Arrhythmias after Implantation of the Left Ventricular Assisted Device Arrhythmias after Implantation of the Left Ventricular Assisted Device

Cardiac arrhythmias has been frequently reported after left ventricular assist devices implantation but currently literature shows no sufficient information on cardiac arrhythmias. Objective: The aim of this study was to assess the frequency and other features of ventricular and supra ventricular ectopic beats ((SVEB), atrial fibrillation (AF)/flutter (AFL) post device implantation. Methods: This is a retrospective study conducted in Department of Cardiac-Surgery, University of Verona Medical School, Verona, Italy from June 2014-September 2016. Rhythm monitoring and registration were collected from 16 patients (13 males; 45±13years) during the first five (05) days after implantation. To assess late post-operative rhythm, patient’s hospital electronic records were used as well asfunctional hemodynamic parameters including mean arterial pressure(MAP), right atrial pressure(RAP), heart rate(HR) and ST-deviation(d-ST). Results: Ventricular arrhythmia (n=9), atrial fibrillation (n=5) or atrial flutter (n=2) episodes were preoperatively present in 11 patients. Postoperatively, 5 patients developed either VT (n=2), AF (n=1) or both VT/AF (n=2) during a follow-up of 18±14 months. Prior to postoperative VT (POVT) episodes (n=123), MAP decreased, HR, d-ST increased and RAP remained unaltered. POVT were initiated either by single VEBS (28%), V-couplets (15%), V-run (46%) or occurred suddenly (11%). Conclusions: Ventricular and supraventricular arrhythmias are common after device implantation. The frequency of sustained VTA was less at early phase as compared to late postoperative phase.

An Analysis of the Art of Illumination in Qur’Ān Manuscripts

This analytical research is based on the study of illumination in Qur’ān manuscripts located in different libraries of Punjab, Pakistan. The focus of this doctoral thesis was analysis and identification of indigenous styles of illumination as found in Qur’ān manuscripts produced in the Subcontinent. The research was carried out through the study of Qur’ān manuscripts produced during a time span of five hundred years i.e. from 9 th /15 th to 13 th /19 th centuries. The tradition of embellishing the text of Qur’ān goes back to the 1 st /7 th century when early Qur’ānic texts were decorated with simple geometric designs. With the passage of time the initial simple shapes evolved into highly complex designs used on the front pages and around the text boxes of Qur’ān manuscripts. Like other art forms, the art of Qur’ān illumination reflects the regional artistic trends where Muslims established their rule. This research however focuses on the styles of illumination which are different from the well documented Persian, Ottoman, Far Eastern or Mamluk styles. The research shows in detail the elements and principles of Qur’ān illumination along with the techniques used for design development. The study is also an attempt to unveil some distinct styles of illumination which flourished in the Subcontinent. The results revealed several indigenous styles of illumination like Indo-Persian, Mughal, Kashmiri, Bihāri and folk illumination designs. The analysis was conducted through non destructive methods and the results are presented taxonomically. These vernacular styles of illumination are identified through the analysis of individual motifs, colour application and the compositional order. This research also identified some distinct illumination trends which were adopted by the illuminators of Subcontinent in 13 th /19 th century indicating to the continuation of the practice of embellishing the Qur’ān manuscripts even after the advent of printing technology in this region.