Molten salt-shielded synthesis of Ti3AlC2 as a precursor for large-scale preparation of Ti3C2Tx MXene binder-free film electrode supercapacitors.

MXenes are a group of two-dimensional materials that are promising for many applications, including as film electrode supercapacitors. When synthesizing such materials, special attention is paid to the conditions for obtaining the MAX phase, the chemical, morphological and structural features of which determine the functional properties of the final product. In this study, the Ti3AlC2 precursor is proposed to be obtained using a technologically simple and accessible method of synthesis in molten salt. This method allows reducing the reaction temperature and creating an antioxidant atmosphere. Ti3C2Tx MXene electrode films are produced by the easily scalable blade coating method without a binder. The synthesized materials were studied by X-ray phase analysis and scanning electron microscopy. Electrochemical testing of Ti3C2Tx film electrodes was carried out in a three-electrode configuration in aqueous solutions of 1M H2SO4, 6M KOH, 1M LiOH and 1M Na2SO4 electrolytes. The maximum specific capacity value for Ti3C2Tx MXene binder-free film electrode supercapacitors is obtained in 1M H2SO4 electrolyte (480 F g-1 at a scan rate of 1 mV s-1). The simple, low-cost and scalable production technology and promising electrochemical characteristics of the Ti3C2Tx MXene binder-free film electrode make it an excellent candidate for new-generation supercapacitors.

Significantly Enhanced Balance of Dielectric Properties of Polyvinylidene Difluoride Three-Phase Composites by Silver Deposited on K2Ni0.93Ti7.07O16 Hollandite Nanoparticles.

Three-phase polymer composites are promising materials for creating electronic device components. The qualitative and quantitative composition of such composites has a significant effect on their functional, in particular dielectric properties. In this study, ceramic filler K2Ni0.93Ti7.07O16 (KNTO) with Ag coating as conductive additive (0.5, 1.0, 2.5 wt.%) was introduced into the polyvinylidene difluoride (PVDF) polymer matrix in amounts of 7.5, 15, 22.5, and 30 vol.%. to optimize the dielectric constant and dielectric loss tangent. The filler was characterized by X-ray phase analysis, Fourier-transform infrared spectroscopy and Scanning electron microscopy methods. The dielectric constant, dielectric loss tangent, and conductivity of three-phase composites KNTO@Ag-PVDF were studied in comparison with two-phase composites KNTO-PVDF in the frequency range from 102 Hz to 106 Hz. The dielectric constant values of composites containing 7.5, 15, 22.5, and 30 vol.% filler were 12, 13, 17.4, 19.2 for pure KNTO and 13, 19, 25, 31 for KNTO@Ag filler (2.5 wt.%) at frequency 10 kHz. The dielectric loss tangent ranged from 0.111 to 0.340 at a filler content of 7.5 to 30 vol.%. A significantly enhanced balance of dielectric properties of PVDF-based composites was found with K2Ni0.93Ti7.07O16 as ceramic filler for 1 wt.% of silver. Composites KNTO@Ag(1 wt.%)-PVDF can be applied as dielectrics for passive elements of flexible electronics.

Intercalation Effects on the Dielectric Properties of PVDF/Ti3C2Tx MXene Nanocomposites.

In this study, we report the effect of intercalation of dimethyl sulfoxide (DMSO) and urea molecules into the interlayer space of Ti3C2Tx MXene on the dielectric properties of poly(vinylidene fluoride) (PVDF)/MXene polymer nanocomposites. MXenes were obtained by a simple hydrothermal method using Ti3AlC2 and a mixture of HCl and KF, and they were then intercalated with DMSO and urea molecules to improve the exfoliation of the layers. Then, nanocomposites based on a PVDF matrix loading of 5-30 wt.% MXene were fabricated by hot pressing. The powders and nanocomposites obtained were characterized by using XRD, FTIR, and SEM. The dielectric properties of the nanocomposites were studied by impedance spectroscopy in the frequency range of 102-106 Hz. As a result, the intercalation of MXene with urea molecules made it possible to increase the permittivity from 22 to 27 and to slightly decrease the dielectric loss tangent at a filler loading of 25 wt.% and a frequency of 1 kHz. The intercalation of MXene with DMSO molecules made it possible to achieve an increase in the permittivity up to 30 at a MXene loading of 25 wt.%, but the dielectric loss tangent was increased to 0.11. A discussion of the possible mechanisms of MXene intercalation influence on the dielectric properties of PVDF/Ti3C2Tx MXene nanocomposites is presented.

Non-invasive three-dimensional electrical activation mapping to predict cardiac resynchronization therapy response: site of latest left ventricular activation relative to pacing site.

AIMS: Pacing remote from the latest electrically activated site (LEAS) in the left ventricle (LV) may diminish response to cardiac resynchronization therapy (CRT). We tested whether proximity of LV pacing site (LVPS) to LEAS, determined by non-invasive three-dimensional electrical activation mapping [electrocardiographic Imaging (ECGI)], increased likelihood of CRT response. METHODS AND RESULTS: Consecutive CRT patients underwent ECGI and chest/heart computed tomography 6-24 months of post-implant. Latest electrically activated site and the distance to LVPS (dp) were assessed. Left ventricular end-systolic volume (LVESV) reduction of ≥15% at clinical follow-up defined response. Logistic regression probabilistically modelled non-response; variables included demographics, heart failure classification, left bundle branch block (LBBB), ischaemic heart disease (IHD), atrial fibrillation, QRS duration, baseline ejection fraction (EF) and LVESV, comorbidities, use of CRT optimization algorithm, angiotensin-converting enzyme inhibitor(ACE)/angiotensin-receptor blocker (ARB), beta-blocker, diuretics, and dp. Of 111 studied patients [64 ± 11 years, EF 28 ± 6%, implant duration 12 ± 5 months (mean ± SD), 98% had LBBB, 38% IHD], 67% responded at 10 ± 3 months post CRT-implant. Latest electrically activated sites were outside the mid-to-basal lateral segments in 35% of the patients. dp was 42 ± 23 mm [31 ± 14 mm for responders vs. 63 ± 24 mm non-responders (P < 0.001)]. Longer dp and the lack of use of CRT optimization algorithm were the only independent predictors of non-response [area under the curve (AUC) 0.906]. dp of 47 mm delineated responders and non-responders (AUC 0.931). CONCLUSION: The distance between LV pacing site and latest electrical activation is a strong independent predictor for CRT response. Non-invasive electrical evaluation to characterize intrinsic activation and guide LV lead deployment may improve CRT efficacy.

Permittivity and Dielectric Loss Balance of PVDF/K1.6Fe1.6Ti6.4O16/MWCNT Three-Phase Composites.

New three-phase composites, destined for application as dielectrics in the manufacturing of passive elements of flexible electronics, and based on polymer (PVDF) matrix filled with powdered ceramics of the hollandite-like (KFTO(H)) structure (5.0; 7.5; 15; 30 vol.%) and carbon (MWCNT) additive (0.5; 1.0; 1.5 wt.% regarding the KFTO(H) amount), were obtained and studied by XRD, FTIR and SEM methods. Chemical composition and stoichiometric formula of the ceramic material synthesized by the sol-gel method were confirmed with the XRF analysis data. The influence of the ceramic and carbon fillers on the electrical properties of the obtained composites was investigated using impedance spectroscopy. The optimal combination of permittivity and dielectric loss values at 1 kHz (77.6 and 0.104, respectively) was found for the compositions containing K1.6Fe1.6Ti6.4O16 (30 vol.%) and MWCNTs (1.0 wt.% regarding the amount of ceramic filler).

Carbon Modification of K1.6Fe1.6Ti6.4O16 Nanoparticles to Optimize the Dielectric Properties of PTFE-Based Composites.

In this work, polymer matrix composites with the compositions PTFE/KFTO(H) and PTFE/KFTO(H)@CB and with filler volume fractions of 2.5, 5.0, 7.5, 15, and 30% (without and with carbon modification at a content of 2.5 wt.% regarding ceramic material) were produced by calendering and hot pressing and studied using FTIR, SEM, and impedance spectroscopy methods. Ceramic filler (KFTO(H)) was synthesized using the sol−gel Pechini method. Its structure was investigated and confirmed by the XRD method with following Rietveld refinement. The carbon black (CB) modification of KFTO(H) was carried out through the calcination of a mixture of ceramic and carbon materials in an argon atmosphere. Afterwards, composites producing all the components' structures weren't destroyed according to the FTIR results. The effect of carbon additive at a content of 2.5 wt.% relating to ceramic filler in the system of polymer matrix composites was shown, with permittivity increasing up to ε' = 28 with a simultaneous decrease in dielectric loss (tanδ < 0.1) at f = 103 Hz for composites of PTFE/KFTO(H)@CB (30 vol.%).

High-k Three-Phase Epoxy/K1.6(Ni0.8Ti7.2)O16/CNT Composites with Synergetic Effect.

Polymer matrix composites based on ED-20 epoxy resin, hollandite K1.6(Ni0.8Ti7.2)O16 and carbon nanotubes with a variable content of 0.107; 0.213 and 0.425 vol.% were obtained for the first time. Initial components and composites produced were characterized by XRD, XRA, FTIR, SEM and Raman spectroscopy. The dielectric properties of composite materials were measured by impedance spectroscopy and determined by the volume ratio of the composite components, primarily by the concentration of CNTs. At a CNT content of 0.213 vol.% (before percolation threshold), the maximum synergistic effect of carbon and ceramic fillers on the dielectric properties of a composite based on the epoxy resin was found. Three-phase composites based on epoxy resin, with a maximum permittivity at a minimum dielectric loss tangent, are promising materials for elements of an electronic component base.

Nonfluoroscopic catheter ablation of paroxysmal atrial fibrillation.

AIMS: Radiofrequency catheter ablation of atrial fibrillation (AF) is one of the most complex ablation procedures. Both patients and operators are exposed to scattered radiation. This study evaluated the safety and efficacy of intracardiac echo (ICE)-guided pulmonary vein isolation (PVI) without fluoroscopy. METHODS: We retrospectively analyzed the data of 481 consecutive patients with paroxysmal AF undergoing radiofrequency PVI with the CARTO 3 system (Biosense Webster, Diamond Bar, CA, USA). ICE-guided PVI without fluoroscopy and without CT/MRI integration (Nonfluoro group) was performed for 245 patients, and conventional fluoroscopy-guided PVI (Fluoro group) was performed for 236 patients. The primary safety endpoint was the incidence of major adverse events. The primary efficacy endpoint was freedom from AF during follow-up. Secondary endpoints included procedure duration, fluoroscopy duration, and acute PVI rate. RESULTS: Mean procedure times between groups were similar (108.8 ± 18.2 minutes in the Non-fluoro group vs 113.6 ± 26.8 minutes in the Fluoro group; P  =  not significant [NS]). Acute PVI was achieved in all patients, with mean radiofrequency application times of 43.4 ± 7.5 and 44.4 ± 10.7 minutes for the Nonfluoro and Fluoro groups, respectively (P  =  NS). The incidence of cardiac tamponade was 1.2% (3/245 patients) in the Nonfluoro group and 0.8% (2/236 patients) in the Fluoro group (P  =  NS). During 15.2 ± 4.1 months of follow-up, after a single procedure, AF recurrence was documented in 65 of 245 (26.5%) patients and 61 of 236 (25.8%) patients in the Nonfluoro and Fluoro groups, respectively (P  =  NS). CONCLUSIONS: Nonfluoroscopic ICE-guided catheter ablation of AF without prior cardiac image integration or angiography is feasible and safe. PVI without fluoroscopy did not affect procedure duration or long-term efficacy.

Mapping of ventricular arrhythmias using a novel noninvasive epicardial and endocardial electrophysiology system.

INTRODUCTION: The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias. METHODS: Eight patients (2 females, mean age 50±17 years) with ischemic (n=3) and nonischemic (n=5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data. Arrhythmia patterns were analyzed using noninvasive phase mapping. RESULTS: Macro-reentrant VT circuits were observed in 3 ischemic and 1 nonischemic cardiomyopathy patient, respectively. In the remaining 4 patients, phase mapping revealed relatively stable rotor activity and multiple wavelets. CONCLUSIONS: Noninvasive cardiac mapping was able to visualize the macro-reentrant circuits in patients with scar-related VT. In patients without myocardial scar only polymorphic VT or VF was inducible, and rotor activity and multiple wavelets were observed.

Noninvasive phase mapping of persistent atrial fibrillation in humans: Comparison with invasive catheter mapping.

BACKGROUND: A novel noninvasive epicardial and endocardial electrophysiology system (NEEES) to identify electrical rotors and focal activity in patients with atrial fibrillation (AF) was recently introduced. Comparison of NEEES data with results from invasive mapping is lacking. METHODS: Six male patients (59 ± 11 years) with persistent AF underwent cardiac mapping with the NEEES, which included the creation of isopotential and phase maps. Then patients underwent catheter mapping using a PentaRay NAV catheter and the CARTO 3 system. Signals acquired by the catheter were analyzed by customized software that applied the same phase mapping algorithm as for the NEEES data. RESULTS: In all patients, noninvasive phase mapping revealed short-lived electrical rotors occurring 1.8 ± 0.3 times per second and demonstrating 1-4 (mean 1.2 ± 0.6) rotation cycles. Most of these rotors (72.7%) aggregated in 2-3 anatomical clusters. In two patients, focal excitation from pulmonary veins was observed. Invasive catheter mapping in the dominant rotor aggregation sites and in the three control sites demonstrated the presence of electrical rotors with properties similar to noninvasively detected rotors. Spearman's correlation coefficient between rotor occurrence rate by noninvasive and invasive mapping was 0.97 (p < .0001). Mean rotors' cycle length at dominant aggregation sites, scores of their full rotations, and the proportion of rotors with clockwise rotation were not significantly different between the mapping modalities. CONCLUSION: In patients with persistent AF, phase processing of unipolar electrograms recorded by catheter mapping could reproduce electrical rotors as characterized by NEEES-based phase mapping.

Comparison of strategies for catheter ablation of focal atrial tachycardia originating near the His bundle region.

BACKGROUND: Recent studies have suggested that para-Hisian atrial tachycardia (AT) can be successfully ablated from the right atrium (RA), left atrium (LA), or noncoronary cusp (NCC) in the aorta; however, the best approach remains unclear. OBJECTIVE: This study aimed to compare different approaches to radiofrequency catheter ablation (RFCA) of para-Hisian AT. METHODS: We retrospectively analyzed 68 consecutive patients (49[72%] women; mean age 61 ± 13 years) treated with RFCA for this type of AT. Mapping of the RA (n = 68), LA (n = 21), and NCC (n = 52) was performed during AT to identify the earliest activation site and to apply RFCA. RESULTS: RFCA successfully terminated AT in the RA in 13 of 28 patients (46.4%), in the LA in 4 of 16 patients (25.0%), and in the NCC in 46 of 52 patients (88.5%) after 1 procedure (P < .05). Atrioventricular block occurred only during RFCA in the RA in 4 of 28 patients (14.3%). After a mean follow-up of 33.5 ± 25.4 months, AT recurrence was observed in 5 of 13 patients (38.5%) ablated in the RA, 1 of 4 (25.0%) ablated in the LA, and 2 of 46 (4.4%) ablated in the NCC (P < .05). RFCA in the LA was effective only if the local activation time (LAT) was earlier than that in the RA. RFCA in the NCC was successful regardless of the LAT (P < .05). CONCLUSION: Mapping and ablation in the NCC should be always considered in cases of AT originating from the His bundle region, regardless of the LAT.

Noninvasive epicardial and endocardial mapping of premature ventricular contractions.

AIMS: The aim of the present study was to estimate the accuracy of a novel non-invasive epicardial and endocardial electrophysiology system (NEEES) for mapping ectopic ventricular depolarizations. METHODS AND RESULTS: The study enrolled 20 patients with monomorphic premature ventricular contractions (PVCs) or ventricular tachycardia (VT). All patients underwent pre-procedural computed tomography or magnetic resonance imaging of the heart and torso. Radiographic data were semi-automatically processed by the NEEES to reconstruct a realistic 3D model of the heart and torso. In the electrophysiology laboratory, body-surface electrodes were connected to the NEEES followed by unipolar EKG recordings during episodes of PVC/VT. The body-surface EKG data were processed by the NEEES using its inverse-problem solution software in combination with anatomical data from the heart and torso. The earliest site of activation as denoted on the NEEES 3D heart model was compared with the PVC/VT origin using a 3D electroanatomical mapping system. The site of successful catheter ablation served as final confirmation. A total of 21 PVC/VT morphologies were analysed and ablated. The chamber of interest was correctly diagnosed non-invasively in 20 of 21 (95%) PVC/VT cases. In 18 of the 21 (86%) cases, the correct ventricular segment was diagnosed. Catheter ablation resulted in acute success in 19 of the 20 (95%) patients, whereas 1 patient underwent successful surgical ablation. During 6 months of follow-up, 19 of the 20 (95%) patients were free from recurrence off antiarrhythmic drugs. CONCLUSION: The NEEES accurately identified the site of PVC/VT origin. Knowledge of the potential site of the PVC/VT origin may aid the physician in planning a successful ablation strategy.

Simultaneous Non-Invasive Epicardial and Endocardial Mapping in Patients With Brugada Syndrome: New Insights Into Arrhythmia Mechanisms.

BACKGROUND: The underlying mechanisms of Brugada syndrome (BrS) are not completely understood. Recent studies provided evidence that the electrophysiological substrate, leading to electrocardiogram abnormalities and/or ventricular arrhythmias, is located in the right ventricular outflow tract (RVOT). The purpose of this study was to examine abnormalities of epicardial and endocardial local unipolar electrograms by simultaneous noninvasive mapping in patients with BrS. METHODS AND RESULTS: Local epicardial and endocardial unipolar electrograms were analyzed using a novel noninvasive epi- and endocardial electrophysiology system (NEEES) in 12 patients with BrS and 6 with right bundle branch block for comparison. Fifteen normal subjects composed the control group. Observed depolarization abnormalities included fragmented electrograms in the anatomical area of RVOT endocardially and epicardially, significantly prolonged activation time in the RVOT endocardium (65±20 vs 38±13 ms in controls; P=0.008), prolongation of the activation-recovery interval in the RVOT epicardium (281±34 vs 247±26 ms in controls; P=0.002). Repolarization abnormalities included a larger area of ST-segment elevation >2 mV and T-wave inversions. Negative voltage gradient (-2.5 to -6.0 mV) between epicardium and endocardium of the RVOT was observed in 8 of 12 BrS patients, not present in patients with right bundle branch block or in controls. CONCLUSIONS: Abnormalities of epicardial and endocardial electrograms associated with depolarization and repolarization properties were found using NEEES exclusively in the RVOT of BrS patients. These findings support both, depolarization and repolarization abnormalities, being operative at the same time in patients with BrS.

Anatomical predictors for successful pulmonary vein isolation using balloon-based technologies in atrial fibrillation.

PURPOSE: We evaluated the correlation between pulmonary venous (PV) anatomy and acute and long-term success of PV isolation (PVI) with two balloon-based ablation catheter techniques. METHODS: One hundred consecutive patients were analyzed in two equal groups treated with either the second-generation cryoballoon (CRYO) catheter or the visually guided laser ablation (VGLA) catheter. All patients underwent multi-detector computed tomography (CT) imaging. The primary and secondary efficacy endpoints were the procedural achievement of proven electrical isolation of all veins and freedom from atrial fibrillation (AF) within a 1-year follow-up period, respectively. RESULTS: Variant PV anatomy was observed in 32% of patients in the CRYO group and in 40% of patients in the VGLA group. All PVs were targeted with either the CRYO catheter (n = 199) or the VGLA catheter (n = 206). One hundred ninety-three of 199 PVs (97%) were successfully isolated in the CRYO group and 194 of 206 PVs (94%) in the VGLA group (p = 0.83). Over a 12-month follow-up, AF recurrence was documented in 11/45 (24%) and 7/43 (16%) patients in the CRYO and the VGLA groups, respectively (p = 0.21). In the CRYO group, a larger left inferior PV size was associated with worse long-term outcome (p = 0.001). In the VGLA group, a larger left superior PV size (p = 0.003) and more oval right inferior PV were associated with worse acute success (p = 0.038). There was no absolute cutoff between PV anatomy and clinical success. CONCLUSIONS: The variability of PV anatomy did not significantly compromise acute success of PVI or patient outcomes.