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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Tourist business organizations face a challenging and the risks dynamic environment reflected its impact on the community and generate extra under pressure in the responsibilities and burdens of exceptional and affected much of factors, accidents and risks as a result of the actions and attitudes of disasters variety may exceed the geography of States border, which requires the absorption of risks facing the tourism and how to manage and deal with them scientific and reasonable grounds for the diagnosis and treatment of risk and how to reduce the aggravation and the different kinds.
As risks affecting the most important and vital to organizations as a tourist aspects of the market share and styles tourist
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To decrease the impact on the environment of building waste, the recycled aggregate may be used in various sustainable engineering applications, such as roller compacted concrete pavement (RCCP). This research examined how using recycled aggregate as a partial replacement for natural aggregate as coarse or fine affected the mechanical properties of roller-compacted concrete pavement. The recycled aggregate was crushed and sieved to coarse and fine aggregate before being used in the roller-compacted concrete pavement. Compressive strength, splitting tensile strength, and flexural strength were all evaluated after the samples were prepared at 28 and 90 days of curing. According to the study's findings, the partial replacem
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This study introduces a series of single and pile group model tests subjected to lateral loads in . multilayered sand from Karbala, Iraq. The aim of this study is to investigate: the performance of the pile groups subjected to lateral loads; in which the pile batter inclination angle is changed; the effect of pile spacing (s/d) ratio, the influence of using different number of piles and pile group configuration. Results revealed that the performance of single negative (Reverse) Battered piles with inclination of 10° and 20° show a gain of 32% and 76 % in the ultimate lateral capacity over the regular ones. For pile groups, the use of a combination of regular, negative and positive battered piles in
... Show MoreIn this current work, Purpose; to clearly the fundamental idea for constructing a design and
investigation of spur gear made of composite material its comes from the combination of (high
speeds, low noise, oil-les running, light weight, high strength, and more load capability)
encountered in modern engineering applications of the gear drives, when the usual metallic gear
cannot too overwhelming these combinations.
An analyzing of stresses and deformation under static and dynamic loading for spur gear tooth
by finite element method with isoparametric eight-nodded in total of 200 brick element with 340
nods in three degree of freedom per node was selected for this analysis. This is responsible for the
catastropic fa
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