Nth Slice Eraser: An Automated Algorithm to Ease Editing Workflow of Organ Contours Generated by Artificial Intelligence.

The time-consuming process of manual contouring of healthy tissue and organs in radiation therapy has prompted the development of computational systems to aid and automate this process, such as artificial intelligence (AI) segmentation and interpolation algorithms. These algorithms are useful in saving time, however, they are not always accurate. Fixing such inaccuracies by editing contours is a manual, time-consuming process as no 'undo' feature currently exists in the most commonly used treatment planning system (TPS).

Utility of cardiac implantable electronic device algorithm for detecting severe sleep-disordered breathing in cardiomyopathy.

Background: Half of patients with heart failure are estimated to have sleep-disordered breathing (SDB). However, many are undiagnosed as they do not report typical symptoms. This study aims to evaluate the implantable cardiac defibrillator (ICD) sleep-disordered breathing algorithm in a cohort of multi-racial Asian patients for detection of SDB against polysomnography (PSG).

Lipoprotein(a) distribution in hospitalised Asian patients with ischaemic heart disease.

Background: Elevated lipoprotein(a) [Lp(a)] is a common hyperlipidaemic condition with strong genetic predisposition and is independently associated with ischaemic heart disease (IHD). A Mendelian randomisation study has suggested that elevated Lp(a) is likely to confer similar causal risks as heterozygous familial hypercholesterolemia for premature IHD. We aimed to characterise the clinical profiles of admitted patients with IHD with at least one Lp(a) measurement.

Long-term clinical outcomes of remote monitoring for implantable cardioverter-defibrillators in Singapore.

Introduction: Remote monitoring (RM) for cardiac implantable electronic devices is on the rise and has been shown to reduce the burden of in-clinic follow-up visits. We aimed to investigate the long-term clinical outcomes of RM versus no RM.

Methods: This was a prospective, single-centre cohort study of consecutive patients with an implantable cardioverter-defibrillator (ICD) or cardiac resynchronisation therapy-defibrillator (CRT-D) followed up from 2018 to 2023.

Dementia Risk of Direct Oral Anticoagulants Versus Warfarin for Atrial Fibrillation: Systematic Review and Meta-Analysis.

Background: Direct-acting oral anticoagulants (DOACs) have demonstrated superior efficacy in preventing stroke and death compared with warfarin in patients with atrial fibrillation (AF), but their influence on dementia risk remains unclear.

Objectives: The purpose of this study was to evaluate the relative risks of dementia in DOAC vs warfarin in patients with AF.

Methods: An electronic literature search was conducted to retrieve studies reporting comparisons of dementia incidence between patients treated with DOACs and warfarin for AF.

Systematic Review and Meta-Analysis of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation With Low Stroke Risk.

Pivotal trials comparing direct oral anticoagulants (DOACs) against warfarin in patients with atrial fibrillation (AF) predominantly involved patients with high stroke risk. This study aimed to evaluate the efficacy and safety of DOAC versus warfarin in patients with low stroke risk. An online literature search was conducted to retrieve studies comparing clinical outcomes between patients treated with DOAC versus warfarin for AF, reporting outcomes for patients at low or minimal risk of stroke (CHADS-VASc scores ranging from 0 to 2 or CHADS scores ranging from 0 to 1).

Cell-free DNA as a potential biomarker for acute myocardial infarction: A systematic review and meta-analysis.

Background: Tissue necrosis releases cell-free deoxyribonucleic acid (cfDNA), leading to rapid increases in plasma concentration with clearance independent of kidney function.

Aim: To explore the diagnostic role of cfDNA in acute myocardial infarction (AMI).

Methods: This systematic review and -analysis included studies of cfDNA in patients with AMI and a comparator group without AMI.

Ablation therapies for paroxysmal atrial fibrillation: A systematic review and patient-level network meta-analysis.

Introduction: Despite promising trials, catheter ablation is still regarded as an adjunct to antiarrhythmic drugs (AADs) in the treatment of paroxysmal atrial fibrillation (PAF). This study aimed to compare the effectiveness of various ablation therapies and AADs.

Method: Randomised controlled trials or propensity score-matched studies comparing atrial tachyarrhythmia recurrence among any combination of ablation modalities or AAD were retrieved.

Catheter Ablation of Ventricular Arrhythmia in Patients With an Implantable Cardioverter-Defibrillator: A Systematic Review and Meta-analysis.

Background: Implantable cardioverter-defibrillator (ICD) shocks are associated with higher rates of mortality and reduced quality of life. In this study we aimed to investigate the effectiveness of catheter ablation (CA) of ventricular tachycardia in patients with an ICD.

Methods: An electronic literature search was conducted to identify randomized controlled trials that compared CA vs control.

Omnipolar activation EGM to identify the earliest breakout site of atrial tachycardia.

AT was mapped with Advisor HD Grid for earliest breakout site via local activation timing (LAT) map and Omnipolar map. While both maps point to earliest breakout site from low anterior right atrium, omnipolar map localised it to a more precise location compared to the earliest breakout site from LAT map. Ablation in this same spot rendered AT non inducible.

A meta-analysis of extended ECG monitoring in detection of atrial fibrillation in patients with cryptogenic stroke.

Objective: The aim of this systematic review is to evaluate the various modalities available for extended ECG monitoring in the detection of atrial fibrillation (AF) following a cryptogenic stroke.

Methods: MEDLINE (Ovid), EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL) were searched from January 2011 to November 2021. All randomised controlled trials and prospective cohort studies including the use of extended ECG monitoring >24 hours with a minimum duration of AF of 30 s in patients with either cryptogenic strokes or transient ischaemic attacks were included.

A case report of bidirectional ventricular tachycardia secondary to aconitum toxicity.

We present a case of malignant ventricular arrhythmia secondary to unintentional aconite poisoning. Healthcare workers need to be vigilant regarding cases of aconitum toxicities, especially in atypical presentations. There is also a need to educate the public regarding the consumption and preparation of potent TCM herbs that may result in lethal toxicity.

Clinicopathological correlates of out-of-hospital cardiac arrests.

Background: Sudden cardiac arrest with or without sudden cardiac death (SCD) represents a heterogeneous spectrum of underlying etiology but is often a catastrophic event. Despite improvements in pre-hospital response and post-resuscitation care, outcomes remain grim. Thus, we aim to evaluate the predictors of survival in out-of-hospital cardiac arrests (OHCAs) and describe autopsy findings of those with the uncertain cause of death (COD).

Subcutaneous Versus Transvenous Implantable Defibrillator Therapy: A Systematic Review and Meta-Analysis of Randomized Trials and Propensity Score-Matched Studies.

Background Subcutaneous implantable cardioverter-defibrillators (S-ICDs) have been of great interest as an alternative to transvenous implantable cardioverter-defibrillators (TV-ICDs). No meta-analyses synthesizing data from high-quality studies have yet been published. Methods and Results An electronic literature search was conducted to retrieve randomized controlled trials or propensity score-matched studies comparing S-ICD against TV-ICD in patients with an implantable cardioverter-defibrillator indication.

A single-centre experience of His bundle pacing without electrophysiological mapping system: implant success rate, safety, pacing characteristics and one-year follow up.

Introduction: Despite the challenges related to His bundle pacing (HBP), recent data suggest an improved success rate with experience. As a non-university, non-electrophysiology specialised centre in Singapore, we report our experiences in HBP using pacing system analyser alone.

Methods: Data of 28 consecutive patients who underwent HBP from August 2018 to February 2019 was retrospectively obtained.

Case report: Wide-complex tachycardia one week post-CRT-D implantation in a patient with pre-existing left bundle branch block.

A 37-year-old female with dilated cardiomyopathy, whose baseline ECG showed sinus rhythm with left bundle branch block pattern, received a cardiac resynchronization therapy defibrillator (CRTD). One week post-implantation, she presented to the emergency department with palpitations, diaphoresis and chest discomfort. ECG showed a wide-complex tachycardia (WCT) episode, which spontaneously converted to sinus rhythm, and was later diagnosed as typical slow-fast atrioventricular nodal re-entrant tachycardia.

The utilization of atrial sensing dipole in single lead implantable cardioverter defibrillator for detection of new-onset atrial high-rate episodes or subclinical atrial fibrillation: A systematic review and meta-analysis.

This meta-analysis aims to evaluate the performance of atrial sensing dipole in single lead implantable cardioverter defibrillator (VDD-ICD) recipients in particular diagnosing new-onset atrial high-rate episodes (AHREs) defined as rate threshold of 200 beats per minute, or subclinical atrial fibrillation (SCAF) defined as device-detected AF without symptoms. We comprehensively searched PubMed, Embase, and ClinicalTrials.gov.

Validation of MyDiagnostick tool to identify atrial fibrillation in a multi-ethnic Asian population.

Introduction: MyDiagnostick is an atrial fibrillation (AF) screening tool that has been validated in the Caucasian population in the primary care setting.

Methods: In our study, we compared MyDiagnostick with manual pulse check for AF screening in the community setting.

Results: In our cohort of 671 candidates from a multi-ethnic Asian population, AF prevalence was found to be 1.