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This paper describes the magmaOffenburg 3D simulation team trying to qualify for RoboCup 2012. While last year’s TDP focused on the tool set created for 3D simulation and the support for heterogeneous robot models, this year we focus on the different ways how robot behavior can be defined in the magmaOffenburg framework and how those behaviors can be improved by learning.
This paper describes the magmaOffenburg 3D simulation team trying to qualify for RoboCup 2013. While last year’s TDP focused on different ways how robot behavior can be defined in the magmaOffenburg framework this year we focus on how we statistically evaluate new features on distributed systems. We also show some results gained through such analysis.
This paper describes the magmaOffenburg 3D simulation team trying to qualify for RoboCup 2011. While last year’s TDP focused on the tool set created for 3D simulation in this year we describe the further improvement in this tools as well as some new features we implemented focusing on heterogeneous robot models which seem to be used in RoboCup 2012.
An additional tool was written to simply generate situation-dependent strategies. Furthermore some tools, described last year, are now integrated in one single GUI to easy things up.
In previous work we [1] and other authors (e.g. [2]) have shown that agent-based systems are successful in optimizing delivery plans of single logistics companies and are meanwhile successfully productive in industry. In this paper we show that agent-based systems are particularly useful to also optimize transport across logistics companies. In intercompany optimization, privacy is of major importance between the otherwise competing companies. Some data has to be treated strictly private like the cost model or the constraint model. Other data like order information has to be shared. However, typically the amount of orders released to other companies has also to be limited. We show that our agent-based approach can be easily fine tuned to trade off privacy against the benefit of cooperation.
The high frequency (HF) catheter ablation is the gold standard for the therapy of many cardiac tachyarrhythmias, such as atrioventricular node re-entry tachycardia (AVNRT), atrioventricular re-entry tachycardia (AVRT) or atrial flutter (AFL). The aim of the study was to simulate the HF ablation of AVNRT, AVRT, AFL and its heat propagation in reference to the supplied power with different electrode material and electrode size. The modeling and simulation were performed with the thermal and electromagnetic simulation software CST® (Computer Simulation Technology, Darmstadt). The modeling and simulation were carried out using ablation catheters with 4 mm tip electrode and 8 mm tip electrode with different electrode materials. Both electrode types were made of platinum and gold respectively. For the measurement of the heat propagation in the heart tissue, the catheters were integrated in the Offenburg heart rhythm model. The HF ablation procedures were performed with the 4 mm platinum tip electrode, with an application duration of 45 seconds and a power output of 40 watts. The HF ablation of the atrioventricular node slow pathway produced a maximum temperature of 66.33 °C. The Kent bundle HF ablation in the left atrium achieved a maximum temperature of 67.14 °C. The HF ablation of the right atrial isthmus resulted 65.96 °C. The 8 mm distal platinum tip electrode and a power output of 60 watts reached 72.85 °C. The 8 mm distal gold tip electrode and a power output of 60 watt reached 64.66 °C, due to the improved thermal conductivity of gold. Virtual heart and ablation electrode models allow the static and dynamic simulation of HF ablation with different electrode material and electrode size. The 3D simulation of the temperature profile may be used to optimize the AVNRT, AVRT and AFL HF ablation.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular (BV) pacing is an established therapy for heart failure (HF) patients with ventricular desynchronization and reduced left ventricular (LV) ejection fraction. The aim of this study was to evaluate electrical ventricular desynchronization with transthoracic and transesophageal signal averaging electrocardiography in HF, to better select patients for CRT.
Methods: 13 HF patients (age 68 ± 10 years; 2 females, 11 males) with New York Heart Association (NYHA) class 2.8 ± 0.5, 28.6 ± 12.6 % LV ejection fraction and 155 ± 24 ms QRS duration (QRSD) were analysed with transthoracic and transesophageal electrocardiogram recording and novel National Intruments LabView 2009 signal averaging software. Esophageal TO Osypka catheter was perorally applied to the esophagus and placed in the position of maximum LV de-flection. The 0.05-Hz high-pass filtered surface electrocardiogram and the 10-Hz high-pass filtered bipolar transesophageal electrocardiogram were recorded with Bard EP-System and 1000-Hz sampling rate.
Results: Transesophageal LV electrogram recording was possible in all HF patients (n=13). Transesophageal interventricular conduction delay (IVCD) was 51 ± 19 ms and measured between the earliest onset of QRS in the 12-channel surface electrocardiogram and the onset of the LV deflection in the transesophageal electrocardiogram. Transesophageal intra-left ventricular delay (LVCD) was 90 ± 16 ms and measured between the onset and offset of the LV deflection in the transesophageal electrocardiogram. QRSD to transesophageal IVCD ratio was 3.43 ± 1.31 ms, QRSD to transesophageal LVCD ratio was 1.75 ± 0.28 ms and QRSD was evaluated between onset and offset of QRS signal in the 12-channel surface electrocardiogram.
Conclusion: Determination of IVCD, LVCD, QRSD-to-IVCD-ratio and QRSD-to-LVCD-ratio by transesophageal LV electrogram recording with LabView 2009 signal averaging technique may be useful parameters of ventricular desynchronisation to improve patient selection for CRT.
IPv6 over resource-constrained devices (6Lo) emerged as a de-facto standard for the Internet of Things (IoT) applications especially in home and building automation systems. We provide results of an investigation of the applicability of 6LoWPAN with RPL mesh networks for home and building automation use cases. The proper selection of Trickle parameters and neighbor reachable time-outs is important in the RPL protocol suite to respond efficiently to any path failure. These parameters were analyzed in the context of energy consumption w.r.t the number of control packets. The measurements were performed in an Automated Physical Testbeds (APTB). The results match the recommendation by RFC 7733 for selecting various parameters of RPL protocol suite. This paper shows the relationship between various RPL parameters and control traffic overhead during network rebuild. Comparative measurement results with Bluetooth Low Energy (BLE) in this work showed that 6Lo with RPL outperformed BLE in this use case with less control traffic overheads.
Background: R-wave synchronised atrial pacing is an effective temporary pacing
therapy in infants with postoperative junctional ectopic tachycardia. In the technique
currently used, adverse short or long intervals between atrial pacing and ventricular
sensing (AP–VS) may be observed during routine clinical practice.
Objectives: The aim of the study was to analyse outcomes of R-wave synchronised
atrial pacing and the relationship between maximum tracking rates and AP–VS
intervals.
Methods: Calculated AP–VS intervals were compared with those predicted by experienced
pediatric cardiologist.
Results: A maximum tracking rate (MTR) set 10 bpm higher than the heart rate (HR)
may result in undesirable short AP–VS intervals (minimum 83 ms). A MTR set 20 bpm
above the HR is the hemodynamically better choice (minimum 96 ms). Effects of either
setting on the AP–VS interval could not be predicted by experienced observers. In our
newly proposed technique the AP–VS interval approaches 95 ms for HR > 210 bpm
and 130 ms for HR < 130 bpm. The progression is linear and decreases strictly
(− 0.4 ms/bpm) between the two extreme levels.
Conclusions: Adjusting the AP–VS interval in the currently used technique is complex
and may imply unfavorable pacemaker settings. A new pacemaker design is advisable
to allow direct control of the AP–VS interval.
Das Buch führt in das umfangreiche Gebiet der digitalen Bildverarbeitung ein. Neben der Hardware wie u.a. Beleuchtung, Kamera und Frame Grabber werden auch Algorithmen und Methoden beschrieben, z.B. zur Rauschunterdrückung, Bildverbesserung, Kantenextraktion und Objekterkennung usw. Die oft anspruchsvollen mathematischen Sachverhalte werden anhand von Bildbeispielen erklärt.
Zur Erkennung bestimmter Fehler, wie zum Beispiel Ätzfehler, Oberflächen-Fremdkörper, Verschmutzungen, bei der Leiterplattenherstellung ist eine Echtfarben-Bildverarbeitung notwendig, über die hier ein Überblick gegeben wird. Zur Farbsegmentierungs sind verschiedene Methoden geeignet, die einmal im Rot-Grün-Blau-Raum oder im HSI-Raum (Hue, Saturation, Intensity - Färbung, Sättigung, Intensität) untersucht und verglichen werden. Clusterfindungsverfahren und Lookup-Tabelle bereiten Schwierigkeiten bei der Erfassung der Farbkanten, zum Beispiel der Kante zwischen dem Kupfer und dem Beschichtungsmaterial. Hier hilft ein geeigneter Algorithmus, der mit Vorsegmentierung arbeitet. Eine Verfeinerung ist mit Hilfe von Kantenfiltern möglich, zum Beispiel das Color-Sobel-Magnitude-Filter.
Das zweibändige Werk richtet sich an Studierende der Fachrichtungen Elektrotechnik, Maschinenbau, Mathematik und Physik an Fachhochschulen und Universitäten, die sich im Fach Mathematik auf Klausuren oder das Vordiplom vorbereiten wollen.
Im Unterschied zu anderen Mathematik-Lehrbüchern, die die Theorie ausführlich diskutieren, wird hier zu Beginn eines jeden Kapitels die Theorie knapp zusammengefaßt. Der Schwerpunkt liegt auf Aufgaben mit Prüfungsniveau und deren ausführlichen Lösungen. Zu Anfang der Kapitel werden grundlegende Definitionen und Sätze wiederholt und anhand einiger Beispiele erläutert. Anschließend folgen Aufgaben mit Musterlösungen. Wo es immer möglich ist, werden auch alternative Lösungsmöglichkeiten diskutiert.
Band 2 umfaßt die Themen:
- Funktionen mehrerer Veränderlicher
- Integralrechnung
- Gewöhnliche Differentialgleichungen
- Differentialgeometrie
- Die Laplace-Transformation
- Fourierreihe und Fouriertransformation
- Vektoranalysis.
Beide Bände zusammen bilden die ideale Grundlage zur Vorbereitung und zum Bestehen von Mathematik-Prüfungen im Studium.
Lange Erfahrungen der Autoren im Lehrfach Mathematik haben die Notwendigkeit gezeigt, den Studierenden eine praktische Möglichkeit der Prüfungsvorbereitung zu bieten. Die Betroffenen können sich durch die Beschäftigung mit qualifizierten mathematischen Aufgaben auf Klausuren und Prüfungen vorbereiten.
Im Unterschied zu Lehrbüchern, die mit theoretischen Grundlagen ausführlich diskutieren, werden diese in dem vorliegenden Werk zu Beginn eines jeden Kapitels kurz zusammengefaßt. Das Schwergewicht liegt hier auf den Aufgaben mit Prüfungsniveau und deren Lösungswegen, die ausführlich beschrieben werden. Grundlegende Definitionen und Sätze werden kurz wiederholt und anhand einiger Beispiele erläutert. Es folgen Aufgaben mit Musterlösungen. Wo es möglich ist, werden auch alternative Lösungswege diskutiert. So ist dieses Werk eine ideale Ergänzung zu mehr theoretisch ausgerichteten Lehrbüchern.
Printed Electronics (PE) is a promising technology that provides mechanical flexibility and low-cost fabrication. These features make PE the key enabler for emerging applications, such as smart sensors, wearables, and Internet of Things (IoTs). Since these applications need secure communication and/or authentication, it is vital to utilize security primitives for cryptographic key and identification. Physical Unclonable Functions (PUF) have been adopted widely to provide the secure keys. In this work, we present a weak PUF based on Electrolyte-gated FETs using inorganic inkjet printed electronics. A comprehensive analysis framework including Monte Carlo simulations based on real device measurements is developed to evaluate the proposed PE-PUF. Moreover, a multi-bit PE-PUF design is proposed to optimize area usage. The analysis results show that the PE-PUF has ideal uniqueness, good reliability, and can operates at low voltage which is critical for low-power PE applications. In addition, the proposed multi-bit PE-PUF reduces the area usage around 30%.
This paper presents an enhancement on QPSK modulation technique for near field communication (NFC). The enhanced modulation is based on continuous-phase QPSK with Gaussian filtering during switch from one phase to the other. Signal processing is done digitally with minimum external discrete components for air interface. The telemetry system can be used to assist a smart capsule (slave) that can be swallowed to establish data communication with external device (master). The system is designed, simulated, and emulated on FPGA showing 20 dB attenuation on side-lobes of the spectrum.
The application relates to an electronic pill for dispensing a substance, in particular a drug, in a human or animal body in a controllable manner, said electronic pill having a housing (3) in which the substance (17) to be dispensed is accommodated and in which a dispensing opening (47) for dispensing the substance (17) is provided, wherein the substance (17) can be subjected to a predetermined pressure in order to be dispensed from the housing (3), having an electronic control unit (53, 59, 61, 63), and having a valve unit (33) which is arranged in the course of a dispensing path and can be moved from an open position to a closed position by the control unit (53, 59, 61, 63). In the housing (3), a throttle section (45) is provided in the course of the dispensing path for the substance (17) to be dispensed.
A new miniaturized capsule with 32bit processor and bidirectional communication system is being developed for multitask application. The capsule is designed to be a platform for medical assistant application inside the body. The processor core SIRIUS has been developed, simulated, synthesized to a netlist and verified. The designed telemetry unit is a synchronous bidirectional communication block using continuous phase DQPSK of 115 kHz low carrier frequency for inductive data transmission suited for human body energy transfer. The communication system can assist the electronic pill to trigger an actuator for drug delivery, to record temperature, or to measure pH of the body. The complete system is designed to fit small-size mass medical application with low power consumption, size of 7x25 mm. The system is designed, simulated, emulated on FPGA, and routed in AMIS Technology.
A new electronic capsule with bidirectional communication system is being developed for multi-task application. The capsule is designed to be a platform for medical assistant application inside the body. The designed telemetry unit is a synchronous bidirectional communication block using continuous phase DQPSK of 115 kHz low carrier frequency for inductive data transmission suited for human body energy transfer. The communication system can assist the electronic pill to trigger an actuator for drug delivery, to record temperature, or to measure pH of the body. It consists additionally to a 32bit processor, memory, external peripheries, and detection facility. The complete system is designed to fit small-size mass medical application with low power consumption, size of 7x25mm. The system is designed, simulated and emulated on FPGA. A final layout of the complete chip design is still under progress.
Die Erfindung betrifft eine elektronische Pille zur steuerbaren Abgabe einer Substanz, insbesondere eines Medikaments, in einem menschlichen oder tierischen Körper, mit einem Gehäuse (3), in welchem die abzugebende Substanz (17) aufgenommen und in welchem eine Abgabeöffnung (47) zur Abgabe der Substanz (17) vorgesehen ist, wobei die Substanz (17) zur Abgabe aus dem Gehäuse (3) mit einem vorbestimmten Druck beaufschlagbar ist, mit einer elektronischen Steuereinheit (53, 59, 61, 63) und mit einer im Verlauf eines Abgabepfades angeordneten Ventileinheit (33), welche von der Steuereinheit (53, 59, 61, 63) von einer Geöffnet-Stellung in eine Geschlossen-Stellung steuerbar ist. Erfindungsgemäß ist im Gehäuse (3) im Verlauf des Abgabepfades für die abzugebende Substanz (17) eine Drosselstrecke (45) vorgesehen.
A new approach of continuous phase QPSK Band-Pass modulation technique is being developed as enhancement to the QPSK modulation scheme for inductive data transmission (NFC). The modulation is based on Gaussian filtering of the phase transition from one state to the other rather than discontinuity in phase shift. The carrier is based on low frequency 115 KHz suitable for human body energy penetration due to its large skin-depth and lower inductive power attenuation. The complete signal processing is done digitally, external coil and capacitor is used for transceiver interface. The telemetry assists a smart pill swallowed by human being to trigger an actuator for drug delivery, record temperature, or perform diagnostic task inside the body. The smart pill includes 32bit processor, 16 Kbyte memory, temperature sensor, telemetry unit, and additional external peripheries. The complete system is designed, embedded in one SoC, and realized on ASIC with chip-area less than 14 mm<sup>2</sup>.
Nowadays the processing power of mobile phones, Smart phones and PDA is increasing, as well as the transmission bandwidth. Nevertheless there is still the need to reduce the content and the need of processing the data. Proposals and solutions for dynamic reduction of the transmitted content will be discussed. For that, device specific properties will be taken into account, aiming at reducing the need of processing power at the client side to display the 3D Virtual Reality data. Therefore, well known technologies like data compression are combined with new approaches to achieve the goal of adaptive content transmission. For device dependant reduction of processing power the data has to be pre-processed at the server side or the server itself has to take over functionality of weak mobile devices.
Nowadays the processing power of mobile phones, smartphones and PDAs is increasing as well as the transmission bandwidth. Nevertheless there is still the need to reduce the content and the need of processing the data. We discuss the proposals and solutions for dynamic reduction of the transmitted content. For that, device specific properties are taken into account, as much as for the aim to reduce the need of processing power at the client side to be able to display the 3D (virtual reality) data. Therefore, well known technologies, e.g. data compression are combined with new developed ideas to reach the goal of adaptive content transmission. To achieve a device dependant reduction of processing power the data have to be preprocessed at the server side or the server even has to take over functionality of weak mobile devices.
This paper shows the results of the evaluation of two sets of mobile web design guidelines concerning mobile learning. The first set of guidelines is concerned with the usage of text on mobile device screens. The second set is concerned with the usage of images on mobile devices. The evaluation is performed by eye tracking (objective) as well as questionnaires and interviews (subjective) respectively.
The iSign project started in 2000 as a web-based laboratory setting for students of electrical engineering. In the meantime it has broadened into a heterogeneous learning environment offering learning material, adaptive user settings and access to a simulation tool. All these offerings can be accessed via web and wireless by different clients, such as PCs, PDAs and mobile phones. User adaptive systems offer unique and personalised environment for every learner and therefore are a very important aspect of modern e-learning systems. The iSign project aims to personalise the content structure based on the learner's behaviour, content pattern, policies, and system environment. The second aspect of the recent research and development within this project is the generation of suitable content and presentation for different clients. This generation is based additionally on the user preferences in order to obtain the desirable presentation for a given device. New, valuable features are added to the mobile application, empowering the user not only to control the simulation process with his mobile device but also to input data, view the simulation's output and evaluate the results. Experiences with students have helped to improve functionality and look-and-feel whilst using the iSign system. Our goal is to provide unconstrained, continuous and personalised access to the laboratory settings and learning material everywhere and at anytime with different devices.
The idea of this game is to use a flashcard system to create a short story in a foreign language. The story is developed by a group of people by exchanging sentences via a flashcard system. This way, people can learn from each other without fear of making mistakes because the group members are anonymous.
Cellular phone antennas are generally designed to have radiation patterns that are as omnidirectional as possible. Omnidirectional antennas allow a phone’s radio to work well for many orientations of the phone with respect to the cellular base station. Recent studies, however, are generating uncertainty about the health effects of prolonged exposure to electromagnetic (EM) radiation from cellular phones. In this paper, an antenna array is designed primarily to minimize users’ exposure to EM radiation. The antenna comprises a beamforming 4 by 3 array of microstrip patch antennas that is controlled by an accelerometer-only inertial navigation system. The proposed design reduces radiated power directed toward the user to below 10% of the total in the worst case.
This paper analyzes the applicability of existing communication technology on the Smart Grid. In particular it evaluates how networks, e.g. Peer-to-Peer (P2P) and decentralized Virtual Private Network (VPN) can help set up an agent-based system. It is expected that applications on Smart Grid devices will become more powerful and be able to operate without a central control instance. We analyze which requirements agents and Smart Grid devices place on communication systems and validate promising approaches. The main focus is to create a logical overlay network that provides direct communication between network nodes. We provide a comparison of different approaches of P2P networks and mesh-VPNs. Finally the advantages of mesh-VPN for agent-based systems are worked out.
In sicherheitskritschen Systemen darf kein Stück Code im Produktionsbetrieb ablaufen, ohne vorher intensive Tests durchlaufen zu haben. Aber auch zur Qualitätssicherung muss Software getestet werden. Um die Codeüberdeckung zu prüfen, sind zusätzliche Prüf-Instruktionen im Quellcode erforderlich. Auf kleinen Systemen mit wenig RAM kann sich der Entwickler dann etwas einfallen lassen, damit das funktioniert.
Learning to Walk With Toes
(2020)
This paper explains how a model-free (with respect to the robot model and the behavior to learn) approach can facilitate learning to walk from scratch. It is applied to a simulated Nao robot with toes. Results show an improvement of 30% in speed compared to a model without toes and also compared to our model-based approach, but with less stability.
This paper treats the Brillouin backscattering in a single mode optical fiber and its implications on the Brillouin Ring Laser Gyroscope (BRLG). The BRLG consists of a fiber ring cavity in which stimulated Brillouin scattering is induced and provides two resonant counterpropagating backscattered waves. If this cavity is rotating around its axis, the backscattered waves get different resonant frequencies because of the Sagnac effect. The frequency difference is proportional to the rotation rate (Omega) by inducing a frequency offset between the counterpropagating waves. Some reported Brillouin spectra exhibit several peaks, which means that one pump wave provides at least two backscattered waves with distinguishable frequencies. In order to understand this multi-backscattering and to take advantage of it for the BRLG, we present results of a simulation of the Brillouin backscattering in a single mode optical fiber.
This paper treats the interaction between acoustic modes and light (Brillouin scattering) in a single mode optical fibre. Different observed spectra of the Brillouin backscattering in several fibres have been already reported. In order to have a clear idea of the process, we made a simulation to be able to `draw' the theoretical Brillouin spectrum of an optical fibre and to identify the origin of the observed backscattered lines.
First, the model and the computation method used in our simulation are described. Second, the experimentally observed spectra of two real fibres are compared with their computed spectra. Real spectra and simulated spectra are in good agreement.
Our work provides an interesting tool to investigate the changes in the Brillouin spectrum when the input parameters (characteristics of an optical fibre) vary. This should give useful indications to people working on systems which use Brillouin backscattering.
The instability of ultra-thin films of an electrolyte bordering a dielectric gas in an external tangential electric field is scrutinized. The solid wall is assumed to be either a conducting or charged dielectric surface. The problem has a steady one-dimensional solution. The theoretical results for a plug-like velocity profile are successfully compared with available experimental data. The linear stability of the steady-state flow is investigated analytically and numerically. Asymptotic long-wave expansion has a triple-zero singularity for a dielectric wall and a quadruple-zero singularity for a conducting wall, and four (for a conducting wall) or three (for a charged dielectric wall) different eigenfunctions. For infinitely small wave numbers, these eigenfunctions have a clear physical meaning: perturbations of the film thickness, of the surface charge, of the bulk conductivity, and of the bulk charge. The numerical analysis provides an important result: the appearance of a strong short-wave instability. At increasing Debye numbers, the short-wave instability region becomes isolated and eventually disappears. For infinitely large Weber numbers, the long-wave instability disappears, while the short-wave instability persists. The linear stability analysis is complemented by a nonlinear direct numerical simulation. The perturbations evolve into coherent structures; for a relatively small external electric field, these are large-amplitude surface solitary pulses, while for a sufficiently strong electric field, these are short-wave inner coherent structures, which do not disturb the surface.
Oxide semiconductors are highly promising candidates for the most awaited, next-generation electronics, namely, printed electronics. As a fabrication route for the solution-processed/printed oxide semiconductors, photonic curing is becoming increasingly popular, as compared to the conventional thermal curing method; the former offers numerous advantages over the latter, such as low process temperatures and short exposure time and thereby, high throughput compatibility. Here, using dissimilar photonic curing concepts (UV–visible light and UV-laser), we demonstrate facile fabrication of high performance In2O3 field-effect transistors (FETs). Beside the processing related issues (temperature, time etc.), the other known limitation of oxide electronics is the lack of high performance p-type semiconductors, which can be bypassed using unipolar logics from high mobility n-type semiconductors alone. Interestingly, here we have found that our chosen distinct photonic curing methods can offer a large variation in threshold voltage, when they are fabricated from the same precursor ink. Consequently, both depletion and enhancement-mode devices have been achieved which can be used as the pull-up and pull-down transistors in unipolar inverters. The present device fabrication recipe demonstrates fast processing of low operation voltage, high performance FETs with large threshold voltage tunability.
Der Studienbeginn wird an der Hochschule Offenburg durch Vorbereitungskurse, sogenannte Brückenkurse, unterstützt. Wir stellen vorläufige Ergebnisse beim Einsatz von Smartphones und Tablets im Rahmen des Physik-Brückenkurses vor, bei dem die Studenten Hilfen zum selbständigen Üben durch eine App erhalten. Durch die Überarbeitung des Kurses und den Einsatz der App konnte der Teilnehmerschwund verringert werden. Die Evaluationsergebnisse bestätigen eine hohe Akzeptanz der Neuerungen seitens der Studierenden. Erste Auswertungen von Ein- und Ausgangstests deuten darauf hin, dass durch den Brückenkurs eine Angleichung der Vorkenntnisse der Studienanfänger erreicht wird, da Teilnehmer mit geringeren Vorkenntnissen tendenziell einen größeren Lernfortschritt erreichen. Durch unterschiedliche Schwierigkeitsstufen und selbstregulierte Übungsphasen in individuellem Tempo können aber auch die Erfordernisse der stärkeren Teilnehmer angemessen berücksichtigt werden.
In this paper we propose a motion framework forbipedal robots that decouples motion definitions from stabilizingthe robot. This simplifies motion definitions yet allows dynamicmotion adaptations. Two applications, walking and stopping onone leg, demonstrate the power of the framework. We show thatour framework is able to perform walking and stopping on one legeven under extreme conditions and improves walking benchmarkssignificantly in the RoboCup 3D soccer simulation domain.
The aim of this research work was to develop a boiler model with few parameters required for energy planning. The showcase considered for this work was the boiler system of the energy center at Offenburg University of Applied Sciences. A grey box model of the boiler was developed systematically starting from model abstraction, simplification, model break-down and to the use of empirical correlations wherever necessary to describe the intermediate effects along with the use of information from manufacturer’s specification in order to reduce parameters. This strategy had resulted in a boiler model with only 6 parameters, namely, nominal burner capacity, water gallery capacity, air ratio, heat capacity of wall, thermal conductance on flue gas and hot water side. Most of these parameters can be obtained through the information available in the spec sheets and thus an energy planner will be able to parameterize the model with low effort. The model was validated with the monitored data of the showcase. It was tested for the start-up, shut-down behavior and the effect of storage.
This paper investigates the maximum torque capability and torque ripple reduction using the asymmetric stator teeth for interior permanence magnet (IPM) synchronous machines. Traditional electric machines have the identical width for all stator teeth and the winding function is fixed. Using different widths for different stator teeth changes the winding function, therefore, the torque ripple components. The mathematical modeling of interior permanent magnet (IPM) synchronous machine torque ripple and finite element analysis simulation results for the characteristic properties of electric machines are presented. Compared with a similar rating IPM machine, certain combinations of the teeth widths can reduce the torque ripple by 80% with less than 4% average torque decline.
This paper discusses a technological solution to real-time road transportation optimization using a commercial multi-agent based system, LS/ATN, which has been proven through real-world deployment to reduce transportation costs for both small and large fleets in the full and part load business. Subsequent to describing the real-time optimization approach, we discuss how the platform is currently evolving to accept live data from vehicles in the fleet in order to improve optimization accuracy. A selection of the predominant pervasive technologies available today for enhancing intelligent route optimization is described.
Lithium-oxygen cells with organic electrolyte suffer high overpotentials during charge, indicating asymmetric charge/discharge reaction mechanisms. We present a multi-physics dynamic modeling and simulation study of the Li/O2 cell cycling behavior. We present three different multi-step mechanisms of the 2 Li + O2 ⇄ Li2O2 cell reaction, (A) a reversible 5-step mechanism, (B) a partially irreversible 6-step mechanism, and (C) a partially irreversible 8-step mechanism that includes reactions of a redox mediator. Model predictions are compared to experimental galvanostatic cycling data of Swagelok cells without and with 2,2,6,6-tetramethylpiperidinyloxyl (TEMPO) as redox mediator. All mechanisms are able to predict the discharge behavior in good agreement to the experimental results. The experimentally observed high charge overpotentials as well as their reduction by using a redox mediator can be qualitatively reproduced with the irreversible reaction mechanisms. However, the particular shape of the experimental charge curve with continuously increasing charge overpotential cannot be reproduced with the present mechanisms.
Lithium–oxygen cells with nonaqueous electrolyte show high overpotentials during charge, indicating asymmetric charge/discharge reaction mechanisms. We present a kinetic modeling and simulation study of the lithium–oxygen cell cycling behavior. The model includes a multistep reaction mechanism of the cell reaction (2Li + O2 ⇄ Li2O2) forming lithium peroxide by precipitation, coupled to a 1D porous-electrode transport model. We apply the model to study the asymmetric discharge/charge characteristics and analyze the influence of a redox mediator dissolved homogeneously in the liquid electrolyte. Model predictions are compared to experimental galvanostatic cycling data of cells without and with 2,2,6,6-tetramethylpiperidinyloxyl (TEMPO) as redox mediator. The predicted discharge behavior shows good agreement with the experimental results. A spatiotemporal analysis of species concentrations reveals inhomogeneous distributions of dissolved oxygen and reaction products within the cathode during discharge. The experimentally observed charge overpotentials as well as their reduction by using a redox mediator can be qualitatively reproduced with a partially irreversible reaction mechanism. However, the proposed models fail to reproduce the particular shape of the experimental charge curve with continuously increasing charge overpotential, which implies that part of the reaction mechanism is still open for investigation in future work.
Electrochemical impedance spectroscopy (EIS) is a widely-used diagnostic technique to characterize electrochemical processes. It is based on the dynamic analysis of two electrical observables, that is, current and voltage. Electrochemical cells with gaseous reactants or products (e.g., fuel cells, metal/air cells, electrolyzers) offer an additional observable, that is, the gas pressure. The dynamic coupling of current and/or voltage with gas pressure gives rise to a number of additional impedance definitions, for which we use the term electrochemical pressure impedance. It also gives rise to different experimental probing approaches. In this article we present a model-based study of electrochemical pressure impedance spectroscopy (EPIS). Possible quantifications and realizations of EPIS are discussed. The study of generic cell geometries consisting of gas reservoir, diffusion layer(s) and electrochemically active layer(s) reveals distinct spiral-shaped features in the Nyquist plot. Using the example of a sodium/oxygen (Na/O2) cell, the dynamic spatiotemporal behavior of the state variables is quantified and interpreted. Results are compared to first experimental EPIS measurements by Hartmann et al. [J. Phys. Chem. C118, 1461, 2014]. A sensitivity analysis highlights the properties of EPIS with respect to geometric, transport, and kinetic parameters. We demonstrate that EPIS is sensitive to transport parameters that are not well-accessible with standard EIS.
Abstract: Electric field of biventricular (BV) pacing, left ventricular (LV) electrode position and electrical interventricular desynchronization are important parameters for successful cardiac resynchronization therapy (CRT) in patients with heart failure, sinus rhythm and reduced LV ejection fraction. The aim of the study was to evaluate electric pacing field of transesophageal left atrial (LA) pacing and BV pacing with 3D heart rhythm simulation. Bipolar right atrial (RA), right ventricular (RV), LV electrodes and multipolar hemispherical esophageal LA electrodes were modeled with CST (Computer Simulation Technology, Darmstadt). Electric pacing field were simulated with bipolar RA and RV pacing with Solid S (Biotronik) electrode, bipolar LV pacing with Attain 4194 (Medtronic) electrode and bipolar LA pacing with TO8 (Osypka) esophageal electrode. 3D heart rhythm model with esophagus allowed electric pacing field simulation of 4-chamber pacing with bipolar intracardiac RA, RV, LV pacing and bipolar transesophageal LA pacing. The pacing amplitudes were 3V RA pacing amplitude, 50V LA pacing amplitude, 1.5V RV pacing amplitude and 3V LV pacing amplitude with 0.5ms pacing pulse duration. The atrioventricular delay between RA pacing and BV pacing was 140ms atrioventricular pacing delay and simultaneous RV and LV pacing. Electric pacing fields were simulated during the different pacing modes AAI, VVI, DDD and DDD0V. The intracardiac far-field pacing potentials were evaluated with intracardiac electrodes and a distance of 1mm from the electrodes with RA electrode 1.104V, RV electrode 0.703V and LV electrode 1.32V. The transesophageal far-field pacing potential was evaluated with transesophageal electrode and a distance of 10mm from the elelctrode with LA electrode 6.076V. Heart rhythm model simulation with esophagus allows evaluation of electric pacing fields in AAI, VVI, DDD, DDD0V and DDD0D pacing modes. Electric pacing field of RA, RV and LV pacing in combination with LA pacing may additional useful pacing mode in CRT non-responders.
Special implant connection module was developed to combine full features of two commercial heart rhythm simulators, ARSI-4 and Intersim II, into a master-slave teaching system. Seven workstations were equipped with the Carelink and Homemonitoring remote patient monitoring systems. This combination enables in-vitro training of physicians, nurses and students in pace-maker and defibrillator measurements during implantation and individual programming in the follow-up. Thus, extended sets of arrhythmias and electrode problems can be used to simulate problems and their solutions in a wide range of the clinical routine.
Introduction: Despite lots of developments in the last years, radiofrequency ablation of rhythm diseases is a safe but still complex procedure that requires special experience and expertise of the physicians and biomedical engineers. Thus, there is a need of special trainings to become familiar with the different equipment and to explain several effects that can be observed during clinical routine.
Methods: The Offenburg University of Applied Sciences offers a biomedical engineering study path specialized in the fields of cardiology, electrophysiology and cardiac electronic implants. It`s Peter Osypka Institute for Pacing and Ablation provides teaching following the slogan “Learning by watching, touching and adjusting”. It conducts lots of trainings for students as well as young physicians interested in electrophysiology and radiofrequency ablation.
Results: In-vitro trainings will be provided using the Osypka HAT 200 and HAT300s, Stockert EPshuttle and SmartAblate system as well as the Boston EPT-1000XP and Maestro 3000 and the Radionics RFG-3E cardiac radio frequency ablation generators. All of them require different handling as well as special accessories like catheter connection cables or boxes and back plates. The participants will be trained in the setup of temperature, power and cut-off impedance dependent on different ablation catheters. Furthermore troubleshooting in hard- and software is part of the program. Performing procedures in pork or animal protein and using physiological saline solution to simulate the blood flow, they can study the influence of contact force and impedance on lesion geometry etc. and to avoid adverse effects like “plops”. Lots of catheter types are available: 4mm tip, 8mm standard and gold tip, open and closed irrigated tip ablation catheters of different companies. The experiments will be completed by measuring the lesion size dependent on the used catheter type and ablation settings.
Conclusion: In-vitro training in radiofrequency ablation is a challenge for biomedical engineering students and young physicians.
Nickel cobalt aluminum oxide (NCA) based lithium-ion battery electrodes exhibit a distinct asymmetry in discharge/charge behavior towards high bulk stoichiometry (low state of charge). We show that basic electrochemical relationships, that is, the Nernst equation and the Butler-Volmer equation, are able to reproduce this behavior when a two-step reaction mechanism is assumed. The two-step mechanism consists of (1) lithium-ion adsorption from the electrolyte onto the active material particle surface under electron transfer, and (2) intercalation of surface-adsorbed lithium atoms into the bulk material. The asymmetry of experimental half-cell data of an NCA electrode cycled at 0.1 C-rate can be quantitatively reproduced with this simple model. The model parameters show two alternative solutions, predicting either a saturated (highly-covered) or a depleted surface for high bulk lithiation.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular (BV) pacing is an established therapy for heart failure (HF) patients with ventricular desynchronisation and reduced left ventricular (LV) function. The aim of this study was to evaluate preejection period (PEP) and left ventricular ejection time (LVET) with transthoracic signal averaging impedance and electrocardiography in HF patients with and without BV pacing.
Methods: 10 HF patients (age 68.9 ± 8 years; 2 females, 9 males) with New York Heart Association (NYHA) class 2,9 ± 0.5, 30.9 ± 10.5 % LV ejection fraction and 159.4 ± 22.9 ms QRS duration were analysed with transthoracic impedance and electrocardiography (Cardioscreen Medis, Ilmenau, Germany) and novel National Intruments LabView 2009 signal averaging software. One day after BV pacing device implantation, AV and VV delays were optimized by transthoracic impedance cardiography and stroke volume (SV) and cardiac output (CO) were gained by Cardioscreen.
Results: Transthoracic impedance and electrocardiography AV and VV delay opimization was possible in all HF patients with BV pacing devices (n= 10). PEP was 154 ± 24ms without BV pacing and measured between onset of QRS in the surface electrocardiogram and onset of ventricular deflection in the impedance cardiogram. LVET was 342 ± 65ms without BV pacing and measured between onset and offset of ventricular deflection in the impedance cardiogram. The use of optimal AV and VV delay BV pacing resulted in improvement of SV from 64.1 ± 26.5 ml to 94.1 ± 33.96 ml (P < 0.05) and CO from 4.05 ± 1.36 l/min to 6.44 ± 1.56 l/min (P < 0.05).
Conclusion: PEP and LVET may be useful parameters of ventricular Desynchronisation. AV and VV delay optimized BV pacing improve SV and CO. Impedance and electrocardiography with LabView 2009 signal averaging may be a simple and useful technique to optimize CRT.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular pacing is an established therapy for heart failure (HF) patients with sinus rhythm and ventricular desynchronisation. The aim of this study was to evaluate interventricular conduction delay (IVCD) and interatrial conduction delay (IACD) before and after premature ventricular contractions (PVC) in HF patients.
Methods: 13 HF patients (age 68 ± 10 years; 2 females, 11 males) with New York Heart Association functional class 2,8 ± 0.5, left ventricular (LV) ejection fraction 28,6 ± 12,6 %, 154 ± 25 ms QRS duration and PVC were analysed with bipolar transesophageal LV and left atrial electrogram recording and National Instruments LabView 2009 software. The level of significance of the t-test is 0,005.
Results: QRS duration increases during PVC (188 ± 32 ms) in comparison to the beat before (154 ± 25 ms, P = ) and after PVC (152 ± 25 ms,). IVCD increases during PVC up to 65 ± 33 ms (51 ± 19 ms in the beat before PVC, P=0.18, 49 ± 19 ms after PVC, P = 0.12). Intra-LV delay of 90 ± 16 ms is not different in the beat before PVC, 90 ± 14 ms during PVC (P = 0.99) and 94 ± 16 ms in the beat after PVC (P = 0.38). IACD is not significantly PVC influenced (67 ± 12 ms before PVC and 65 ± 13 ms after PVC, P = 0.71). Intra-left atrial conduction delay is not significant longer during PVC (57 ± 28 ms) than in the beat before PVC (54 ± 13 ms, P = 0.51) or after PVC (54 ± 8 ms, P = 0.45). PQ duration increases significantly after PVC (224 ± 95 ms) in comparison to the beat before PVC (176± 29 ms, P =...).
Conclusion: Transesophageal left cardiac electrocardiography with LabView 2009 software can improve evaluation of IVCD and IACD before, during and after PVC in HF patient selection for CRT.
Pressure dynamics in metal-oxygen (metal-air) batteries: a case study on sodium superoxide cells
(2014)
Electrochemical reactions in metal–oxygen batteries come along with the consumption or release of gaseous oxygen. We present a novel methodology for investigating electrode reactions and transport phenomena in metal–oxygen batteries by measuring the pressure dynamics in an enclosed gas reservoir above the oxygen electrode. The methodology is exemplified by a room-temperature sodium–oxygen battery forming sodium superoxide (NaO2) in an electrolyte of diethylene glycol dimethyl ether (diglyme) and sodium trifluoromethanesulfonate (NaOSO2CF3, NaOTf). The experiments are supported by microkinetic simulations with a one-dimensional multiphysics continuum model. During galvanostatic cycling over 30 cycles, a constant oxygen consumption/release rate is observed upon discharge/charge. The number of transferred electrons per oxygen molecule is calculated to 1.01 ± 0.02 and 1.03 ± 0.02 for discharge and charge, respectively, confirming the nature of the oxygen reaction product as superoxide O2–. The same ratio is observed in cyclic voltammetry experiments with low scan rate (<1 mV/s). However, at higher scan rates, the ratio increases as a result of oxygen transport limitations in the electrolyte. We introduce electrochemical pressure impedance spectroscopy (EPIS) for simultaneously analyzing current, voltage, and pressure of electrochemical cells. Pressure recording significantly increases the sensitivity of impedance toward oxygen transport properties of the porous electrode systems. In addition, we report experimental data on the diffusion coefficient and solubility of oxygen in electrolyte solutions as important parameters for the microkinetic models.
Cardiac resynchronization therapy with atrioventricular and interventricular delay optimized biventricular pacing is an established therapy for symptomatic heart failure patients with prolongation of QRS duration, left bundle branch block and reduced left ventricular ejection fraction. The aim of the investigation was to evaluate right atrial, right ventricular and left ventricular electrical signals of implantable electronic cardiac devices with and without signal averaging technique with novel LabVIEW software. Electrical interatrial conduction delay and inter-ventricular conduction delay may be useful parameters to evaluate electrical atrial and ventricular desynchronization in heart failure patients.
Cardiac resynchronization therapy (CRT) is an established class I level A biventricular pacing therapy in chronic heart failure patients with left bundle branch block and reduced left ventricular ejection fraction, but not all patients improved clinically. Purpose of the study was to evaluate electrical interatrial conduction delay (IACD) to interventricular conduction delay (IVCD) ratio with focused transesophageal left atrial and left ventricular electrocardiography.
Methods: Thirty eight chronic heart failure patients (age 63.4±10.2 years; 3 females, 35 males) with New York Heart Association (NYHA) functional class 3.0±0.2 and 171.71±36.17ms QRS duration were analysed using posterior left atrial and left ventricular transesophageal electrocardiography with hemispherical electrodes before CRT. Electrical IACD was measured between onset of P-wave in the surface ECG and onset of left atrial signal. Electrical IVCD was measured between onset of QRS complex in the surface ECG and onset of left ventricular signal.
Results: Electrical IACD and IVCD could be evaluated by transesophageal left atrial and left ventricular electrocardiography in all heart failure patients with correlation to 1.18±0.92 IACD-IVCD-ratio (r=-0.57, P<0.001; r=0.66, P<0.001). There were 32 CRT responder with reduction of NYHA class from 3.0±0.22 to 1.97±0.31 (P<0.001) during 16.5±18.9 month CRT with 75.19±33.49ms IACD, 78.91±24.73ms IVCD, 1.04±0.66 IACD-IVCD-ratio and correlation between IACD and IACDIVCD- ratio (r=0.84, P<0.001). There were 6 CRT nonresponder with no reduction of NYHA class from 3.0±0.3 to 2.9±0.5 during 14.3±13.7 month biventricular pacing, 50.0±28.26ms IVCD (P=0.014), 1.92±1.65 IACD-IVCD-ratio (P=0,029) and correlation between 67.0±24.9ms IACD and IACD-IVCD-ratio (r=0.85, P=0.031).
Conclusions: Focused transesophageal left atrial and left ventricular electrocardiography can be utilized to analyse electrical IACD and IVCD in heart failure patients. IACDIVDC- ratio may be a useful parameter to evaluate electrical left cardiac desynchronization in heart failure patients.
Cardiac resynchronization therapy is an established therapy for heart failure patients with sinus rhythm, reduced left ventricular ejection fraction and prolongation of QRS duration. The aim of the study was to evaluate ventricular desynchronization with electrical interventricular delay (IVD) to left ventricular delay (LVD) ratio in atrial fibrillation heart failure patients. IVD and LVD were measured by transesophageal posterior left ventricular ECG recording. In atrial fibrillation heart failure patients with prolonged QRS duration, the mean IVD-to-LVD-ratio was 0.84 +/- 0.42 with a range from 0.17 to 2.2 IVD-to-LVD-ratio. IVD-to-LVD-ratio correlated with QRS duration. IVD-to-LVD-ratio may be a useful parameter to evaluate electrical ventricular desynchronization in atrial fibrillation heart failure patients.
Hintergrund: Das elektrische interventrikuläre Delay (IVD) und die Lage der linksventrikulären (LV) Elektrode zum Ort der spätesten LV Erregung sind bei Patienten (P) mit Herzinsuffizienz (HF), reduzierter LV Funktion und breiter QRS Dauer (QRSD) von Bedeutung für den Erfolg der kardialen Resynchronisationstherapie (CRT). Die LV Elektrokardiographie ermöglicht eine Abschätzung des elektrischen IVD. Ziel der Studie besteht in der nicht-invasiven Evaluierung des elektrischen IVD bei Patienten (P) mit Vorhofflimmern (AFib) mit und ohne CRT mit biventrikulärer (BV) Stimulation.
Methoden: Bei 49 HF P mit AFib (Alter 63,9 ± 10,8 Jahre; 43 Männer und 6 Frauen) mit New York Heart Association (NYHA) Klasse 2,9 ± 0,4, LV Ejektionsfraktion 26,03 ± 7,99 % und QRS-Dauer (QRSD) 143,69 ± 35,62 ms wurde das elektrische IVD als Intervall zwischen Beginn des QRS-Komplexes im Oberflächen EKG und Beginn des LV Signals im transösophagealen LV EKG bei 31 HF P mit AFib und bei 18 HF P mit AFib und CRT präoperativ bestimmt. Das fokussierte bipolare LV EKG wurde mittels Osypka TO Sonde mit halbkugelförmigen Elektroden in Höhe des maximalen LV Signals registriert.
Ergebnisse: Bei 31 HF P mit AFib betrugen QRSD 135,48 ± 38,78 ms, IVD 49,55 ± 26,38 ms, QRSD-IVD-Verhältnis 3,12 ± 1,11 und das IVD korrelierte mit der QRSD (r=0,75, P<0,001) und dem QRSD-IVD-Verhältnis (r=-0,67, P<0,001) (Fig.). Bei 18 HF P mit AFib und CRT Defibrillator betrugen QRSD 157,83 ± 24,38 ms, IVD 61,94 ± 26,88 ms, QRSD-IVD-Verhältnis 3,12 ± 1,89 und das IVD korrelierte mit der QRSD (r=0,47, P=0,049) und dem QRSD-IVD-Verhältnis (r=-0,73, P<0,001). Bei 72,2 % CRT Responder (R) (n=13) betrugen QRSD 158,15 ± 22,4 ms, IVD 64,23 ± 24,62 ms, QRSD-IVD-Verhältnis 2,82 ± 1,32 und das IVD korrelierte mit der QRSD (r=0,57, P=0,043) und dem QRSD-IVD-Verhältnis (r=-0,76, P=0,0024). Bei 27,8 % CRT Non-Responder (NR) (n=5) betrugen QRSD 157 ± 31,94 ms, IVD 56 ± 34,52 ms, QRSD-IVD-Verhältnis 3,88 ± 2,98 und das IVD korrelierte nicht mit der QRSD (r=0,33, P=0,591) und dem QRSD-IVD-Verhältnis (r=-0,732, P=0,159). Die CRT R verbesserten sich in der NYHA Klasse von 3 ± 0,2 auf 2,2 ± 0,3 (P<0,001) während 15,3 ± 13,1 Monaten BV Stimulation. Bei 15 CRT NR kam es zu keiner Verbesserung der NYHA Klasse von 3 auf 3,3 ± 0,97 (P=0,529) während 18,8 ± 20,7 Monaten BV Stimulation.
Schlussfolgerungen: Das transösophageale LV EKG ermöglicht bei HF-P mit AFib die nichtinvasive Messung des elektrischen IVD präoperativ vor CRT. IVD und QRSD-IVD-Verhältnis sind möglicherweise einfach anwendbare Parameter zur Vorhersage von CRT R und CRT NR bei P mit AFib.
Background: Cardiac resynchronization therapy (CRT) with biventricular (BV) pacing is an established therapy for heart failure (HF) patients (P) with sinus rhythm, reduced left ventricular (LV) ejection fraction (EF) and electrical ventricular desynchronization. The aim of the study was to evaluate electrical interventricular delay (IVD) and left ventricular delay (LVD) in right ventricular (RV) pacemaker pacing before upgrading to CRT BV pacing.
Methods: HF P (n=11, age 69.0 ± 7.9 years, 1 female, 10 males) with DDD pacemaker (n=10), DDD defibrillator (n=1), RV pacing, New York Heart Association (NYHA) class 3.0 ± 0.2 and 24.5 ± 4.9 % LVEF were measured by surface ECG and transesophageal bipolar LV ECG before upgrading to CRT defibrillator (n=8) and CRT pacemaker (n=3). IVD was measured between onset of QRS in the surface ECG and onset of LV signal in the transesophageal ECG. LVD was measured between onset and offset of LV signal in the transesophageal ECG. CRT atrioventricular (AV) and BV pacing delay were optimized by impedance cardiography.
Results: Interventricular and intraventricular desynchronization in RV pacemaker pacing were 228.2 ± 44.8 ms QRS duration, 86.5 ± 32.8ms IVD, 94.4 ± 23.8ms LVD, 2.6 ± 0.8 QRS-IVD-ratio with correlation between IVD and QRS-IVD-ratio (r=-0.668 P=0.0248) and 2.3 ± 0.7 QRS-LVD-ratio. The LVEF-IVD-ratio was 0.3 ± 0.1 with correlation between IVD and LVEF-IVD-ratio (r=-0.8063 P=0.00272) and with correlation between QRS duration and LVEF-IVD-ratio (r=-0.7251 P=0.01157). Optimal sensing and pacing AV delay were 128.3 ± 24.8 ms AV delay after atrial sensing (n=6) and 173.3 ± 40.4 ms AV delay after atrial pacing (n=3). Optimal BV pacing delay was -4.3 ± 11.3 ms between LV and RV pacing (n=7). During 30.4 ± 29.6 month CRT follow-up, the NYHA class improved from 3.1 ± 0.2 to 2.2 ± 0.3.
Conclusions: Transesophageal electrical IVD and LVD in RV pacemaker pacing may be additional useful ventricular desynchronization parameters to improve P selection for upgrading RV pacemaker pacing to CRT BV pacing.
Cardiac resynchronization therapy with atrioventricular and interventricular pacing delay optimized biventricular pacing is an established therapy for heart failure patients with sinus rhythm and reduced left ventricular ejection fraction. The aim of the study was to evaluate atrioventricular and interventricular pacing delay optimization in cardiac resynchroniza-tion therapy by transthoracic impedance cardiography in biventricular pacing with different left ventricular electrode po-sition. In biventricular pacing heart failure patients with lateral, posterolateral and anterolateral left ventricular electrode position, the mean optimal atrioventricular sening delay was 108.6 ± 20.3 ms and the mean optimal interventricular pac-ing delay -12.3 ± 25.9 ms. Transthoracic impedance cardiography may be a useful technique to optimize atrioventricular and interventricular pacing delay in biventricular pacing with different left ventricular electrode position.
Background: The electrical field (E-field) of the biventricular (BV) stimulation is important for the success of cardiac resynchronization therapy (CRT) in patients with cardiac insufficiency and widened QRS complex. The 3D modeling allows the simulation of CRT and high frequency (HF) ablation.
Purpose: The aim of the study was to model different pacing and ablation electrodes and to integrate them into a heart model for the static and dynamic simulation of atrial and BV stimulation and high frequency (HF) ablation in atrial fibrillation (AF).
Methods: The modeling and simulation was carried out using the electromagnetic simulation software CST (CST Darmstadt). Five multipolar left ventricular (LV) electrodes, one epicardial LV electrode, four bipolar right atrial (RA) electrodes, two right ventricular (RV) electrodes and one HF ablation catheter were modeled. Selected electrodes were integrated into the Offenburg heart rhythm model for the electrical field simulation. The simulation of an AV node ablation at CRT was performed with RA, RV and LV electrodes and integrated ablation catheter with an 8 mm gold tip.
Results: The right atrial stimulation was performed with an amplitude of 1.5 V with a pulse width of 0.5. The far-field potentials generated by the atrial stimulation were perceived by the right and left ventricular electrode. The far-field potential at a distance of 1 mm from the right ventricular electrode tip was 36.1 mV. The far-field potential at a distance of 1 mm from the left ventricular electrode tip was measured with 37.1 mV. The RV and LV stimulation were performed simultaneously at amplitude of 3 V at the LV electrode and 1 V at the RV electrode with a pulse width of 0.5 ms each. The far-field potentials generated by the BV stimulations could be perceived by the RA electrode. The far-field potential at the RA electrode tip was 32.86 mV. AV node ablation was simulated with an applied power of 5 W at 420 kHz and 10 W at 500 kHz at the distal 8 mm ablation electrode.
Conclusions: Virtual heart and electrode models as well as the simulations of electrical fields and temperature profiles allow the static and dynamic simulation of atrial synchronous BV stimulation and HF ablation at AF. The 3D simulation of the electrical field and temperature profile may be used to optimize the CRT and AF ablation.
Das Ausmaß der elektrischen ventrikulären Desynchronisation bei reduzierter linksventrikulärer Funktion ist von Bedeutung für den Erfolg der Resynchronisationstherapie der Herzinsuffizienz mit biventrikulärer Stimulation. Das Ziel der Untersuchung besteht in der nichtinvasiven Messung der elektrischen inter-ventrikulären Desynchronisation mit und ohne ischämische Herzerkrankung bei kardialen Resynchronisationstherapie Respondern. Bei Patienten mit 25,3 ± 7,3 % reduzierter linksventrikulärer Ejektionsfraktion und 166,9 ± 38,5 ms QRS-Dauer wurde das transösophageale linksventrikuläre EKG abgeleitet. Die QRS-Dauer korrelierte mit dem interventrikulären und links-ventrikulären Delay bei Resynchronisationstherapie Respondern mit nicht-ischämischer Herzerkrankung.
Termination of atrial flutter (AFL) is not possible in all AFL patients (P) with transesophageal left atrial pacing (TLAP) with undirected electrical pacing field (EPF) and high atrial pacing threshold. Purpose of the study was to evaluate bipo-lar transesophageal left atrial electrocardiography (TLAE) and TLAP with directed EPF for evaluation and termination of AFL with and without simultaneous transesophageal echocardiography (TEE).
Methods: AFL P were analysed using either a TO electrode with one cylindrical (CE) and three or seven hemispherical electrodes (HE) or TEE electrode with four HE (Osypka, Rheinfelden, Germany). Burst TLAP cycle length was between 200msand 50ms.
Results: AFL cycle length was 233±30 ms with mean ventricular cycle length of 540±149 ms. AFL could be terminated by rapid bipolar TLAP with directed EPF using HE-HE and CE-HE with induction of atrial fibrillation (AF), induction of AF and spontaneous conversion to sinus rhythm and direct conversion to sinus rhythm. Directed EPF was simulated with finite element method.
Conclusions: AFL can be evaluated by bipolar TLAE. AFL can be terminated with rapid TLAP with directed EPF with and without simultaneous TEE. Bipolar TLAE with rapid TLAP is a safe, simple and useful method for evaluation and termination of AFL.
Cardiac resynchronisation therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients with interventricular conduction delay (IVCD). The aim of the study was to evaluate transesophageal IVCD and left ventricular (LV) pacing with directed electrical pacing field (EPF) in HF patients.
Methods: HF patients were analysed with bipolar transesophageal LV electrocardiogram recording and LV pacing with constant voltage stimulus output, 4 ms stimulus duration, distal cylindrical electrode (CE) and seven 6 mm hemispherical electrodes (HE) with 15 mm electrode distance (TO, Dr. Osypka, Rheinfelden, Germany).
Results: LV electrocardiogram recording with HE-HE and CE-HE evaluated a mean IVCD of 79.9 ± 36.7 ms. Directed EPF with CE-HE and HE-HE allowed LV VAT (n=12) and LV D00 pacing (n=5) with a mean effective capture output of 97.35 ± 6.64 V. In 15 responders with IVCD of 87 ± 33 ms arterial pulse pressure (PP) increased from 65 ± 24 mmHg to 79 ± 27 mmHg (p < 0.001). EPF was simulated with finite element method.
Conclusions: Transesophageal LV electrocardiography and directed EPF pacing with CE and HE allowed the evaluation of IVCD and PP to select patients for BV pacing.
Cardiac resynchronization therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients with inter- and intraventricular conduction delay. The aim of this pilot study was to test the feasibility of both transesophageal measurement of left ventricular (LV) electrical delay and transesophageal LV pacing prior to implantation, to better select patients for CRT.
Transösophageales interventrikuläres Delay bei Vorhofflimmern und kardialer Resynchronisation
(2013)
Die transösophageale linksventrikuläre Elektrokardiographie ermöglicht die Evaluierung der elektrischen ventrikulären Desynchronisation im Rahmen der kardialen Resynchronisationstherapie der Herzinsuffizienz. Das Ziel der Untersuchung besteht in der präoperativen Abschätzung des transösophagealen interventrikulären Delays bei Vorhofflimmern und kardialer Resynchronisationstherapie. Bei Patienten mit Vorhofflimmern, Herzinsuffizienz New York Heart Association Klasse 3,0 ± 0,2 und QRS-Dauer 159,6 ± 23,9 ms wurde das fokusierte transösophageale linksventrikuläre EKG abgeleitet. Die kardiale Resynchronisationstherapie Responder QRS-Dauer korrelierte mit dem transösophagealen interventrikulären Delay bei Vorhofflimmern.
Introduction: Cardiac resynchronization therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients (P) with ventricular desynchronisation, but not all patients improved clinically. Aim of this study was to evaluate electrical intra-left ventricular conduction delay (LVCD) and interventricular conduction delay (IVCD), to better select patients for CRT.
Methods: 65 HF patients (age 63.4 ± 10.6 years; 7 females, 58 males) with New York Heart Association (NYHA) class 3 ± 0.2, 24.4 ± 6.7 % left ventricular (LV) ejection fraction and 167.4 ± 35.6 ms QRSD were included. Esophageal TO Osypka focused hemispherical electrodes catheter was perorally applied in position of maximum LV deflection to measure LVCD between onset and offset of LV deflection and IVCD between earliest onset of QRS in the 12-channel surface ECG and onset of LV deflection in the focused bipolar transesophageal LV electrogram.
Results: There were 50 responders with LVCD of 76.5 ± 20.4 ms, IVCD of 80.5 ± 26.1 ms (P=0.34) and QRSD of 171 ± 37.7 ms. 15 non-responders had longer LVCD of 90 ± 28.5 ms (P = 0.045), shorter IVCD of 50.1 ± 29.1 ms (P < 0.001) and QRSD of 155.3 ± 25 ms (P=0.14). During 21.3 ± 20.3 month BV pacing follow-up, the responder`s NYHA classes improved from 3 ± 0.2 to 2. ± 0.3 (P < 0.001) whereas the non-responders NYHA classes did not improve from 3 ± 0.2 to 2.9 ± 0.3 (P = 0.43) during 15.7 ± 13.9 month BV pacing follow-up (53 Boston, 10 Medtronic and 2 St. Jude CRT devices).
Conclusion: Determination of electrical LVCD and IVCD by focused bipolar transesophageal LV electrogram recording may be an additional useful technique to improve patient selection for CRT.
Cardiac resynchronization therapy (CRT) with biventricular (BV) pacing is an established therapy in approximately two-thirds of symptomatic heart failure (HF) patients (P) with left bundle branch block (LBBB). The aim of this study was to evaluate left atrial (LA) conduction delay (LACD) and left ventricular (LV) conduction delay (LVCD) using pre-implantational transesophageal electrocardiography (ECG) in sinus rhythm (SR) CRT responder (R) and non-responder (NR).
Methods: SR HF P (n=52, age 63.6±10.4 years; 6 females, 46 males) with New York Heart Association (NYHA) class 3.0±0.2, 24.4±7.1 % LV ejection fraction and 171.2±37.6 ms QRS duration (QRSD) were measured by bipolar filtered transesophageal LA and LV ECG recording with hemispherical electrodes (HE) TO catheter (Osypka AG, Rheinfelden, Germany). LACD was measured between onset of P-wave in the surface ECG and onset of LA deflection in the LA ECG. LVCD was measured between onset of QRS in the surface ECG and onset of LV deflection in the LV ECG.
Results: There were 78.8 % SR CRT R (n=41) with 171.2±36.9 ms QRSD, 73.3±25.7 ms LACD, 80.0±24.0 ms LVCD and 2.3±0.5 QRSD-LVCD-ratio. SR CRT R QRSD correlated with LACD (r=0.688, P<0.001) and LVCD (r=0.699, P<0.001). There were 21.2 % SR CRT NR (n=11) with 153.4±22.4 ms QRSD (P=0.133), 69.8±24.8 ms LACD (n=6, P=0.767), 54.2±31.0 ms LVCD (P<0.0046) and 3.9±2.5 QRSD-LVCD-ratio (P<0.001). SR CRT NR QRSD not corre-lated with IACD (r=-0.218, P=0.678) and IVCD (r=0.042, P=0.903). During a 22.8±21.3 month CRT follow-up, the CRT R NYHA class improved from 3.1±0.3 to 1.9±0.3 (P<0.001). In CRT NR, NYHA class not improved (2.9±0.4 to 2.9±0.2, P=1) during 11.2±9.8 months BV pacing.
Conclusions: Transesophageal LA and LV ECG with HE can be utilized to analyse LACD and LVCD in HF P. Pre-implantational LVCD and QRSD-LVCD-ratio may be additional useful parameters to improve P selection for SR CRT.
Capture threshold (CT) for transesophageal left atrial (LA) pacing (TLAP) and transesophageal left ventricular (LV) pacing (TLVP) with conventional cylindrical electrodes (CE) are higher than TLAP feeling threshold (FT). Purpose of the study was to evaluate focused TLAP CT and FT for supraventricular tachycardia (SVT) initiation and focused TLVP CT for cardiac resynchronisation therapy (CRT) simulation.
Methods: SVT initiation in patients (P) with palpitations (n=49, age 47 ± 17 years) was analysed during spontaneous rhythm and during focused bipolar TLAP with atrial constant current stimulus output, distal CE and three or seven 6 mm hemispherical electrodes (HE) (TO, Osypka AG, Rheinfelden, Germany). CRT simulation in heart failure P (n=75, age 62 ± 11 years) was evaluated by focused bipolar TLAP and/or TLVP with ventricular constant voltage stimulus output and different pacing mode.
Results: Focused electrical pacing field between CE and HE (n=28) allowed low threshold TLAP with 8.0 ± 2.6 mA CT at 9.9 ms stimulus duration (SD) which was lower than 9.2 ± 4.5 mA FT at 9.9 ms SD. Focused electrical pacing field between HE and HE (n=21) allowed low threshold TLAP with 8.1 ± 2.2 mA CT at 9.9 ms SD which was lower than 9.8 ± 5.0 mA FT at 9.9 ms SD. SVT initiation by programmed AAI TLAP was possible in 23 P and not possible in 26 P. CRT simulation was evaluated with TLAP and TLVP with VAT, D00 and V00 pacing mode and 95.5 ± 10.9 V TLVP CT at 4.0 ms SD.
Conclusions: Programmed focused AAI TLAP allowed initiation of SVT with very low CT and high FT and focused electrical pacing field between CE-HE and HE-HE.CRT simulation with focused TLAP and/or TLVP with VAT, D00 and V00 pacing mode may be a useful technique to detect responders to CRT.
Introduction: Cardiac resynchronisation therapy (CRT) with atrioventricular (AV) and interventricular (VV) optimized biventricular pacing (BV) is an established therapy for heart failure (HF) patients. The aim of the study was to compare AV and VV delay optimization with cardiac output (CO), cardiac index (CI), contractility index (IC) and acceleration index (ACI) impedance cardiographic (ICG) methods in CRT.
Methods: 15 HF patients (age 66 ± 10 years; 2 females, 13 males) in New York Heart Association (NYHA) class 3.1 ± 0.4, left ventricular (LV) ejection fraction 21.3 ± 7.8 % and QRS duration 176.1 ± 31.7 ms underwent AV and VV delay optimization with CO, CI, IC and ACI (Cardioscreen ®, Medis GmbH, Ilmenau, Germany) at different AV and VV delay BV pacing settings versus right ventricular (RV) pacing one day after implantation of a CRT device.
Results: Optimal AV delay after atrial sensing was 108.6 ± 20.3 ms (n=14) and optimal AV delay after atrial pacing 190 ± 14.1 ms (n=2) with AV delay range from 80 ms to 200 ms. Optimal VV delay was -12.3 ± 25.9 ms left ventricular before RV pacing. RV versus BV pacing mode resulted in improvement of CO from 3.4 ± 1.2 l/min to 4.4 ± 1.4 l/min (p<0.001), CI from 1.8 ± 0.64 l/min/m² to 2.4 ± 0.78 l/min/m² (p<0.001), IC from 0.028 ± 0.011 1/s to 0.036 ± 0.013 1/s (p<0.001) and ACI from 0.667 ± 0.227 1/s² to 0.834 ± 0.282 1/s² (p<0.002). During 34 ± 26 month BV pacing, the NYHA class improved from 3.1 ± 0.4 to 2.1 ± 0.4 (p<0.001).
Conclusion: AV and VV delay optimized BV pacing acutely improve hemodynamic parameters of transthoracic ICG and their NYHA class during long-term follow-up. ICG may be a simple and useful technique to optimize AV and VV delay in CRT.
Introduction: Cardiac resynchronisation therapy (CRT) with atrioventricular (AV) and interventricular (VV) optimized biventricular pacing (BV) is an established therapy for heart failure (HF) patients with electrical interventricular conduction delay (IVCD). The aim of the study was to compare AV and VV delay optimization with cardiac output (CO) and acceleration index (ACI) impedance cardiographic (ICG) methods.
Methods: HF patients with IVCD 86.8 ± 33 ms (n=15, age 66 ± 10 years; 2 females, 13 males), New York Heart Association (NYHA) functional class 3.1 ± 0.4, left ventricular (LV) ejection fraction 21.3 ± 7.8 % and QRS duration 176.1 ± 31.7 ms underwent AV and VV delay optimization with CO and ACI methods (Cardioscreen, Medis GmbH, Ilmenau, Germany). After evaluation of optimal AV delay, we evaluated optimal VV delay during simultaneous LV and right ventricular (RV) pacing (LV=RV), LV before RV pacing (LV-RV) and RV before LV pacing (RV-LV).
Results: Optimal VV delay was -12.3 ± 25.9 ms LV-RV pacing with VV delay range from -80 ms LV-RV pacing to +20 ms RV-LV pacing and RV=LV pacing. Optimal AV delay after atrial sensing was 108.6 ± 20.3 ms (n=14) and optimal AV delay after atrial pacing 190 ± 14.1 ms (n=2) with AV delay range from 80 ms to 200 ms. RV versus BV pacing mode resulted in improvement of CO from 3.4 ± 1.2 l/min to 4.4 ± 1.4 l/min (p<0.001) and ACI from 0.667 ± 0.227 1/s² to 0.834 ± 0.282 1/s² (p<0.002). During 34 ± 26 month BV pacing, the NYHA class improved from 3.1 ± 0.4 to 2.1 ± 0.4 (p<0.001).
Conclusion: AV and VV delay optimized BV pacing acutely improve ICG CO and ACI and their NYHA class during long-term follow-up. ICG may be a simple and useful technique to optimize AV and VV delay in CRT.
Introduction: Cardiac resynchronization therapy (CRT) with left ventricular (LV) pacing is an established therapy for heart failure (HF) patients (P) with ventricular desynchronisation and reduced LV ejection fraction (EF). The aim of this study was to test the utilization of the transesophageal approach to measure arterial pulse pressure (PP) during LV pacing and electrical interventricular conduction delay (IVCD), to better select patients for CRT.
Methods: 32 HF patients (age 64 ± 10 years; 5 females, 27 males) with New York Heart Association (NYHA) class 2.8 ± 0.6, 27 ± 11 % LV EF and 155 ± 35 ms QRS duration were analysed with semi-invasive left cardiac pacing and electrocardiography. Esophageal TO8 Osypka catheter of 10.5 F diameter was perorally applied to the esophagus and placed in the position of maximum left atrial (LA) deflection and maximum LV deflection to measure PP with VAT or D00 pacing modes.
Results: Temporary transesophageal LV pacing was possible with VAT mode (n=16) and D00 mode (n=16) in all patients. In 15 Δ-PP-responders, PP was higher during LV pacing on than LV pacing off (78.3 ± 26.6 versus 65.9 ± 23.7 mmHg, P < 0.001) and NYHA class improved from 3.1 ± 0.35 to 2.1 ± 0.35 (P < 0.001) during 29 ± 26 month biventricular (BV) pacing follow-up (6 Medtronic and 9 Boston BV pacing devices). In 17 Δ-PP-non-responders, PP was not higher during LV pacing on than LV pacing off (61.5 ± 23.9 versus 60.9 ± 23.5 mmHg, P = 0.066). IVCD was significant longer in Δ-PP-responders than in Δ-PP-non-responders (87 ± 33 ms versus 37± 29 ms, P < 0.001).
Conclusion: Semi-invasive transesophageale LA and LV pacing with D00 and VAT mode and LV electrogram recording may be useful techniques to predict CRT improvement.
Hintergrund: Richtung und Stärke des elektrischen Feldes (E-Feld) der biventrikulären (BV) Stimulation und elektrische interventrikuläre Desynchronisation sind bei Patienten mit Herzinsuffizienz und verbreitertem QRS Komplex von Bedeutung für den Erfolg der kardialen Resynchronisationstherapie (CRT). Das 3D Herzrhythmusmodell (HRM) ermöglicht die
Simulation von CRT und Hochfrequenz (HF) Ablation. Das Ziel der Studie besteht in der Integration von Schrittmacher- und Ablationselektroden in das HRM zur E-Feld Simulation der BV Stimulation und thermischen Feld (T-Feld) Simulation der HF Ablation von Vorhofflimmern (AF).
Methoden: Es wurden fünf multipolare linksventrikuläre (LV) Elektroden, eine epikardiale LV Elektrode, vier bipolare rechtsatriale (RA) Elektroden, zwei rechtsventrikuläre (RV) Elektroden und ein HF Ablationskatheter mit CST (Computer Simulation Technology, Darmstadt) modelliert und das HRM (Schalk et al: Clin Res Cardiol 106, Suppl 1, April 2017, P1812) um den Koronarvenensinus (CS) erweitert (HRM-CS). E-Feld Simulationen bei vorhofsynchroner BV Stimulation und bei RA Stimulation mit RV und LV Ableitung erfolgten mit den Elektroden Select Secure 3830, Capsure VDD-2 5038 und Attain OTW 4194 im HRM+CS (Fig.). F-Feld Simulationen der HF Ablation von AF bei CRT wurden mit integriertem Ablationskatheter AlCath G FullCircle (Biotronik) simuliert.
Ergebnisse: HRM-CS ermöglichte 3D E-Feld Simulationen bei vorhofsynchroner bipolarer BV Stimulation und bei bipolarer RA Stimulation mit bipolarer RV und LV Ableitung. RV und LV Stimulation erfolgten zeitgleich bei einer Amplitude von 3 V an der LV Elektrode und 1 V an der RV Elektrode mit einer Impulsbreite von jeweils 0,5 ms. Die von der BV Stimulationen erzeugten Fernpotentiale konnten von der RA Elektrode wahrgenommen werden. Das Fernpotential an der RA Elektrodenspitze betrug 32,86 mV und in 1 mm Abstand von der RA Elektrodenspitze ergab sich ein Fernpotential von 185,97 mV. HRM-CS ermöglichte 3D T-Feld Simulationen der HF Ablation von AF bei CRT. Das T-Feld bei HF Ablation des AV-Knotens wurde mit einer anliegenden Leistung von 5 W bei 420 kHz an der distalen 8 mm Ablationselektrode simuliert. Die Temperatur an der Katheterspitze betrug nach 5 s Ablationsdauer 88,66 °C, in 1 mm Abstand von der Katheterspitze im Myokard 42,17 °C und in 2 mm Abstand 37,49 °C.
Schlussfolgerungen: HRM-CS und Elektrodenmodelle ermöglichen die 3D Simulationen von E-Feldern bei vorhofsynchroner BV Stimulation, RA Stimulation mit RV und LV Wahrnehmung und von T-Feldern bei HF Ablation. E-Feld Simulationen von RA, RV und LV Stimulation und Sensing können möglicherweise zur Vorhersage von CRT Respondern genutzt werden.
Background: Cardiac resynchronization therapy (CRT) is an established therapy for heart failure (HF) patients (P) with reduced left ventricular (LV) ejection fraction and electrical interventricular desynchronization, but not all P improved clinically. The aim of the study was to evaluate electrical interventricular delay (IVD) to LV delay (LVD) ratio in atrial fibrillation (AF) CRT responder (R) and non-responder (NR).
Methods: AF P (n = 18, age 60.6 ± 11.4 years, 1 female, 17 males) with HF New York Heart Association (NYHA) class 3.0 ± 0.2, 25.3 ± 5.9 % LV ejection fraction and 157.8 ± 24.4 ms QRS duration (QRSD) were measured by surface ECG and focused transesophageal bipolar LV ECG before implantation of CRT pacemaker (n = 2) or CRT defibrillator (n = 16). IVD was measured between onset of QRS in the surface ECG and onset of LV signal in the LV ECG. LVD was measured between onset and offset of LV signal in the LV ECG.
Results: Electrical ventricular desynchronization in AF CRT P were 61.9 ± 26.9ms IVD, 80.6 ± 24.3ms LVD, 0.85 ± 0.41 IVD-LVD-ratio (Figure), 3.12 ± 1.89 QRSD-IVD-ratio and 2.07 ± 0.47 QRSD-LVD-ratio. There were 72.2 % AF CRT R (n = 13) with 64.2 ± 24.6ms IVD and 77.8 ± 21.6ms LVD with Pearson correlation to 0.89 ± 0.39 IVD-LVD-ratio (r = 0.87, P < 0.01; r = -0.69, P < 0.01), 2.82 ± 1.32 QRSD-IVD-ratio (r = -0.76, P < 0.01; r = 0.67, P = 0.011) and 2.13 ± 0.46 QRSD-LVD-ratio (r = 0.57, P = 0.041; r = -0.85, P < 0.01). There were 27.8% AF CRT NR (n = 5) with 56.0 ± 34.5ms IVD and 87.8 ± 31.9ms LVD without correlation to 0.74 ± 0.48 IVD-LVD-ratio, 3.88 ± 2.98 QRSD-IVD-ratio and 1.90 ± 0.48 QRSD-LVD-ratio. During 15.3 ± 13.1 month CRT follow-up, the AF CRT R NYHA class improved from 3.0 ± 0.2 to 2.2 ± 0.3 (P < 0.001). During 18.8 ± 20.7 month CRT follow-up, the AF CRT NR NYHA class not improved from 3 to 3.3 ± 0.97.