Heart failure remains a major public health concern with a 5-year mortality rate higher than that of most cancers. Myocardial disease in heart failure is frequently accompanied by impairment of the specialized electrical conduction system and myocardium. We introduce an epicardial mesh made of electrically conductive and mechanically elastic material, to resemble the innate cardiac tissue and confer cardiac conduction system function, to enable electromechanical cardioplasty. Our epicardium-like substrate mechanically integrated with the heart and acted as a structural element of cardiac chambers. The epicardial device was designed with elastic properties nearly identical to the epicardial tissue itself and was able to detect electrical signals reliably on the moving rat heart without impeding diastolic function 8 weeks after induced myocardial infarction. Synchronized electrical stimulation over the ventricles by the epicardial mesh with the high conductivity of 11,210 S/cm shortened total ventricular activation time, reduced inherent wall stress, and improved several measures of systolic function including increases of 51% in fractional shortening,~90% in radial strain, and 42% in contractility. The epicardial mesh was also capable of delivering an electrical shock to terminate a ventricular tachyarrhythmia in rodents. Electromechanical cardioplasty using an epicardial mesh is a new pathway toward reconstruction of the cardiac tissue and its specialized functions.

We develop a conservative, second-order accurate fully implicit discretization of the Navier-Stokes (NS) and CahnHilliard (CH) system that has an associated discrete energy functional. This system provides a diffuse-interface description of binary fluid flows with compressible or incompressible flow components [R. Soc. Lond. Proc. Ser. A Math. Phys. Eng. Sci. 454 (1998Sci. 454 ( ) 2617. In this work, we focus on the case of flows containing two immiscible, incompressible and density-matched components. The scheme, however, has a straightforward extension to multi-component systems. To efficiently solve the discrete system at the implicit time-level, we develop a nonlinear multigrid method to solve the CH equation which is then coupled to a projection method that is used to solve the NS equation. We demonstrate convergence of our scheme numerically in both the presence and absence of flow and perform simulations of phase separation via spinodal decomposition. We examine the separate effects of surface tension and external flow on the decomposition. We find surface tension driven flow alone increases coalescence rates through the retraction of interfaces. When there is an applied external shear, the evolution of the flow is nontrivial and the flow morphology repeats itself in time as multiple pinchoff and reconnection events occur. Eventually, the periodic motion ceases and the system relaxes to a global equilibrium. The equilibria we observe appears has a similar structure in all cases although the dynamics of the evolution is quite different. We view the work presented in this paper as preparatory for a detailed investigation of liquid-liquid interfaces with surface tension where the interfaces separate two immiscible fluids [On the pinchoff of liquid-liquid jets with surface tension, in preparation]. To this end, we also include a simulation of the pinchoff of a liquid thread under the Rayleigh instability at finite Reynolds number.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the general population. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. This guideline is based on recent data of the Korean population and the recent guidelines of the European Society of Cardiology, European Association for Cardio-Thoracic Surgery, American Heart Association, and Asia Pacific Heart Rhythm Society. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF. This guideline deals with optimal stroke prevention, screening, rate and rhythm control, risk factor management, and integrated management of AF.

We consider a Keller-Segel model coupled to the incompressible Navier-Stokes equations in spatial dimensions two and three. We establish the local existence of regular solutions and present some blow-up criteria for both cases that equations of oxygen concentration is of parabolic or hyperbolic type. We also prove global existence and decay estimate in time under the some smallness conditions of initial data.