Twin shaping filter technique for signals compensation in CZT detectors grown by the vertical bridgman method

CdTe/CdZnTe is a consolidated material to realize detectors for a large variety of applications, such as medical, industrial, and space research. An Italian collaboration, involving the CNR/IMEM and INAF/IASF institutes, was born some years ago with the aim to develop a national capability to produce CZT detectors starting from the material growth to the final detection device. Some important features of these detectors (pulse height, energy resolution, photopeak efficiency) are affected by the charge collection efficiency: the low mobility of the charge carriers (particularly the holes) and trapping/detrapping phenomena can degrade the CdTe/CZT detectors response, depending on the distance between the charge formation position and the collecting electrodes. Several efforts have been made to improve the detection efficiency as well as the energy resolution, using both the optimization of the electrode geometry (drift strip technique, coplanar-grid, small pixel effect) and pulse height compensation methods to overcome the hole trapping problem. We have studied a bi-parametric method that uses a twin pulse shaping active filter to analyze the same signal: one slow, which is proportional to the energy of the photon, and one fast, which depends on the position of the interaction with respect to the collecting electrode. The experimental results obtained with the application of this bi-parametric technique on planar CZT detectors of good quality grown by the Vertical Bridgman method at CNR/IMEM are presented as a function of the bias voltage, photon energy and shaping time pairs

Long-term survival in patients undergoing cardiac resynchronization therapy: the importance of performing atrio-ventricular junction ablation in patients with permanent atrial fibrillation

Aims To investigate the effects of cardiac resynchronization therapy (CRT) on survival in heart failure (HF) patients with permanent atrial fibrillation (AF) and the role of atrio-ventricular junction (AVJ) ablation in these patients. Methods and results Data from 1285 consecutive patients implanted with CRT devices are presented: 1042 patients were in sinus rhythm (SR) and 243 (19%) in AF. Rate control in AF was achieved by either ablating the AVJ in 118 patients (AVJ-abl) or prescribing negative chronotropic drugs (AF-Drugs). Compared with SR, patients with AF were significantly older, more likely to be non-ischaemic, with higher ejection fraction, shorter QRS duration, and less often received ICD back-up. During a median follow-up of 34 months, 170/1042 patients in SR and 39/243 in AF died (mortality: 8.4 and 8.9 per 100 person-year, respectively). Adjusted hazard ratios were similar for all-cause and cardiac mortality [0.9 (0.57-1.42), P = 0.64 and 1.00 (0.60-1.66) P = 0.99, respectively]. Among AF patients, only 11/118 AVJ-abl patients died vs. 28/125 AF-Drugs patients (mortality: 4.3 and 15.2 per 100 person-year, respectively, P < 0.001). Adjusted hazard ratios of AVJ-abl vs. AF-Drugs was 0.26 [95% confidence interval (CI) 0.09-0.73, P = 0.010] for all-cause mortality, 0.31 (95% CI 0.10-0.99, P = 0.048) for cardiac mortality, and 0.15 (95% CI 0.03-0.70, P = 0.016) for HF mortality. Conclusion Patients with HF and AF treated with CRT have similar mortality compared with patients in SR. In AF, AVJ ablation in addition to CRT significantly improves overall survival compared with CRT alone, primarily by reducing HF deat

Right ventricular endocardial segmentation in CMR images using a novel inter-modality statistical shape modelling approach

Statistical shape modelling (SSM) approaches have been proposed as a powerful tool to segment the left ventricle in cardiac magnetic resonance (CMR) images. Our aim was to extend this method to segment the RV cavity in CMR images and validate it compared to the conventional gold-standard (GS) manual tracing. A SSM of the RV was built using a database of 4347 intrinsically 3D surfaces, extracted from transthoracic 3D echo cardiographic (3DE) images of 219 retrospective patients. The SSM was then scaled and deformed on the base of some features extracted, with different strategies, from each short-axis plane until a stable condition was reached. The proposed approach, tested on 14 patients, resulted in a high correlation (r2=0.97) and narrow limits of agreement (± 17% error) when comparing the semiautomatic volumes to the GS, confirming the accuracy of this approach in segmenting the RV endocardium

Prospective blinded evaluation of a novel sensing methodology designed to reduce inappropriate shocks by the subcutaneous implantable cardioverter-defibrillator

Background: Most inappropriate shocks from the subcutaneous implantable cardioverter-defibrillator (S-ICD) are caused by cardiac oversensing. A novel sensing methodology, SMART Pass (SP; Boston Scientific Corporation, Natick, MA), aims to reduce cardiac oversensing. Objective: The purpose of this study was to evaluate the effect of SP on shocks in ambulatory patients with S-ICD. Methods: Patients implanted in 2015–2016 and enrolled in a remote patient monitoring system were included and followed for 1 year. Shocks were adjudicated by 3 independent blinded reviewers as appropriate or inappropriate. Shock incidence was calculated for patients with SP programmed enabled or disabled at implantation, censoring patients when SP programming changed or at the last transmission. The SP setting (enabled vs disabled) was modeled as a time-dependent Cox regression variable. Results: The cohort consisted of 1984 patients, and a total of 880 shocks were adjudicated. At implantation, SP was enabled in 655 patients (33%) and disabled in 1329 patients (67%). SP reduced the risk for the first inappropriate shock by 50% (P <.001) and the risk for all inappropriate shocks by 68% (P <.001) in multivariate analysis adjusted for age and device programming. The incidence of inappropriate shocks was 4.3% in the SP enabled arm vs 9.7% in the SP disabled arm. The incidence of appropriate shocks was similar (5.2

Research of the Additional Losses Occurring in Optical Fiber at its Multiple Bends in the Range Waves 1310nm, 1550nm and 1625nm Long

Article is devoted to research of the additional losses occurring in the optical fiber at its multiple bends in the range waves of 1310 nanometers, 1550 nanometers and 1625 nanometers long. Article is directed on creation of the external factors methods which allow to estimate and eliminate negative influence. The automated way of calculation of losses at a bend is developed. Results of scientific researches are used by engineers of "Kazaktelekom" AS for practical definition of losses service conditions. For modeling the Wolfram|Alpha environment - the knowledge base and a set of computing algorithms was chosen. The greatest losses are noted on wavelength 1310nm and 1625nm. All dependences are nonlinear. Losses with each following excess are multiplicative

European Cardiac Resynchronization Therapy Survey II: rationale and design

The Cardiac Resynchronization Therapy (CRT) Survey II is a 6 months snapshot survey initiated by two ESC Associations, the European Heart Rhythm Association and the Heart Failure Association, which is designed to describe clinical practice regarding implantation of CRT devices in a broad sample of hospitals in 47 ESC member countries. The large volume of clinical and demographic data collected should reflect current patient selection, implantation, and follow-up practice and provide information relevant for assessing healthcare resource utilization in connection with CRT. The findings of this survey should permit representative benchmarking both nationally and internationally across Europ

European Cardiac Resynchronization Therapy Survey II: rationale and design

The Cardiac Resynchronization Therapy (CRT) Survey II is a 6 months snapshot survey initiated by two ESC Associations, the European Heart Rhythm Association and the Heart Failure Association, which is designed to describe clinical practice regarding implantation of CRT devices in a broad sample of hospitals in 47 ESC member countries. The large volume of clinical and demographic data collected should reflect current patient selection, implantation, and follow-up practice and provide information relevant for assessing healthcare resource utilization in connection with CRT. The findings of this survey should permit representative benchmarking both nationally and internationally across Europ