Phototherapy to Facilitate Wound Healing Following Pacemaker Infection: A Promising Tool to Improve Outcomes.

Device infection remains a dreaded and increasingly common complication of pacemaker procedures, often mandating removal of all implanted materials. Intensive wound management may be necessary following extraction, requiring multiple follow-up encounters in the outpatient setting. Here, a case of pacemaker pocket infection necessitating complete system extraction is presented.

Neutrino Intensity Interferometry: Measuring Protoneutron Star Radii During Core-Collapse Supernovae.

Intensity interferometry is a technique that has been used to measure the size of sources ranging from the quark-gluon plasma formed in heavy ion collisions to the radii of stars. We investigate using the same technique to measure protoneutron star (PNS) radii with the neutrino signal received from a core-collapse supernovae. Using a full wave-packet analysis, including the neutrino mass for the first time, we derive criteria where the effect can be expected to provide the desired signal, and find that neutrinos from the next Galactic supernova should contain extractable PNS radius information.

Safe extraction of Riata looped extruding filler cables.

The Riata 1590 lead model contains both electrically active cables (AC) and filler cables (FC) that run in pairs within lumens along the lead body. FC are yet to be described as lead components that may be externalized from either external abrasion or inside-out abrasion seen in the recalled St. Jude leads.

Detection of a Riata™ insulation failure by the Medtronic Lead Integrity Alert™.

We describe a case of insulation failure in a Riata implantable cardioverter defibrillator lead [St Jude Medical (SJM), St Paul, MN, USA] detected by the Lead Integrity Alert (LIA)™, without impedance changes. The Medtronic LIA may permit early detection of Riata lead failure.

Dynamical collective calculation of supernova neutrino signals.

We present the first calculations with three flavors of collective and shock wave effects for neutrino propagation in core-collapse supernovae using hydrodynamical density profiles and the S matrix formalism. We explore the interplay between the neutrino-neutrino interaction and the effects of multiple resonances upon the time signal of positrons in supernova observatories. A specific signature is found for the inverted hierarchy and a large third neutrino mixing angle and we predict, in this case, a dearth of lower energy positrons in Cherenkov detectors midway through the neutrino signal and the simultaneous revelation of valuable information about the original fluxes.

The effect of vagally induced dispersion of action potential duration on atrial arrhythmogenesis.

Objective: The purpose of this study is to ascertain the effects of spatially variable ACh distributions on arrhythmogenesis in a morphologically realistic computer model of canine atria.

Background: Vagal stimulation releases acetylcholine (ACh), which causes a dose-dependent reduction in action potential duration (APD) in the atria. Due to the nonuniform distribution of nerve endings, APD dispersion may result, which has been shown to play a role in the breakup of activity.

Substrate size as a determinant of fibrillatory activity maintenance in a mathematical model of canine atrium.

Tissue size has been considered an important determinant of atrial fibrillation (AF), but recent work has questioned the critical size hypothesis. Here, we use a previously developed mathematical model of the two-dimensional canine atrium with realistic action potential, ionic, and conduction properties to address substrate size effects on the maintenance of fibrillatory activity. Cholinergic AF was simulated at different acetylcholine (ACh) concentrations ([ACh]) and distributions, with substrate area varied 11.

Ionic determinants of functional reentry in a 2-D model of human atrial cells during simulated chronic atrial fibrillation.

Recent studies suggest that atrial fibrillation (AF) is maintained by fibrillatory conduction emanating from a small number of high-frequency reentrant sources (rotors). Our goal was to study the ionic correlates of a rotor during simulated chronic AF conditions. We utilized a two-dimensional (2-D), homogeneous, isotropic sheet (5 x 5 cm(2)) of human atrial cells to create a chronic AF substrate, which was able to sustain a stable rotor (dominant frequency approximately 5.

Mechanisms of atrial fibrillation termination by pure sodium channel blockade in an ionically-realistic mathematical model.

The mechanisms by which Na+-channel blocking antiarrhythmic drugs terminate atrial fibrillation (AF) remain unclear. Classical "leading-circle" theory suggests that Na+-channel blockade should, if anything, promote re-entry. We used an ionically-based mathematical model of vagotonic AF to evaluate the effects of applying pure Na+-current (I(Na)) inhibition during sustained arrhythmia.

Mechanisms of termination of atrial fibrillation by Class I antiarrhythmic drugs: evidence from clinical, experimental, and mathematical modeling studies.

Sodium channel blocking drugs (Class I antiarrhythmic agents) have been used for the termination of atrial fibrillation (AF) and for sinus rhythm maintenance for almost 100 years. Despite this long history, the mechanisms that underlie their efficacy in AF remain poorly understood. Classic notions about the determinants of cardiac reentry, as embodied in leading circle theory, and of AF, as reflected in the multiple wavelet hypothesis, suggest that cardiac conduction slowing should promote, rather than prevent, AF.

Development of a computer algorithm for the detection of phase singularities and initial application to analyze simulations of atrial fibrillation.

Atrial fibrillation (AF) is a common cardiac arrhythmia, but its mechanisms are incompletely understood. The identification of phase singularities (PSs) has been used to define spiral waves involved in maintaining the arrhythmia, as well as daughter wavelets. In the past, PSs have often been identified manually.

Remodeling of Ca(2+)-handling by atrial tachycardia: evidence for a role in loss of rate-adaptation.

Background: Loss of rate-dependent action potential (AP) duration (APD) adaptation is a characteristic feature of atrial tachycardia-induced remodeling (ATR). ATR causes sarcolemmal ion-channel remodeling (ICR) and changes in Ca(2+)-handling. The present studies were designed to quantify Ca(2+)-handling changes and then to apply a mathematical AP model to assess the contributions of Ca(2+)-handling abnormalities and ICR to loss of APD rate-adaptation.

Cholinergic atrial fibrillation in a computer model of a two-dimensional sheet of canine atrial cells with realistic ionic properties.

Classical concepts of atrial fibrillation (AF) have been rooted in Moe's multiple-wavelet hypothesis and simple cellular-automaton computer model. Recent experimental work has raised questions about the multiple-wavelet mechanism, suggesting a discrete "driver region" underlying AF. We reexplored the theoretical basis for AF with a 2-dimensional computer model of a 5x10-cm sheet of atrial cells with realistic ionic and coupling properties.

Time-dependent transients in an ionically based mathematical model of the canine atrial action potential.

Ionically based cardiac action potential (AP) models are based on equations with singular Jacobians and display time-dependent AP and ionic changes (transients), which may be due to this mathematical limitation. The present study evaluated transients during long-term simulated activity in a mathematical model of the canine atrial AP. Stimulus current assignment to a specific ionic species contributed to stability.