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MRI Techniques Can Predict Future Sudden Cardiac Death

By MedImaging International staff writers
Posted on 19 Jul 2022

Image: Abnormal heart metabolism may predict future sudden cardiac death (Photo courtesy of Pexels)

Sudden cardiac death (SCD) accounts for 50% of all cardiovascular deaths in the US, claiming more than 300,000 American lives annually, according to the American Heart Association. Currently, an implantable cardioverter-defibrillator (ICD) - a small, battery-powered device placed in the chest to detect and stop irregular heart rhythms - is the primary means of preventing SCD in high-risk patients. The device continuously monitors the heart rhythm and delivers electric shocks, when needed, to restore a regular heart rhythm. The battery life of an ICD is typically between five to seven years. Now, a new study has found that adults with abnormal heart metabolism are up to three times more likely to experience life-threatening arrhythmias (an irregular heart rhythm), and magnetic resonance imaging (MRI) techniques could be used to detect the condition and predict future SCD.

In the small, but rigorous study, researchers at the Johns Hopkins University School of Medicine (Baltimore, MD, USA) measured the levels of adenosine triphosphate (ATP), the primary chemical cellular energy source, in the hearts of 46 people prior to getting an ICD for primary prevention. The cardiac ATP levels were measured on clinical MRI scanners using a magnetic resonance spectroscopy (MRS) technique developed at Johns Hopkins Medicine, to determine which patients had abnormal ATP metabolism. All patients were followed up every three to six months for an average of 10 years to determine which patients had appropriate ICD firings for life-threatening arrhythmias.

Results showed that people with low cardiac ATP levels (impaired metabolism) had a three-fold higher risk of sudden cardiac death (if not saved by ICD intervention) compared to those with normal ATP metabolism. This was still the case when adjusted for low left ventricular ejection fraction, the metric currently used to determine the need for a primary prevention ICD. The researchers say the study findings could complement current approaches and lead to better predictions for who is most likely to need, or not need an ICD. However, they stress, that more studies are needed to assess different and larger populations.

“We believe this is the first time that impaired cardiac metabolism in people has been linked to an increased risk of life-threatening arrhythmias or sudden cardiac death,” said study senior author Robert Weiss, M.D., professor of medicine at the Johns Hopkins University School of Medicine. “This could open a window for a whole new approach, a metabolic approach for treating or preventing severe arrhythmias, which is something that is not currently available in cardiology.”

“Over seven years, 60-70% of these devices never discharge to save a life,” added T. Jake Samuel, Ph.D., first author of the study and fellow in cardiology at Johns Hopkins Medicine. “We’re spending billions of dollars a year on ICDs that are implanted and have procedural and post-procedural risks. There is a need for non-invasive approaches to better assess risk for who needs or doesn’t need an ICD to prevent sudden cardiac death in people.”

Related Links:
Johns Hopkins University School of Medicine

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66 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

67 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

68 (59.127807617188): SELECT fid FROM jos_deeppockets WHERE id=294793918 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793918 AND published='1' LIMIT 1

69 (36.001205444336): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (279.90341186523): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (277.04238891602): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (50.067901611328): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (51.021575927734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (32.901763916016): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (271.08192443848): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (71.048736572266): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 1814.8422241211): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (62.227249145508): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

105 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

106 (79.870223999023): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (72.002410888672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (471.11511230469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

109 (162.12463378906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

110 (108.00361633301): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (597.00012207031): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (940.08445739746): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (631.09397888184): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

115 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

116 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

117 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

118 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

119 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

120 (416.99409484863): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 145354.03251648): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (226.97448730469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

123 (159.02519226074): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

124 (!!!!! 7647.0375061035): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793918 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793918 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 2355906.0096741): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 2037018.7759399): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (460.14785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (344.03800964355): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (57.93571472168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (231.02760314941): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (792.02651977539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 1286.9834899902): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (!!!!! 3048.1815338135): SELECT name FROM jos_deeppockets WHERE id=212

136 (257.96890258789): SELECT name FROM jos_deeppockets WHERE id=212

137 (!!!!! 1471.996307373): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (614.16625976562): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 9674.072265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

140 (380.9928894043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

141 (!!!!! 17441.987991333): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 6283.0448150635): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (!!!!! 1003.9806365967): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793918 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 1130.1040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (!!!!! 4012.1078491211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 4224.0619659424): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

147 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

148 (!!!!! 1188.0397796631): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

150 (!!!!! 2287.8646850586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

151 (422.00088500977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793918 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793918 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (39.815902709961): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (41.007995605469): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

156 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793918 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793918 AND published='1' LIMIT 1

157 (56.982040405273): select jos_twitters.link from jos_twitters where cat=10

158 (29.802322387695): select jos_facebook.link from jos_facebook where cat=10

159 (52.928924560547): select jos_google_plus.link from jos_google_plus where cat=10

160 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

161 (355.95893859863): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1443.8629150391): insert into jos_banners_delta values (14615,'2025-04-30 21:19:11','3.15.27.235','view'),(14202,'2025-04-30 21:19:11','3.15.27.235','view'),(14203,'2025-04-30 21:19:11','3.15.27.235','view')

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