Transient drop in the heart beat or transient heart block (AVB) may be consider the main cause of syncope or presyncope inpatients with bifascicular block and syncope According to the Guidelines for cardiac pacing pacemaker consider part of treatment. Aims of our study were to evaluate whether there is role for EPS in patients BFB and to evaluate the symptoms after pacing. 42 patients were enrolled in this study, with mean age value (63.4± 12.2years), suffer from interventricular conductive defect and syncope; patients underwent EPS on admission time, and pacemaker implantation accordingly and programmed follow up for the device in the last four years. Our patients were 25 (59.5%) male and 17 (40.5%)female, all of them with syncope or presncope and good left ventricular systolic function and the left ventricular ejection fraction (LVEF ≥55%). Left bundle branch block was found in 28 (66.71%) patients, while right bundle branch block were found in,14 (33.3) of them, the result of the EPS was find the cut of HV interval for pacing which represent that that the threshold at level of 75 have a sensitivity of 91% and specificity of 80%. The greater HV intervals gave more successful results for pacing. Pacemaker was implanted in 27 (64.3%) of the patients, with significant relation between pacing and syncope disappeared after pacemaker implantation (p value 000) and in 15 (35.7%) no pacemaker was implanted with persistent symptoms. Pacing were more between patients with coronary artery disease and LBBB with abnormal EPS finding. Permanent pacemaker implantation can implant directly in those old patients with syncope and bifascicular block that associated with LBBB and coronaries artery diseases without or before EP study
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The calculation of the oil density is more complex due to a wide range of pressuresand temperatures, which are always determined by specific conditions, pressure andtemperature. Therefore, the calculations that depend on oil components are moreaccurate and easier in finding such kind of requirements. The analyses of twenty liveoil samples are utilized. The three parameters Peng Robinson equation of state istuned to get match between measured and calculated oil viscosity. The Lohrenz-Bray-Clark (LBC) viscosity calculation technique is adopted to calculate the viscosity of oilfrom the given composition, pressure and temperature for 20 samples. The tunedequation of state is used to generate oil viscosity values for a range of temperatu
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This study carry’s out the correlation and the effect of two main variables, these variables are Job Satisfaction included six sub: wages - salaries and justice and yield, working conditions and services, pattern of supervision and the relationship with the manger, Relationship with colleagues, the content of the work and the variety of tasks, development and promotion opportunities available to an individual, and Organizational Performance included two sub variables: Efficiency, Effectiveness. This research was conducted using a questioner as a main tool, This questioner was distributed randomly to a research community composed of
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The flexible joint robot (FJR) typically experiences parametric variations, nonlinearities, underactuation, noise propagation, and external disturbances which seriously degrade the FJR tracking. This article proposes an adaptive integral sliding mode controller (AISMC) based on a singular perturbation method and two state observers for the FJR to achieve high performance. First, the underactuated FJR is modeled into two simple second-order fast and slow subsystems by using Olfati transformation and singular perturbation method, which handles underactuation while reducing noise amplification. Then, the AISMC is proposed to effectively accomplish the desired tracking performance, in which the integral sliding surface is designed to reduce cha
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