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Mapping and isolation of pulmonary veins using a novel cryoballoon technique:short-and mid-term outcomes

中华医学会心电生理和起搏分会第十次全国学术年会

作者： Jin-hong gerds-li Eckard Fleck Department of Cardiology First Affiliated Hospital of Jinan University Department of Internal Medicine/Cardiology German Heart Institute BerlinBerlinGermay

Objective To compare the efficacy,safety of atrial fibrillation ablation using PVAC device and simplified cryoballoon catheter via three-dimensional rotational angiography(3D-RTA). Methods 98 patients with symptomatic,medically refractory AF were recruited.52 patients underwent simplified cryoablation and 46 patients underwent PVAC *** age was 60±11 years for patients underwent cryoablation and 62±11 years for patients underwent PVAC ablation(P=NS). Results Mean procedural and fluoroscopic times were 157.8±42.6 minutes and 36.6±14.2 minutes respectively for cryoablation,and 125.2±28.7 minutes and 30.5±11.3 minutes respectively for PVAC ablation(Plism and two cases of mild pericardial effusions were detected in patients underwent PVAC ablation(1.9%vs.6.5%,P=0.034).No incidence of PV stenosis was observed during the follow-up checks in all *** follow-up was 10±7 months (3-39months).74.5%patients reported significantly improved symptoms or were entirely asymptomatic, and no significant difference between patients in both groups.31/52(59.6%) patients undergoing cryoablation and 31/46(67.4%) patients undergoing PVAC ablation were re(?)ed free from AF at the end of follow-up(P=NS). Conclusion Both achiev(?) acute and short-tern efficacy rates,with relatively lower success *** both also achieved low(?) procedural time and(?) roscc py *** rates of complications are relatively low in both techniqu(?)(1.9%in cryoballo(?) technique and 6.5%in PVAC technique, respectively.P=0.034),include transient PNP and air *** with cryoballoon technique, PVAC technique achieved even lower procedural time and fluoroscopy time,but higher acute efficacy rate and complication *** technique was more conv

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Mapping and isolation of pulmonary veins using a novel cryob...

新型冷冻球囊导管消融技术治疗心房颤动中短期随访研究

中华医学会心电生理和起搏分会第十次全国学术年会

作者： Jin-Hong gerds-li Eckard Fleck artment of Internal Medicine/Cardiology German Heart Institute BerlinBerlinGermany

Objective To investigate the feasibility and efficacy of a simplified cryoballoon technique in which a microcircular mapping guide wire is was introduced into the central lumen of the cryoballoon catheter to record real time PV potentials during and after cryoablation without interchanging or exchanging catheters. Methods and Results 52 patients(aged 60±11 years) with symptomatic atrial fibrillation(AF),of them 41 cases with paroxysmal AF and 11 cases with persistent AF were enrolled.A single transseptal puncture was made and a 28-mm cryoballoon catheter(Arctic Front,Medtronic,AF Solutions) was inserted through a steerable sheath(FlexCath,Medtronic,AF Solutions) into the left atrium.A mapping catheter(6-pole or 10-pole) with a 0.035-inch shaft diameter(ProMAP,ProRhythm Inc.) was introduced into the PV through the central lumen of the cryoballoon catheter serving as a recording tool and a "guide-wire." A three-dimensional reconstruction atriography(3D-ATG) of left atrium(LA) and PVs was obtained based on rotational angiography(3D-RA) during the procedure.A total of 184 PVs (184/208,88.5%) were completely isolated using this novel cryoballoon *** total procedural time was 157.8±42.6 minutes;the fluoroscopy time was 36.6±14.2 *** cryoablation time was 38.9±13.8 minutes per *** follow-up(mean 12±8 months,range 3-39 months),49(94.2%) patients had significantly improved symptoms or were entirely asymptomatic and 31(59.6%) patients were free from atrial *** was one occurrence of phrenic nerve palsy during the cryoablation in the right superior pulmonary vein,which fully recovered after three months. Conclusion The use of a single cryoballoon catheter in combination with a 6-pole(or 10-pole) micromapping catheter inserted through the central lumen and visually guided via a 3D-ATG during mapping and ablation appears to be safe and *** and validation of the targeted PVI can be performed simultaneously and allows PVI to

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中国实用内科杂志 2014年第1期34卷 54-57页

作者：陈小明 Jin-Hong gerds-li 李自成暨南大学附属第一医院心内科广州510630 德国柏林心脏中心柏林13353

目的评估一种带有环状标测导管的新型冷冻球囊技术用于心房颤动导管消融的可行性和有效性。方法入选2009年1月至2011年3月德国柏林心脏中心就诊的52例症状性心房颤动患者(41例阵发性心房颤动,11例持续性心房颤动),采用这种带有环状标测... 详细信息

目的评估一种带有环状标测导管的新型冷冻球囊技术用于心房颤动导管消融的可行性和有效性。方法入选2009年1月至2011年3月德国柏林心脏中心就诊的52例症状性心房颤动患者(41例阵发性心房颤动,11例持续性心房颤动),采用这种带有环状标测导管的新型冷冻球囊技术进行心房颤动消融治疗。结果共184支肺静脉(184/208,88.5%)被成功隔离。总术程时间为(157.8±42.6)min,曝光时间为(36.6±14.2)min,总消融时间为(38.9±13.8)min。随访(12±8)个月后,31例(59.6%)患者成功维持窦律。仅有1例患者在消融右上肺静脉时出现膈神经麻痹并在3个月后完全恢复。无一例出现肺静脉狭窄。结论这种新型冷冻球囊导管消融技术安全有效,可简化PVI操作。

关键词：冷冻球囊肺静脉隔离心房颤动消融

应用新型肺静脉消融导管进行心房颤动肺静脉隔离术

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临床心血管病杂志 2012年第11期28卷 833-837页

作者：陈小明 gerds-li Jin-hong 李自成暨南大学附属第一医院心内科广州510630 德国心脏中心柏林心内科电生理室

目的:评估环状标测与功率比式多极射频能量释放相结合的新型多极肺静脉消融导管(PVAC),在心房颤动(房颤)消融术中应用的可行性和安全性。方法:共入选47例有症状的房颤患者,其中32例为阵发性房颤(PAF组),15例为持续性房颤(PSF组),应用PVA... 详细信息

目的:评估环状标测与功率比式多极射频能量释放相结合的新型多极肺静脉消融导管(PVAC),在心房颤动(房颤)消融术中应用的可行性和安全性。方法:共入选47例有症状的房颤患者,其中32例为阵发性房颤(PAF组),15例为持续性房颤(PSF组),应用PVAC进行肺静脉隔离术。结果:介入手术时间平均(126.4±29.5)min[PAF组:(123.7±15.7)min,PSF组:(132.0±36.6)min,P>0.05];X线透视时间平均(30.3±11.3)min[PAF组:(29.4±9.8)min,PSF组:(32.3±14.2)min,P>0.05];PVAC消融时间平均(21.6±7.7)min[PAF组:(20.5±6.0)min,PSF组:(24.0±10.4)min,P>0.05]。在总共188支肺静脉中,有5支因其内未能检测到肺动脉电位而未实施消融术;其余183支实施消融术,其中172支(94.0%)被成功隔离。2例患者在术后第1天发现轻度的心包积液并在1周后自行吸收;所有患者均未发现肺静脉狭窄。随访(6±5)个月(3～21个月),32例(68.1%)症状明显改善或完全消失,29例(61.7%)成功维持窦性心律。结论:应用功率比式双极及单极射频能量的PVAC是一种安全可行的房颤消融新技术。

关键词：心房颤动消融肺静脉隔离旋转式心房造影术

Combined use of three-dimensional rotational angiogram of left atrium and circular multi-electrode ablation catheter for pulmonary vein isolation

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Chinese Medical Journal 2012年第1期125卷 144-148页

作者： TANG Min Charalampos Kriatselis Sotiris Nedios Mathias Roser Stephan Goetze Eckard Fleck Jin-Hong gerds-li Department of Arrhythmia Fuwai Cardiovascular HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100037 China Department of Internal Medicine/Cardiology German Heart Institute Berlin 13353 Germany

Background A novel circular pulmonary vein ablation catheter （PVAC） has been introduced for pulmonary vein isolation （PVI）.Accurate delineation of left atrium-pulmonary vein （LA-PV） anatomy is important for this *** aim of this study was to test whether the 3-dimensional rotational angiography （3D RTA） of the left atrium can facilitate PVI using PVAC *** Twenty patients with paroxysmal atrial fibrillation （AF） were enrolled in this *** 3D RTA was reconstructed and registered with live fluoroscopy in all the *** ablation was performed with a PVAC catheter in the navigation of registered 3D *** The 3DRTA image was successfully reconstructed and registered with live fluoroscopy in all patients （100%）.The LA-PV anatomy was delineated clearly in all *** of the PVAC inside the registered 3D RTA,ensured accurate placement within the atrium to perform ablation,and the PVAC was correctly placed inside the PV ostium to verify the *** the PVs were *** procedural time was （87.5±12.1） minutes,and fluoroscopy time was （20.1±6.3） ***-up after （7.1±1.5） months showed freedom from AF in 70% （14/20） *** PV stenosis was *** Intraprocedure reconstructed and registered 3D RTA can clearly delineate the LA-PV anatomy in *** results demonstrate the feasibility and reliability of combining use of 3DRA and PVAC in AF ablation procedures.

关键词： atrial fibrillation ablation angiography three dimension

Semi-automated detection of rangeland runoff and erosion control berms using high-resolution topography data

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International Soil and Water Conservation Research 2024年第1期12卷 217-226页

作者： li li Changjiang River Scientific Research Institute of Changjiang Water Resources Commission Wuhan430010China Research Center on Mountain Torrent&Geologic Disaster Prevention Ministry of Water ResourcesWuhan430010China University of Arizona School of Natural Resources and the EnvironmentTucsonAZ85719USA

An inventory of topographic modifications is essential to addressing their impacts on hydrological and morphological processes in human-altered ***,such inventories are generally *** study presents two workflows for semi-automatic detection of linear earthen runoff and erosion control berms in rangelands using high-resolution topographic *** workflows consist of initial object identification by applying either morphological grayscale reconstruction(MGR)or the Geomorphon(GEO)method,followed by identification refinements through filters based on objects’horizontal and vertical *** sites were selected within the Altar Valley,Arizona,in the southwestern United *** site was used for developing workflows and optimizing filter thresholds,and the other two sites were used to validate *** results showed that:1)The MGR-based workflow methodology could produce final precision and detection rates of up to 92%and 75%,respectively,and take less than 5 s for a 10.1 km^(2) site;2)The workflow based on the MGR method yielded greater identification accuracy than did the GEO workflow;3)Object length,orientation,and eccentricity were important characteristics for identifying earthen berms,and are sensitive to general channel flow direction and berm shape;4)Manual interrogation of topographic data and imagery can significantly improve identification precision *** proposed workflows will be useful for developing inventories of runoff and erosion control structures in support of sustainable rangeland management.

关键词： Earthen berm Rangeland Grayscale morphological reconstruction Geomorphon liDAR

Perturbed low-thrust geostationary orbit transfer guidance via polynomial costate estimation

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Chinese Journal of Aeronautics 2024年第3期37卷 181-193页

作者： Zhao li Hengnian li Fanghua JIANG Junfeng li State Key Laboratory of Astronautic Dynamics Xi’an Satellite Control CenterXi’an 710043China School of Aerospace Engineering Tsinghua UniversityBeijing 100084China

This paper proposes an optimal,robust,and efficient guidance scheme for the perturbed minimum-time low-thrust transfer toward the geostationary *** Earth’s oblateness perturbation and shadow are taken into *** is difficult for a Lyapunov-based or trajectory-tracking guidance method to possess multiple characteristics at the same time,including high guidance optimality,robustness,and onboard computational *** this work,a concise relationship between the minimum-time transfer problem with orbital averaging and its optimal solution is identified,which reveals that the five averaged initial costates that dominate the optimal thrust direction can be approximately determined by only four initial modified equinoctial orbit elements after a coordinate *** on this relationship,the optimal averaged trajectories constituting the training dataset are randomly generated around a nominal averaged *** polynomial regression models are trained on the training dataset and are regarded as the costate *** the transfer,the spacecraft can obtain the real-time approximate optimal thrust direction by combining the costate estimations provided by the estimators with the current state at any ***,all these computations onboard are *** simulation results show that the proposed guidance scheme possesses extremely high guidance optimality,robustness,and onboard computational efficiency.

关键词： Low thrust Orbital transfer Trajectory optimization Guidance Indirect method Orbital averaging Machine learning Geostationary satellites

Theoretical Analysis of Cooperative Driving at Idealized Unsignalized Intersections

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Tsinghua Science and Technology 2024年第1期29卷 257-270页

作者： Shen li Jiawei Zhang Zhenwu Chen li li Department of Civil Engineering Tsinghua UniversityBeijing 100084China Department of Automation Tsinghua UniversityBeijing 100084China Shenzhen Urban Transport Planning Center Co. Ltd.Shenzhen 518000China

Cooperative driving is widely viewed as a promising method to better utilize limited road resources and alleviate traffic *** recent years,several cooperative driving approaches for idealized traffic scenarios(i.e.,uniform vehicle arrivals,lengths,and speeds)have been ***,theoretical analyses and comparisons of these approaches are *** this study,we propose a unified group-by-group zipper-style movement model to describe different approaches synthetically and evaluate their *** derive the maximum throughput for cooperative driving plans of idealized unsignalized intersections and discuss how to minimize the delay of *** obtained conclusions shed light on future cooperative driving studies.

关键词： cooperative driving connected and automated vehicles unsignalized intersection

Effects of mid-passage gap with a variable surface angle on a turbine vane endwall’s aerothermal and film cooling performances

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Chinese Journal of Aeronautics 2024年第6期37卷 20-37页

作者： Zhiyu li Kaiyuan ZHANG Zhigang li Jun li Institute of Turbomachinery Xi’an Jiaotong UniversityXi’an 710049China

The mid-passage gap is an inevitable structure in a vane passage due to turbine vanes being manufactured *** coolant from this gap is able to prevent hot mainstream ingression and provide cooling protection for the endwall.A novel idea of enlarging the endwall’s coverage area and reducing the endwall’s thermal load by applying the mid-passage gap with variable surface angles is carried out in this *** endwall’s aerothermal and film cooling performances under four mid-passage gap modes at three typical mass flow ratio conditions are numerically *** indicate that under the traditional mid-passage mode,the coolant flows into the mainstream with a perpendicular incidence angle and can’t stick to the ***,cooling failure occurs,and the endwall’s thermal load is badly *** film cooling level at the suction-side endwall is improved when applying the mid-passage gap of a 45surface angle due to the secondary vortex being *** addition,when applying the mid-passage gap of a 135surface angle,the horseshoe vortex is pushed away,and the coverage area at the pressure-side endwall is enlarged *** best film cooling performance is achieved when the upstream surface angle is 135and the downstream surface angle is 45due to the adiabatic film cooling effectiveness being increased at both the pressure-and suction-side *** the mass flow ratio is 1.5%,the coverage area is enlarged by 43%,and the area-averaged adiabatic film cooling effectiveness is increased by 37%,when compared with those under the traditional mid-passage mode.

关键词： Film cooling Heat transfer Surface angle Mid-passagegap Turbinevane endwall