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- Walfridsson, Håkan, et al.
(författare)
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Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation: results on health-related quality of life and symptom burden. The MANTRA-PAF trial
- 2015
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Ingår i: Europace. - : Oxford University Press (OUP): Policy B - Oxford Open Option B - CC-BY. - 1099-5129 .- 1532-2092. ; 17:2, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Aims The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF. In this substudy, we evaluated the effect of these treatment modalities on the Health-Related Quality of Life (HRQoL) and symptom burden of patients at 12 and 24 months. Methods and results During the study period, 294 patients were enrolled in the MANTRA-PAF trial and randomized to receive AAD (N = 148) or RFA (N = 146). Two generic questionnaires were used to assess the HRQoL [Short Form-36 (SF-36) and EuroQol-five dimensions (EQ-5D)], and the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) was used to evaluate the symptoms appearing during the trial. All comparisons were made on an intention-to-treat basis. Both randomization groups showed significant improvements in assessments with both SF-36 and EQ-5D, at 24 months. Patients randomized to RFA showed significantly greater improvement in four physically related scales of the SF-36. The three most frequently reported symptoms were breathlessness during activity, pronounced tiredness, and worry/anxiety. In both groups, there was a significant reduction in ASTA symptom index and in the severity of seven of the eight symptoms over time. Conclusion Both AAD and RFA as first-line treatment resulted in substantial improvement of HRQoL and symptom burden in patients with PAF. Patients randomized to RFA showed greater improvement in physical scales (SF-36) and the EQ-visual analogue scale.
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| 6. |
- Yuan, S, et al.
(författare)
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Localization of cardiac arrhythmias : conventional noninvasive methods
- 1991
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Ingår i: International Journal of Cardiac Imaging. - 0167-9899. ; 7:3-4, s. 193-205
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Tidskriftsartikel (refereegranskat)abstract
- Noninvasive localization of the accessory pathway (AP) in patients with the Wolff-Parkinson-White syndrome and of the site of origin of ventricular tachycardia (VT) is reviewed. 12-lead electrocardiography (ECG) is the most readily available method for localization of both the AP and the site of VT origin. Many published ECG criteria are introduced. The application of body surface potential mapping, vectorcardiography, nuclear phase imaging, echocardiography, computed tomography, nuclear magnetic resonance, and signal-averaged ECG in the localization of these arrhythmogenic substrates is also described. We believe that ECG is the most sensitive noninvasive method for AP localization as well as being convenient and simple; it may be used as the only noninvasive method for the initial evaluation. The left lateral AP, which occurs with an incidence of more than 40%, could be localized preoperatively by noninvasive methods only. For localization of the site of VT origin, none of the noninvasive methods is accurate enough for guiding the surgical and catheter-mediated ablative therapies so far.
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| 7. |
- Alhede, Christina, et al.
(författare)
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Antiarrhythmic medication is superior to catheter ablation in suppressing supraventricular ectopic complexes in patients with atrial fibrillation
- 2017
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Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 244, s. 186-191
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Tidskriftsartikel (refereegranskat)abstract
- Background: Supraventricular ectopic complexes (SVEC) originating in the pulmonary veins are known triggers of atrial fibrillation (AF) which led to the development of pulmonary vein isolation for AF. However, the long-term prevalence of SVEC after catheter ablation (CA) as compared to antiarrhythmic medication (AAD) is unknown. Our aims were to compare the prevalence of SVEC after AAD and CA and to estimate the association between baseline SVEC burden and AF burden during 24 months of follow-up. Methods: Patients with paroxysmal AF (N = 260) enrolled in the MANTRA PAF trial were treated with AAD (N = 132) or CA (N = 128). At baseline and 3, 6, 12, 18 and 24 months follow-up patients underwent 7-day Holter monitoring to assess SVEC and AF burden. We compared SVEC burden between treatments with Wilcoxon sum rank test. Results: Patients treated with AAD had significantly lower daily SVEC burden during follow-up as compared to CA (AAD: 19 [6-58] versus CA: 39 [14-125], p = 0.003). SVEC burden increased post-procedurally followed by a decrease after CA whereas after AAD SVEC burden decreased and stabilized after 3 months of follow-up. Patients with low SVEC burden had low AF burden after both treatments albeit this was more pronounced after CA at 24 months of follow-up. Conclusion: AAD was superior to CA in suppressing SVEC burden after treatment of paroxysmal AF. After CA SVEC burden increased immediately post-procedural followed by a decrease whereas after AAD an early decrease was observed. Lower SVEC burden was highly associated with lower AF burden during follow-up especially after CA. (C) 2017 Elsevier B.V. All rights reserved.
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| 8. |
- Alhede, Christina, et al.
(författare)
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Higher burden of supraventricular ectopic complexes early after catheter ablation for atrial fibrillation is associated with increased risk of recurrent atrial fibrillation
- 2018
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Ingår i: Europace. - : OXFORD UNIV PRESS. - 1099-5129 .- 1532-2092. ; 20:1, s. 50-57
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Tidskriftsartikel (refereegranskat)abstract
- Aims Early identification of patients who could benefit from early re-intervention after catheter ablation is highly warranted. Our aim was to investigate the association between post-procedural burden of supraventricular ectopic complexes (SVEC) and the risk of long-term atrial fibrillation (AF) recurrence. Methods and results A total of 125 patients undergoing catheter ablation for AF were included. Patients underwent 7-day Holter recordings immediately post-procedural. The number of SVEC in post-procedural Holter recordings was categorized into quartiles: 0-72, 73-212, 213-782 and amp;gt;= 783 SVEC/day. Long-term AF recurrence was defined as a combined endpoint of AF amp;gt;= 1 min during follow-up Holter recordings, cardioversion or hospitalization for AF after a 3-month blanking period and within 24 months of follow-up. High post-procedural supraventricular ectopy burden was associated with an increased risk of long-term AF recurrence in a dose-dependent manner (amp;gt;= 783 SVEC: HR 4.6 [1.9-11.5], P amp;lt; 0.001) irrespective of AF recurrence during the blanking period or other risk factors. In patients with early AF recurrence amp;lt; 90 days after catheter ablation ectopy burden was also highly predictive of long-term AF recurrence (SVEC amp;gt;= 213: HR 3.0 [1.3-6.7], P = 0.007). Correspondingly, patients with early AF recurrence but low ectopy burden remained at low risk of long-term AF recurrence after the blanking period. Conclusion Our results indicate that post-procedural ectopy burden is highly associated with long-term AF recurrence and could be a potent risk marker for selection of patients for early re-ablation. Development of future ablation risk stratification and strategies should include focus on post-procedural ectopy burden.
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| 9. |
- Alhede, Christina, et al.
(författare)
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The impact of supraventricular ectopic complexes in different age groups and risk of recurrent atrial fibrillation after antiarrhythmic medication or catheter ablation
- 2018
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Ingår i: International Journal of Cardiology. - : ELSEVIER IRELAND LTD. - 0167-5273 .- 1874-1754. ; 250, s. 122-127
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Supraventricular ectopic complexes (SVEC) are known risk factors of recurrent atrial fibrillation (AF). However, the impact of SVEC in different age groups is unknown. We aimed to investigate the risk of AF recurrence with higher SVEC burden in patients +/- 57 years, respectively, after treatment with antiarrhythmic medication (AAD) or catheter ablation (CA). Methods: In total, 260 patients with LVEF amp;gt;40% and age amp;lt;= 70 years were randomized to AAD (N = 132) or CA (N = 128) as first-line treatment for paroxysmal AF. All patients underwent 7-day Holter monitoring at baseline, and after 3, 6, 12, 18 and 24 months and were categorized according to median age +/- 57 years. We used multi-variate Cox regression analyses and we defined high SVEC burden at 3 months of follow-up as the upper 75th percentile amp;gt;195 SVEC/day. AF recurrence was defined as AF amp;gt;= 1 min, AF-related cardioversion or hospitalization. Results: Age amp;gt;57 years were significantly associated with higher AF recurrence rate after CA (58% vs 36%, p = 0.02). After CA, we observed a higher SVEC burden during follow-up in patients amp;gt;57 years which was not observed in the younger age group treatedwith CA (p = 0.006). High SVEC burden at 3 months after CA was associated with AF recurrence in older patients but not in younger patients (amp;gt;57 years: HR 3.4 [1.4-7.9], p = 0.005). We did not find any age-related differences after AAD. Conclusion: We found that younger and older patients respond differently to CA and that SVEC burden was only associated with AF recurrence in older patients. (C) 2017 Elsevier B.V. All rights reserved.
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| 10. |
- Becker, J. C., et al.
(författare)
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What do national flags stand for? : An exploration of associations across 11 countries
- 2017
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Ingår i: Journal of Cross-Cultural Psychology. - : Sage Publications. - 0022-0221 .- 1552-5422. ; 48:3, s. 335-352
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Tidskriftsartikel (refereegranskat)abstract
- We examined the concepts and emotions people associate with their national flag, and how these associations are related to nationalism and patriotism across 11 countries. Factor analyses indicated that the structures of associations differed across countries in ways that reflect their idiosyncratic historical developments. Positive emotions and egalitarian concepts were associated with national flags across countries. However, notable differences between countries were found due to historical politics. In societies known for being peaceful and open-minded (e.g., Canada, Scotland), egalitarianism was separable from honor-related concepts and associated with the flag; in countries that were currently involved in struggles for independence (e.g., Scotland) and countries with an imperialist past (the United Kingdom), the flag was strongly associated with power-related concepts; in countries with a negative past (e.g., Germany), the primary association was sports; in countries with disruption due to separatist or extremist movements (e.g., Northern Ireland, Turkey), associations referring to aggression were not fully rejected; in collectivist societies (India, Singapore), obedience was linked to positive associations and strongly associated with the flag. In addition, the more strongly individuals endorsed nationalism and patriotism, the more they associated positive emotions and egalitarian concepts with their flag. Implications of these findings are discussed.
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| 11. |
- Carlsen, O. C. L., et al.
(författare)
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Physical activity in pregnancy: a Norwegian-Swedish mother-child birth cohort study
- 2021
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Ingår i: AJOG Global Reports. - : Elsevier BV. - 2666-5778. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Physical activity during pregnancy is important for maternal and offspring health. Optimal conditions during pregnancy may help reduce the burden of noncommunicable diseases. National and international guidelines recommend at least 150 minutes of physical activity of at least moderate intensity per week. To optimize physical activity in pregnant women, it is important to identify factors associated with higher levels of physical activity. OBJECTIVE: This study aimed to explore types and levels of physical activity in midpregnancy in Norway and Sweden and to identify factors associated with higher levels of physical activity. MATERIALS AND METHODS: From the population-based mother-child cohort Preventing Atopic Dermatitis and Allergies in Children study recruiting 2697 women in Norway and Sweden from 2014 to 2016, we included 2349 women who answered an electronic questionnaire at enrollment in midpregnancy. Women were asked about regular physical activity in the last 2 weeks of pregnancy and afterward for types and levels of physical activity in pregnancy and before pregnancy and socioeconomic status, lifestyle, and maternal health. Logistic regression analyses were used to identify factors associated with higher levels of physical activity in pregnancy, defined as >30 minutes per session of ≥2 times per week of moderate- or high-intensity brisk walking, strength training, jogging, and bicycling. RESULTS: No regular physical activity during the last 2 weeks before answering the questionnaire at midpregnancy was reported by 689 women (29%). In this study, 1787 women (76%) reported weekly strolling during pregnancy. Regular physical activity at least twice weekly in the first half of pregnancy was reported as brisk walking by 839 women (36%), bicycling by 361 women (15%), strength training by 322 women (14%), and other activities by <10% of women. Among the 1430 women with regular moderate- or high-intensity physical activity, the estimated median duration per week was 120 minutes. Higher physical activity levels were achieved in 553 women (23.5%) by brisk walking, 287 women (12.2%) by strength training, 263 women (11.2%) by bicycling, and 114 women (4.9%) by jogging. Higher physical activity levels were positively associated with regular physical activity before pregnancy, dog ownership, and atopic dermatitis and negatively associated with higher body mass index, study location in Østfold, previous pregnancy or pregnancies, non-Nordic origin, suburban living, and sick leave. CONCLUSION: At midpregnancy, 29% of women were inactive, and less than 50% of women had at least 2 hours of moderate-intensity physical activity weekly. Awareness of physical activity in pregnancy should be discussed at pregnancy follow-up visits, particularly among women with higher body mass index, sick leave, previous pregnancy or pregnancies, and non-Nordic origin.
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- Yuan, S, et al.
(författare)
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Dispersion of repolarization following double and triple programmed stimulation. A clinical study using the monophasic action potential recording technique
- 1996
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Ingår i: European Heart Journal. - 0195-668X. ; 17, s. 1080-
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Tidskriftsartikel (refereegranskat)abstract
- To study the dispersion of ventricular repolarization following double and triple programmed stimulation and its correlation with the inducibility of ventricular arrhythmias, monophasic action potentials were simultaneously recorded from the right ventricular apex and outflow tract during programmed stimulation in 12 patients with ventricular arrhythmias and a normal QT interval. The time difference between the ends of the two monophasic action potentials were used as a measure of the dispersion of ventricular repolarization, which consists of the activation time difference and the monophasic action potential duration difference. During double and triple programmed stimulation, the dispersion of ventricular repolarization increased significantly with the shortening of the coupling interval but decreased slightly with the shortening of the preceding interval. The induction of the ventricular arrhythmias in these patients was invariably associated with a marked increase in the dispersion of ventricular repolarization. The maximal dispersion of ventricular repolarization was significantly larger in the seven patients with polymorphic ventricular tachycardia and/or ventricular flutter/fibrillation induced than in the four patients with monomorphic ventricular tachycardia induced. Analysis of the two components of the dispersion of ventricular repolarization revealed that the increased dispersion of ventricular repolarization was mainly caused by an increase in the activation time difference in the monomorphic ventricular tachycardia subgroup, and by increases in both the activation time difference and monophasic action potential duration difference in the polymorphic ventricular tachycardia/fibrillation subgroup. These findings suggest that increased dispersion of ventricular repolarization is one of the underlying mechanisms accounting for the myocardial vulnerability to ventricular arrhythmias and that repolarization disturbance is important for the genesis of polymorphic ventricular tachycardia/fibrillation.
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| 16. |
- Yuan, S, et al.
(författare)
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Signed value of monophasic action potential duration difference. A useful measure in evaluation of dispersion of repolarization in patients with ventricular arrhythmias
- 1997
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Ingår i: European Heart Journal. - 0195-668X. ; 18:8, s. 38-1329
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To evaluate the usefulness of the signed value of monophasic action potential duration difference in analysing the cause of dispersion of ventricular repolarization.METHODS AND RESULTS: Monophasic action potentials were simultaneously recorded from the right ventricular apex and outflow tract during programmed stimulation in 36 patients with ventricular arrhythmias. The time difference between the ends of repolarization on the two monophasic action potentials was used as a measure of the dispersion of ventricular repolarization, and the signed value of the monophasic action potential duration difference was used to specify the contributions of the activation time difference and the monophasic action potential duration difference to the dispersion of ventricular repolarization. During right ventricular pacing, single and double programmed stimulation and at the induction of ventricular arrhythmias, the dispersion of ventricular repolarization and the signed value of monophasic action potential duration difference were markedly greater in the 11 patients with polymorphic ventricular tachycardia/ventricular fibrillation induced than in the 13 patients with monomorphic ventricular tachycardia induced, and in the 10 patients with clinical polymorphic ventricular tachycardia/ventricular fibrillation/cardiac arrest than in the 12 patients with sustained monomorphic ventricular tachycardia. This disclosed that the increased dispersion of ventricular repolarization was caused by increases in both the activation time difference and the monophasic action potential duration difference in the former, but mainly by an increased activation time difference in the latter groups.CONCLUSION: The signed value of monophasic action potential duration difference can specify whether an increased dispersion of ventricular repolarization is caused by inhomogeneous repolarization, inhomogeneous conduction or both, and thereby it is useful in study of the mechanism of ventricular arrhythmias.
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| 19. |
- Battley, M., et al.
(författare)
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Hydroelastic behaviour of slam loaded composite hull panels
- 2008
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Ingår i: High Perform. Yacht Des. Conf., HPYD. - 9781622769124 ; , s. 37-46
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Konferensbidrag (refereegranskat)abstract
- The effects of stiffness on hydroelastic responses of composite marine hull panels subjected to water slamming loads have been experimentally characterised. Panels included a very flexible single skin laminate, a medium stiffness sandwich panel and a very stiff sandwich panel. Panels were tested at a deadrise angle of 10° for a range of water impact velocities from 0.5 to 7m/s in a Servo-hydraulic Slam Testing System. Results demonstrate that the panel stiffness has a significant effect on the responses of slam loaded composite panels. Flexible panels had reductions in the local velocity at the centre of the panel relative to the water, reducing peak pressures at the panel centre. Pressures increased near to the chine edge of the panel, possibly due to reductions in the local deadrise angle due to panel deformation. Such effects were particularly noticeable when the loading rate was of similar order to the first natural frequency of the panel. The implications of the effects of panel stiffness on effective pressure and panel structural response on composite structural design are discussed.
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| 22. |
- Davidsson, P, et al.
(författare)
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DESIGN AND OPERATION OF A LOW-TEMPERATURE SCANNING TUNNELING MICROSCOPE SUITABLE FOR OPERATION BELOW 1-K
- 1992
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Ingår i: Ultramicroscopy. - 0304-3991 .- 1879-2723. ; 42-44, s. 1470-1475
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Tidskriftsartikel (refereegranskat)abstract
- A scanning tunneling microscope suitable for very low temperatures has been designed, and preliminary testing has been carried out. In order to improve cooling and temperature uniformity the instrument is arranged for operation immersed in the 3He-4He mixture inside the mixing chamber of a small dilution refrigerator. A discussion of the specific problems present in the design of this kind of an instrument is given as well as a description of our design. Special attention is given to the vacuum sealing and vibration-damping solutions required.
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| 23. |
- Gulliksen, Marte S., et al.
(författare)
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Make it NOW! : Learning, Exploring and Understanding
- 2018
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Ingår i: FORMakademisk. - Oslo : OsloMet - Oslo Metropolitan University. - 1890-9515. ; 11:2, s. 1-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This issue of FormAkademisk features selected articles developed from papers presented at the Make it NOW! Learning, Exploring and Understanding conference in Rauma, Finland, September 28-30, 2016. This NordFo conference was organized by Rauma Unit of Turku University´s Department of Teacher Education. NordFo is a Nordic forum, supported by NordPlus, which since the 1980s has worked towards initiating, stimulating and reporting research and development work within the subject art and craft, textile work and woodwork and the teacher education in these subjects in the Nordic countries. The conference Make it NOW! aimed to “…provide an arena for discussions on craft, design and technology as an innovative combination of knowledge and skills related to eco-social values in altering the world according to human needs and wants” (International NordFo Conference in Rauma, 2016). This special issue of FormAkademisk called for articles with an emphasis on the theme Researching embodied making and learning – New methodological vistas on Making, however this did not exclude papers from other sessions. Additionally, this issue contains two other, independent articles that fit this special issue’s scope.
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| 28. |
- Pehrson, S M, et al.
(författare)
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Clinical value of transesophageal atrial stimulation and recording in patients with arrhythmia-related symptoms or documented supraventricular tachycardia--correlation to clinical history and invasive studies
- 1994
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Ingår i: Clinical Cardiology. - : Wiley. - 0160-9289 .- 1932-8737. ; 17:10, s. 528-534
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Tidskriftsartikel (refereegranskat)abstract
- The main objective of the present study was to evaluate the clinical applicability of transesophageal atrial stimulation (TAS) and recording with regard to inducibility of supraventricular tachycardia (SVT) in patients with either an ECG-documented paroxysmal SVT or a clinical history of palpitations suggesting this disease. A further objective was to assess the inducibility of SVT and to compare the inducibility by TAS with that obtained by an invasive electrophysiologic study (EPS). A total of 64 patients (aged 13-74 years) with ECG-documented paroxysmal SVT (n = 50) or only a history of palpitations (n = 14) was referred for TAS. Preexcitation was present in 35 patients. The study protocol included single and double extrastimuli delivered at a basic paced interval of 500 ms, and incremental atrial stimulation until a cycle length of 275 ms or a second-degree AV block appeared. In 10 patients atropine intravenously was required for induction. The same protocol was used in 34 of the patients who also underwent invasive EPS. TAS was completed in 56 of 64 patients (88%). In this group SVT was induced during TAS in 84% (47/56). Of patients with ECG-documented tachycardia, clinical tachycardia was induced in 90% (35/39) with ECG-documented regular paroxysmal SVT and in 67% of patients (4/6) with ECG-documented atrial fibrillation. In patients without ECG-documented tachycardia, clinically relevant arrhythmia was induced in 73% (8/11). In 30 of 32 patients (94%) with an inducible tachycardia during invasive EPS, it was also possible to induce the tachycardia by TAS. We concluded that TAS is a simple and noninvasive diagnostic tool for evaluation of clinical arrhythmia in patients with documented or suspected paroxysmal SVT. The inducibility of SVT seems comparable to that obtained by invasive EPS.
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| 31. |
- Spyridonis, F., et al.
(författare)
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A study on the state-of-the-art of e-infrastructures uptake in Africa
- 2015
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Ingår i: Palgrave Communications. - : Palgrave Macmillan Ltd.. - 2055-1045. ; 1
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Tidskriftsartikel (refereegranskat)abstract
- e-Science is a pioneering method that uses integrated collections of Information and Communication Technologies (ICTs), or e-Infrastructures, to enable scientists across the world to collaboratively work on more and more ambitious projects. Have advances and access to ICTs enabled African e-Infrastructure development? This paper aims to understand the current state of e-Infrastructure uptake in Africa and present some of these initiatives across the African continent by exploring the current landscape emerging from a survey of early consumers. These initiatives are discussed in terms of key projects and user communities that they are addressing. In line with wider perceptions that e-Infrastructures will re-shape the ways research is performed, this study yielded 34 current or planned e-Infrastructure projects across 13 African countries addressing a range of research domains, and identified 7 user communities across these disciplines. Our findings suggest that the African research community is increasingly interested and involved in e-Infrastructure development activities in response to the issue of limited access to dedicated global research and education resources. The study can contribute to the ongoing discussion on how e-Infrastructures can positively promote the research, technological development and innovation potential of developing countries.
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