Breathing a low-density gas reduces respiratory muscle force development and marginally improves exercise performance in master athletes.

INTRODUCTION: We tested the hypothesis that breathing heliox, to attenuate the mechanical constraints accompanying the decline in pulmonary function with aging, improves exercise performance. METHODS: Fourteen endurance-trained older men (67.9 ± 5.9 year, [Formula: see text]O2max: 50.8 ± 5.8 ml/kg/min; 151% predicted) completed two cycling 5-km time trials while breathing room air (i.e., 21% O2-79% N2) or heliox (i.e., 21% O2-79% He). Maximal flow-volume curves (MFVC) were determined pre-exercise to characterize expiratory flow limitation (EFL, % tidal volume intersecting the MFVC). Respiratory muscle force development was indirectly determined as the product of the time integral of inspiratory and expiratory mouth pressure (∫Pmouth) and breathing frequency. Maximal inspiratory and expiratory pressure maneuvers were performed pre-exercise and post-exercise to estimate respiratory muscle fatigue. RESULTS: Exercise performance time improved (527.6 ± 38 vs. 531.3 ± 36.9 s; P = 0.017), and respiratory muscle force development decreased during inspiration (- 22.8 ± 11.6%, P < 0.001) and expiration (- 10.8 ± 11.4%, P = 0.003) with heliox compared with room air. EFL tended to be lower with heliox (22 ± 23 vs. 30 ± 23% tidal volume; P = 0.054). Minute ventilation normalized to CO2 production ([Formula: see text]E/[Formula: see text]CO2) increased with heliox (28.6 ± 2.7 vs. 25.1 ± 1.8; P < 0.001). A reduction in MIP and MEP was observed post-exercise vs. pre-exercise but was not different between conditions. CONCLUSIONS: Breathing heliox has a limited effect on performance during a 5-km time trial in master athletes despite a reduction in respiratory muscle force development.

High-density mapping of the average complex interval helps localizing atrial fibrillation drivers and predicts catheter ablation outcomes.

Background: Persistent Atrial Fibrillation (PersAF) electrogram-based ablation is complex, and appropriate identification of atrial substrate is critical. Little is known regarding the value of the Average Complex Interval (ACI) feature for PersAF ablation. Objective: Using the evolution of AF complexity by sequentially computing AF dominant frequency (DF) along the ablation procedure, we sought to evaluate the value of ACI for discriminating active drivers (AD) from bystander zones (BZ), for predicting AF termination during ablation, and for predicting AF recurrence during follow-up. Methods: We included PersAF patients undergoing radiofrequency catheter ablation by pulmonary vein isolation and ablation of atrial substrate identified by Spatiotemporal Dispersion or Complex Fractionated Atrial Electrograms (>70% of recording). Operators were blinded to ACI measurement which was sought for each documented atrial substrate area. AF DF was measured by Independent Component Analysis on 1-minute 12-lead ECGs at baseline and after ablation of each atrial zone. AD were differentiated from BZ either by a significant decrease in DF (>10%), or by AF termination. Arrhythmia recurrence was monitored during follow-up. Results: We analyzed 159 atrial areas (129 treated by radiofrequency during AF) in 29 patients. ACI was shorter in AD than BZ (76.4 ± 13.6 vs. 86.6 ± 20.3 ms; p = 0.0055), and mean ACI of all substrate zones was shorter in patients for whom radiofrequency failed to terminate AF [71.3 (67.5-77.8) vs. 82.4 (74.4-98.5) ms; p = 0.0126]. ACI predicted AD [AUC 0.728 (0.629-0.826)]. An ACI < 70 ms was specific for predicting AD (Sp 0.831, Se 0.526), whereas areas with an ACI > 100 ms had almost no chances of being active in AF maintenance. AF recurrence was associated with more ACI zones with identical shortest value [3.5 (3-4) vs. 1 (0-1) zones; p = 0.021]. In multivariate analysis, ACI < 70 ms predicted AD [OR = 4.02 (1.49-10.84), p = 0.006] and mean ACI > 75 ms predicted AF termination [OR = 9.94 (1.14-86.7), p = 0.038]. Conclusion: ACI helps in identifying AF drivers, and is correlated with AF termination and AF recurrence during follow-up. It can help in establishing an ablation plan, by prioritizing ablation from the shortest to the longest ACI zone.

Fibrillatory Wave Amplitude Evolution during Persistent Atrial Fibrillation Ablation: Implications for Atrial Substrate and Fibrillation Complexity Assessment.

Background. Fibrillatory Wave Amplitude (FWA) has been described as a non-invasive marker of atrial fibrillation (AF) complexity, and it predicts catheter ablation outcome. However, the actual determinants of FWA remain incompletely understood. Objective. To assess the respective implications of anatomical atrial substrate and AF spectral characteristics for FWA. Methods. Persistent AF patients undergoing radiofrequency catheter ablation were included. FWA was measured on 1-min ECG by TQ concatenation in Lead I, V1, V2, and V5 at baseline and immediately before AF termination. FWA evolution during ablation was compared to that of AF dominant frequency (DF) measured by Independent Component Analysis on 12-lead ECG. FWA was compared to the extent of endocardial low-voltage areas (LVA I < 10%; II 10-20%; III 20-30%; IV > 30%), to the surface of healthy left atrial tissue, and to P-wave amplitude in sinus rhythm. The predictive value of FWA for AF recurrence during follow-up was assessed. Results. We included 29 patients. FWA remained stable along ablation procedure with comparable values at baseline and before AF termination (Lead I p = 0.54; V1 p = 0.858; V2 p = 0.215; V5 p = 0.14), whereas DF significantly decreased (5.67 ± 0.68 vs. 4.95 ± 0.58 Hz, p < 0.001). FWA was higher in LVA-I than in LVA-II, -III, and -IV in Lead I and V5 (p = 0.02 and p = 0.01). FWA in V5 was strongly correlated with the surface of healthy left atrial tissue (R = 0.786; p < 0.001). FWA showed moderate to strong correlation to P-wave amplitude in all leads. Finally, FWA did not predict AF recurrence after a follow-up of 23.3 ± 9.8 months. Conclusions. These findings suggest that FWA is unrelated to AF complexity but is mainly determined by the amount of viable atrial myocytes. Therefore, FWA should only be referred as a marker of atrial tissue pathology.

Non-invasive characterisation of macroreentrant atrial tachycardia types from a vectorcardiographic approach with the slow conduction region as a cornerstone.

BACKGROUND AND OBJECTIVES: Macroreentrant atrial tachyarrhythmias (MRATs) can be caused by different reentrant circuits. The treatment for each MRAT type may require ablation at different sites, either at the right or left atria. Unfortunately, the reentrant circuit that drives the arrhythmia cannot be ascertained previous to the electrophysiological intervention. METHODS: A noninvasive approach based on the comparison of atrial vectorcardiogram (VCG) loops is proposed. An archetype for each group was created, which served as a reference to measure the similarity between loops. Methods were tested in a variety of simulations and real data obtained from the most common right (peritricuspid) and left (perimitral) macroreentrant circuits, each divided into clockwise and counterclockwise subgroups. Adenosine was administered to patients to induce transient AV block, allowing the recording of the atrial signal without the interference of ventricular signals. From the vectorcardiogram, we measured intrapatient loop consistence, similarity of the pathway to archetypes, characterisation of slow velocity regions and pathway complexity. RESULTS: Results show a considerably higher similarity with the loop of its corresponding archetype, in both simulations and real data. We found the capacity of the vectorcardiogram to reflect a slow velocity region, consistent with the mechanisms of MRAT, and the role that it plays in the characterisation of the reentrant circuit. The intra-patient loop consistence was over 0.85 for all clinical cases while the similarity of the pathway to archetypes was found to be 0.85 ± 0.03, 0.95 ± 0.03, 0.87 ± 0.04 and 0.91 ± 0.02 for the different MRAT types (and p<0.02 for 3 of the 4 groups), and pathway complexity also allowed to discriminate among cases (with p<0.05). CONCLUSIONS: We conclude that the presented methodology allows us to differentiate between the most common forms of right and left MRATs and predict the existence and location of a slow conduction zone. This approach may be useful in planning ablation procedures in advance.

Recovery from Fatigue after Cycling Time Trials in Elite Endurance Athletes.

INTRODUCTION: We determined the recovery from neuromuscular fatigue in six professional (PRO) and seven moderately trained (MOD) cyclists after repeated cycling time trials of various intensities/durations. METHOD: Participants performed two 1-min (1minTT) or two 10-min (10minTT) self-paced cycling time trials with 5 min of recovery in between. Central and peripheral fatigue were quantified via preexercise to postexercise (15-s through 15-min recovery) changes in voluntary activation (VA) and potentiated twitch force. VA was measured using the interpolated twitch technique, and potentiated twitch force was evoked by single (QTsingle) and paired (10-Hz (QT10) and 100-Hz (QT100)) electrical stimulations of the femoral nerve. RESULTS: Mean power output was 32%-72% higher during all the time trials and decreased less (-10% vs -13%) from the first to second time trial in PRO compared with MOD (P < 0.05). Conversely, exercise-induced reduction in QTsingle and QT10/QT100 was significantly lower in PRO after every time trial (P < 0.05). Recovery from fatigue from 15 s to 2 min for QTsingle and QT10/QT100 was slower in PRO after every time trial (P < 0.05). In both groups, the reduction in QTsingle was lower after the 10minTTs compared with 1minTTs (P < 0.05). Conversely, VA decreased more after the 10minTTs compared with 1minTTs (P < 0.05). CONCLUSION: Our findings showed that excitation-contraction coupling was preserved after exercise in PRO compared with MOD. This likely contributed to the improved performance during repeated cycling time trials of various intensity/duration in PRO, despite a slower rate of recovery in its early phase. Finally, the time course of recovery from neuromuscular fatigue in PRO was dependent on the effects of prolonged low-frequency force depression.

Rhythm dynamics of the aging heart: an experimental study using conscious, restrained mice.

Heart rate variability (HRV) is a measure of variation in time interval between heartbeats and reflects the influence of autonomic nervous system and circulating/locally released factors on sinoatrial node discharge. Here, we tested whether electrocardiograms (ECGs) obtained in conscious, restrained mice, a condition that affects sympathovagal balance, reveal alterations of heart rhythm dynamics with aging. Moreover, based on emergence of sodium channels as modulators of pacemaker activity, we addressed consequences of altered sodium channels on heart rhythm. C57Bl/6 mice and mice with enhanced late sodium current due to Nav1.5 mutation at Ser571 (S571E) at ~4 to ~24 mo of age, were studied. HRV was assessed using time- and frequency-domain and nonlinear parameters. For C57Bl/6 and S571E mice, standard deviation of RR intervals (SDRR), total power of RR interval variation, and nonlinear standard deviation 2 (SD2) were maximal at ~4 mo and decreased at ~18 and ~24 mo, together with attenuation of indexes of sympathovagal balance. Modulation of sympathetic and/or parasympathetic divisions revealed attenuation of autonomic tone at ~24 mo. At ~4 mo, S571E mice presented lower heart rate and higher SDRR, total power, and SD2 with respect to C57Bl/6, properties reversed by late sodium current inhibition. At ~24 mo, heart rate decreased in C57Bl/6 but increased in S571E, a condition preserved after autonomic blockade. Collectively, our data indicate that aging is associated with reduced HRV. Moreover, sodium channel function conditions heart rate and its age-related adaptations, but does not interfere with HRV decline occurring with age.NEW & NOTEWORTHY We have investigated age-associated alterations of heart rate properties in mice using conscious electrocardiographic recordings. Our findings support the notion that aging is coupled with altered sympathovagal balance with consequences on heart rate variability. Moreover, by using a genetically engineered mouse line, we provide evidence that sodium channels modulate heart rate and its age-related adaptations.

A novel framework for noninvasive analysis of short-term atrial activity dynamics during persistent atrial fibrillation.

ECG-based representation of atrial fibrillation (AF) progression is currently limited. We propose a novel framework for a more sensitive noninvasive characterization of the AF substrate during persistent AF. An atrial activity (AA) recurrence signal is computed from body surface potential map (BSPM) recordings, and a set of characteristic indices is derived from it which captures the short- and long-term recurrent behaviour in the AA patterns. A novel measure of short- and long-term spatial variability of AA propagation is introduced, to provide an interpretation of the above indices, and to test the hypothesis that the variability in the oscillatory content of AA is due mainly to a spatially uncoordinated propagation of the AF waveforms. A simple model of atrial signal dynamics is proposed to confirm this hypothesis, and to investigate a possible influence of the AF substrate on the short-term recurrent behaviour of AA propagation. Results confirm the hypothesis, with the model also revealing the above influence. Once the characteristic indices are normalized to remove this influence, they show to be significantly associated with AF recurrence 4 to 6 weeks after electrical cardioversion. Therefore, the proposed framework improves noninvasive AF substrate characterization in patients with a very similar substrate. Graphical Abstract Schematic representation of the proposed framework for the noninvasive characterization of short-term atrial signal dynamics during persistent AF. The proposed framework shows that the faster the AA is propagating, the more stable its propagation paths are in the short-term (larger values of Speed in the bottom right plot should be interpreted as lower speed of propagation of the corresponding AA propagation patters).

Similar Cardioventilatory but Greater Neuromuscular Stimuli With Interval Drop Jump Than With Interval Running.

CONTEXT: Drop jumps and high-intensity interval running are relevant training methods to improve explosiveness and endurance performance, respectively. Combined training effects might, however, be achieved by performing interval drop jumping. PURPOSE: To determine the acute effects of interval drop jumping on oxygen uptake (V˙O2)-index of cardioventilatory/oxidative stimulation level and peripheral fatigue-a limiting factor of explosiveness. METHODS: Thirteen participants performed three 11-minute interval training sessions during which they ran 15 seconds at 120% of the velocity that elicited maximal V˙O2 (V˙O2max) (ITrun), or drop jumped at 7 (ITDJ7) or 9 (ITDJ9) jumps per 15 seconds, interspersed with 15 seconds of passive recovery. V˙O2 and the time spent above 90% of V˙O2max (V˙TO2max) were collected. Peripheral fatigue was quantified via preexercise to postexercise changes in evoked potentiated quadriceps twitch (ΔQT). Power output was estimated during ITDJs using optical sensors. RESULTS: All participants reached 90% of V˙O2max or higher during ITrun and ITDJ9, but only 11 did during ITDJ7. V˙TO2max was not different between ITrun and ITDJ9 (145 [76] vs 141 [151] s; P = .92) but was reduced during ITDJ7 (28 [26] s; P = .002). Mean ΔQT in ITDJ9 and ITDJ7 was not different (-17% [9%] vs -14% [8%]; P = .73) and greater than in ITrun (-8% [7%]; P = .001). No alteration in power output was found during ITDJs (37 [10] W·kg-1). CONCLUSION: Interval drop jumping at a high work rate stimulated the cardioventilatory and oxidative systems to the same extent as interval running, while the exercise-induced increase in fatigue did not compromise drop jump performance. Interval drop jumping might be a relevant strategy to get concomitant improvements in endurance and explosive performance.

Novel Methods for High-resolution Assessment of Cardiac Action Potential Repolarization.

The profile of the action potential (AP) of cardiomyocytes contributes to the modality of ventricular repolarization of the heart. Experimentally, the examination of the AP in isolated cardiomyocytes provides information on their electrical properties, adaptations to physiological and pathological conditions, and putative ionic mechanisms involved in the process. Currently, there are no available platforms for automated assessment of AP properties and standard methodologies restrict the examination of the AP repolarization to discrete, user-defined ranges, neglecting significant intervals of the electrical recovery. This study proposes two automatic methods to assess AP profile throughout the entire repolarization phase. One method is based on AP data inversion and direct extraction of patterns describing beat-to-beat dynamics. The second method is based on evolutive singular value decomposition (ESVD), which identifies common patterns in a series of consecutive APs. The two methodologies were employed to analyze electrical signals collected from cardiomyocites obtained from healthy mice and animals with diabetes, a condition associated with alterations of AP properties in cardiac cells. Our methodologies revealed that the duration of the early repolarization phase of the AP tended to become progressively longer during a stimulation train, whereas the late repolarization progressively shortened. Although this behavior was comparable in the two groups of cells, alterations in AP dynamics occurred at distinct repolarization levels, a feature highlighted by the ESVD approach. In conclusion, the proposed methodologies allow detailed, automatic analysis of the AP repolarization and identification of critical alterations occurring in the electrical behavior of myocytes under pathological conditions.

Spectral and spatiotemporal variability ECG parameters linked to catheter ablation outcome in persistent atrial fibrillation.

With the increasing prevalence of atrial fibrillation (AF), there is a strong clinical interest in determining whether a patient suffering from persistent AF will benefit from catheter ablation (CA) therapy at long term. This work presents several regression models based on noninvasive measures automatically computed from the standard 12-lead electrocardiogram (ECG) such as AF dominant frequency (DF), spectral concentration and spatiotemporal variability (STV). Sixty-two AF patients referred to CA were enrolled in this study. Forty-seven of them had no recurrence after CA during an average follow-up of 14 ± 8 months. The ECG features were extracted from an ECG recorded before the CA intervention and they were combined by means of logistic regression. The combination of DF and STV values from different precordial leads reached AUC = 0.939, outperforming the best results by using only one kind of features, such as DF (AUC = 0.801), and yielding a global accuracy of 93.5% for discriminating the best long-term responders to CA. These results point out the need to take into consideration the spatial variation of spectral ECG parameters to build predictive models dealing with AF.

Increased Fatigue Response to Augmented Deceptive Feedback during Cycling Time Trial.

PURPOSE: This study aimed to investigate the effect of different magnitudes of deception on performance and exercise-induced fatigue during cycling time trial. METHODS: After three familiarization visits, three women and eight men performed three 5-km cycling time trials while following a simulated dynamic avatar reproducing either 100% (5K100%), 102% (5K102%), or 105% (5K105%) of the subject's previous fastest trial. Quadriceps muscle activation was quantified with surface electromyography. Fatigue was quantified by preexercise to postexercise (10 s through 15 min recovery) changes in quadriceps maximal voluntary contraction (MVC) force, potentiated twitch force evoked by electrical femoral nerve stimulation (QTSingle) and voluntary activation (VA, twitch interpolation technique). RESULTS: Greater quadriceps muscle activation in 5K102% versus 5K100% (12% ± 11%) was found in parallel with a 5% ± 2% and 2% ± 1% improvement in power output and completion time, respectively (P < 0.01). Exercise-induced reduction in MVC force and VA were 14% ± 19% and 28% ± 31% greater at exercise termination (at 10 s), whereas QTSingle recovery (from 10 s to 15 min) was 5% ± 5% less in 5K102% versus 5K100% (P < 0.01). No difference in performance or fatigue indices measured at exercise termination was found between 5K100% and 5K105%. CONCLUSIONS: Muscle activation and performance improvements during a deceptive cycling time trial were achieved only with a 2% magnitude of deception and were associated with a further impairment in MVC force, QTSingle recovery and VA compared to control. Performance improvement during cycling time trial with augmented deceptive feedback therefore resulted in exacerbated exercise-induced peripheral and central fatigue.

Non-invasive prediction of catheter ablation outcome in persistent atrial fibrillation by fibrillatory wave amplitude computation in multiple electrocardiogram leads.

BACKGROUND: Catheter ablation (CA) of persistent atrial fibrillation (AF) is challenging, and reported results are capable of improvement. A better patient selection for the procedure could enhance its success rate while avoiding the risks associated with ablation, especially for patients with low odds of favorable outcome. CA outcome can be predicted non-invasively by atrial fibrillatory wave (f-wave) amplitude, but previous works focused mostly on manual measures in single electrocardiogram (ECG) leads only. AIM: To assess the long-term prediction ability of f-wave amplitude when computed in multiple ECG leads. METHODS: Sixty-two patients with persistent AF (52 men; mean age 61.5±10.4years) referred for CA were enrolled. A standard 1-minute 12-lead ECG was acquired before the ablation procedure for each patient. F-wave amplitudes in different ECG leads were computed by a non-invasive signal processing algorithm, and combined into a mutivariate prediction model based on logistic regression. RESULTS: During an average follow-up of 13.9±8.3months, 47 patients had no AF recurrence after ablation. A lead selection approach relying on the Wald index pointed to I, V1, V2 and V5 as the most relevant ECG leads to predict jointly CA outcome using f-wave amplitudes, reaching an area under the curve of 0.854, and improving on single-lead amplitude-based predictors. CONCLUSION: Analysing the f-wave amplitude in several ECG leads simultaneously can significantly improve CA long-term outcome prediction in persistent AF compared with predictors based on single-lead measures.

Reduction in Kv Current Enhances the Temporal Dispersion of the Action Potential in Diabetic Myocytes: Insights From a Novel Repolarization Algorithm.

BACKGROUND: Diabetes is associated with prolongation of the QT interval of the electrocardiogram and enhanced dispersion of ventricular repolarization, factors that, together with atherosclerosis and myocardial ischemia, may promote the occurrence of electrical disorders. Thus, we tested the possibility that alterations in transmembrane ionic currents reduce the repolarization reserve of myocytes, leading to action potential (AP) prolongation and enhanced beat-to-beat variability of repolarization. METHODS AND RESULTS: Diabetes was induced in mice with streptozotocin (STZ), and effects of hyperglycemia on electrical properties of whole heart and myocytes were studied with respect to an untreated control group (Ctrl) using electrocardiographic recordings in vivo, ex vivo perfused hearts, and single-cell patch-clamp analysis. Additionally, a newly developed algorithm was introduced to obtain detailed information of the impact of high glucose on AP profile. Compared to Ctrl, hyperglycemia in STZ-treated animals was coupled with prolongation of the QT interval, enhanced temporal dispersion of electrical recovery, and susceptibility to ventricular arrhythmias, defects observed, in part, in the Akita mutant mouse model of type I diabetes. AP was prolonged and beat-to-beat variability of repolarization was enhanced in diabetic myocytes, with respect to Ctrl cells. Density of Kv K(+) and L-type Ca(2+) currents were decreased in STZ myocytes, in comparison to cells from normoglycemic mice. Pharmacological reduction of Kv currents in Ctrl cells lengthened AP duration and increased temporal dispersion of repolarization, reiterating features identified in diabetic myocytes. CONCLUSIONS: Reductions in the repolarizing K(+) currents may contribute to electrical disturbances of the diabetic heart.

Comparison of sEMG processing methods during whole-body vibration exercise.

The objective was to investigate the influence of surface electromyography (sEMG) processing methods on the quantification of muscle activity during whole-body vibration (WBV) exercises. sEMG activity was recorded while the participants performed squats on the platform with and without WBV. The spikes observed in the sEMG spectrum at the vibration frequency and its harmonics were deleted using state-of-the-art methods, i.e. (1) a band-stop filter, (2) a band-pass filter, and (3) spectral linear interpolation. The same filtering methods were applied on the sEMG during the no-vibration trial. The linear interpolation method showed the highest intraclass correlation coefficients (no vibration: 0.999, WBV: 0.757-0.979) with the comparison measure (unfiltered sEMG during the no-vibration trial), followed by the band-stop filter (no vibration: 0.929-0.975, WBV: 0.661-0.938). While both methods introduced a systematic bias (P < 0.001), the error increased with increasing mean values to a higher degree for the band-stop filter. After adjusting the sEMG(RMS) during WBV for the bias, the performance of the interpolation method and the band-stop filter was comparable. The band-pass filter was in poor agreement with the other methods (ICC: 0.207-0.697), unless the sEMG(RMS) was corrected for the bias (ICC ⩾ 0.931, %LOA ⩽ 32.3). In conclusion, spectral linear interpolation or a band-stop filter centered at the vibration frequency and its multiple harmonics should be applied to delete the artifacts in the sEMG signals during WBV. With the use of a band-stop filter it is recommended to correct the sEMG(RMS) for the bias as this procedure improved its performance.

sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity.

The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG) spectrum recorded during whole-body vibration (WBV) exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental) and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05), and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05). This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity. Key pointsThe spikes observed in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activityThe motion artifacts are more pronounced in the first spike than the following spikes in the sEMG spectrumReflex activity during WBV exercises is enhanced with an additional load of approximately 50% of the body mass.

Relationship Between Lower Limb Muscle Activity and Platform Acceleration During Whole-Body Vibration Exercise.

The purpose of this study was to identify the influence of different magnitudes and directions of the vibration platform acceleration on surface electromyography (sEMG) during whole-body vibration (WBV) exercises. Therefore, a WBV platform was used that delivers vertical vibrations by a side-alternating mode, horizontal vibrations by a circular mode, and vibrations in all 3 planes by a dual mode. Surface electromyography signals of selected lower limb muscles were measured in 30 individuals while they performed a static squat on a vibration platform. The WBV trials included 2 side-alternating trials (Side-L: 6 Hz, 2.5 mm; Side-H: 16 Hz, 4 mm), 2 circular trials (Circ-L: 14 Hz, 0.8 mm; Circ-H: 43 Hz, 0.8 mm), and 4 dual-mode trials that were the combinations of the single-mode trials (Side-L/Circ-L, Side-L/Circ-H, Side-H/Circ-L, Side-H/Circ-H). Furthermore, control trials without vibration were assessed, and 3-dimensional platform acceleration was quantified during the vibration. Significant increases in the root mean square of the sEMG (sEMGRMS) compared with the control trial were found in most muscles for Side-L/Circ-H (+17 to +63%, p ≤ 0.05), Side-H/Circ-L (+7 to +227%, p ≤ 0.05), and Side-H/Circ-H (+21 to +207%, p < 0.01) and in the lower leg muscles for Side-H (+35 to +138%, p ≤ 0.05). Furthermore, only the vertical platform acceleration showed a linear relationship (r = 0.970, p < 0.001) with the averaged sEMGRMS of the lower limb muscles. Significant increases in sEMGRMS were found with a vertical acceleration threshold of 18 m·s(-2) and higher. The present results emphasize that WBV exercises should be performed on a platform that induces vertical accelerations of 18 m·s(-2) and higher.

The relationship between R-wave magnitude and ventricular volume during continuous left ventricular assist device assistance: experimental study.

The current use of left ventricular assist devices (LVADs) as destination therapy is associated with the clinical need of monitoring patient-pump interaction. To this aim, the present work investigated the possibility of getting useful information about the status of the assisted left ventricle using electrocardiographic (ECG) data. A total of six animals, undergoing Gyro Centrifugal Pump 2 implantation (a new version of Gyro Centrifugal Pump C1E3 [Kyocera Corporation, Kyoto, Japan]) and CircuLite Synergy Micropump (CircuLite, Inc., Saddlebrooke, NJ, USA) in atrio-aortic connection, were analyzed. Data refer to different LVAD speeds with consequently different levels of ventricular unloading. From ECG signal, the R wave peak was individuated together with the corresponding left ventricular volume. Then on both signals, a moving average analysis was performed to reduce the effect of the ventilation. A regression and correlation analysis performed on the two resulting signals evidenced that the R wave peak and the ventricular volume are strictly related. Specifically, any change of LVAD speed, inducing a change in ventricular volume, is associated with a change in R wave peak value. The present work is a first step in investigating the usefulness of the ECG signal during LVAD therapy, for the monitoring of mechanical parameters of the heart such as the ventricular volumes. The correlation found between the ECG and the ventricular volume can be a promising starting point for possible future noninvasive LVAD patient monitoring.

Exercise performance is regulated during repeated sprints to limit the development of peripheral fatigue beyond a critical threshold.

We hypothesized that exercise performance is adjusted during repeated sprints in order not to surpass a critical threshold of peripheral fatigue. Twelve men randomly performed three experimental sessions on different days, i.e. one single 10 s all-out sprint and two trials of 10 × 10 s all-out sprints with 30 s of passive recovery in between. One trial was performed in the unfatigued state (CTRL) and one following electrically induced quadriceps muscle fatigue (FTNMES). Peripheral fatigue was quantified by comparing pre- with postexercise changes in potentiated quadriceps twitch force (ΔQtw-pot) evoked by supramaximal magnetic stimulation of the femoral nerve. Central fatigue was estimated by comparing pre- with postexercise voluntary activation of quadriceps motor units. The root mean square (RMS) of the vastus lateralis and vastus medialis EMG normalized to maximal M-wave amplitude (RMS.Mmax (-1)) was also calculated during sprints. Compared with CTRL condition, pre-existing quadriceps muscle fatigue in FTNMES (ΔQtw-pot = -29 ± 4%) resulted in a significant (P < 0.05) reduction in power output (-4.0 ± 0.9%) associated with a reduction in RMS.Mmax (-1). However, ΔQtw-pot postsprints decreased by 51% in both conditions, indicating that the level of peripheral fatigue was identical and independent of the degree of pre-existing fatigue. Our findings show that power output and cycling EMG are adjusted during exercise in order to limit the development of peripheral fatigue beyond a constant threshold. We hypothesize that the contribution of peripheral fatigue to exercise limitation involves a reduction in central motor drive in addition to the impairment in muscular function.

Determination of the optimal parameters maximizing muscle activity of the lower limbs during vertical synchronous whole-body vibration.

PURPOSE: To describe the most effective parameters maximizing muscle activity during whole-body vibration (WBV) exercises on a vertically vibrating (VV) platform. METHODS: The influence of (1) WBV vs. no vibration, (2) vibration frequency (25, 30, 35, 40 Hz), (3) platform peak-to-peak displacement (1.2, 2 mm), and (4) additional loading (no load, 17, 33 kg) on surface electromyographic (sEMG) activity of five lower limb muscles was investigated in eighteen participants. RESULTS: (1) Comparing WBV to no vibration, sEMGRMS of the calf muscles was significantly higher with an additional load of 33 kg independently of the displacement and the frequency (P < 0.05). During WBV, (2) muscle activity at 40 Hz WBV was significantly higher than at 25 Hz for the gastrocnemius lateralis (GL) for all loads, and for the vastii medialis and lateralis using the 33 kg load (P < 0.05); (3) sEMGRMS of all lower limb muscles was significantly increased with the 2 mm compared to the 1.2 mm peak-to-peak displacement (P < 0.05); (4) an effect of additional load was found in the GL, with significantly higher neuromuscular activation for the 33 kg load than no load (P < 0.05). CONCLUSIONS: On a VV platform, we recommend the use of a high platform displacement in combination with a high vibration frequency to provoke the highest muscle activity enhancement. Without maxing out the acceleration stimuli, calf muscles' sEMG can be enhanced with an additional load of 33 kg which corresponded to 50 % of the body mass.