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Miniature Variable Pressure - Scanning Electron Microscopy (MVP-SEM)

Variable Pressure (or Environmental) Scanning Electron Microscopy (VP-SEM) combined with Energy Dispersive X-ray Spectroscopy (EDS) is one of the most powerful methods for characterizing the sub-micron topography and chemical composition of uncoated samples. Terrestrially, VP-SEM is extensively used to non-destructively study geologic and manufactured materials with high spatial resolution (tens of nanometers) and large depth-of-field. An SEM offers a geologist a first survey of microscopic mineral phases via secondary electron imaging (SEI), which provides a topographic look at a sample, as well as backscattered electron (BEI) imaging, which contrasts the phases present based on their geochemistry (atomic number). A VP-SEM utilizes a gas in the sample chamber as a charge dissipation and signal amplification method, allowing analysis of a sample without preparation in the form of a conductive coating. A miniaturized VP-SEM operating in-situ on a lander or rover would be able to use the CO2-rich Martian atmosphere (e.g., Nier et al., 1976; Williams 2016) as an imaging medium for this purpose. Adaptation of a VP-SEM for in-situ Mars surface studies will provide a new imaging capability (via SEI) that is at least an order of magnitude higher resolution than the Mars Hand Lens Imager (MAHLI) on the Mars Science Laboratory (Williams et al., 2015), and equal to or better than the achieved resolution of the Atomic Force Microscope on the Phoenix Mars lander (Pike et al., 2011). In addition, the MVP-SEM is capable of BSI and simultaneous chemical analysis of the imaged region. In this sense, the MVP-SEM can be regarded as an instrument suite that will provide a new set of information not achievable by any other instrument. The Miniaturized Variable Pressure Scanning Electron Microscope (MVP-SEM) was designed, built, and benchtop tested by a team at NASA’s Marshall Space Flight Center and Jet Propulsion Laboratory (JPL), Jacobs Space Exploration Group, Applied Physics Technologies, Inc. (AP-Tech), and Creare LLC, working with a team of technical and science collaborators. Benchtop testing was successful, proving concept feasibility. To date, the MVP-SEM has achieved an imaging resolution of <100 nm in the lab, and with continued optimization, even better performance (~50 nm resolution) is possible. Use in-situ on the lunar or other planetary surfaces would require some redesign to optimize instrument performance, but such an instrument would be equally useful.

Variable Pressure Scanning Electron Microscopy

NASA's Habitation Development Status: Current Concepts and ISRU Opportunities

Introduction: The National Aeronautics and Space Administration (NASA) is embarking on a bold journey to return humankind to the Moon and onward to Mars with innovative commercial, international, and academic partnerships [1]. Under the Artemis series of missions, NASA seeks to establish sustained human exploration of deep space through an objectives-based approach [2]. This approach drives the identification of needed system functionality and the current and future capabilities which will eventually allow humanity to sustainably live beyond Earth. Providing evolvable and scalable habitation is a cornerstone function that calls for the collection and integration of current, developmental, and future technologies that can meet near-term exploration needs while growing into long-term sustained presence. NASA is advancing in-space habitation through its Next Space Technologies for Exploration Partnerships (NextSTEP) model while designing lunar, Mars transit, and Mars surface habitat government reference concepts for Artemis missions. These efforts have unveiled possible near-term opportunities for the in-space resource utilization community if human habitation is considered a future customer of space resources. NextSTEP Habitation Development: NASA is closely working with commercial partners under its NextSTEP Appendix A model to advance habitation systems in the arena of inflatable and composite habitation structures. Such efforts promise efficiencies in volumetric packaging and overall spacecraft mass respectively. Recent testing by commercial partners have helped to quantify possible failure mechanisms for inflatable structures while advancing their technology towards eventual flight certification. The advancement of such Class II habitation structures, in which the habitat is only fully deployed once in-space or on a planetary surface [3], is critical to providing increased habitable volume for long-duration missions with no additional mass penalties. The progression of such technology is infused into NASA’s government reference concepts for notional deep space habitation concepts. Current Government Reference Concepts: To best inform the formulation of future collaborative solicitations, NASA employs the practice of internally developing reference concepts for future exploration elements. These concepts aid in identifying the functions and capabilities needed to complete NASA missions as well as feasible solutions within the timeframe needed. Government reference concepts for a lunar Surface Habitat, Mars Transit Habitat, and Mars Sur-face Habitat are continuously being developed and updated to better guide the Agency’s overall exploration architecture. Lunar Surface Habitat. As NASA returns to the Moon, it is evaluating possible lunar surface habitation concepts. The Surface Habitat (SH) reference concept entails a hybrid metallic-inflatable structure capable of initially housing two crew for surface stays of up to 30 days in duration [4]. While initial missions may span ~7 days in duration, consideration is being given to expanding SH’s capability to support a crew of four for up to 60 days over its 15-year design life [5]. Functionally, the SH serves as a ‘hub’ for all Artemis crewed surface operations, providing internal volume for maintenance, medical, logistics, science utilization, and extravehicular activity (EVA) support in addition to core habitation functionality such as environmental control and life support (ECLS) and power generation and distribution among many others. Additionally, NASA has entered a study agreement with the Italian Space Agency (Agenzia Spaziale Italiana – ASI) to investigation a possible Multi-Purpose Habitat (MPH) as an additional or augmenting habit-able element for the lunar surface [6]. Mars Transit Habitat. NASA’s current architectural concept for initial human missions to Mars entails the utilization of a transit habitat (TH) to transport a four-person crew to and from Mars orbit, departing from and returning to a lunar near-rectilinear halo orbit (NRHO), over the course of a ~1,200-day mission [5]. While holding a similar 15-year design lifetime, TH will also support a series of analog mission activities in NRHO to gradually test the systems and interaction with lunar surface elements, some of which may be adapted for Mars surface exploration. Holding similar functional capabilities as SH, TH is sized to support much longer durations in space and greater logistical independence. Mars Surface Habitat. NASA is still exploring the concept of operations for initial crewed missions to Mars. As such, the Mars Surface Habitat (MSH) concept is still in its infancy as options for mobile, pressurized habitation and stationary habitats are being explored. It is expected MSH will leverage heavily from the lunar SH and possible lunar pressurized rover, however the very different Martian environment will likely necessitate modifications. ISRU Opportunities: Despite the advancements under NASA’s NextSTEP habitation work and continually optimized reference concepts, NASA is facing near-term mass and power challenges that may create opportunities to the ISRU community by providing yet another possible customer for space resources. While NASA desires to use regenerative ECLS systems (ECLSS) for all habitation concepts, their operation comes with initial mass penalties and maintenance overheads when compared to simpler open-loop architectures. Because of this, NASA is currently pro-posing an open-loop, consumables-based architecture for its surface habitats to achieve initial launch and delivery lander mass targets while scarring for the in-corporation of regenerative ECLSS to meet longer mission durations and sustained presence. With such an architecture, oxygen and potable water are needed consumables, which initial ISRU systems may be able to provide in a pilot capacity. Although the TH is expecting to utilize regenerative ECLSS, advancements in lunar surface-based ISRU and possible re-supply of spacecraft in lunar or Mars orbit could significantly reduce the logistical need for ECLSS related spares on TH and possibly allow a similar open-loop and consumables-based architecture. Table 1 Notional ECLSS consumables per mission use for SH and TH [5]. SH (28-day) Open Loop: Water (kg) 288 | Oxygen (kg) 30 TH (1110-day) Closed-Loop: Water (kg) 182 | Oxygen (kg) 123 In addition to ECLSS mass concerns, the SH is facing challenges with energy storage to support operations over periods of darkness exceeding 100 hours. Both battery and fuel cell-based power architectures are being traded, opening options for external power generation and energy storage. One possibility is ISRU-produced H2 and O2 feeding external primary fuel cell systems which could supplement habitation power generation while reducing initial mass and volume until much more powerful fission power systems might be deployed. Conclusion: Significant advancements are being made in evolvable habitation concepts that span from near-term technologies, such as inflatable structures under NextSTEP, to potentially revolutionary capabilities like the lunar surface construction as funded through the Moon-to-Mars Planetary Autonomous Construction Technologies (MMPACT) project [7]. As NASA investigates both heritage capabilities and rap-idly advancing, disruptive technologies, there are likely many near-term opportunities for initial ISRU capabilities to significantly aid human habitation and increase self-sufficiency beyond Earth.

habitation

NASA's Habitation Development Status: Current Concepts and ISRU Opportunities

Introduction: The National Aeronautics and Space Administration (NASA) is embarking on a bold journey to return humankind to the Moon and onward to Mars with innovative commercial, international, and academic partnerships. Under the Artemis series of missions, NASA seeks to establish sustained human exploration of deep space through an objectives-based approach. This approach drives the identification of needed system functionality and the current and future capabilities which will eventually allow humanity to sustainably live beyond Earth. Providing evolvable and scalable habitation is a cornerstone function that calls for the collection and integration of current, developmental, and future technologies that can meet near-term exploration needs while growing into long-term sustained presence. NASA is advancing in-space habitation through its Next Space Technologies for Exploration Partnerships (NextSTEP) model while designing lunar, Mars transit, and Mars surface habitat government reference concepts for Artemis missions. These efforts have unveiled possible near-term opportunities for the in-space resource utilization community if human habitation is considered a future customer of space resources. NextSTEP Habitation Development: NASA is closely working with commercial partners under its NextSTEP Appendix A model to advance habitation systems in the arena of inflatable and composite habitation structures. Such efforts promise efficiencies in volumetric packaging and overall spacecraft mass respectively. Recent testing by commercial partners have helped to quantify possible failure mechanisms for inflatable structures while advancing their technology towards eventual flight certification. The advancement of such Class II habitation structures, in which the habitat is only fully deployed once in-space or on a planetary surface, is critical to providing increased habitable volume for long-duration missions with no additional mass penalties. The progression of such technology is infused into NASA’s government reference concepts for notional deep space habitation concepts. Current Government Reference Concepts: To best inform the formulation of future collaborative solicitations, NASA employs the practice of internally developing reference concepts for future exploration elements. These concepts aid in identifying the functions and capabilities needed to complete NASA missions as well as feasible solutions within the timeframe needed. Government reference concepts for a lunar Surface Habitat, Mars Transit Habitat, and Mars Sur-face Habitat are continuously being developed and updated to better guide the Agency’s overall exploration architecture. Lunar Surface Habitat. As NASA returns to the Moon, it is evaluating possible lunar surface habitation concepts. The Surface Habitat (SH) reference concept entails a hybrid metallic-inflatable structure capable of initially housing two crew for surface stays of up to 30 days in duration. While initial missions may span ~7 days in duration, consideration is being given to expanding SH’s capability to support a crew of four for up to 60 days over its 15-year design life. Functionally, the SH serves as a ‘hub’ for all Artemis crewed surface operations, providing internal volume for maintenance, medical, logistics, science utilization, and extravehicular activity (EVA) support in addition to core habitation functionality such as environmental control and life support (ECLS) and power generation and distribution among many others. Additionally, NASA has entered a study agreement with the Italian Space Agency (Agenzia Spaziale Italiana – ASI) to investigation a possible Multi-Purpose Habitat (MPH) as an additional or augmenting habit-able element for the lunar surface. Mars Transit Habitat. NASA’s current architectural concept for initial human missions to Mars entails the utilization of a transit habitat (TH) to transport a four-person crew to and from Mars orbit, departing from and returning to a lunar near-rectilinear halo orbit (NRHO), over the course of a ~1,200-day mission. While holding a similar 15-year design lifetime, TH will also support a series of analog mission activities in NRHO to gradually test the systems and interaction with lunar surface elements, some of which may be adapted for Mars surface exploration. Holding similar functional capabilities as SH, TH is sized to support much longer durations in space and greater logistical independence. Mars Surface Habitat. NASA is still exploring the concept of operations for initial crewed missions to Mars. As such, the Mars Surface Habitat (MSH) concept is still in its infancy as options for mobile, pressurized habitation and stationary habitats are being explored. It is expected MSH will leverage heavily from the lunar SH and possible lunar pressurized rover, however the very different Martian environment will likely necessitate modifications. ISRU Opportunities: Despite the advancements under NASA’s NextSTEP habitation work and continually optimized reference concepts, NASA is facing near-term mass and power challenges that may create opportunities to the ISRU community by providing yet another possible customer for space resources. While NASA desires to use regenerative ECLS systems (ECLSS) for all habitation concepts, their operation comes with initial mass penalties and maintenance overheads when compared to simpler open-loop architectures. Because of this, NASA is currently pro-posing an open-loop, consumables-based architecture for its surface habitats to achieve initial launch and delivery lander mass targets while scarring for the in-corporation of regenerative ECLSS to meet longer mission durations and sustained presence. With such an architecture, oxygen and potable water are needed consumables, which initial ISRU systems may be able to provide in a pilot capacity. Although the TH is expecting to utilize regenerative ECLSS, advancements in lunar surface-based ISRU and possible re-supply of spacecraft in lunar or Mars orbit could significantly reduce the logistical need for ECLSS related spares on TH and possibly allow a similar open-loop and consumables-based architecture. In addition to ECLSS mass concerns, the SH is facing challenges with energy storage to support operations over periods of darkness exceeding 100 hours. Both battery and fuel cell-based power architectures are being traded, opening options for external power generation and energy storage. One possibility is ISRU-produced H2 and O2 feeding external primary fuel cell systems which could supplement habitation power generation while reducing initial mass and volume until much more powerful fission power systems might be deployed. Conclusion: Significant advancements are being made in evolvable habitation concepts that span from near-term technologies, such as inflatable structures under NextSTEP, to potentially revolutionary capabilities like the lunar surface construction as funded through the Moon-to-Mars Planetary Autonomous Construction Technologies (MMPACT) project. As NASA investigates both heritage capabilities and rap-idly advancing, disruptive technologies, there are likely many near-term opportunities for initial ISRU capabilities to significantly aid human habitation and increase self-sufficiency beyond Earth.

habitation

System Health Management for a Series/Parallel Partial Hybrid Powertrain with Distributed Electric Propulsion

Electrified aircraft powertrains contain multiple interacting subsystems, making them much more complex than traditional aircraft propulsion systems in terms of integration and control. Electrification enables aircraft to have distributed thrust-producing fans that the flight control system can leverage for enhanced maneuverability, further increasing the control complexity. A NASA concept aircraft, the SUbsonic Single Aft eNgine (SUSAN) Electrofan, is such a vehicle. SUSAN is a series/parallel partial hybrid-electric single-aisle transport aircraft that takes advantage of its electrified powertrain to provide fuel burn and emissions benefits when compared to the state-of-the-art. Achieving these benefits requires an appropriately designed control architecture that coordinates the various powertrain and flight control subsystems. As such, the SUSAN aircraft is designed with a high level of automation, allowing it to properly manage coupled subsystems and react rapidly to failures and anomalies. To do this effectively, algorithms that perform component health management, fault detection, isolation, and accommodation, and continuous optimization, must be developed and implemented. This paper describes the development of some of these algorithms for system health management applied to the powertrain of the SUSAN concept aircraft.

Electrified Aircraft Propulsion

System Health Management for a Series/Parallel Partial Hybrid Powertrain with Distributed Electric Propulsion

Electrified aircraft powertrains contain multiple interacting subsystems, making them much more complex than traditional aircraft propulsion systems in terms of integration and control. Electrification enables aircraft to have distributed thrust-producing fans that the flight control system can leverage for enhanced maneuverability, further increasing the control complexity. A NASA concept aircraft, the SUbsonic Single Aft eNgine (SUSAN) Electrofan, is such a vehicle. SUSAN is a series/parallel partial hybrid-electric single-aisle transport aircraft that takes advantage of its electrified powertrain to provide fuel burn and emissions benefits when compared to the state-of-the-art. Achieving these benefits requires an appropriately designed control architecture that coordinates the various powertrain and flight control subsystems. As such, the SUSAN aircraft is designed with a high level of automation, allowing it to properly manage coupled subsystems and react rapidly to failures and anomalies. To do this effectively, algorithms that perform component health management, fault detection, isolation, and accommodation, and continuous optimization, must be developed and implemented. This paper describes the development of some of these algorithms for system health management applied to the powertrain of the SUSAN concept aircraft.

Electrified Aircraft Propulsion

System Health Management for a Series/Parallel Partial Hybrid Powertrain with Distributed Electric Propulsion

Electrified aircraft powertrains contain multiple interacting subsystems, making them much more complex than traditional aircraft propulsion systems in terms of integration and control. Electrification enables aircraft to have distributed thrust-producing fans that the flight control system can leverage for enhanced maneuverability, further increasing the control complexity. A NASA concept aircraft, the SUbsonic Single Aft eNgine (SUSAN) Electrofan, is such a vehicle. SUSAN is a series/parallel partial hybrid-electric single-aisle transport aircraft that takes advantage of its electrified powertrain to provide fuel burn and emissions benefits when compared to the state-of-the-art. Achieving these benefits requires an appropriately designed control architecture that coordinates the various powertrain and flight control subsystems. As such, the SUSAN aircraft is designed with a high level of automation, allowing it to properly manage coupled subsystems and react rapidly to failures and anomalies. To do this effectively, algorithms that perform component health management, fault detection, isolation, and accommodation, and continuous optimization, must be developed and implemented. This paper describes the development of some of these algorithms for system health management applied to the powertrain of the SUSAN concept aircraft.

Electrified Aircraft Propulsion

Bell-Curve Genetic Algorithm for Mixed Continuous and Discrete Optimization Problems

In this manuscript we have examined an extension of BCB that encompasses a mix of continuous and quasi-discrete, as well as truly-discrete applications. FVe began by testing two refinements to the discrete version of BCB. The testing of midpoint versus fitness (Tables 1 and 2) proved inconclusive. The testing of discrete normal tails versus standard mutation showed was conclusive and demonstrated that the discrete normal tails are better. Next, we implemented these refinements in a combined continuous and discrete BCB and compared the performance of two discrete distance on the hub problem. Here we found when "order does matter" it pays to take it into account.

Kincaid, Rex K.

Advanced Method Optimization with Categorical and Constrained Continuous Parameters

Traditional approaches to analytical method optimization (e.g., univariate and “guess-and-check”) can be time-consuming, costly, and often fail to identify true optima within the parameter space. Previous work defined and implemented a generalized technique for method optimization for continuous method parameters, but a knowledge gap remains for the incorporation of categorical variables into these advanced method optimization schemes. This work presents and validates a generalized optimization approach that incorporates both continuous and categorical variables while also utilizing a multivariate, multiobjective optimization scheme with Karush–Kuhn–Tucker conditions to bound the optimization space to solutions within the physical limitations of the parameter space. Method optimization from a case study using GC–MS for the analysis of 11 analytical standards with objectives to minimize peak width and maximize peak height resulted in a 3 orders of magnitude improvement in the average peak height and a 2 orders of magnitude improvement in the average peak width compared to the least optimal (but reasonable) instrumental parameters utilized in this study. This approach to optimization allows for a customizable method optimization in which users can include both continuous and categorical variables to achieve objectives specific to their analytical goals. This approach significantly reduces the labor and cost associated with traditional method development approaches and can be applied in a variety of scientific fields across a range of laboratory techniques (e.g., instrument method development, sample preparation, and extraction techniques).

Amorphous materials

Landsat Data Continuity Mission (LDCM) - Optimizing X-Band Usage

The NASA version of the low-density parity check (LDPC) 7/8-rate code, shortened to the dimensions of (8160, 7136), has been implemented as the forward error correction (FEC) schema for the Landsat Data Continuity Mission (LDCM). This is the first flight application of this code. In order to place a 440 Msps link within the 375 MHz wide X band we found it necessary to heavily bandpass filter the satellite transmitter output . Despite the significant amplitude and phase distortions that accompanied the spectral truncation, the mission required BER is maintained at < 10(exp -12) with less than 2 dB of implementation loss. We utilized a band-pass filter designed ostensibly to replicate the link distortions to demonstrate link design viability. The same filter was then used to optimize the adaptive equalizer in the receiver employed at the terminus of the downlink. The excellent results we obtained could be directly attributed to the implementation of the LDPC code and the amplitude and phase compensation provided in the receiver. Similar results were obtained with receivers from several vendors.

Garon, H. M.

Aerostructural Weight Estimation for a Transonic Truss-Braced Wing using the Higher-fidelity Conceptual Design and Structural Optimization Tool

Continued development and enhancements of the Higher-fidelity Conceptual Design and structural optimization (HCDstruct) tool has been driven largely by advanced aircraft concepts of interest to NASA. While previous versions of HCDstruct were limited to hybrid wing body (HWB) and generalized tube and wing (TW) aircraft concepts, the latest version of HCDstruct supports the analysis of Truss-Braced Wing (TBW) aircraft concepts, where users can model both high and low wing configurations as well as strut and jury geometries parametrically. Additionally, new methods for modeling advanced composite materials within HCDstruct have been implemented. These recent tool enhancements were demonstrated for an independent assessment of the NASA/Boeing SUGAR Phase VI Mach 0.8 Transonic Truss-Braced Wing (TTBW) concept.

Zachary D. Windous

A simple introduction to the SiMPL method for density-based topology optimization

We introduce a novel method for solving density-based topology optimization problems: Sigmoidal Mirror descent with a Projected Latent variable (SiMPL). The SiMPL method (pronounced as “the simple method”) optimizes a design using only first-order derivative information of the objective function. The bound constraints on the density field are enforced with the help of the (negative) Fermi–Dirac entropy, which is also used to define a non-symmetric distance function called a Bregman divergence on the set of admissible designs. This Bregman divergence leads to a simple update rule that is further simplified with the help of a so-called latent variable. Because the SiMPL method involves discretizing the latent variable, it produces a sequence of pointwise-feasible iterates, even when high-order finite elements are used in the discretization. Numerical experiments demonstrate that the method outperforms other popular first-order optimization algorithms. In conclusion, to outline the general applicability of the technique, we include examples with (self-load) compliance minimization and compliant mechanism optimization problems.

Calculus of Variations and Optimization

Optimal design of compact spur gear reductions

The optimal design of compact spur gear reductions includes the selection of bearing and shaft proportions in addition to gear mesh parameters. Designs for single mesh spur gear reductions are based on optimization of system life, system volume, and system weight including gears, support shafts, and the four bearings. The overall optimization allows component properties to interact, yielding the best composite design. A modified feasible directions search algorithm directs the optimization through a continuous design space. Interpolated polynomials expand the discrete bearing properties and proportions into continuous variables for optimization. After finding the continuous optimum, the designer can analyze near optimal designs for comparison and selection. Design examples show the influence of the bearings on the optimal configurations.

Savage, M.

Stability Analysis of Streaks Induced by Optimized Vortex Generators

Numerical computations are performed to investigate the potential for transition control in an axisymmetric boundary layer via fully realizable, streamwise stationary streaks induced by an azimuthally periodic array of surface mounted vortex generators (VGs). Previous work has shown that suitable streaks of this type can significantly reduce the growth of Mack’s second mode instabilities, but large streak amplitudes can make the flow susceptible to previously absent streak instabilities that can become the leading cause of transition. Here, we use the adjoint capabilities of the SU2 flow solver to optimize the VG shape to maximize the reduction in the growth of second-mode disturbances while also preventing the streak amplitudes from reaching large enough values to precipitate an earlier onset of transition via streak instabilities. The geometry and the freestream flow conditions are selected to match a relevant trajectory lo-cation from the HIFiRE-1 flight experiment. Results show that the optimized VGs can increase the mean streak amplitude by 117% with respect to a manually developed baseline design. The stability of this optimized basic state is analyzed via the plane-marching parabolized stability equations, predicting a fully laminar flow over the entire cone, or equivalently, yielding transition delay of 130% versus the 17% for the baseline VGs.

Boundary layer transition

Nonsmooth trajectory optimization - An approach using continuous simulated annealing

An account is given of the properties of a continuous simulated annealing algorithm that can function as a global optimization tool for nonsmooth dynamic systems, as shown in the case of a trajectory-optimization program implementation. The approach is shown to successfully solve the problem of nonsmooth trajectory optimization for a high performance rigid-body aircraft. The results obtained demonstrate the superiority of the simulated annealing algorithm over widely used algorithms.

Lu, Ping

Multiplier-continuation algorthms for constrained optimization

Several path following algorithms based on the combination of three smooth penalty functions, the quadratic penalty for equality constraints and the quadratic loss and log barrier for inequality constraints, their modern counterparts, augmented Lagrangian or multiplier methods, sequential quadratic programming, and predictor-corrector continuation are described. In the first phase of this methodology, one minimizes the unconstrained or linearly constrained penalty function or augmented Lagrangian. A homotopy path generated from the functions is then followed to optimality using efficient predictor-corrector continuation methods. The continuation steps are asymptotic to those taken by sequential quadratic programming which can be used in the final steps. Numerical test results show the method to be efficient, robust, and a competitive alternative to sequential quadratic programming.

Lundberg, Bruce N.

Diagnostic yield and optimal duration of continuous-loop event monitoring for the diagnosis of palpitations. A cost-effectiveness analysis

BACKGROUND: Continuous-loop event recorders are widely used for the evaluation of palpitations, but the optimal duration of monitoring is unknown. OBJECTIVE: To determine the yield, timing, and incremental cost-effectiveness of each week of event monitoring for palpitations. DESIGN: Prospective cohort study. PATIENTS: 105 consecutive outpatients referred for the placement of a continuous-loop event recorder for the evaluation of palpitations. MEASUREMENTS: Diagnostic yield, incremental cost, and cost-effectiveness for each week of monitoring. RESULTS: The diagnostic yield of continuous-loop event recorders was 1.04 diagnoses per patient in week 1, 0.15 diagnoses per patient in week 2, and 0.01 diagnoses per patient in week 3 and beyond. Over time, the cost-effectiveness ratio increased from $98 per new diagnosis in week 1 to $576 per new diagnosis in week 2 and $5832 per new diagnosis in week 3. CONCLUSIONS: In patients referred for evaluation of palpitations, the diagnostic yield of continuous-loop event recording decreases rapidly after 2 weeks of monitoring. A 2-week monitoring period is reasonably cost-effective for most patients and should be the standard period for continuous-loop event recording for the evaluation of palpitations.

NASA Discipline Cardiopulmonary