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.

Evaluation of Regional Services Network of Allama Iqbal Open University and Developing a Plan of Action for Future

The AIOU has a large Regional Services Network of Regional Centres and Campuses all over the country. Students are getting guidance and strengthening the process of learning. In Distance Education the Regional Network is of importance, where teaching and learning is actually taking place. Regional Centers are implementing the multidisciplinary education for about one million students every year. The research aimed at An Analytical study of Regional Services Network of Allama Iqbal Open University. It also aimed developing a Plan of Action for Future in the field of Distance Education at national level. The research study was descriptive in nature for which six questionnaires were designed after the study of related literature on five point lekirt scale and for which survey was conducted through the questionnaires. The objectives of the study were, to examine the functioning of the present system and the role of different functionaries in the AIOU regional network, identify the problems in the implementation of the process in order to achieve the defined AIOU objectives in the regions, to determine standard and usefulness of the services being provided to students in the regions, in term of tutors, resource person ,technological aids and physical facilities already available in the regions and to propose a plan of action to meet the future needs of AIOU regional network. The population of the study comprised all Tutors and Students of M.Ed programme, all Regional Directors, all Regional Coordinators, Study Centre Coordinators and the Director Regional Services. The sample of the study comprised 150 Tutors, 350 Students, 25 Regional Directors, 80 Regional Coordinators, 150 Study Coordinators and the Director Regional Services. For this purpose six questionnaires were prepared in consultation with the supervisor and other experts in the field. The collected data was presented and tabulated in Chapter IV. Different statistical tools including percentage, Chi-square were applied for the analysis the data. Based on the analysis of data findings and conclusions were drawn and recommendations were made. Major finding of the study indicated that present system needs further strengthening of the structure. The other findings indicated lack of training, resources and man power. Technology and latest communication equipments were also common deficiencies in the region. Future studies have also been recommended by the researcher as Open Universities are important educational innovations of 21st century and developed a Model of Distance Education System in Pakistani perspective.