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Fever is a potential side effect of the Covid-19 vaccination. Patients with Brugada syndrome (BrS) have an increased risk of life-threatening arrhythmias when experiencing fever. Prompt treatment with antipyretic drugs is suggested in these patients.To evaluate the incidence and management of fever within 48 h from Covid-19 vaccination among BrS patients.One hundred sixty-three consecutive patients were enrolled in a prospective registry involving five European hospitals with a dedicated inherited disease ambulatory.The mean age was 50 ± 14 years and 121 (75%) patients were male. Prevalence of Brugada electrocardiogram (ECG) pattern type-1, -2, and -3 was 32%, 44%, and 24%, respectively. Twenty-eight (17%) patients had an implantable cardioverter-defibrillator (ICD). Fever occurred in 32 (19%) BrS patients after 16 ± 10 h from vaccination, with a peak of body temperature of 37.9° ± 0.5°. Patients with fever were younger (39 ± 13 vs. 48 ± 13 years, p = .04). No additional differences in terms of sex and cardiovascular risk factors were found between patients with fever and not. Twenty-seven (84%) out of 32 patients experienced mild fever and five (16%) moderate fever. Pharmacological treatment with antipyretic drugs was required in 18 (56%) out of 32 patients and was associated with the resolution of symptoms. No patient required hospital admission and no arrhythmic episode was recorded in patients with ICD within 48 h after vaccination. No induced type 1 BrS ECG pattern and new ECG features were found among patients with moderate fever.Fever is a common side effect in BrS patients after the Covid-19 vaccination. Careful evaluation of body temperature and prompt treatment with antipyretic drugs may be needed.

Nowadays, in the centre of Catania, the several visible archaeologies seem more irrelevant objects than ancient treasures. This is due to fact they are fenced in scattered holes without any common idea. “Bohob”, the group of architects we belong to, is conducting a research in order to address this burning problem by means of a two-pronged approach. On one hand, by the Drawing of the City, a large plan of Catania including all the archaeological ruins representing their integral role in the building of the city and in forcing the shape of the modern town; on the other hand, by the Minimum Projects, consisting of shrines on a citywide scale in which the ruins are enclosed as well as appearing as gems and not as temporary objects in the urban pattern. The core essence of the research is studying the relationship between the archae-ology and the city via an interdisciplinary method based on the brand-new digital forms of representation; starting from considering the ancient as “active part” in the construction of the town and its little fragments as gems mounted in the urban pattern.

Background Few studies have examined the causes of syncope/collapse recurrences in patients with a previously implanted pacemaker for bradyarrhythmic syncope. Objective The purpose of this study was to assess the causes of syncope/collapse recurrences after pacemaker implantation for bradyarrhythmic syncope in a large patient population. Methods The SYNCOpal recurrences in patients treated with permanent PACing for bradyarrhythmic syncope (SYNCOPACED) registry was a prospective multicenter observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for bradyarrhythmic syncope. During follow-up, the time to the first syncope/collapse recurrence was recorded. Patients with syncope/collapse recurrences underwent a predefined diagnostic workup aimed at establishing the mechanism of syncope/collapse. Results During a median follow-up of 50 months, 213 patients (15.6%) reported at least 1 syncope/collapse recurrence. The risk of syncope/collapse recurrence was highest in patients who underwent implantation for cardioinhibitory vasovagal syncope (26.4%), followed by unexplained syncope and chronic bifascicular block (21.5%), cardioinhibitory carotid sinus syndrome (17.2%), atrial fibrillation needing pacing (15.5%), atrioventricular block (13.6%), and sinus node disease (12.5%) (P = .017). The most frequent cause of syncope/collapse recurrence was reflex syncope (27.7%), followed by orthostatic hypotension (26.3%), pacemaker or lead malfunction (5.6%), structural cardiac disease (5.2%), and atrial and ventricular tachyarrhythmias (4.7% and 3.8%, respectively). In 26.8% of cases, the mechanism of syncope/collapse remained unexplained. Conclusion In patients receiving a pacemaker for bradyarrhythmic syncope, reflex syncope and orthostatic hypotension are the most frequent mechanisms of syncope/collapse recurrence after implantation. Pacing system malfunction, structural cardiac diseases, and tachyarrhythmias are rare mechanisms. The mechanism remains unexplained in >25% of patients.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in 1–2% of the general population. Catheter ablation has become an important treatment modality for patients with symptomatic drug-refractory AF. We report data regarding the AF ablation approaches and modalities in the Italian “real world.” The survey was set-up to collect data on ablation procedure across Italy. All centers performing AF ablation were invited, regardless of the number of annual procedures, to complete a questionnaire regarding their ablation approaches. All centers reported data regarding procedures performed during the year 2017. A total of 3260 procedures were reported from 49 participating hospitals. Most of Italian regions were included in the study. The majority of the centers performed “Always” pulmonary vein isolation (PVI) in paroxysmal and persistent AF catheter ablation, while adjunctive lesions in persistent AF ablation were planned in most of them but not all, and 16% never performed lesions other than PVI. During ablation procedure, vitamin k inhibitors were uninterrupted in 55% of centers, while direct oral anticoagulant in 44% of centers was used uninterruptedly. No relationship was observed between patient data and the number of procedures performed at each center. This survey suggests that the adherence of Italian centers to the most recent European Society of Cardiology guidelines for AF ablation is reasonably high.

Aims To evaluate the risk of syncopal recurrences after pacemaker implantation in a population of patients with syncope of suspected bradyarrhythmic aetiology. Methods and results Prospective, multicentre, observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for syncope of bradyarrhythmic aetiology (proven or presumed). Before pacemaker implantation, all patients underwent a cardiac work-up in order to establish the bradyarrhythmic aetiology of syncope. According to the results of the diagnostic work-up, patients were divided into three groups: Group A, patients in whom a syncope-electrocardiogram (ECG) correlation was established (n = 329, 24.1%); Group B, those in whom clinically significant bradyarrhythmias were detected without a documented syncope-ECG correlation (n = 877, 64.3%); and Group C, those in whom bradyarrhythmias were not detected and the bradyarrhythmic origin of syncope remained presumptive (n = 158, 11.6%). During a median follow-up of 50 months, 213 patients (15.6%) reported at least one syncopal recurrence. Patients in Groups B and C showed a significantly higher risk of syncopal recurrences than those in Group A [hazard ratios (HRs): 1.60 and 2.66, respectively, P Conclusion In selecting patients with syncope of suspected bradyarrhythmic aetiology for pacemaker implantation, establishing a correlation between syncope and bradyarrhythmias maximizes the efficacy of pacing and reduces the risk of syncopal recurrences.

Outflow tract (OT) premature ventricular contractions (PVCs) are commonly found in clinical practice; in most cases, PVCs are benign and observed in structurally normal hearts, not requiring any therapeutic intervention. In this study, we therefore sought to evaluate with cardiac magnetic resonance (CMR) patients with PVC and apparently normal heart at echocardiographic examination, in order to identify possible substrates linked with higher prevalence of arrhythmias or structural heart disease. Thirty-three consecutive patients with frequent PVCs originating from the ventricular OT (right and left) were enrolled in the study and assessed by echocardiography and CMR. All patients had normal baseline electrocardiogram. CMR showed structural changes in 5 patients out of 33; in 3 cases, areas of fibrosis limited in one case to the middle basal segments of the interventricular septum and in two patients to the middle basal segments of the inferior-lateral wall were found. In 2 other cases, however, late gadolinium enhancement showed significant anomalies characterized in one patient by extensive areas of subepicardial fibrosis of the left ventricle, suitable with arrhythmogenic left dominant dysplasia; in another patient, a marked trabeculation of left ventricular medium apical segments suitable with non-compaction myocardium was present. CMR may identify cases of structural heart disease in subjects with OT PVCs and apparently normal electrocardiogram and echocardiogram examinations. A preliminary screening with CMR may be considered before any further invasive electrophysiology assessment and therapeutic planning.

In patients with unexplained syncope and bifascicular block (BFB), syncope may be caused by intermittent atrioventricular (AV) block. When a correlation between syncope and bradyarrhythmia is not documented in these patients, 2 alternative management strategies can be adopted: (1) empiric pacemaker (PM) implantation or (2) long-term continuous electrocardiographic monitoring by implantable loop recorder (ILR).The purpose of this study was to compare the risk of syncope recurrence associated with empiric PM implantation or ILR monitoring.A prospective, multicenter, observational study enrolled consecutive patients with unexplained, recurrent, traumatic syncope and BFB who underwent ILR monitoring or empiric PM implantation. The risk and causes of syncope recurrence were assessed and compared between the 2 groups. Individual 1:1 propensity matching of baseline characteristics was performed.A total of 309 consecutive patients (age 77.2 ± 12.2 years; 60.8% male) were enrolled. Propensity matching yielded 89 matched pairs. After median follow-up of 33 months, empiric PM implantation was associated with a significantly lower risk of syncope recurrence than ILR monitoring (19.1 vs 46.1%; P.001). A total of 35 patients (39.3%) who underwent ILR monitoring developed bradyarrhythmias (68.6% paroxysmal AV block) requiring PM implantation during follow-up. Excluding bradyarrhythmic syncope, the most frequent causes of syncope recurrence in both study groups were reflex syncope and orthostatic hypotension.In patients with unexplained, recurrent, traumatic syncope and BFB, empiric PM implantation significantly reduced the risk of syncope recurrence in comparison with ILR monitoring. A high rate of patients who underwent ILR monitoring developed bradyarrhythmias requiring PM implantation.

Por medio de algunos mapas y vistas se reconoce la particularísima relación entre Catania y el Etna: la ciudad está asentada sobre el volcán que llega hasta el mar. La Veduta dalla parte meridionale grabada por Sebastiano Ittar -casi un frente más que perspectiva- permite distinguir cuatro paisajes sucesivos.

Background: Brugada syndrome (BrS) is an inherited primary channelopathy syndrome associated to sudden cardiac death. Overall, variants have been identified in eighteen genes encoding for ion channel subunits and seven genes for regulatory proteins. Recently, a missense variant in DLG1 has been found within a BrS phenotype-positive patient. DLG1 encodes for synapse associated protein 97 (SAP97), a protein characterized by the presence of multiple domains for protein–protein interactions including PDZ domains. In cardiomyocytes, SAP97 interacts with Nav1.5, a PDZ binding motif of SCN5A and others potassium channel subunits. Aim of the Study: To characterize the phenotype of an Italian family with BrS syndrome carrying a DLG1 variant. Methods: Clinical and genetic investigations were performed. Genetic testing was performed with whole-exome sequencing (WES) using the Illumina platform. According to the standard protocol, a variant found by WES was confirmed in all members of the family by bi-directional capillary Sanger resequencing. The effect of the variant was investigated by using in silico prediction of pathogenicity. Results: The index case was a 74-year-old man with spontaneous type 1 BrS ECG pattern that experienced syncope and underwent ICD implantation. WES of the index case, performed assuming a dominant mode of inheritance, identified a heterozygous variant, c.1556G>A (p.R519H), in the exon 15 of the DLG1 gene. In the pedigree investigation, 6 out of 12 family members had the variant. Carriers of the gene variant all had BrS ECG type 1 drug induced and showed heterogeneous cardiac phenotypes with two patients experiencing syncope during exercise and fever, respectively. The amino acid residue #519 lies near a PDZ domain and in silico analysis suggested a causal role for the variant. Modelling of the resulting protein structure predicted that the variant disrupts an H-bond and a likelihood of being pathogenic. As a consequence, it is likely that a conformational change affects protein functionality and the modulating role on ion channels. Conclusions: A DLG1 gene variant identified was associated with BrS. The variant could modify the formation of multichannel protein complexes, affecting ion channels to specific compartments in cardiomyocytes.

The Southern Europe Thomson Backscattering Source for Applied Research (STAR) is a compact hard Xray source designed by INFN, for advanced applied materials-science research. It is funded by Progetto MaTeRiA, a partnership between the University of Calabria and CNISM (Consorzio Nazionale Interuniversitario per le Scienze fisiche della Materia). The machine has been installed at the University of Calabria (UNICAL); the X-ray beam is produced using the Thomson Back-scattering process, where relativistic electron bunches, accelerated by a 60 MeV Linear Accelerator (LINAC), interact with very short photon pulses, produced a by a 30 mJ@5 ps IR (Infrared) Pulsed Laser. The EPICS-based command/control system (ComConS) of the STAR machine has been designed and currently is under commissioning, using state of the art technologies and making extensive use of COTS hardware and software, assuring full control and supervision of the whole machine and all relevant subsystems: Beam diagnostics, Magnets power supplies, RF devices, Laser systems, Vacuum subsystem, Machine Protection System, Personnel Protection System and Trigger and Timing system. A growth potential has been considered since design phase, in order to take into account any future expansions of the control system during the lifecycle of the facility, without impact on the performance. Scalability of systems is also a crucial issue. The current design allows to generate tunable collimated monochromatic X-rays in the range between 10 and 200 keV. Possible future evolution will be to obtain a machine to generate higher energy X-ray beams, towards the MeV. The control system from both SW and HW points of view has to accommodate this need, as well as operating the machine for a long lifecycle.

After a decade since the 20-20-20 Climate-Energy package, there are still many challenges to be faced in order to achieve decarbonisation of the electric energy sector. The European Union has set very challenging objectives for 2030 by providing for an even more massive diffusion of the distributed renewable generation units. In order to do so, the active participation of citizens in the mechanisms of production and sale of electricity has been identified as key factor for achieving these objectives. For this reason, RED-II and IEM directives introduced new entities, which allow citizens to become active players in the electricity system by producing, storing and selling self-produced renewable electricity. This research paper aims at analysing the Renewable Energy Community scheme resulting from the Italian implementation of EU regulations and how it will impact on the electric distribution systems. The study has been performed considering national statistics and shows that Renewable Energy Community can contribute to achieve 63% of the 2030 target of the renewable energy sources installation.

European physical journal special topics 229(24), 3675 - 4284 (2020). doi:10.1140/epjst/e2020-000127-8, This report presents the conceptual design of a new European research infrastructure EuPRAXIA. The concept has been established over the last four years in a unique collaboration of 41 laboratories within a Horizon 2020 design study funded by the European Union. EuPRAXIA is the first European project that develops a dedicated particle accelerator research infrastructure based on novel plasma acceleration concepts and laser technology. It focuses on the development of electron accelerators and underlying technologies, their user communities, and the exploitation of existing accelerator infrastructures in Europe. EuPRAXIA has involved, amongst others, the international laser community and industry to build links and bridges with accelerator science — through realising synergies, identifying disruptive ideas, innovating, and fostering knowledge exchange. The Eu-PRAXIA project aims at the construction of an innovative electron accelerator using laser- and electron-beam-driven plasma wakefield acceleration that offers a significant reduction in size and possible savings in cost over current state-of-the-art radiofrequency-based accelerators. The foreseen electron energy range of one to five gigaelectronvolts (GeV) and its performance goals will enable versatile applications in various domains, e.g. as a compact free-electron laser (FEL), compact sources for medical imaging and positron generation, table-top test beams for particle detectors, as well as deeply penetrating X-ray and gamma-ray sources for material testing. EuPRAXIA is designed to be the required stepping stone to possible future plasma-based facilities, such as linear colliders at the high-energy physics (HEP) energy frontier. Consistent with a high-confidence approach, the project includes measures to retire risk by establishing scaled technology demonstrators. This report includes preliminary models for project implementation, cost and schedule that would allow operation of the full Eu-PRAXIA facility within 8—10 years., Published by Springer, Heidelberg

The energy transition is changing the electrical power system. The increasing number of distributed energy resources in the distribution system and the digitalisation of most of the sensors and actuators are bringing the electrical grid to became a Smart Grid. Component and system testing for Smart Grid topics can introduce many challenges. ERIGrid Project tried to Figure out some of the upcoming issues investigating the possibility to expand Smart Grids laboratories potentialities and capabilities by means of research institutes cooperation and Research Infrastructures integration. Different tools for laboratory integration have been developed in the project. Among them a new methodology, called Holistic Test Description, has been developed with the goal to help researchers to clearly identify the test scope and the best test procedure to be adopted. Moreover a new communication tool, called JaNDER, has been developed by Ricerca sul Sistema Energetico (RSE) which is also member of the consortium of ERIGrid Project. This tool allows real time data communication between Research Infrastructures in an easy and effective way enabling a virtual connection between laboratories. These tools have been successfully tested and proved in the Distributed Energy Resources Test Facility (DER-TF) of RSE both by RSE researchers and also external users demonstrating the possibility to largely extend Smart Grid laboratories experimental potentialities. This paper shows some of the developed tools and presents some tests performed in RSE DER-TF that demonstrate how laboratories integration can reduce test set-up timing, optimise laboratory usage and improve the quality of experimental testing activities.

Over the last years the number of Electric Vehicles (EVs) has been growing more than expected, and a massive growth is foreseen for the next decade. An increase of consumption due to EV charging is then expected, with possible drawbacks, like undesired peaks, for distribution and transmission system operators. However, EVs are indeed storage systems, and, therefore, they can be employed to provide flexibility to the power system: this is known as the Vehicle-to-Grid (V2G) concept. This paper aims at investigating a V2G control strategy for the EV charging stations in a public or private parking lot, in order to provide flexibility services by participating in the Ancillary Service Market (ASM).The energy to be exchanged on the ASM, and also on the Day-Ahead Market (DAM), is obtained by solving an optimal control problem that maximizes the EV charging station operator’s daily profit while ensuring the desired minimum State of Charge (SoC) of each EV at the end of the recharge. The cycling aging of EV batteries is considered in particular via the price of the discharged energy. The problem is formulated in a robust way to take into account uncertainties on ASM bid acceptance. The bidding prices on the ASM act as problem inputs, and therefore have to be suitably chosen. The different heuristic strategies proposed here for this choice are based on an analysis performed on one-year data of the Italian ASM. The mixed heuristic and robust approach yields different economic results, depending on the adopted bidding price strategy. The results provide interesting input for further developments of business cases for V2G applications.

Sacubitril/valsartan has been associated with a positive reverse left ventricular remodelling in patients with heart failure with reduced ejection fraction (HFrEF). These patients may also benefit from an ICD implant. We aimed to assess EF improvement after 6 months of treatment with sacubitril/valsartan, evaluating when ICD as primary prevention was no longer indicated.Multicentre, observational, prospective study enrolling all consecutive patients with HFrEF and EF ≤ 35% with an ICD as primary prevention and starting treatment with sacubitril/valsartan (NCT03935087). Resynchronization therapy and patients experiencing appropriate ICD therapies before sacubitril/valsartan were excluded.Two-hundred-and-thirty patients were enrolled (73.9% males, mean age 64.3 ± 12.1 years) After 6 months of treatment, a reduction in left ventricular end-diastolic and end-systolic volumes was noted and LVEF increased from 28.3 ± 5.6% to 32.2 ± 6.5% (p 0.001). At 6 months, a non-ischemic aetiology of cardiomyopathy and a final dose of sacubitril/valsartan 24/26 mg twice daily were associated with a higher probability of an absolute increase of 5% in LVEF. A total of 5.3% of primary prevention patients still had an arrhythmic event in the first 6 months after treatment with sacubitril/valsartan started.Sacubitril/valsartan improves systolic function in HFrEF, mainly due to reverse left ventricular remodelling. Improvement in EF after 6 months of treatment could help prevent ICD implantation in nearly one out of four patients, with important clinical and economic implications. However, the risk of sudden cardiac death in this recovered HFrEF population has not been thoroughly studied, and the present data should be interpreted only as hypothesis-generating.

This chapter deals with the coupling of smart grid laboratories for joint experiments. Therefore, various possibilities are outlined and a reference implementation is introduced. Finally, the vision of a distributed, virtual research infrastructure is presented.

Residential battery storage to perform load shifting and demand side management has become of utmost importance to improve hosting capacity, increase renewable energy penetration and meet environmental targets, especially with energy community policies. As the lifetime of electrochemical batteries depends upon their scheduling and environmental conditions, the multi-year effects of operational strategies can affect the economics of the investment. However, rarely complete long-term simulations of the operation of storage systems are performed to assess the battery profitability including the operational effects of aging, and limited studies account for a large statistics of consumers. In this study, we propose a multi-year sizing methodology for residential applications, where the complete lifetime of batteries is simulated at 15-min time resolution till complete degradation using an improved non-linear non-convex degradation model; the photovoltaic plant aging is also considered. An extensive analysis on the economics and commercial size best suited for 399 real load profiles in Italy is proposed. Results suggest that the break-even price of the storage is about 400 €/kWh, which is lower than the average commercial price, and that, as reviewed, current market components may be unfit for consumers with low energy demand. Net Present Value (NPV) and Discounted PayBack Time (DPBT) can reach 500-1500 € and 8-11 years.

In recent years, the use of Lithium-ion batteries in smart power systems and hybrid/electric vehicles has become increasingly popular since they provide a flexible and cost-effective way to store and deliver power. Their full integration into more complex systems requires an accurate estimate of the energy a battery is currently storing, a.k.a. State of Charge (SoC). However, the standard techniques present in the literature provide an accurate estimation of the SoC only having a priori knowledge about the battery. Moreover, their accuracy degrades if the battery working conditions (e.g., external temperature) are variable over time, or battery measurements necessary for the SoC estimation are affected by offset or gain biases. To overcome these limitations, this paper proposes a novel data-driven optimization based methodology for battery SoC estimation, namely VDB-SE. The proposed methodology provides accurate SoC estimations without knowing battery model parameters, such as capacity and internal resistance, whose characterization would require complex and long laboratory tests. Experimental verification and comparisons demonstrate that VDB-SE performance are comparable to the state-of-the-art algorithms over a wide range of working conditions. Indeed, the difference in terms of performance is smaller than 0.2%. Moreover, experimental results showed that on a real energy storage system the proposed method provides a SoC estimation with an error of less than 2.1%.

Background Prolonged QT corrected (QTc) intervals are associated with adverse cardiovascular outcomes both in healthy and high-risk populations. Our objective was to evaluate the QTc intervals during a takotsubo cardiomyopathy (TTC) episodes and their potential prognostic role. Hypothesis Dynamic changes of QTc interval during hospitalization for TTC could be associated with outcome at follow-up. Methods Fifty-two consecutive patients hospitalized for TTC were enrolled. Twelve-lead electrocardiogram (ECG) was performed within 3 h after admission and repeated after 3, 5, and 7 days. Patients were classified in 2 groups: group 1 presented the maximal QTc interval length at admission and group 2 developed maximal QTc interval length after admission. Results Mean admission QTc interval was 493 ± 71 ms and mean QTc peak interval was 550 ± 76 ms (P

A high brightness electron Linac is being built in the Compton Gamma Source at the ELI Nuclear Physics facility in Romania. To achieve the design luminosity, a train of 32, 16 ns spaced, bunches with a nominal charge of 250 pC will collide with the laser beam in the interaction point. Electron beam spot size is measured with optical transition radiation profile monitors. In order to measure the beam properties along the train, the screens must sustain the thermal stress due to the energy deposited by the bunches; moreover, the optical radiation detecting system must have the necessary accuracy and resolution. This paper deals with the analytical studies as well as numerical simulations to investigate the thermal behavior of the screens impinged by the nominal bunch; the design and the performance of the optical detection line is discussed as well. In particular with the numerical simulations the behavior of the aluminum and silicon under thermal stress can be studied. The simulations allow us to see how the heat spreads on the OTR screen and frame, and what are their deformations during the heating.

Es bien conocido el aprecio que desde hace tiempo tiene la Iglesia por el método ver-juzgar-actuar, sin embargo, las reflexiones de la filosofía y la sociología hacen considerar hoy la necesidad de enriquecer el momento del ver, con unos elementos fenomenológicos y hermenéuticos que lo hagan más histórico y menos objetivista y de lograr además una mayor interacción entre los tres momentos. En este sentido, la investigación propone la inserción de las historias de vida de las personas y las comunidades como un camino nuevo de conocimiento de la realidad. En efecto, la realidad no sólo consiste en el hecho desnudo, sino también en el hecho tal y como lo percibe el sujeto; no sólo es suceso, sino también narración. Así, las historias de vida, y el consecuente método autobiográfico constituyen, según la investigación, un recurso vital en la planificación pastoral; no simplemente un apéndice secundario o un recurso simplemente aplicativo, sino, un momento intrínseco de la reflexión y de la experiencia teológica y pastoral.

In order to systematically plan, specify, and execute system-level test for smart grids in a cyber-physical and multi-domain manner, the ERIGrid holistic testing approach is introduced. Also, the corresponding test description and templates are discussed.

Background Temporary transvenous cardiac pacing (TTCP) is a standard procedure in current practice, despite limited coverage in consensus guidelines. However, many authors reported several complications associated with TTCP, especially development of infections of cardiac implantable electronic devices (CIED). The aim of this survey was to provide a country-wide picture of current practice regarding TTCP. Methods Data were collected using an online survey that was administered to members of the Italian Association of Arrhythmology and Cardiac Pacing. Results We collected data from 102 physicians, working in 81 Italian hospitals from 17/21 regions. Our data evidenced that different strategies are adopted in case of acute bradycardia with a tendency to limit TTCP mainly to advanced atrioventricular block. However, some centers reported a greater use in elective procedures. TTCP is usually performed by electrophysiologists or interventional cardiologists and, differently from previous reports, mainly by a femoral approach and with nonfloating catheters. We found high inhomogeneity regarding prevention of infections and thromboembolic complications and in post-TTCP management, associated with different TTCP volumes and a strategy for management of acute bradyarrhythmias. Conclusion This survey evidenced a high inhomogeneity in the approaches adopted by Italian cardiologists for TTCP. Further studies are needed to explore if these divergences are associated with different long-term outcomes, especially incidence of CIED-related infections.

Selected validation scenarios and corresponding test cases in the context of the ERIGrid project are presented in this chapter. Furthermore, the benefits of using the ERIGrid validation method and testing tools are discussed on the realized system validation examples.

Figure 20.1 was not correct in the published article. The original article has been corrected. The published apologizes for the inconvenience.

This paper aims to perform a technical feasibility study of a Virtual Energy Storage System (VESS) composed of 1400 residential users with a PV plant and a Battery Energy Storage System (BESS). A control strategy has been developed and applied to find out the amount of grid services that the VESS is able to provide. The results show that, aggregating hundreds of residential users with a BESS, there is sufficient power and energy margin to provide grid services ensuring the services behind the meter such as the self-consumption functionality. The results of the feasibility study are quite promising: the VESS is able to provide up to 49 MWh of grid services, both upward and downward, over the day.

The paper describes a test protocol developed in order to build the aging model of electrochemical accumulators and estimate the expected lifetime with different operating conditions. The test procedure has been verified performing aging tests on three lithium-ion cells. The paper presents and comments the results and provides suggestions for further aging tests on batteries.

This paper presents the experimental activities performed in a microgrid to demonstrate the advantages of a State of Energy (SoE) estimator for a Battery Energy Storage System (BESS) model integrated into the Energy Management System (EMS) of an energy community. The improved model of the BESS in the EMS, compared to the classical one, allows to increase the reliability of the SoE estimation, hence the results of the micro-grid management optimization.

We report the case of a 38-year-old woman with history of syncope and polymorphic ventricular tachycardia; tachycardia was inducible at exercise stress test, not at electrophysiologic study. Phases of QT prolongation were found at ambulatory electrocardiogram monitoring. The woman came to our attention for periodic control of implantable loop recorder. Rest electrocardiogram at admission unexpectedly showed sinus bradycardia, junctional rhythm, and ventricular premature beats. Furthermore, loop recorder control revealed a short run of bidirectional tachycardia, not associated with syncope. Final diagnosis was catecholaminergic polymorphic ventricular tachycardia, and the patient was implanted with an ICD. We therefore report an unusual case of bidirectional ventricular tachycardia associated with sinus node dysfunction and junctional escape rhythm. We hypothesize that a diffuse dysfunction of cardiac conduction system, presumably based on diffuse disorder of calcium handling, may be responsible for both sinus node failure and ventricular tachycardia.

Emerging Directions and Future Trends Introduction Percutaneous left atrial appendage (LAA) occlusion has emerged as an alternative therapeutic approach to medical therapy for stroke prevention in patients with atrial fibrillation. 3D printing is a novel technology able to create a patient specific model of any given anatomical portion of the heart. Results Herein we report the first 2 cases of LAA occlusion procedure with 2 different systems, the Wave Crest device (Coherex Medical, Inc., USA) and the Amplatzer Amulet device (St. Jude Medical, St. Paul, MN, USA), in which a 3D printed LAA model (Care Tronik, Prato, Italy) was used in a rehearse phase. Both patients had history of paroxysmal AF and previous transient ischemic attack (TIA) occurred during oral anticoagulation with correct INR. In the first patient the occlusive device was positioned within the LAA after a rehearse occlusion using the 3D printed LAA plus a 27 mm Coherex Wavecrest device, demonstrating a good compression and sealing, particularly considering a proximal lobe of the appendage. In the second patient an attempt with the 27 mm Amulet device delivered within the 3D printed LAA, based on angiography and transesophageal echocardiographic (TEE), revealed insufficient covering of the proximal part of LAA vestibule; the device was released only after a second test with the 31 mm Amulet demonstrating a good sealing. Conclusion These 2 cases demonstrated that 3D model could help in finding the correct position within LAA, sizing the device and guiding the choice of the closure device despite the measurements provided by angiography and TEE.

BACKGROUND: Transient pacing failure caused by transient increased pacing threshold has been reported in patients with transient left ventricular apical dysfunction (Takotsubo cardiomyopathy [TC]). Normal pacing thresholds usually recover after normalization of systolic dysfunction. HYPOTHESIS: Pacing failure correlates with clinics of TC. METHODS: We report the case of a 76‐year‐old man with a dual chamber pacemaker, admitted for acute chest pain and dyspnea and final diagnosis of TC. One month after index admission, the patient came back complaining again of chest pain. Unexpectedly, admission electrocardiogram showed ventricular pacing failure and an increased pacing threshold. In the following weeks, pacing threshold gradually recovered with left ventricular ejection fraction and QTc values. RESULTS: Ventricular pacing threshold correlated directly to QTc values and inversely to left ventricular ejection fraction over time (P

rf photoguns find several types of applications as high brightness electron sources for free-electron lasers, energy recovery linacs, Compton and Thomson sources, and high-energy linear colliders. The high peak current and low transverse emittance of the generated beam are obtained with the combination of a high peak electric field ($g100\text{ }\text{ }\mathrm{MV}/\mathrm{m}$) at the cathode surface, a proper choice of the solenoid field around, or immediately after, the gun, and special fabrication and treatments of the cathode itself. On the other hand, to increase the average electron current, a high repetition rate ($g100\text{ }\text{ }\mathrm{Hz}$) and/or a multibunch rf gun have to be developed. These types of devices are, in general, fabricated by brazing processes of copper machined parts. The brazing processes require a large vacuum furnace, are very expensive, and pose a not negligible risk of failure. A new fabrication technique for this type of structure has been recently developed and implemented at the Laboratories of Frascati of the National Institute of Nuclear Physics (INFN-LNF, Italy) and already applied to an rf gun now operating at a relatively low cathode peak field and low repetition rate [D. Alesini et al., Phys. Rev. Accel. Beams 18, 092001 (2015)]. It is based on the use of special rf-vacuum gaskets that allow a brazing-free realization process. The $S$-band gun of the Extreme Light Infrastructure-Nuclear Physics Gamma Beam System, under construction in Magurele (Bucharest, Romania), has been realized with this new technique and represents a further and fundamental step toward the consolidation of this technology for high gradient particle accelerator fabrication. It operates at 100 Hz with a $120\text{ }\text{ }\mathrm{MV}/\mathrm{m}$ cathode peak field and $1.5\text{\ensuremath{-}}\ensuremath{\mu}\mathrm{s}$-long rf pulses to house the 32 bunches necessary to reach the target gamma flux. High gradient tests, performed at full power and a full repetition rate, have shown the extremely good performances of the structure in terms of the breakdown rate and conditioning time and definitively demonstrated the reliability and suitability of such fabrication process for high gradient structure realization. In this paper, we report and discuss the electromagnetic and thermomechanical design, the realization process, and all the experimental results at low and high power at a full repetition rate.

The article describes a new State of Energy estimator that can be applied to an electrochemical Energy Storage System. The developed estimator was tested on a lead-acid storage system, already aged, connected to a real micro-grid. The results show an accuracy four times better than the state of the art, in particular its average error is 6%.

Distributed generation, energy storage systems and a growing number of loads are interfaced to the grid through power electronic converters. In this context, a distributed system in direct current could guarantee advantages from different points of view. This paper assesses, through an analytical study, the energetic and economic savings achievable by the adoption of a low voltage direct current distribution grid in order to replace the traditional grid in alternating current to supply a residential district. According to the analyses carried out appears that the benefits achievable by the adoption of distributed grids in direct current are reduced from energy and economic point of view. The economic benefits occur for the single user when the distribution grid, starting from secondary substation, is completely in direct current. This causes an higher cost for the distribution system operator in the realization of the secondary substation, where must be installed a suitable power converter. The distribution system operator could however achieve many benefits from technical point of view because the adoption of distributed grids in direct current allows a better and simple integration of renewable sources and storage systems.