Rationale and Design of the Personalized Therapy Study: Evaluating Real-World Performance of Two Automated Defibrillation Therapy Algorithms.

Background: Barriers to maximizing patient benefit with implantable defibrillation devices include limited ability to tailor antitachycardia pacing (ATP) therapy in real-time and identify patients at risk of heart failure (HF) events early on. The Personalized Therapy study aims to evaluate the performance of two algorithms, intrinsic ATP (iATP) and TriageHF, to address these barriers in routine clinical practice.

Methods And Results: The Personalized Therapy Study was designed as a prospective, multicenter, post-market registry study expected to enroll approximately 2,200 patients meeting the following criteria: (1) implanted with a study-eligible device regardless of procedure type; (2) Medtronic CareLink® Network enrolled; (3) TriageHF enabled within CareLink and High Risk Alert notifications turned ON; and (4) iATP enabled.

Rhythm-Ready: Harnessing Smart Devices to Detect and Manage Arrhythmias.

Purpose Of Review: To survey recent progress in the application of implantable and wearable sensors to detection and management of cardiac arrhythmias.

Recent Findings: Sensor-enabled strategies are critical for the detection, prediction and management of arrhythmias. In the last several years, great innovation has occurred in the types of devices (implanted and wearable) that are available and the data they collect.

Admissions for posttransplant lymphoproliferative disorder: a 9-year longitudinal analysis of the National (Nationwide) Inpatient Sample.

Background: Posttransplant lymphoproliferative disorder (PTLD), a term that encompasses a wide array of malignancies that occur after transplant, can be one of the most devastating transplant complications. While there have been major advancements in care, especially after the landmark PTLD-1 trial in 2012, there is a paucity of information on hospitalizations for PTLD and the changes in hospitalizations over time.

Methods: This retrospective cohort study used the National Inpatient Sample to identify hospitalizations for PTLD that occurred between 2009 and 2018.

Cardiac Contractility Modulation for Heart Failure: Current and Future Directions.

Cardiac contractility modulation (CCM) is a Food and Drug Administration-approved device-based therapy for patients with heart failure. The system delivers biphasic electric stimulation to the ventricular myocardium during the absolute refractory period to augment left ventricular contraction. CCM therapy promotes acute and chronic changes at the cellular level, leading to favorable remodeling throughout the myocardium.

Evolution and prognosis of tricuspid and mitral regurgitation following cardiac implantable electronic devices: a systematic review and meta-analysis.

Aims: Significant changes in tricuspid regurgitation (TR) and mitral regurgitation (MR) post-cardiac implantable electronic devices (CIEDs) are increasingly recognized. However, uncertainty remains as to whether the risk of CIED-associated TR and MR differs with right ventricular pacing (RVP) via CIED with trans-tricuspid RV leads, compared with cardiac resynchronization therapy (CRT), conduction system pacing (CSP), and leadless pacing (LP). The study aims to synthesize extant data on risk and prognosis of significant post-CIED TR and MR across pacing strategies.

A divergent one-pot thiol-Michael strategy to create β-thiophene-fused porphyrins.

A divergent one-pot domino strategy for the synthesis of nickel(II) and copper(II) β-thiophene-fused 5,10,15,20-tetraarylporphyrins was developed through a thiol-Michael addition of thioglycolic/thiolactic acid to the corresponding 2-iminoporphyrins, formed after the reaction of nickel(II) and copper(II) 2-formyl-5,10,15,20-tetraarylporphyrins with sterically hindered -butylamine in 1,2-dichloroethane at 80 °C. Interestingly, the reaction of 2-formylporphyrins with comparatively less sterically hindered primary amines and thioglycolic acid afforded a mixture of β-substituted porphyrinic thiazolidinones and β-thiophene-fused porphyrins. A similar one-pot thiol-Michael protocol was applied to construct a novel free-base thieno[2,3-]--tetrakis(4-methoxyphenyl)porphyrin, which underwent zinc insertion by using zinc acetate in a CHCl-MeOH mixture and afforded zinc(II) β-thiophene-fused -tetrakis(4-methoxyphenyl)porphyrin in an appreciable isolated yield.

Cardiac implantable electronic device-induced tricuspid regurgitation: Implications and management.

Tricuspid regurgitation (TR) secondary to cardiac implantable electronic devices (CIEDs) has been well documented and is associated with worse cardiovascular outcomes. A variety of mechanisms have been proposed including lead-induced mechanical disruption of the tricuspid valvular or subvalvular apparatus and pacing-induced electrical dyssynchrony. Patient characteristics such as age, sex, baseline atrial fibrillation, and pre-existing TR have not been consistent predictors of CIED-induced TR.

Atrial fibrillation and risk of adverse outcomes in heart failure with reduced, mildly reduced, and preserved ejection fraction: A systematic review and meta-analysis.

Introduction: Heart failure (HF) and atrial fibrillation (AF) frequently co-exist. Contemporary classification of HF categorizes it into HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF). Aggregate data comparing the risk profile of AF between these three HF categories are lacking.

Persistence of significant secondary mitral regurgitation post-cardiac resynchronization therapy and survival: a systematic review and meta-analysis : Mitral regurgitation and mortality post-CRT.

Cardiac resynchronization therapy (CRT) significantly reduces secondary mitral regurgitation (MR) in patients with severe left ventricular systolic dysfunction. However, uncertainty remains as to whether improvement in secondary MR correlates with improvement with mortality seen in CRT. We conducted a meta-analysis to determine the association of persistent unimproved significant secondary MR (defined as moderate or moderate-to-severe or severe MR) compared to improved MR (no MR or mild MR) post-CRT with all-cause mortality, cardiovascular mortality, and heart failure hospitalization.

Filtering of remote monitoring alerts transmitted by cardiac implantable electronic devices and reclassification of atrial fibrillation events by a new algorithm.

Background: Cardiac implantable electronic devices (CIEDs) are an important means of atrial fibrillation (AF) detection. However, the AF burden measurements and notifications transmitted by CIEDs are not directly related to the clinical classification of paroxysmal, persistent, or permanent AF. Moreover, AF alerts are the most frequent form of notification, imposing a time-consuming review on caregivers.

Dronedarone Versus Sotalol in Antiarrhythmic Drug-Naive Veterans With Atrial Fibrillation.

Background: Sotalol and dronedarone are both used for maintenance of sinus rhythm for patients with atrial fibrillation. However, while sotalol requires initial monitoring for QT prolongation and proarrhythmia, dronedarone does not. These treatments can be used in comparable patients, but their safety and effectiveness have not been compared head to head.

Fully-integrated photonic tensor core for image convolutions.

Convolutions are one of the most critical signal and image processing operations. From spectral analysis to computer vision, convolutional filtering is often related to spatial information processing involving neighbourhood operations. As convolution operations are based around the product of two functions, vectors or matrices, dot products play a key role in the performance of such operations; for example, advanced image processing techniques require fast, dense matrix multiplications that typically take more than 90% of the computational capacity dedicated to solving convolutional neural networks.