Long-term clinical outcomes and cost-effectiveness of catheter vs thoracoscopic surgical ablation in long-standing persistent atrial fibrillation using continuous cardiac monitoring: CASA-AF randomized controlled trial.

Background: Long-term clinical outcomes of catheter ablation (CA) compared to thoracoscopic surgical ablation (SA) to treat patients with long-standing persistent atrial fibrillation (LSPAF) are not known.

Objective: The purpose of this study was to compare the long-term (36-month) clinical efficacy, quality of life, and cost-effectiveness of SA and CA in LSPAF.

Methods: Participants were followed up for 3 years using implantable loop recorders and questionnaires to assess the change in quality of life.

Do religious and cultural considerations militate against body donation? An overview and a Christian perspective.

The development of anatomy as a scientific undertaking appears to have left little room for religious and cultural input into the conduct of anatomical investigations. This has been brought to the fore by questionnaires regarding the willingness or otherwise of individuals to donate their bodies for dissection, with higher levels of willingness from those without religious affiliations. This has led to the assumption that there is inherent opposition to body donation by those with a religious stance, although there has been little exploration of this.

Left Atrial Function Predicts Atrial Arrhythmia Recurrence Following Ablation of Long-Standing Persistent Atrial Fibrillation.

Background: Left atrial (LA) function following catheter or surgical ablation of de-novo long-standing persistent atrial fibrillation (AF) and its impact on AF recurrence was studied in patients participating in the CASA-AF trial (Catheter Ablation vs. Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation).

Methods: All patients underwent echocardiography preablation, 3 and 12 months post-ablation.

Anatomists' uses of human skeletons: Ethical issues associated with the India bone trade and anonymized archival collections.

Concerns have recently been expressed about the continuing availability of human bones from India, obtained originally for educational purposes but lacking the requisite informed consent that would be expected today. More generally, a broader claim is being made, namely, that the practice of using any unconsented bones in educational settings is unethical and should cease. These calls, in turn, raise broader issues regarding the availability of anonymous archival collections in anatomy museums.

Variation in optimal hemodynamic atrio-ventricular delay of biventricular pacing with different endocardial left ventricular lead locations using precision hemodynamics.

Introduction: It is not known whether the optimal atrioventricular (AV ) delay varies between left ventricular (LV) pacing site during endocardial biventricular pacing (BiVP) and may therefore needs consideration.

Methods: We assessed the hemodynamic AV in patients with chronic heart failure undergoing endocardial LV lead implantation. AV was assessed during atrio-BiVP with a "roving LV lead.

Is inadequate anatomical knowledge on the part of physicians hazardous for successful clinical practice?

Purpose: The physicians say that the least anatomy is required for clinical practice. But the disease causes anatomical distortions or variations in structures impairing functions of organs and systems. So, the diagnosis and analysis of treatment of disease depend on interwoven inter-relationship among Anatomy, Physiology, Pathology, Radiology and clinical sciences.

Novel aggregated multiposition noncontact mapping of atrial tachycardia in humans: From computational modeling to clinical validation.

Background: A novel aggregated multiposition noncontact mapping (AMP-NCM) algorithm is proposed to diagnose cardiac arrhythmias.

Objective: The purpose of this study was to computationally determine an accuracy threshold and to compare the accuracy and clinical utility of AMP-NCM to gold standard contact mapping.

Methods: In a cellular automata model, the number of catheter positions and chamber coverage were varied to establish accuracy requirements for clinically relevant AMP-NCM.

Individualized ablation strategy to treat persistent atrial fibrillation: Core-to-boundary approach guided by charge-density mapping.

Background: Noncontact charge-density mapping allows rapid real-time global mapping of atrial fibrillation (AF), offering the opportunity for a personalized ablation strategy.

Objective: The purpose of this study was to compare the 2-year outcome of an individualized strategy consisting of pulmonary vein isolation (PVI) plus core-to-boundary ablation (targeting the conduction pattern core with an extension to the nearest nonconducting boundary) guided by charge-density mapping, with an empirical PVI plus posterior wall electrical isolation (PWI) strategy.

Methods: Forty patients (age 62 ± 12 years; 29 male) with persistent AF (10 ± 5 months) prospectively underwent charge-density mapping-guided PVI, followed by core-to-boundary stepwise ablation until termination of AF or depletion of identified cores.

Anatomy in a Post-Covid-19 World: Tracing a New Trajectory.

In responding to Covid-19 anatomists have succeeded in adapting their teaching to online delivery. However, long-term reliance on this mode of teaching raises the prospect that transferring the whole of the learning environment to an impersonal digital world will lead to loss of anatomy's humanistic side. In looking to a future increasingly dependent upon digital input to teaching, a number of roadblocks are identified.

Catheter Ablation of Atrial Fibrillation in Patients With Functional Mitral Regurgitation and Left Ventricular Systolic Dysfunction.

The efficacy of catheter ablation for atrial fibrillation (AF) in patients with functional mitral regurgitation (MR) and left ventricular (LV) systolic dysfunction (LVSD) is not known. The aim of the study is to determine the efficacy of catheter ablation for AF in patients with functional MR and LVSD, and to validate its effects on the severity of MR and cardiac reverse remodeling. We performed a retrospective study of 54 patients with functional MR who underwent AF ablation, including 21 (38.

Spectral characterization and impact of stepwise ablation protocol including LAA electrical isolation on persistent AF.

Objectives: To study how left atrial appendage electrical isolation (LAAEI) impacts atrial dominant frequency (DF) in patients with long-standing persistent atrial fibrillation (LSPAF).

Background: LAAEI is associated with a high probability of freedom from atrial fibrillation (AF) and spectral analysis may identify high-frequency sources. How LAAEI impacts the AF dynamics and the subgroup of LSPAF patients in whom LAAEI would be most beneficial, is unclear.

A Primer on Constructing Plasticity Phenotypes to Classify Experience-Dependent Development of the Visual Cortex.

Many neural mechanisms regulate experience-dependent plasticity in the visual cortex (V1), and new techniques for quantifying large numbers of proteins or genes are transforming how plasticity is studied into the era of big data. With those large data sets comes the challenge of extracting biologically meaningful results about visual plasticity from data-driven analytical methods designed for high-dimensional data. In other areas of neuroscience, high-information content methodologies are revealing more subtle aspects of neural development and individual variations that give rise to a richer picture of brain disorders.

Catheter ablation vs. thoracoscopic surgical ablation in long-standing persistent atrial fibrillation: CASA-AF randomized controlled trial.

Aims: Long-standing persistent atrial fibrillation (LSPAF) is challenging to treat with suboptimal catheter ablation (CA) outcomes. Thoracoscopic surgical ablation (SA) has shown promising efficacy in atrial fibrillation (AF). This multicentre randomized controlled trial tested whether SA was superior to CA as the first interventional strategy in de novo LSPAF.

Diverse activation patterns during persistent atrial fibrillation by noncontact charge-density mapping of human atrium.

Background: Global simultaneous recording of atrial activation during atrial fibrillation (AF) can elucidate underlying mechanisms contributing to AF maintenance. A better understanding of these mechanisms may allow for an individualized ablation strategy to treat persistent AF. The study aims to characterize left atrial endocardial activation patterns during AF using noncontact charge-density mapping.

Ethical Responses to the Covid-19 Pandemic: Implications for the Ethos and Practice of Anatomy as a Health Science Discipline.

The move of much anatomy teaching online in response to the Covid-19 pandemic has been successfully implemented within very short time frames. This has necessitated a high degree of dependence upon the use of digitized cadaveric resources, has entailed immense workload demands on staff, and has disrupted students' studies. These educational exigencies have been accompanied by ethical uncertainties for a discipline centered on study of the dead human body.

Validation of Dipole Density Mapping During Atrial Fibrillation and Sinus Rhythm in Human Left Atrium.

Objectives: This study sought to validate the accuracy of noncontact electrograms against contact electrograms in the left atrium during sinus rhythm (SR) and atrial fibrillation (AF).

Background: Noncontact mapping offers the opportunity to assess global cardiac activation in the chamber of interest. A novel noncontact mapping system, which records intracardiac voltage to derive cellular charge sources (dipole density), allows real-time mapping of AF to guide ablation.

Cultural practices of the Zulu ethnic group on the body and their influence on body donation.

Cultural practices in the African continent have been thought to impact negatively on body donation. Thus, most African countries continue to rely on unclaimed bodies for dissection programs, or bequests from the white population. The latter situation is dominant in South African medical schools.

Ethical Perspectives on Body Donation Following Physician-Assisted Death.

The increasing availability of physician-assisted death (PAD) has opened up a novel means of making donated bodies available for anatomical dissection. This practice has come to the fore in Canada, but is unlikely to be confined to that country as legislation changes in other countries. The ethical considerations raised by this development are placed within the framework of the ethical guidelines on body donation promulgated by the International Federation of Associations of Anatomists.

Classification of Visual Cortex Plasticity Phenotypes following Treatment for Amblyopia.

Monocular deprivation (MD) during the critical period (CP) has enduring effects on visual acuity and the functioning of the visual cortex (V1). This experience-dependent plasticity has become a model for studying the mechanisms, especially glutamatergic and GABAergic receptors, that regulate amblyopia. Less is known, however, about treatment-induced changes to those receptors and if those changes differentiate treatments that support the recovery of acuity versus persistent acuity deficits.

Confucian Ethics on the Commercial Use of Human Bodies and Body Parts: Yi (Righteousness) or/and Li (Profit)?

In China as elsewhere in the world, human bodies and body parts have long been used for a wide range of medical and non-medical purposes. In recent decades, China has played a considerable role in some of the public exhibitions of plastinated bodies and body parts, and the commercial trade in organ donations. These contemporary developments have raised numerous challenging ethical and governance questions.

Characterization of the Mechanism and Substrate of Atrial Tachycardia Using Ultra-High-Density Mapping in Adults With Congenital Heart Disease: Impact on Clinical Outcomes.

Background Atrial tachycardia ( AT ) is common in patients with adult congenital heart disease and is challenging to map and ablate. We used ultra-high-density mapping to characterize the AT mechanism and investigate whether substrate characteristics are related to ablation outcomes. Methods and Results A total of 50 AT s were mapped with ultra-high-density mapping in 23 procedures.

Three-dimensional Printing in Anatomy Education: Assessing Potential Ethical Dimensions.

New technological developments have frequently had major consequences for anatomy education, and have raised ethical queries for anatomy educators. The advent of three-dimensional (3D) printing of human material is showing considerable promise as an educational tool that fits alongside cadaveric dissection, plastination, computer simulation, and anatomical models and images. At first glance its ethical implications appear minimal, and yet the more extensive ethical implications around clinical bioprinting suggest that a cautious approach to 3D printing in the dissecting room is in order.

Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF): study protocol for a randomised controlled trial.

Background: Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation.