Publications by authors named "Halperin H"

Effective radiation therapy aims to maximize the radiation dose delivered to the tumor while minimizing damage to the surrounding healthy tissues, which can be a challenging task when the tissue-tumor space is small. To eliminate the damage to healthy tissue, it is now possible to inject biocompatible hydrogels between cancerous targets and surrounding tissues to create a spacer pocket. Conventional methods have limitations in poor target visualization and device tracking.

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Radiofrequency (RF) ablation is a minimally invasive therapy for atrial fibrillation. Conventional RF procedures lack intraoperative monitoring of ablation-induced necrosis, complicating assessment of completeness. While spectroscopic photoacoustic (sPA) imaging shows promise in distinguishing ablated tissue, multi-spectral imaging is challenging in vivo due to low imaging quality caused by motion.

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Background: Outcomes from cardiopulmonary resuscitation (CPR) following sudden cardiac arrest are suboptimal. Postresuscitation targeted temperature management has been shown to have benefit in subjects with sudden cardiac arrest due to ventricular fibrillation, but there are few data for outcomes from sudden cardiac arrest due to pulseless electrical activity. In addition, intra-CPR cooling is more effective than postresuscitation cooling.

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Article Synopsis
  • Wearable electronics, like the YouCare device, are becoming popular for health monitoring, capable of recording ECG signals continuously without the need for user initiation by embedding leads in garments.
  • A study compared ECG data from the YouCare garment with a conventional Holter monitor in 30 patients and found that the YouCare device provided a good quality of ECG signals and was mostly synchronized with the Holter monitor.
  • Patients reported that the YouCare device was significantly more comfortable than the Holter monitor, indicating a preference for the garment-based approach in health monitoring.
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Background: Healthcare resource use for atrial fibrillation (AF) is high, but it may not be equivalent across all patients. We examined whether sex differences exist for AF high-cost users (HCUs), who account for the top 10% of total acute care costs.

Methods: All patients aged ≥ 20 years who presented to the emergency department (ED) or were hospitalized with AF were identified in Alberta, Canada, between 2011 and 2015.

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Background: In the US, 1.4 million people have implanted ICDs for reducing the risk of sudden death due to ventricular arrhythmias. Cardiac MRI (cMR) is of particular interest in the ICD patient population as cMR is the optimal imaging modality for distinguishing cardiac conditions that predispose to sudden death, and it is the best method to plan and guide therapy.

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Objective: Implanted Cardioverter Defibrillators (ICDs) induce a large (100 parts per million) inhomogeneous magnetic field in the magnetic resonance imaging (MRI) scanner which cannot be corrected by the scanner's built-in shim coils, leading to significant image artifacts that can make portions of the heart unreadable. To compensate for the field inhomogeneity, an active shim coil capable of countering the field deviation in user-defined regions was designed that must be optimally placed at patient-specific locations. We aim to develop and evaluate an MR-safe robotic solution for automated shim coil positioning.

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Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients.

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Out-of-hospital cardiac arrest is a leading cause of death in the US, with a mortality rate over 90%. Preclinical studies demonstrate that cooling during cardiopulmonary resuscitation (CPR) is highly beneficial, but can be challenging to implement clinically. No medications exist for improving long-term cardiac arrest survival.

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Recent advancements in smart, wearable technologies have allowed the detection of various medical conditions. In particular, continuous collection and real-time analysis of electrocardiogram data have enabled the early identification of pathologic cardiac rhythms. Various algorithms to assess cardiac rhythms have been developed, but these utilize excessive computational power.

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Background: Studies have shown that magnetic resonance imaging (MRI) does not have clinically important effects on the device parameters of non-MRI-conditional implantable cardioverter-defibrillators (ICDs). However, data on non-MRI-conditional ICD detection and treatment of arrhythmias after MRI are limited.

Objective: To examine if non-MRI-conditional ICDs have preserved shock function of arrhythmias after MRI.

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Extracorporeal cardiopulmonary resuscitation (eCPR) is emerging as an effective, lifesaving resuscitation strategy for select patients with prolonged or refractory cardiac arrest. Currently, a paucity of evidence-based recommendations is available to guide clinical management of eCPR patients. Despite promising results from initial clinical trials, neurological injury remains a significant cause of morbidity and mortality.

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High-resolution scar characterization using late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR) is useful for guiding ventricular arrhythmia (VA) treatment. However, imaging study quality may be degraded by breath-holding difficulties, arrhythmias, and implantable cardioverter-defibrillators (ICDs). We evaluated the effect of image quality on left ventricle (LV) base to apex scar interpretation in pre-VA ablation LGE-CMR.

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Study Objectives: The aim of this study was to measure changes in adherence to noninvasive ventilation (NIV) in children during the first year of the COVID-19 pandemic.

Methods: Retrospective chart review of children (0-18 years) using home NIV through the Stollery's Pediatric NIV program in Edmonton, Canada during March 2019 to March 2021. Demographics, clinical characteristics, and adherence information from machine downloads were collected prior to and during the first year of the COVID-19 pandemic.

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Article Synopsis
  • The study aimed to evaluate the effects of epinephrine on coronary perfusion pressure (CPP) during CPR in a multicenter trial, addressing limitations of single lab experiments with varying patient populations.
  • Forty-five swine were used across five laboratories, with three treatment groups: continuous IV epinephrine infusion, boluses of epinephrine, or placebo, after inducing ventricular fibrillation and CPR.
  • Results showed no significant differences in CPP between the treatment groups, indicating that standard doses of epinephrine did not improve outcomes compared to placebo, while highlighting inter-laboratory variability in results.
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Out-of-hospital cardiac arrest (OHCA) remains a major public health problem. Even in high-income countries, survival rates have plateaued in the range of ten percent, stimulating an ongoing interest in developing novel approaches to resuscitation. Emergency Medical Services (EMS)-witnessed OHCAs constitute a subgroup of overall OHCA that occur after the arrival of EMS, leading to rapid initiation of resuscitation and significantly improved survival.

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Article Synopsis
  • External defibrillators are essential for treating heart arrhythmias and cardiac arrest by delivering shocks that can cause significant muscle movement; a new Reduced Motion Defibrillator (RMD) was developed to minimize this motion by stimulating chest muscles slowly before delivering the shock.
  • The study aimed to assess the effectiveness of the RMD in swine, focusing on motion during defibrillation and how it could potentially shorten arrhythmia treatment times or simplify cardioversion methods.
  • Results showed that the RMD decreased muscle contraction during shocks, and optimal settings for the tetanizing waveform (25-35 V, 0.25- to 0.75-second duration) effectively reduced movement compared to standard biphasic defibr
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Brachytherapy is a radiation based treatment that is implemented by precisely placing focused radiation sources into tumors. In advanced interstitial cervical cancer bracytherapy treatment, this is performed by placing a metallic rod ("stylet") inside a hollow cylindrical tube ("catheter") and advancing the pair to the desired target. The stylet is removed once the target is reached, followed by the insertion of radiation sources into the catheter.

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Purpose: Develop a deflectable intracardiac MR imaging (ICMRI) guiding-sheath to accelerate imaging during MR-guided electrophysiological (EP) interventions for radiofrequency (500 kHz) ablation (RFA) of arrythmia. Requirements include imaging at three to five times surface-coil SNR in cardiac chambers, vascular insertion, steerable-active-navigation into cardiac chambers, operation with ablation catheters, and safe levels of MR-induced heating.

Methods: ICMRI's 6 mm outer-diameter (OD) metallic-braided shaft had a 2.

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Article Synopsis
  • The CERTAINTY study aims to improve the identification of individuals at low risk for ventricular arrhythmia (VA) among those who may need implantable cardioverter-defibrillators (ICDs) to reduce complications.* -
  • This study utilizes deep learning techniques to analyze cine cardiac magnetic resonance (CMR) images, developing two neural networks: one for extracting cardiac features (Cine Fingerprint Extractor) and another for predicting VA risk (Risk Predictor).* -
  • Findings show that a cine risk score derived from CMR images effectively differentiates between patients with and without VA, suggesting that cine CMR can enhance risk predictions in patients being considered for primary prevention ICDs.*
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Electroanatomic mapping is the gold standard for the assessment of ventricular tachycardia. Acquiring high resolution electroanatomic maps is technically challenging and may require interpolation methods to obtain dense measurements. These methods, however, cannot recover activation times in the entire biventricular domain.

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