Interatrial block and atrial arrhythmias in centenarians: Prevalence, associations, and clinical implications

Data are lacking on the characteristics of atrial activity in centenarians, including interatrial block (IAB). The aim of this study was to describe the prevalence of IAB and auricular arrhythmias in subjects older than 100 years and to elucidate their clinical implications. We studied 80 centenarians (mean age 101.4 ± 1.5 years; 21 men) with follow-ups of 6–34 months. Of these 80 centenarians, 71 subjects (88.8%) underwent echocardiography. The control group comprised 269 septuagenarians. A total of 23 subjects (28.8%) had normal P wave, 16 (20%) had partial IAB, 21 (26%) had advanced IAB, and 20 (25.0%) had atrial fibrillation/flutter. The IAB groups exhibited premature atrial beats more frequently than did the normal P wave group (35.1% vs 17.4%; P < .001); also, other measurements in the IAB groups frequently fell between values observed in the normal P wave and the atrial fibrillation/flutter groups. These measurements included sex preponderance, mental status and dementia, perceived health status, significant mitral regurgitation, and mortality. The IAB group had a higher previous stroke rate (24.3%) than did other groups. Compared with septuagenarians, centenarians less frequently presented a normal P wave (28.8% vs 53.5%) and more frequently presented advanced IAB (26.3% vs 8.2%), atrial fibrillation/flutter (25.0% vs 10.0%), and premature atrial beats (28.3 vs 7.0%) (P < .01). Relatively few centenarians (<30%) had a normal P wave, and nearly half had IAB. Our data suggested that IAB, particularly advanced IAB, is a pre–atrial fibrillation condition associated with premature atrial beats. Atrial arrhythmias and IAB occurred more frequently in centenarians than in septuagenarians.

Cavotricuspid isthmus: anatomy and electrophysiology features: its evaluation before radiofrequency ablation

The cavotricuspid isthmus (CTI) in the lower pan of the right atrium, between the inferior caval vein and the tricuspid valve, is considered crucial in producing a conduction delay and. hence, favoring the perpetuation of a reentrant circuit. Non-uniform wall thickness, muscle fiber orientation and the marked variability in muscular architecture in the CTI should be taken into consideration from the perspective of anisotropic conduction, thus producing an electrophysiologic isthmus. The purpose of this article is to review the anatomy and electrophysiology of the CTI in human hearts to provide useful information to plan CTI radio frequency ablation for the patients with atrial flutter.

Fenomeni aeroelastici nelle strutture civili. Inquadramento teorico, quadro normativo e applicazioni.

Il presente lavoro di tesi illustra lo studio di due fenomeni aeroelastici: il vortex shedding e il flutter. Il primo riguarda le vibrazioni indotte dall’azione del vento su funi in acciaio, il secondo invece riguarda l’instabilità flesso-torsionale tipica di ponti sospesi e strallati e dunque di ponti a grande luce libera e aventi impalcati estremamente flessibili. Questi due fenomeni possono condurre la struttura a gravi danneggiamenti o addirittura al collasso e per tale motivo è necessario eseguire studi approfonditi. Due le applicazioni pratiche riscontrate nel presente elaborato: la prima si focalizza sulle oscillazioni che si hanno in alcuni cavi che sostengono la copertura del nuovo stadio del Cairo in Egitto, la seconda riguarda l’instabilità aeroelastica che può verificarsi in un ponte, quale quello sullo stretto di Messina, quando la campata centrale sospesa raggiunge luci mai tentate prima. Dopo un inquadramento generale dei due fenomeni sopra citati e dopo averli descritti da un punto di vista normativo, si è cercato di capire come intervenire al fine di trovare soluzioni efficienti: si è infatti progettato un dispositivo di smorzamento delle vibrazioni per i cavi e si è proceduto con uno studio sperimentale per individuare una audace e rivoluzionaria soluzione per il famigerato ponte sullo stretto di Messina.

Wind analysis of the Messina Strait Bridge design project proposal with stabilizing cables

A new study on suspension bridges has been prompted by the big disaster of the Tacoma Narrow Bridge at half its design speed. The aerodynamic instability of long-span bridges has been studied using wind tunnel tests. As a result of improved aerodynamic performance from the geometrical configuration of the bridge deck, the aerodynamic criteria for suspension and cable-stayed bridges have become well established in recent years, thereby allowing longer bridge spans to be developed. Although the Messina Strait Bridge has yet to be constructed, we are looking forward to evaluating the impact of different deck cross-sections on both aerodynamic stability and cost reduction. To further improve the aerodynamic characteristics of long-span suspension bridges, an optimized multi-box bridge deck model with two side decks for traffic lanes, two middle railway decks, and three gaps separating them has been proposed aerodynamic performance has been experimentally verified. 1:80 scale wind tunnel tests have been conducted. According to the current MIDAS Model, the first torsional and the first vertical frequency ratios are 1.27787 and 1.36[1] respectively. It is the torsional/vertical frequency ratio, combined with the deck aerodynamic properties, that determines the wind response properties of the bridge for the most dangerous possible form of aeroelastic instability. The classic flutter is caused by the coupling of torsional and vertical modes. Stabilizing cables to the deck could be a solution to this classic flutter by reducing lateral displacement of the deck and increasing frequency ratios. Stabilizing cables will be installed on the deck in three different orientations: vertical, inclined, and horizontal, with diameters of 80 cm, 60 cm, and 40 cm in each orientation respectively. An overview of the research undertaken on this topic will be presented, as well as the most important findings.