Home Sotalol Initiation for the Management of Atrial and Ventricular Arrhythmias Using Remote Electrocardiographic Monitoring.

Background: Sotalol is a class III antiarrhythmic drug used for the management of patients with atrial fibrillation to maintain sinus rhythm. Sotalol-induced QT interval prolongation can be proarrhythmic and is conventionally initiated in an inpatient setting where routine electrocardiographic (ECG) monitoring is available while sotalol reaches the steady state. The emergence of cellular-compatible home ECG devices, such as AliveCor's Kardia Mobile 6L, which offers 6-lead ECG, has made it possible to accurately measure QT intervals outside the hospital.

Relative contribution of canopy and soil effects between plants with different metal tolerance along a metal pollution gradient.

Multiple effects, operating either on the long-term (soil-engineering effects) or on the short-term during plant life (microclimate modification or resources pre-emption), can act simultaneously and determine the outcome of plant-plant interactions. These diverse effects have not been disentangled along a gradient of metal/metalloid pollution, although this is crucial for understanding the dominant species turnover along the gradient, and thus the driving processes of facilitation recurrently found in metalliferous ecosystems, which could help improving ecological restoration of these degraded ecosystems. Here, we experimentally assessed different short-term effects of two dominant forbs of highly polluted habitats (Hutchinsia alpina and Arenaria multicaulis, tolerant to metal stress) and two grasses of less polluted habitats (Agrostis capillaris and Festuca rubra, less tolerant to metal stress) on target plant species (the same as the dominant species mentioned above) transplanted along a large metal pollution gradient.

The role of ecotypic variation for plant facilitation in a metal-polluted system: Stress-intolerant target ecotypes are the best beneficiaries and stress-tolerant nurse ecotypes the best benefactors.

Disentangling competitive-response and -effect abilities has strongly improved our understanding of the role of competition for the diversity and composition of plant communities. Much less is known about the relative importance of facilitative-effect and -response abilities in harsh ecosystems. Here, we aim to fill this gap by simultaneously assessing the facilitative-response and -effect abilities of different species and ecotypes in former mining sites in the French Pyrenees, both in naturally occurring communities and in a common-garden designed on a slag heap.

Junctional Tachycardia: A Critical Reassessment.

Junctional tachycardia (JT) is typically considered to have an automatic mechanism originating from the distal atrioventricular node. When there is 1:1 retrograde conduction via the fast pathway, JT would resemble the typical form of atrioventricular nodal re-entrant tachycardia (AVNRT). Atrial pacing maneuvers have been proposed to exclude AVNRT and suggest a diagnosis of JT.

CHADS-VASc score stratifies mortality risk in patients with and without atrial fibrillation.

Objectives: The CHADS-VASc score is the preferred risk model for anticoagulation decision-making in atrial fibrillation (AF) patients. Recent studies have found this score to have prognostic value in other cardiovascular diseases. We assessed the relationships between CHADS-VASc score and long-term mortality in adults referred for stress testing, METHODS: 165 184 consecutive patients from January 1991 to December 2014 from a prospective registry were studied, with CHADS-VASc score calculated for all patients, and AF and anticoagulation status were recorded.

Cardiac Resynchronization Therapy With or Without Defibrillation in Patients With Nonischemic Cardiomyopathy: A Systematic Review and Meta-Analysis.

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Comparative Analysis of Procedural Outcomes and Complications Between De Novo and Upgraded Cardiac Resynchronization Therapy.

Objectives: This study compared rates of procedural success and complications between de novo cardiac resynchronization therapy (CRT) implantation versus upgrade, including characterization of technical challenges.

Background: CRT upgrade is common, but data are limited on the incidence of procedural success and complications as compared to de novo implantation.

Methods: All patients who underwent a transvenous CRT procedure at a single institution between 2013 and 2018 were reviewed for procedure outcome, 90-day complications, reasons for unsuccessful left ventricular lead delivery, and the presence of venous occlusive disease (VOD) that required a modified implantation technique.

Postoperative bridging anticoagulation and left ventricular assist system thrombosis.

Reduced emphasis on early postoperative bridging anticoagulation is one explanation for the increased incidence of HeartMate II (HM II) pump thrombosis. We conducted a single-center analysis of initial postoperative anticoagulation practices and their impact on the incidence of HM II pump thrombosis. Data was collected on 105 patients undergoing primary HM II implant from 2009 to 2014.

Adoptive Transfer of Invariant NKT Cells as Immunotherapy for Advanced Melanoma: A Phase I Clinical Trial.

Invariant NKT cells (iNKT) are innate-like CD1d-restricted T cells with immunoregulatory activity in diseases including cancer. iNKT from advanced cancer patients can have reversible defects including IFNγ production, and iNKT IFNγ production may stratify for survival. Previous clinical trials using iNKT cell activating ligand α-galactosylceramide have shown clinical responses.

Variability in Antithrombotic Therapy Regimens Peri-TAVR: A Single Academic Center Experience.

Introduction: The aim of this study was to describe peri-procedural antithrombotic use in patients undergoing transcatheter aortic valve replacement (TAVR) at a single academic medical center.

Methods: Retrospective collection of antiplatelet and anticoagulant use during the index hospitalization for all patients undergoing TAVR at our institution from April 2009 through March 2014.

Results: Of a total of 255 patients undergoing the procedure, 132 (51%) had an indication for anticoagulation pre-TAVR and 92 (70% of those with an indication) were on treatment.

Biologic Activity of Autologous, Granulocyte-Macrophage Colony-Stimulating Factor Secreting Alveolar Soft-Part Sarcoma and Clear Cell Sarcoma Vaccines.

Purpose: Alveolar soft-part sarcoma (ASPS) and clear cell sarcoma (CCS) are rare mesenchymal malignancies driven by chromosomal translocations that activate members of the microphthalmia transcription factor (MITF) family. However, in contrast to malignant melanoma, little is known about their immunogenicity. To learn more about the host response to ASPS and CCS, we conducted a phase I clinical trial of vaccination with irradiated, autologous sarcoma cells engineered by adenoviral-mediated gene transfer to secrete granulocyte-macrophage colony-stimulating factor (GM-CSF).

The Mll partial tandem duplication: differential, tissue-specific activity in the presence or absence of the wild-type allele.

The partial tandem duplication of MLL (MLL-PTD) is found in 5% to 10% of patients with acute myeloid leukemia (AML) and normal cytogenetics. Its expression in leukemic blasts is coincident with a silenced wild-type (WT) MLL allele. We therefore generated mice expressing the Mll-PTD in the absence of Mll-WT.