The patients were divided into two groups: the non‐smoker group, i.e., “never smokers (n = 29),” and the smoker group consisting of 30 patients who were either “former smokers (n = 15)” or “current smokers (n = 15)”. The diameter of all four PVs and the left atrial volume tended to be larger in the smoker group. During the mean follow‐up period of 306 ± 95 days, the AF recurrence rate was higher in the smoker group than in the non‐smoker group (43% vs. 14%, p < 0.05). The relative risk of AF recurrence associated with smoking was 3.19 (95% CI 1.23 to 8.27, p = 0.017). The AF recurrence rate was increased in both current smokers (40%) and former smokers (47%) compared to never smokers (14%).

Conclusions: AF recurrence after PV isolation was significantly higher in the smoking patients. The substrate of AF may be worsened by exposure to cigarette smoking.
Short‐term Venous Patency after Implantation of Permanent Pacemakers or Implantable Cardioverter Defibrillators
Authors: Nakae Takeshi , Enjoji Yoshihisa , Noro Mahito , Sugi Kaoru
Published: August 2012

There is little information on venous patency after pacing leads are inserted in veins during pacemaker or implantable cardioverter defibrillator (ICD) implantation. Herein we present a report on venous patency during the immediate postoperative period after permanent pacemaker or ICD implantation.

Subjects and Methods: Twenty‐five patients underwent a permanent pacemaker or ICD implantation by venous puncture method, and venography was performed 1 week later. We assessed the pacemaker‐implantation side, approach used, implanted device, number of implanted leads, and clinical symptoms.

Results: Narrowing of the vein was found in 14 patients (56%), including 7 patients (28%) with occlusion. Stenosis and occlusion were seen more in patients with left‐sided implantation than those with right‐sided implantation (71% vs. 25%, P < 0.05). ICD implantation was more frequently associated with venous stenosis or occlusion than pacemaker implantation (65% vs. 37.5%, P < 0.05). The approach used and the number of leads implanted did not correlate with venous stenosis or occlusion. Six of the 7 patients who developed complete occlusion showed clinical symptoms.

Conclusion: Thrombus formation after pacemaker implantation can occur in the acute stage within 1 week. The incidence of venous stenosis or thrombus formation was higher with leftsided implantation and ICD.
Catheter Ablation of a Complex Atrial Tachycardia after Surgical Repair of Tetralogy of Fallot Guided by Combined Noncontact and Contact Mapping
Authors: Fujii Eitaro , Senga Michiharu , Sugiura Shinya , Yamazato Shoichiro , Nakanura Mashio , Ito Masaaki
Published: August 2012

A 34‐year‐old man with a surgically repaired Tetralogy of Fallot complained of palpitation, fatigue, and presyncope. A 12‐lead ECG showed atrial tachycardia with a cycle length of 250 ms and a P wave morphology positive in leads II, III and aVF, and negative in lead V1. Although the EnSite system (version 6.OJ) made use of noncontact mapping to delineate the counterclockwise reentry around the crista tenninalis, it was difficult to rule out the incisional atrial reentry because the location of the surgical incision was far from the multi‐electrode array. Since the bipolar contact mapping of the EnSite system revealed the location of the atriotomy incision, entrainment mapping during the tachycardia demonstrated the critical reentry circuit around the crista terminalis. Radiofrequency ablation targeting the critical isthmus from the lower position of the crista terminalis to the posterior dense scar which was continuous with the inferior vena cava, and to the atriotomy scar, eliminated the tachycardia.
A Case of Adenosine Sensitive Atrial Tachycardia Originating from the His‐Bundle Region Successfully Ablated from the Non‐coronary Aortic Cusp
Authors: Yamashita Seigo , Yamane Teiichi , Matsuo Seiichiro , Ito Keiichi , Narui Ryohsuke , Hioki Mika , Nakane Tokiko , Tokuda Michifumi , Aramaki Yasuko , Inada Keiichi , Shibayama Kenri , Miyanaga Satoru , Yoshida Hiroshi , Date Taro , Miyazaki Hidekazu , Abe Kunihiko , Sugimoto Ken‐ichi , Yoshimura Michihiro
Published: August 2012

The case of a patient with narrow QRS tachycardia is herein presented. During an electrophysiological study, this tachycardia was diagnosed as a focal atrial tachycardia with a high sensitivity to adenosine‐5′‐triphosphate (2 mg), and originating from near the His‐bundle region. We could not ablate the earliest activation site in the right atrium because of the simultaneous recording of the His potential. The radiofrequency applications in the right atrium around the earliest activation site failed to terminate the tachycardia. Subsequent attempt of radiofrequency application in the non‐coronary aortic cusp, where the earliest atrial activation without His potential was obtained, successfully eliminated the tachycardia without any atrioventricular nodal injury.
Sick Sinus Syndrome After a Single Oral Administration of Garenoxacin
Authors: Sugiyama Chiyo , Kojima Yoshinobu , Hashimoto Yasumasa , Morishita Kentaro , Sato Hironobu , Kumada Hirokazu , Morita Norihiko
Published: August 2012

This report presents the case of a 60‐year‐old female who demonstrated sick sinus syndrome after a single administration of Garenoxacin (GRNX). She was administered GRNX for an upper respiratory infection and 10 minutes thereafter, she suddenly felt palpitation and numbness of both arms. She was transferred to the hospital 2 hours after taking GRNX. An electrocardiogram showed bradycardia with junctional escape beats and the longest sinus arrest was 4 seconds. She was treated with a temporary pacemaker and 21 hours after the administration of GRNX her sinus node function was observed to have completely improved. GRNX‐induced sick sinus syndrome was suspected because her clinical course was compatible with the concentration of GRNX and her other cardiological assessments, including an electrophysiologic study (EPS) which were conducted on the 9th day of the admission, were normal. GRNX has less effect on the QT interval than other quinolone agents. However, physicians should be aware of the risk of sick sinus syndrome because GRNX is frequently prescribed in outpatient clinics.
Purkinje‐related Arrhythmias
Authors: Nogami Akihiko
Published: August 2012

The Purkinje system has been found to be responsible for the mechanism of some ventricular tachyarrhythmias. These ventricular tachyarrhythmias can be called Purkinjerelated arrhythmias, and are manifested as monomorphic ventricular tachycardia (VT) and polymorphic VT, including ventricular fibrillation (VF). In monomorphic VTs, 4 distinct tachycardias have been found to be related to the Purkinje system: (1) verapamil‐sensitive left fascicular VT, (2) Purkinje fiber‐mediated VT post infarction, (3) bundle branch reentry (BBR) and interfascicular reentry VTs, and (4) focal Purkinje VT. In polymorphic VT and VF, the Purkinje system may also play an important role. The Purkinje network plays a pivotal role in both the initiation and perpetuation of VF. A triggering ventricular premature beat could arise from either the right or left Purkinje system, and the catheter ablation of the trigger results in a very high cure rate for VF. In patients with an electrical storm, catheter ablation of the triggering VPBs from the Purkinje system should be used as an electrical bailout therapy.
Three Dimensional Electroanatomical Mapping of Lower Loop Reentry in Patients with Intracardiac Operation
Authors: Kawata Hiro , Suyama Kazuhiro , Yokoawa Miki , Yamagata Kenichiro , Yokoyama Teruki , Makimoto Hisaki , Doi Atsushi , Yamada Yuko , Okamura Hideo , Noda Takashi , Satomi Kazuhiro , Shimizu Wataru , Aihara Naohiko , Kamakura Shiro
Published: August 2012

Introduction: The aim of this study was to clarify the characteristics of lower loop reentry (LLR. in patients who underwent cardiac surgery.

Methods: Of 194 patients from 2000 to 2007 with negative flutter waves in the inferior leads (II, III, and aVf), 4 patients had LLR and reentrant circuits identified by a 3D activation sequence mapping system. We studied the characteristics of the surface electrocardiogram (ECG. patterns of those LLRs.

Results: All 4 patients had a history of an intracardiac operation. The 3D activation sequence mapping system during the LLR exhibited a clockwise (CW. wavefront around the inferior vena cava (IVC. from the caudal view. During the LLR, the right atrium (RA. free wall was activated in a caudal‐cranial sequence and a collision of two activation wavefronts from the lower RA and upper RA occurred at the RA free wall.

Conclusions: The 3D activation mapping during the AT revealed an activation wavefront propagating around the IVC and the diagnosis of LLR. Detailed 3D electroanatomical mapping and pacing study are needed to identify the reentrant circuit of LLR in patients with previous intracardiac surgery.
Safety and Efficacy of Low‐Dose Continuous Infusion of Landiolol, an Ultra‐Short‐Acting β‐blocker, in Cardiac Surgery
Authors: Sato Manabu , Suenaga Etsuro , Fumoto Hideyuki , Kawasaki Hiromitsu , Koga Shugo , Maki Fumie
Published: August 2012

Introduction: Landiolol hydrochloride is an ultra‐short‐acting β‐blocker that is administered intravenously and has many advantages in cardiac surgery. This study was performed to examine the safety and efficacy of low‐dose landiolol continuous infusion in cardiac surgery.

Methods and Results: Nineteen patients who underwent either aortic valve replacement or coronary artery bypass surgery received low‐dose continuous infusion of landiolol (2.8 ± 0.75 μg/kg/min. from the time of skin incision until the second postoperative day. Nineteen patients who did not receive landiolol served as controls. Heart rate, arterial pressure, cardiac index, and stroke volume were measured and the occurrence of supraventricular tachyarrythmia was monitored for one week after surgery. Landiolol decreased the heart rate without causing hemodynamic deterioration. The incidence of supraventricular tachyarrythmia was 32% and 47% in the landiolol and control groups, respectively (P = 0.50).

Conclusions: Landiolol is effective for decreasing heart rate while maintaining other hemodynamic parameters. Our data did not show a clear prophylactic effect of landiolol on postoperative supraventricular tachyarrythmia.
Success in Avoiding Reoperation through Follow‐up in a Case of Sick Sinus Syndrome Despite Transient Marked Elevation in Atrial Threshold
Authors: Sasaoka Shunsuke , Muramatsu Toshiya , Sakai Tsuyoshi
Published: August 2012

The patient was a 43‐year‐old male whose chief complaint was syncope. Electrocardiography at the first visit revealed escaped rhythm (38 bpm). After hospitalization he developed reverse common atrial flutter (AFL) and underwent catheter ablation. After termination of atrial flutter by ablation, sinus arrest was noted, allowing a diagnosis of bradycardia‐tachycardia syndrome, for which the patient underwent pacemaker implantation.

Twenty days after implantation, a marked elevation of atrial threshold was noted, despite absence of a change in lead resistance or position, and atrial capturing was not possible even at the maximum output (8 V/ 1.2 ms). The cause remained unknown and the patient was followed without active intervention. Atrial threshold normalized during the follow‐up, but no change was noted in lead resistance or position even at the time of normalization.
A Case of Loss of Consciousness due to Epilepsy Diagnosed Using an Implantable Loop Recorder
Authors: Betsuyaku Tetsuo , Sato Minoru , Sugiyama Eitaro , Muto Harutatsu , Minoshima Akiho , Tamada Atsushi , Fujita Masaaki , Inoue Hitoki , Teranishi Jun‐ichi , Takenaka Takashi , Okamoto Hiroshi
Published: August 2012

We report a case of clonic‐tonic seizures diagnosed using an implantable loop recorder, a device for detecting cardiac arrhythmias. A 65‐year‐old man was referred to our hospital for loss of consciousness with myotonic jerks during sleep. He had experienced several similar episodes. No family history of sudden death was evident, and no structural heart disease was present. Coronary angiography with intracoronary acetylcholine (ACh) showed neither organic stenosis nor vasospastic angina. Ventricular tachyarrhythmias were not induced by programmed electrical stimuli. Sleep electroencephalography, brain magnetic resonance imaging and magnetic resonance angiography revealed no specific findings. We implanted a loop recorder to monitor rhythm abnormalities. One month later, an attack occurred at night. His wife recognized the episode and activated the implantable loop recorder. No arrhythmia was recorded, but myopotentials characteristic of tonic‐clonic seizures were detected.
Comparison of Automatic and Manual Threshold Testing in Patients with Permanent Pacemakers: Results from COMET Study
Authors: Ando Kenji , Miura Fumiharu , Masani Fumiaki , Kakugawa Hiroyuki , Tejima Tomoyuki , Doi Kentaro
Published: August 2012

Background: Automaticity of cardiac devices is designed to reduce the burden on physicians while securing patient safety. The aim of this study is to elucidate accuracy of automatic adjustment algorithm of pacing output and effectiveness of this feature for time reduction during clinic visits.

Methods and Results: Patients implanted with pacemakers capable of automatically adjusting the pacing output were enrolled. During their routine device follow‐ups, pacing thresholds were compared between manual measurements and most recently recorded data in the device, which had been measured automatically at prespecified timing. Difference betwee n −0.25 and 0.5 volts were predefined as equivalent. Time required for conventional follow‐up was also compared to device interrogation and data assessment. A total of 359 patients from 32 centers were enrolled. Calculated 95% confidence interval of difference in volts for atrium was (−0.0625, 0) and the difference for ventricle was nonsignificant. These results met the equivalence criteria. Observed time to interrogate and assess device‐stored pacing threshold was shorter by average of 3.3 minutes compared to manual method.

Conclusions: The pacing threshold determined by the automatic measurement algorithm was accurate. Follow‐up time was shorter when utilizing automaticity of pacemakers. The system is safe and time efficient.
Carvedilol, a Non‐Selective β‐with α1‐Blocker is Effective in Long QT Syndrome Type 2
Authors: Kimura Hiromi , Mizusawa Yuka , Itoh Hideki , Miyamoto Akashi , Kawamura Mihoko , Kawaguchi Tamiro , Naiki Nobu , Oka Yuko , Ohno Seiko , Makiyama Takeru , Ito Makoto , Horie Minoru
Published: August 2012

Background: β‐blockers offer the first line therapy in congenital long QT syndrome (LQTS), and are more effective to prevent the cardiac event in LQTS type 1 than in type 2 or 3. In contrast, left cardiac sympathetic denervation (LCS D) was shown to be highly effective in patients refractory to β‐blockers. Total sympathetic ablation by LCSD indicates the addititional involvement of α‐adr enoceptor‐mediated pathway. In genotyped LQT2 patients, we therefore hypothesized that blockade of α‐adrenoceptor in addition to α‐adrenoceptor by carvedilol could reduce cardiac events more efficiently than other types of β‐blockers.

Methods and Results: The study population consisted of 51 genotyped LQT2 patients (18 males, 23 ± 11years old). They were divided into 2 groups (group 1: 43 patients treated with selective β‐blockers, group 2: 8 patients with carvedilol) and retrospectively analyzed the efficacy of the respective β‐blocker therapy in suppressing cardiac events. Cardiac events were observed in 11 patients of group 1 (26%) but none in group 2 during a follow‐up period of 83 ± 80 months (P = 0.098).

Conclusions: Carvedilol may be a potentially beneficial therapy for genotyped LQT2 patients who are refractory to other β selective blockers.
Reel Syndrome: A Variant Form of Twiddler's Syndrome
Authors: Munawar Muhammad , Munawar Dian L. , Basalamah Faris , Pambudi Jimmy
Published: August 2012

Reel syndrome is a variant form of twiddler's syndrome. We describe a 53 years old woman who was referred to our hospital because of symptomatic sinus bradycardia. Subsequently she underwent dual chamber pacemaker implantation and was sent back to the previous hospital on the following day. She was referred again because of sudden syncope due to low heart rate 2 weeks following implantation. Chest X‐ray revealed leads had pulled out of the heart and coiled up around the pacemaker generator; a diagnosis of reel syndrome was made. The difference between the two syndromes, risk factors and preventive measures were discussed.
Ventricular Pacing via the Coronary Sinus in a Patient with a Mechanical Tricuspid Valve Prosthesis
Authors: Swampillai Janice , Heald Spencer C. , Devlin Gerard P. , Stiles Martin K.
Published: August 2012

Implantation of a transvenous endocardial pacing lead in the right ventricle is contra‐indicated after mechanical tricuspid valve replacement; therefore a surgical approach to the epicardium is usually required. This case report describes ventricular pacing via a branch of the coronary sinus in a patient with mechanical mitral, aortic and tricuspid valve replacements. In conclusion, this approach is minimally invasive, provides effective ventricular stimulation with low pacing threshold and stable lead position, and is a feasible option when transvenous right ventricular pacing is not possible.
Collision modelling for the interface-resolved simulation of spherical particles in viscous fluids
Authors: Kempe Tobias , Fröhlich Jochen
Published: August 2012

The paper presents a model for particle–particle and particle–wall collisions during interface-resolving numerical simulations of particle-laden flows. The accurate modelling of collisions in this framework is challenging due to methodological problems generated by interface approach and contact as well as due to the greatly different time scales involved. To cope with this situation, multiscale modelling approaches are introduced avoiding excessive local grid refinement during surface approach and time step reduction during the surface contact. A new adaptive model for the normal forces in the phase of ‘dry contact’ is proposed, stretching the collision process in time to match the time step of the fluid solver. This yields a physically sound and robust collision model with modified stiffness and damping determined by an optimization scheme. Furthermore, the model is supplemented with a new approach for modelling the tangential force during oblique collisions which is based on two material parameters: a critical impact angle separating rolling from sliding and the friction coefficient for the sliding motion. The resulting new model is termed the adaptive collision model (ACM). All proposed sub-models only contain physical parameters, and virtually no numerical parameters requiring adjustment or tuning. The new model is implemented in the framework of an immersed boundary method but is applicable with any spatial and temporal discretization. Detailed validation against experimental data was performed so that a general and versatile model for arbitrary collisions of spherical particles in viscous fluids is now available.
Bubble breakup simulation in nozzle flows
Authors: Ivashnyov Oleg E. , Ivashneva Marina N.
Published: August 2012

Experiments on high-pressure vessel decompression have shown that vaporization occurs in ‘boiling shocks’ moving with a velocity of ${\ensuremath{\sim} }10~\mathrm{m} ~{\mathrm{s} }^{\ensuremath{-} 1} $. To explain this phenomenon, a model accounting for bubble breakup was suggested (Ivashnyov, Ivashneva & Smirnov, J. Fluid. Mech., vol. 413, 2000, pp. 149–180). It was shown that the explosive boiling was caused by chain bubble fragmentation, which led to a sharp increase in the interface area and instantaneous transformation of the mixture into an equilibrium state. In the present study, this model is used to simulate nozzle flows with no change in the free parameters chosen earlier for modelling a tube decompression. It is shown that an advanced model ensures the best correspondence to experiments for flashing flows in comparison with an equilibrium model and with a model of boiling at a constant number of centres. It is also shown that the formation of a boiling shock in a critical nozzle flow leads to autovibrations.
The effect of yellow pea protein and fibre on short-term food intake, subjective appetite and glycaemic response in healthy young men
Authors: Smith Christopher E. , Mollard Rebecca C. , Luhovyy Bohdan L. , Anderson G. Harvey
Published: August 2012

Pulses are low-glycaemic foods rich in protein (20–25 %), resistant starch and fibre that suppress appetite and glycaemia. The objective of the present study was to elucidate the component(s) of yellow peas responsible for these benefits and assess their efficacy as value-added food ingredients. We investigated the effects of 10 or 20 g of isolated yellow pea protein (P10 and P20) or fibre (F10 and F20) on food intake (FI) at an ad libitum pizza meal served at 30 min (Expt 1, n 19) or 120 min (Expt 2, n 20) and blood glucose (BG) and appetite in young, healthy males (20–30 years). In Expt 1, P20 led to lower FI than control (4937 (sem 502) v. 5632 (sem 464) kJ (1180 (sem 120) v. 1346 (sem 111) kcal)) and all other treatments (P < 0·01) and lower cumulative FI (pizza meal kcal+treatment kcal; CFI) compared to F10 (5460 (sem 498) v. 6084 (sem 452) kJ (1305 (sem 119) v. 1454 (sem 108) kcal); P = 0·033). Both protein treatments suppressed mean pre-meal (0–30 min) BG compared to control (P < 0·05), whereas only P20 suppressed mean post-meal (50–120 min) BG (P < 0·01). There was no effect of treatment on pre-meal or post-meal appetite. In Expt 2, there was no effect of treatment on FI, CFI, or pre- or post-meal BG or appetite. In conclusion, protein is the component responsible for the short-term effects of yellow peas in the regulation of glycaemia and FI, but its second-meal effects disappear by 2 h post-consumption.
Regular consumption of pulses for 8 weeks reduces metabolic syndrome risk factors in overweight and obese adults
Authors: Mollard R. C. , Luhovyy B. L. , Panahi S. , Nunez M. , Hanley A. , Anderson G. H.
Published: August 2012

Pulses are low in energy density, supporting their inclusion in the diet for the management of risk factors of the metabolic syndrome (MetSyn). The aim of the present study was to describe the effects of frequent consumption (five cups/week over 8 weeks) of pulses (yellow peas, chickpeas, navy beans and lentils), compared with counselling to reduce energy intake by 2093 kJ/d (500 kcal/d), on risk factors of the MetSyn in two groups (nineteen and twenty-one subjects, respectively) of overweight or obese (mean BMI 32·8 kg/m2) adults. Body weight, waist circumference, blood pressure, fasting blood parameters and 24 h food intakes were measured at weeks 1, 4 and 8. Blood glucose, insulin, C-peptide, glucagon-like peptide-1 (GLP-1) and ghrelin were measured after a 75 g oral glucose load at weeks 1 and 8. At week 8, both groups reported reductions in energy intake, waist circumference, systolic blood pressure, glycosylated Hb (HbA1c) and glucose AUC and homeostasis model of insulin resistance (HOMA-IR) following the glucose load (P < 0·05). However, HDL, fasting C-peptide and insulin AUC responses were dependent on diet (P < 0·05). HDL and C-peptide increased by 4·5 and 12·3 %, respectively, in the pulse group, but decreased by 0·8 and 7·6 %, respectively, in the energy-restricted group. Insulin AUC decreased in both females and males on the energy-restricted diet by 24·2 and 4·8 %, respectively, but on the pulse diet it decreased by 13·9 % in females and increased by 27·3 % in males (P < 0·05). In conclusion, frequent consumption of pulses in anad libitumdiet reduced risk factors of the MetSyn and these effects were equivalent, and in some instances stronger, than counselling for dietary energy reduction.
Pulse consumption in Canadian adults influences nutrient intakes
Authors: Mudryj Adriana N. , Yu Nancy , Hartman Terryl J. , Mitchell Diane C. , Lawrence Frank R. , Aukema Harold M.
Published: August 2012

Pulses (dry beans, peas, lentils) are nutrient-dense foods that are recommended as good choices in either the vegetable or meat and alternative food groups in Canada's Food Guide. To examine the prevalence and the effect of pulse consumption on nutrient intake in Canadian adults ( ≥ 19 years), we analysed cross-sectional data (n 20 156) from the 2004 Canadian Community Health Survey, Cycle 2·2. Participants were divided into non-consumers and quartiles of pulse intake. Sample weights were applied and logistic regression analysis was used to explore the association of nutrient intakes and pulse consumption, with cultural background, sex, age and economic status included as covariates. On any given day, 13 % of Canadians consume pulses, with the highest consumption in the Asian population. The pulse intake of consumers in the highest quartile was 294 (se 40) g/d and, compared with non-consumers, these individuals had higher intakes of carbohydrate, fibre and protein. As well, the micronutrient intake of pulse consumers was enhanced, resulting in fewer individuals who were below the estimated average requirement for thiamin, vitamin B6, folate, Fe, Mg, P and Zn, compared with non-consumers. Although pulses are generally low in Na, its intake also was higher in pulse consumers. Among the higher quartiles of pulse consumers, fruit and vegetable intake was one serving higher. These data indicate that pulse consumption supports dietary advice that pulses be included in healthful diets. Further studies elucidating the sources of increased Na in pulse consumers will be necessary so that dietary advice to increase consumption of pulses will maximise their nutritional benefits.
Assessment of the mechanisms exerting glucose-lowering effects of dried peas in glucose-intolerant rats
Authors: Whitlock Kevin A. , Kozicky Lisa , Jin Alena , Yee Homun , Ha Christine , Morris Jill , Field Catherine J. , Bell Rhonda C. , Ozga Jocelyn A. , Chan Catherine B.
Published: August 2012

The present study compared the effects of feeding uncooked pea fractions (embryov.seed coat) on glucose homeostasis in glucose-intolerant rats and examined potential mechanisms influencing glucose homeostasis. Rats were made glucose intolerant by high-fat feeding, after which diets containing both high-fat and pea fractions were fed for 4 weeks. Rats fed diets containing uncooked pea seed coats low (non-coloured seed coat; NSC) or high (coloured seed coat; CSC) in proanthocyanidins but not embryos had improved oral glucose tolerance (P < 0·05). NSC also lowered fasting and glucose-stimulated insulin secretion (P < 0·05), decreased β-cell mass by 50 % (P < 0·05) and lowered levels of malondialdehyde, a marker of oxidative stress. Furthermore, NSC decreased the mucosal thickness of the colon by 25 % (P < 0·05), which might affect fibre fermentation and other gut functions. Small but statistically significant (P < 0·05) effects consistent with enhanced glucose transport or metabolism were observed in the skeletal muscle of rats fed NSC or CSC, for example, increased levels of AMP-dependent kinase or akt. We conclude that pea seed coats are the fraction exerting beneficial effects on glucose tolerance. Most of the changes were small in amplitude, suggesting that additive effects on multiple tissues may be important. NSC content appeared to have the most beneficial effects in improving glucose homeostasis but our ability to detect the effect of flavonoids may have been limited by their low concentration in the diet.
Non-digestible fraction of beans (Phaseolus vulgarisL.) modulates signalling pathway genes at an early stage of colon cancer in Sprague–Dawley rats
Authors: Haydé Vergara-Castañeda , Ramón Guevara-González , Lorenzo Guevara-Olvera , Dave Oomah B. , Rosalía Reynoso-Camacho , Paul Wiersma , Guadalupe Loarca-Piña
Published: August 2012

Colorectal cancer is one of the most common causes of morbidity and mortality in Western countries, the second cause of cancer mortality in the USA and a major public health problem in Mexico. A diet rich in legumes is directly related to the prevention of colon cancer, showing an inverse relationship with the development of colorectal adenomas in human subjects. The present study shows the results of molecular changes involved in theTp53pathway at an early stage in the distal colon tissue of azoxymethane (AOM)-induced colon cancer in rats evaluated by PCR array after exposure to diets containing the non-digestible fraction (NDF) of cooked bean (cultivar Bayo Madero). Significant differences were detected in seventy-two genes of theTp53-mediated signalling pathway involved in apoptosis, cell-cycle regulation and arrest, inhibition of proliferation and inflammation, and DNA repair.Tp53,Gadd45a,Cdkn1aandBaxwere highly expressed (9·3-, 18·3-, 5·5- and 3·5-fold, respectively) in the NDF+AOM group, whereasCdc25c,Ccne2,E2f1andBcl2were significantly suppressed ( − 9·2-, − 2·6-, − 18·4- and − 3·5-fold, respectively), among other genes, compared with the AOM group, suggesting that chemoprevention of aberrant crypt foci results from a combination of cell-cycle arrest in G1/S and G2/M phases and cell death by apoptotic induction. We demonstrate that the NDF from common bean modulates gene expression profiles in the colon tissue of AOM-induced rats, contributing to the chemoprotective effect of common bean on early-stage colon cancer.
Dietary dry bean effects on hepatic expression of stress and toxicity-related genes in rats
Authors: Daniell Erica L. , Ryan Elizabeth P. , Brick Mark A. , Thompson Henry J.
Published: August 2012

Dry bean (Phaseolus vulgarisL.) consumption is associated with reduced risk for a number of chronic diseases. In westernised societies, dry bean consumption is particularly low (approximately 2–4 kg/capita per year) and little information is available about the safety of increasing dietary intake in humans to achieve levels that prevent and control chronic diseases. In anticipation of a human intervention study to address the safety and efficacy of increasing bean consumption, a dose–response study with dietary beans was conducted to establish whether increased bean consumption in rats exhibits changes indicative of hepatic stress or toxicity. Transcript levels from a panel of stress and toxicity-related genes were analysed in female Sprague–Dawley rats fed a dose range of dietary beans that bracketed amounts relevant to human consumption globally. Cooked red bean was incorporated into a purified diet formulation at 0, 7·5, 15, 30 or 60 % w/w for the assessment of adaptive patterns of gene expression using quantitative PCR array. Of the eighty-four genes evaluated, the expressions ofCyp3a11,Cyp7a1,Fmo1,Gstm1,MifandUgt1a6were elevated, whereas the expression ofHspa8was down-regulated. Liver gene expression was not modulated in a manner indicative of an adverse response. Only the expression of the cholesterol 7α hydoxylase and UDP-glucuronosyltransferase genes increased in a dose-dependent manner at nutritionally relevant dietary bean concentrations. These candidate genes may contribute to the health benefits attributed to increased bean consumption.
Edible dry bean consumption (Phaseolus vulgarisL.) modulates cardiovascular risk factors and diet-induced obesity in rats and mice
Authors: Zhu Zongjian , Jiang Weiqin , Thompson Henry J.
Published: August 2012

Pulses are grain legumes that have sustained the civilisations of the world throughout their development; yet this staple food crop has fallen into disuse, particularly in Westernised societies, and decreased consumption parallels increased prevalence of CVD. The objective of the present study was to identify mechanisms that account for the cardioprotective activity of dry bean (Phaseolus vulgarisL.), one of the four primary pulse crops, which is widely produced and consumed globally. Laboratory assays that can be used forin vivoscreening of dry beans and other pulses to identify those with the greatest potential to benefit human health are also reported. Sprague–Dawley rats and a diet-induced obesity model in C57Bl/6 mice were used to assess the effect of cooked dry bean incorporated into a purified diet formulation on plasma lipids and hepatic proteins involved in the regulation of lipid biosynthesis. In both animal species, short-term feeding of a bean-containing diet reduced plasma total cholesterol and LDL-cholesterol without affecting HDL-cholesterol or total TAG. Mechanisms associated with cholesterol catabolism and excretion are the likely targets of the bean effect. Unexpectedly, bean-fed obese mice experienced weight loss as well as an improved plasma lipid profile within a 12 d time frame. These findings support the use of short-term (7–14 d) assays to investigate mechanisms that account for the cardioprotective and weight regulatory effects of dry bean and to screen dry bean germplasm resources for types of bean with high protective activity. These same assays can be used to identify the bioactive components of bean that account for the observed effects.
Review of the health benefits of peas (Pisum sativumL.)
Authors: Dahl Wendy J. , Foster Lauren M. , Tyler Robert T.
Published: August 2012

Pulses, including peas, have long been important components of the human diet due to their content of starch, protein and other nutrients. More recently, the health benefits other than nutrition associated with pulse consumption have attracted much interest. The focus of the present review paper is the demonstrated and potential health benefits associated with the consumption of peas,Pisum sativumL., specifically green and yellow cotyledon dry peas, also known as smooth peas or field peas. These health benefits derive mainly from the concentration and properties of starch, protein, fibre, vitamins, minerals and phytochemicals in peas. Fibre from the seed coat and the cell walls of the cotyledon contributes to gastrointestinal function and health, and reduces the digestibility of starch in peas. The intermediate amylose content of pea starch also contributes to its lower glycaemic index and reduced starch digestibility. Pea protein, when hydrolysed, may yield peptides with bioactivities, including angiotensin I-converting enzyme inhibitor activity and antioxidant activity. The vitamin and mineral contents of peas may play important roles in the prevention of deficiency-related diseases, specifically those related to deficiencies of Se or folate. Peas contain a variety of phytochemicals once thought of only as antinutritive factors. These include polyphenolics, in coloured seed coat types in particular, which may have antioxidant and anticarcinogenic activity, saponins which may exhibit hypocholesterolaemic and anticarcinogenic activity, and galactose oligosaccharides which may exert beneficial prebiotic effects in the large intestine.
Judicial Independence in the Democratic Republic of Congo: Myth or Reality?
Authors: Liwanga Roger-Claude
Published: August 2012

Soon after the first democratic elections were organized in 2006, the Democratic Republic of Congo engaged in a series of juridical reforms to ensure that the judiciary is free from interference from the other branches of government: the legislature and the executive. Accordingly, Law No 06/020 of 2006 on the Status of Magistrates and Law No 08/013 of 2008 on the Organization and Functioning of the Supreme Council of the Judiciary were enacted. This article examines judicial independence in the Democratic Republic of Congo today, and assesses the impact of the newly adopted legislation by comparing it with the preceding statutory provisions on the functioning of the judiciary. Do the laws on the status of magistrates and on the organization and functioning of the supreme council of the judiciary, as recently enacted, effectively strengthen the independence of the judiciary?
The Contours of Profit-Making Activities of Non-Profit Companies: An Analysis of the New South African Companies Act
Authors: Cassim Maleka Femida
Published: August 2012

While for-profit companies regularly embark on non-profit activities, the converse issue has recently come to attention, namely whether non-profit companies may embark on profit-making activities. This has given rise to a confusing conundrum of practical importance, not only in South Africa but also in other jurisdictions. This article discusses whether non-profit companies, under the South African Companies Act of 2008, may have purely commercial objects. It also addresses the intertwined question of the contours of permissible profit-making activities. Since the non-profit company is the modern successor to the section 21 company under the previous Companies Act of 1973, this article considers the recent case of Cuninghame v First Ready Development 249, in which the Supreme Court of Appeal was faced with the problem of a section 21 company with a commercial object. The article also explores the administration of rental pool agreements by non-profit companies, which arose in the Cuninghame case.