Predictors of first-pass isolation in patients with recurrent atrial fibrillation: A retrospective cohort study.

Background: Pulmonary vein isolation (PVI) is superior to antiarrhythmics for the management of atrial fibrillation, but repeat ablation is often required for durable rhythm control. Factors influencing first-pass isolation (FPI) and whether FPI predicts durable isolation are not well known.

Objective: The study sought to determine factors associated with FPI and rates of chronic reconnection among those with and without FPI at index PVI in patients undergoing repeat ablation.

Consistency of ablations with trainee and increasing independence during fellowship training-Analysis of ablation data by CARTONET.

Introduction: Training in clinical cardiac electrophysiology (CCEP) involves the development of catheter handling skills to safely deliver effective treatment. Objective data from analysis of ablation data for evaluating trainee of CCEP procedures has not previously been possible. Using the artificial intelligence cloud-based system (CARTONET), we assessed the impact of trainee progress through ablation procedural quality.

Does radiofrequency ablation procedural data improve the accuracy of identifying atrial fibrillation recurrence?

Radiofrequency ablation (RFA) using the CARTO 3D mapping system is a common approach for pulmonary vein isolation to treat atrial fibrillation (AF). Linkage between CARTO procedural data and patients' electronical health records (EHR) provides an opportunity to identify the ablation-related parameters that would predict AF recurrence. The objective of this study is to assess the incremental accuracy of RFA procedural data to predict post-ablation AF recurrence using machine learning model.

Predictive utility of the impedance drop on AF recurrence using digital intraprocedural data linked to electronic health record data.

Background: Local impedance drop in cardiac tissue during catheter ablation may be a valuable measure to guide atrial fibrillation (AF) ablation procedures for greater effectiveness.

Objective: The study sought to assess whether local impedance drop during catheter ablation to treat AF predicts 1-year AF recurrence and what threshold of impedance drop is most predictive.

Methods: We identified patients with AF undergoing catheter ablation in the Mercy healthcare system.

Long-duration spaceflight adversely affects post-landing operator proficiency.

Performance of astronaut pilots during space shuttle landing was degraded after a few weeks of microgravity exposure, and longer-term exposure has the potential to impact operator proficiency during critical landing and post-landing operations for exploration-class missions. Full-motion simulations of operationally-relevant tasks were utilized to assess the impact of long-duration spaceflight on operator proficiency in a group of 8 astronauts assigned to the International Space Station, as well as a battery of cognitive/sensorimotor tests to determine the underlying cause of any post-flight performance decrements. A ground control group (N = 12) and a sleep restriction cohort (N = 9) were also tested to control for non-spaceflight factors such as lack of practice between pre- and post-flight testing and fatigue.

Impaired motor preparation and execution during standing reach in people with chronic stroke.

Movement preparation of both anticipatory postural adjustments (APAs) and goal directed movement during a standing reaching task in adults with chronic hemiparesis and healthy controls was investigated. Using a simple reaction time paradigm, while standing on two separate force platforms, subjects received a warning light cue to "get ready to reach" followed 2.5s later by an imperative light cue to "reach as quickly as possible" with the paretic arm (matched arm for controls) to touch a target in front of them for a total of 90 trials.

Pre-adaptation to noisy Galvanic vestibular stimulation is associated with enhanced sensorimotor performance in novel vestibular environments.

Performance on a visuomotor task in the presence of novel vestibular stimulation was assessed in nine healthy subjects. Four subjects had previously been adapted to 120 min exposure to noisy Galvanic vestibular stimulation (GVS) over 12 weekly sessions of 10 min; the remaining five subjects had never experienced GVS. Subjects were seated in a flight simulator and asked to null the roll motion of a visual bar presented on a screen using a joystick.

Central adaptation to repeated galvanic vestibular stimulation: implications for pre-flight astronaut training.

Healthy subjects (N = 10) were exposed to 10-min cumulative pseudorandom bilateral bipolar Galvanic vestibular stimulation (GVS) on a weekly basis for 12 weeks (120 min total exposure). During each trial subjects performed computerized dynamic posturography and eye movements were measured using digital video-oculography. Follow up tests were conducted 6 weeks and 6 months after the 12-week adaptation period.

Temporal Characteristics of High-Frequency Lower-Limb Oscillation during Freezing of Gait in Parkinson's Disease.

A cardinal feature of freezing of gait (FOG) is high frequency (3-8 Hz) oscillation of the legs, and this study aimed to quantify the temporal pattern of lower-body motion prior to and during FOG. Acceleration data was obtained from sensors attached to the back, thighs, shanks, and feet in 14 Parkinson's disease patients performing timed-up-and-go tasks, and clinical assessment of FOG was performed by two experienced raters from video. A total of 23 isolated FOG events, defined as occurring at least 5 s after gait initiation and with no preceding FOG, were identified from the clinical ratings.

Autonomous identification of freezing of gait in Parkinson's disease from lower-body segmental accelerometry.

Background: We have previously published a technique for objective assessment of freezing of gait (FOG) in Parkinson's disease (PD) from a single shank-mounted accelerometer. Here we extend this approach to evaluate the optimal configuration of sensor placement and signal processing parameters using seven sensors attached to the lumbar back, thighs, shanks and feet.

Methods: Multi-segmental acceleration data was obtained from 25 PD patients performing 134 timed up and go tasks, and clinical assessment of FOG was performed by two experienced raters from video.

Safety and immediate effect of noninvasive transcranial pulsed current stimulation on gait and balance in Parkinson disease.

Background: Noninvasive electrical stimulation of the brain (ESB) is being investigated as a valued intervention to enhance motor performance.

Objective: To ascertain the safety and ability of transcranial pulsed current stimulation (tPCS) to modulate variables of protective stepping and gait of individuals with Parkinson's disease.

Method: Ten patients participated in a pilot study.

Improving fine motor function after brain injury using gesture recognition biofeedback.

Purpose: We developed a gesture recognition biofeedback (GRB) device for improving fine motor function in persons with brain injury using surface muscle pressures of the forearm to provide real-time visual biofeedback. The GRB apparatus is easy to don by moderately impaired users and does not require precise placement of sensors.

Method: The efficacy of GRB training with each subject was assessed by comparing its effectiveness against standard repetitive training without feedback.

Short-term changes in protective stepping for lateral balance recovery in older adults.

Background: Fall prevention for older adults is dependent on the ability to maintain protective balance. This study measured the short-term changes of protective stepping following waist-pull perturbations in the medio-lateral direction, to identify what, if any, properties of protective stepping are improved with repeated perturbation exposures.

Methods: Sixty waist-pulls (2 directions × 5 intensities × 6 repetitions) from a single session were analyzed separately as early, middle, and late testing periods, for a comparison over time of typical responses.

Surface muscle pressure as a measure of active and passive behavior of muscles during gait.

While surface electromyography (SEMG) can accurately register electrical activity of muscles during gait, there are no methods to estimate muscular force non-invasively. To better understand the mechanical behavior of muscle, we evaluated surface muscle pressure (SMP) in conjunction with SEMG. Changes in anterior thigh radial pressure during isometric contractions and gait were registered by pressure sensors on the limb.