Contact Force in Atrial Fibrillation: Role of Atrial Rhythm and Ventricular Contractions: Co-Force Atrial Fibrillation Study

In an experimental model, variable and intermittent contact force (CF) resulted in a significant decrease in lesion volume. In humans, variability of CF during pulmonary vein isolation has not been characterized. Methods and Results-In 20 consecutive patients undergoing CF-guided circumferential pulmonary vein isolation, 914 radiofrequency applications (530 in sinus rhythm and 384 in atrial fibrillation) were analyzed. The variability of the 60% CF range (CF60%) was 17 ± 9.6 g. Hundred seventy-one (19%) applications were delivered with constant, 717 (78%) with variable, and 26 (3%) with intermittent CF. The mean CF and force-time integral were significantly higher during applications with variable than with intermittent or constant CF. There was no significant difference in CF variability, CF60% variability, and force-time integral between applications delivered in sinus rhythm and atrial fibrillation. The main reasons for CF variability were systolo-diastolic heart movement (29%) and respiration (27%). In 10 additional patients, during adenosine-induced atrioventricular block, the minimum CF significantly increased at 19 sites (5.3 ± 4.4 versus 13.4 ± 5.9 g; P < 0.001) and at 16 sites intermittent or variable CF became constant. At only 1 site systolo-diastolic movement remained the main reason for variable CF. Conclusions-CF during pulmonary vein isolation remains highly variable despite efforts to optimize contact. CF and CF parameters were similar during sinus rhythm and atrial fibrillation. The main reasons for CF variability are systolodiastolic heart movement and respiration. The systolo-diastolic peaks and nadirs of CF are because of ventricular contractions at the large majority of pulmonary vein isolation sites.

State-Selective Attachment of Helium to Molecular Ions in a New Cryogenic Ion Trap

Light is the main information about the interstellar medium accessible on Earth. Based on this information one can conclude on the composition of the region where the light originates from, as well as on its history. The requirement for this is that it is possible to identify the different absorption and emission features in the spectrum and assign them to certain molecules, atoms or ions. To enable the identification of the different species, precise spectroscopic investigations of the species in the laboratory are necessary. In this work a new spectroscopic method is presented, which can be used to record pure rotational spectra of mass selected, cold, stored molecular ions. It is based on the idea of state specific attachment of helium atoms to the stored molecular ions. The new technique has been made possible through the development and recent completion of two new 22-pole ion trap instruments in the work group of Laboratory Astrophysics at the University of Cologne. These new instruments have the advantage to reach temperatures as low as 4K compared to the 10K of the predecessor instrument. These low temperatures enable the ternary attachment of helium atoms to the stored molecular ions and by this make it possible to develop this new method for pure rotational spectroscopy. According to this, this work is divided into two parts. The first part deals with the new FELion experiment that was build and characterized in the first part of the thesis. FELion is a cryogenic 22-pole ion trap apparatus, allowing to generate, mass select, store and cool down, and analyze molecular ions. The different components of the instrument, e.g. the Storage Ion Source for generating the ions or the first quadrupole mass filter, are described and characterized in this part. Besides this also the newly developed control and data acquisitions system is introduced. With this instrument the measurements presented in the second part of the work were performed. The second part deals with the new action spectroscopic method of state-selective helium attachment to the stored molecular ions. For a deeper analysis of the new technique the systems of CD+ and helium and HCO+ and helium are investigated in detail. Analytical and numerical models of the process are presented and compared to experimental results. The results of these investigations point to a seemingly very general applicability of the new method to a wide class of molecular ions. In the final part of the thesis measurements of the rotational spectrum of l-C3H+ are presented. These measurements have to be high-lighted, since it was possible for the first time in the laboratory to unambiguously measure four low-lying rotational transitions of l-C3H+. These measurements (Brünken et al. ApJL 783, L4 (2014)) enabled the reliable identification of so far unidentified emision lines observed in several regions of the interstellar medium (Pety et al. Astron. Astrophys. 548, A68 (2012), McGuire et al. The Astrophysical Journal 774, 56 (2013) and McGuire et al. The Astrophysical Journal 783, 36 (2014)).

The analysis and detection of new psychoactive substances in biological matrices

New psychoactive substances (NPSs) have appeared on the recreational drug market at an unprecedented rate in recent years. Many are not new drugs but failed products of the pharmaceutical industry. The speed and variety of drugs entering the market poses a new complex challenge for the forensic toxicology community. The detection of these substances in biological matrices can be difficult as the exact compounds of interest may not be known. Many NPS are sold under the same brand name and therefore users themselves may not know what substances they have ingested. The majority of analytical methods for the detection of NPSs tend to focus on a specific class of compounds rather than a wide variety. In response to this, a robust and sensitive method was developed for the analysis of various NPS by solid phase extraction (SPE) with gas chromatography mass spectrometry (GCMS). Sample preparation and derivatisation were optimised testing a range of SPE cartridges and derivatising agents, as well as derivatisation incubation time and temperature. The final gas chromatography mass spectrometry method was validated in accordance with SWGTOX 2013 guidelines over a wide concentration range for both blood and urine for 23 and 25 analytes respectively. This included the validation of 8 NBOMe compounds in blood and 10 NBOMe compounds in urine. This GC-MS method was then applied to 8 authentic samples with concentrations compared to those originally identified by NMS laboratories. The rapid influx of NPSs has resulted in the re-analysis of samples and thus, the stability of these substances is crucial information. The stability of mephedrone was investigated, examining the effect that storage temperatures and preservatives had on analyte stability daily for 1 week and then weekly for 10 weeks. Several laboratories identified NPSs use through the cross-reactivity of these substances with existing screening protocols such as ELISA. The application of Immunalysis ketamine, methamphetamine and amphetamine ELISA kits for the detection of NPS was evaluated. The aim of this work was to determine if any cross-reactivity from NPS substances was observed, and to determine whether these existing kits would identify NPS use within biological samples. The cross- reactivity of methoxetamine, 3-MeO-PCE and 3-MeO-PCP for different commercially point of care test (POCT) was also assessed for urine. One of the newest groups of compounds to appear on the NPS market is the NBOMe series. These drugs pose a serious threat to public health due to their high potency, with fatalities already reported in the literature. These compounds are falsely marketed as LSD which increases the chance of adverse effects due to the potency differences between these 2 substances. A liquid chromatography tandem mass spectrometry (LC-MS/MS) method was validated in accordance with SWGTOX 2013 guidelines for the detection for 25B, 25C and 25I-NBOMe in urine and hair. Long-Evans rats were administered 25B-, 25C- and 25I-NBOMe at doses ranging from 30-300 µg/kg over a period of 10 days. Tail flick tests were then carried out on the rats in order to determine whether any analgesic effects were observed as a result of dosing. Rats were also shaved prior to their first dose and reshaved after the 10-day period. Hair was separated by colour (black and white) and analysed using the validated LC-MS/MS method, assessing the impact hair colour has on the incorporation of these drugs. Urine was collected from the rats, analysed using the validated LC-MS/MS method and screened for potential metabolites using both LC-MS/MS and quadrupole time of flight (QToF) instrumentation.

Some parameters that affect CDMA capacity analysis. Results using GIS based simulation

In previous papers we describe a model for capacity analysis in CDMA systems using DC-Cell, a GIS based planning tool developed at Universidad Politecnica de Valencia, and MATLAB. We show some initial results of that model, and now, we are exploring different parameters like cell size, proximity between cells, number of cells in the system and “clustering” CDMA in order to improve the planning process for third generation systems. In this paper we show the results for variations of some of these parameters, specifically the cell size and number of cells. In CDMA systems is quite common to suppose only one carrier frequency for capacity estimation, and it is intuitive to think that for more base stations, mean more users. However the multiple access interference problem in CDMA systems could establish a limit for that supposition in a similar way that occurs in FDMA and TDMA systems.

High resolution mass spectrometry for quantitative analysis and untargeted screening of algal toxins in mussels and passive samplers

Measurement of marine algal toxins has traditionally focussed on shellfish monitoring while, over the last decade, passive sampling has been introduced as a complementary tool for exploratory studies. Since 2011, liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been adopted as the EU reference method (No.15/2011) for detection and quantitation of lipophilic toxins. Traditional LC-MS approaches have been based on low-resolution mass spectrometry (LRMS), however, advances in instrument platforms have led to a heightened interest in the use of high-resolution mass spectrometry (HRMS) for toxin detection. This work describes the use of HRMS in combination with passive sampling as a progressive approach to marine algal toxin surveys. Experiments focused on comparison of LRMS and HRMS for determination of a broad range of toxins in shellfish and passive samplers. Matrix effects are an important issue to address in LC-MS; therefore, this phenomenon was evaluated for mussels (Mytilus galloprovincialis) and passive samplers using LRMS (triple quadrupole) and HRMS (quadrupole time-of-flight and Orbitrap) instruments. Matrix-matched calibration solutions containing okadaic acid and dinophysistoxins, pectenotoxin, azaspiracids, yessotoxins, domoic acid, pinnatoxins, gymnodimine A and 13-desmethyl spirolide C were prepared. Similar matrix effects were observed on all instruments types. Most notably, there was ion enhancement for pectenotoxins, okadaic acid/dinophysistoxins on one hand, and ion suppression for yessotoxins on the other. Interestingly, the ion selected for quantitation of PTX2 also influenced the magnitude of matrix effects, with the sodium adduct typically exhibiting less susceptibility to matrix effects than the ammonium adduct. As expected, mussel as a biological matrix, quantitatively produced significantly more matrix effects than passive sampler extracts, irrespective of toxin. Sample dilution was demonstrated as an effective measure to reduce matrix effects for all compounds, and was found to be particularly useful for the non-targeted approach. Limits of detection and method accuracy were comparable between the systems tested, demonstrating the applicability of HRMS as an effective tool for screening and quantitative analysis. HRMS offers the advantage of untargeted analysis, meaning that datasets can be retrospectively analysed. HRMS (full scan) chromatograms of passive samplers yielded significantly less complex data sets than mussels, and were thus more easily screened for unknowns. Consequently, we recommend the use of HRMS in combination with passive sampling for studies investigating emerging or hitherto uncharacterised toxins.

The interaction between two oppositely travelling, horizontally offset, antisymmetric quasi-geostrophic hetons

We investigate numerically the nonlinear interactions between hetons. Hetons are baroclinic structures consisting of two vortices of opposite sign lying at different depths. Hetons are long-lived. They most often translate (they can sometimes rotate) and therefore they can noticeably contribute to the transport of scalar properties in the oceans. Heton interactions can interrupt this translation and thus this transport, by inducing a reconfiguration of interacting hetons into more complex baroclinic multipoles. More specifically, we study here the general case of two hetons, which collide with an offset between their translation axes. For this purpose, we use the point vortex theory, the ellipsoidal vortex model and direct simulations in the three-dimensional quasi-geostrophic contour surgery model. More specifically, this paper shows that there are in general three regimes for the interaction. For small horizontal offsets between the hetons, their vortices recombine as same-depth dipoles which escape at an angle. The angle depends in particular on the horizontal offset. It is a right angle for no offset, and the angle is shallower for small but finite offsets. The second limiting regime is for large horizontal offsets where the two hetons remain the same hetonic structures but are deflected by the weaker mutual interaction. Finally, the intermediate regime is for moderate offsets. This is the regime where the formation of a metastable quadrupole is possible. The formation of this quadrupole greatly restrains transport. Indeed, it constrains the vortices to reside in a closed area. It is shown that the formation of such structures is enhanced by the quasi-periodic deformation of the vortices. Indeed, these structures are nearly unobtainable for singular vortices (point vortices) but may be obtained using deformable, finite-core vortices.

Selected Reaction Monitoring (SRM) frente a Western Blot

We propose the SRM technology as a complementary method to the Western Blot for the detection and quantification of proteins in a sample. The technique Western Blot has its own limitations: i) only a protein-of-choice is detected, ignoring any non-relevant proteins, ii) the sensitivity of the technique depends on the specificity of the antibody and iii) Western Blot is expensive and time-consuming. The advantages of SRM with respect Western Blot are remarkable: i) you can detect up to hundreds of different proteins in a sample, ii) SRM is more sensitive, because just 50 copies of the target protein per cell are enough for the detection and iii) once it has been made an investment in the necessary machinery to develop this technique, the detection of proteins in a sample turns into a cheaper, faster, more specific and full-quantitative procedure, without the need of using antibodies. First of all, SRM requires the identification of little peptides, obtained by tryptic digestion, whose sequence must be unique for a single protein or isoform. There is software for that aim. Then, it’s necessary to create isotope-labeled peptides of that identified for acting as internal standards. That sample is introduced in a triple quadrupole mass spectrometer: it passes through a first quadrupole, which functions as a filter, where the fragments are selected, previously ionized, attending to the mass/charge (m/z) relation that correspond to that unique fragments of the protein of interest. In this first selection may be other peptides from other proteins, with the same m/z but with different sequence. To select those that are exclusive from the target protein, the fragments are moved to a second quadrupole, where they are fragmented again with a physical method, and so new smaller fragments are generated. All the new fragments are conduced to the third quadrupole, where just those which come from the protein of interest are selected, attending at their m/z again. The target peptide concentration is determined by measuring the observed signal response for the target peptide relative to that of the isotopic-labeled peptide, the concentration of which is calculated from a pre-determined calibration-response curve. Calibration curves have to be generated for each target peptide in the sample. Because SRM technology is increasing its use, there have been developed databases where the scientific community upload information about protocols and standards for each protein with the aim to facilitate the work to other researchers.

Magnetic and Acoustic Investigations of Turbulent Spherical Couette Flow

Title of dissertation: MAGNETIC AND ACOUSTIC INVESTIGATIONS OF TURBULENT SPHERICAL COUETTE FLOW Matthew M. Adams, Doctor of Philosophy, 2016 Dissertation directed by: Professor Daniel Lathrop Department of Physics This dissertation describes experiments in spherical Couette devices, using both gas and liquid sodium. The experimental geometry is motivated by the Earth's outer core, the seat of the geodynamo, and consists of an outer spherical shell and an inner sphere, both of which can be rotated independently to drive a shear flow in the fluid lying between them. In the case of experiments with liquid sodium, we apply DC axial magnetic fields, with a dominant dipole or quadrupole component, to the system. We measure the magnetic field induced by the flow of liquid sodium using an external array of Hall effect magnetic field probes, as well as two probes inserted into the fluid volume. This gives information about possible velocity patterns present, and we extend previous work categorizing flow states, noting further information that can be extracted from the induced field measurements. The limitations due to a lack of direct velocity measurements prompted us to work on developing the technique of using acoustic modes to measure zonal flows. Using gas as the working fluid in our 60~cm diameter spherical Couette experiment, we identified acoustic modes of the container, and obtained excellent agreement with theoretical predictions. For the case of uniform rotation of the system, we compared the acoustic mode frequency splittings with theoretical predictions for solid body flow, and obtained excellent agreement. This gave us confidence in extending this work to the case of differential rotation, with a turbulent flow state. Using the measured splittings for this case, our colleagues performed an inversion to infer the pattern of zonal velocities within the flow, the first such inversion in a rotating laboratory experiment. This technique holds promise for use in liquid sodium experiments, for which zonal flow measurements have historically been challenging.

Measurement of picosecond lifetimes in neutron-rich Xe isotopes

Background: Lifetimes of nuclear excited states in fission fragments have been studied in the past following isotope separation, thus giving access mainly to the fragments' daughters and only to long-lived isomeric states in the primary fragments. For the first time now, short-lived excited states in the primary fragments, produced in neutron-induced prompt fission of U-235 and Pu-241, were studied within the EXILL&FATIMA campaign at the intense neutron-beam facility of the Institute Laue-Langevin in Grenoble. Purpose: We aim to investigate the quadrupole collective properties of neutron-rich even-even Xe-138,Xe-140,Xe-142 isotopes lying between the double shell closure N = 82 and Z = 50 and a deformed region with octupole collectivity. Method: The gamma rays emitted from the excited fragments were detected with a mixed array consisting of 8 HPGe EXOGAM Clover detectors (EXILL) and 16 LaBr3(Ce) fast scintillators (FATIMA). The detector system has the unique ability to select the interesting fragment making use of the high resolution of the HPGe detectors and determine subnanosecond lifetimes using the fast scintillators. For the analysis the generalized centroid difference method was used. Results: We show that quadrupole collectivity increases smoothly with increasing neutron number above the closed N = 82 neutron shell. Our measurements are complemented by state-of-the-art theory calculations based on shell-model descriptions. Conclusions: The observed smooth increase in quadrupole collectivity is similar to the evolution seen in the measured masses of the xenon isotopic chain and is well reproduced by theory. This behavior is in contrast to higher Z even-even nuclei where abrupt change in deformation occurs around N = 90.

Liquid chromatographic-mass spectrometric method for determination of drug content uniformity of two commonly used dermatology medications in a split-tablet dosage form

Purpose: To develop and validate a simple, efficient and reliable Liquid chromatographic-mass spectrometric (LC-MS/MS) method for the quantitative determination of two dermatological drugs, Lamisil® (terbinafine) and Proscar® (finasteride), in split tablet dosage form. Methods: Thirty tablets each of the 2 studied medications were randomly selected. Tablets were weighed and divided into 3 groups. Ten tablets of each drug were kept intact, another group of 10 tablets were manually split into halves using a tablet cutter and weighed with an analytical balance; a third group were split into quarters and weighed. All intact and split tablets were individually dissolved in a water: methanol mixture (4:1), sonicated, filtered and further diluted with mobile phase. Optimal chromatographic separation and mass spectrometric detection were achieved using an Agilent 1200 HPLC system coupled with an Agilent 6410 triple quadrupole mass spectrometer. Analytes were eluted through an Agilent eclipse plus C8 analytical column (150 mm × 4.6 mm, 5 μm) with a mobile phase composed of solvent A (water) containing 0.1% formic acid and 5mM ammonium formate pH 7.5, and solvent B (acetonitrile mixed with water in a ratio A:B 55:45) at a flow rate of 0.8 mL min-1 with a total run time of 12 min. Mass spectrometric detection was carried out using positive ionization mode with analyte quantitation monitored by multiple reaction monitoring (MRM) mode. Results: The proposed analytical method proved to be specific, robust and adequately sensitive. The results showed a good linear fit over the concentration range of 20 - 100 ng mL-1 for both analytes, with a correlation coefficient (r2) ≥ 0.999 and 0.998 for finasteride and terbinafine, respectively. Following tablet splitting, the drug content of the split tablets fell outside of the proxy USP specification for at least 14 halves (70 %) and 34 quarters (85 %) of FIN, as well as 16 halves (80 %) and 37 quarters (92.5 %) of TBN. Mean weight loss, after splitting, was 0.58 and 2.22 % for FIN half- and quarter tablets, respectively, and 3.96 and 4.09 % for TBN half- and quarter tablets,respectively. Conclusion: The proposed LC-MS/MS method has successfully been used to provide precise drug content uniformity of split tablets of FIN and TBN. Unequal distribution of the drug on the split tablets is indicated by the high standard deviation beyond the accepted value. Hence, it is recommended not to split non-scored tablets especially, for those medications with significant toxicity

Assessment oxidative stress biomarkers –neuroprostanes and dihomo-isoprostanes- in elite triathletes urine after two weeks of moderate altitude training

This randomized and controlled trial investigated whether the increase in elite training at different altitudes altered the oxidative stress biomarkers of the nervous system. This is the first study to investigate four F4-neuroprostanes and four F2-dihomo-isoprostanes quantified in 24-hour urine. The quantification was carried out by Ultra High Pressure Liquid Chromatography-triple Quadrupole-Tandem Mass Spectrometry (UHPLC-QqQ-MS/MS). Sixteen elite triathletes agreed to participate in the project. They were randomized in two groups, a group submitted to Altitude Training (n=8) and a group submitted to Sea Level Training (n=8), with a Control group of non-athletes (n=8). After experimental period, the Altitude Training group triathletes gave significant data: 17-epi-17-F2t-dihomo-IsoP (from 5.2 ± 1.4 µg/mL 24 h-1 to 6.6 ± 0.6 µg/mL 24 h-1), ent-7(RS)-7-F2t-dihomo-IsoP (from 6.6 ± 1.7 µg/mL 24 h-1 to 8.6 ± 0.9 µg /mL 24 h-1), and ent-7-epi-7-F2t-dihomo-IsoP (from 8.4 ± 2.2 µg/mL 24 h-1 to 11.3 ± 1.8 µg/mL 24 h-1) increased, while, of the neuronal degeneration-related compounds, only 10-epi-10-F4t-NeuroP (8.4 ± 1.7 µg/mL 24 h-1) and 10-F4t-NeuroP (5.2 ± 2.9 µg/mL 24 h-1) were detected in this group. For the control group and sea level training groups, no significant changes had occurred at the end of the 2-weeks experimental period. Therefore, and as the main conclusion, the training at moderate altitude increased the F4-NeuroPs- and F2-dihomo-isoPs-related oxidative damage of the central nervous system (CNS) compared to similar training at sea level.

Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report

Background: Monozygotic monochorionic triplet pregnancy with conjoined twins is a very rare condition and is associated with many complications. Case: In this study, we describe a monochorionic–diamniotic triplet pregnancy after in vitro fertilization with an intracytoplasmic sperm injection. At a gestational age of 6 weeks and 4 days of pregnancy one gestational sac was observed, and at a gestational age of 12 weeks and 2 days, triplets with conjoined twins were diagnosed. After consulting with the parents, they chose fetal reduction of the conjoined twins. Selective feticide was successfully performed by radiofrequency ablation at 16 weeks of pregnancy. Unfortunately, the day after the procedure, the membrane ruptured, and 1 week later, all fetuses and placenta were spontaneously aborted. Conclusion: Monochorionic triplet pregnancy with conjoined twins is very rare. These pregnancies are associated with very serious complications. Intra cytoplasmic sperm injection increases the rate of monozygotic twinning and conjoined twins. Counseling with parents before IVF is very important.

Laser cooling and trapping of argon metastable atomic beam

The high velocity of free atoms associated with the thermal motion, together with the velocity distribution of atoms has imposed the ultimate limitation on the precision of ultrahigh resolution spectroscopy. A sample consisting of low velocity atoms would provide a substantial improvement in spectroscopy resolution. To overcome the problem of thermal motion, atomic physicists have pursued two goals; first, the reduction of the thermal motion (cooling); and second, the confinement of the atoms by means of electromagnetic fields (trapping). Cooling carried sufficiently far, eliminates the motional problems, whereas trapping allows for long observation times. In this work the laser cooling and trapping of an argon atomic beam will be discussed. The experiments involve a time-of-flight spectroscopy on metastable argon atoms. Laser deceleration or cooling of atoms is achieved by counter propagating a photon against an atomic beam of metastable atoms. The solution to the Doppler shift problem is achieved using spatially varying magnetic field along the beam path to Zeeman shift the atomic resonance frequency so as to keep the atoms in resonance with a fixed frequency cooling laser. For trapping experiments a Magnetooptical trap (MOT) will be used. The MOT is formed by three pairs of counter-propagating laser beams with mutual opposite circular polarization and a frequency tuned slightly below the center of the atomic resonance and superimposed on a magnetic quadrupole field.

Identification technologies to support Alzheimer contexts

Alzheimer's disease makes great demands on care by assistants, due to the fact that they cannot distract their attention from patients while they are at the same time managing records. For that reason, technologies to complement this process need to be adapted. In this work we present a proposal to adapt identification technologies: Radiofrequency Identification (RFID) and Near Field Communications (NFC), focusing especially on the last one. We fuse both technologies and apply them to an Alzheimer's day center. Patients are tagged with two kinds of labels: 13.56Mhz.Mifare for NFC and UHF for RFID. With the first one we tag the context, which means patients, devices (displays, exercise books, etc) and places. With a simple interaction, which involves touching tags with mobile phones, it is possible to manage the information easily. Moreover, with RFID, we localize each patient by the simple act of their passing by an antenna placed in the doors.

Anatomical basis for the cardiac interventional electrophysiologist

The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch’s triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.