Influence of Meteorological Parameters on the Prevalence of TEE Detected Left Atrial Appendage Thrombi.

(1) Background: Meteorological factors seem to exert various effects on human health, influencing the occurrence of diseases such as thromboembolic events and strokes. Low atmospheric pressure in summer may be associated with an increased likelihood of ischemic stroke. The aim of this study was to investigate the potential impact of meteorological conditions on left atrial appendage (LAA) thrombus formation.

Influence of Heart Rate and Change in Wavefront Direction through Pacing on Conduction Velocity and Voltage Amplitude in a Porcine Model: A High-Density Mapping Study.

Background: Understanding the dynamics of conduction velocity (CV) and voltage amplitude (VA) is crucial in cardiac electrophysiology, particularly for substrate-based catheter ablations targeting slow conduction zones and low voltage areas. This study utilizes ultra-high-density mapping to investigate the impact of heart rate and pacing location on changes in the wavefront direction, CV, and VA of healthy pig hearts.

Methods: We conducted in vivo electrophysiological studies on four healthy juvenile pigs, involving various pacing locations and heart rates.

[Isthmus-dependent right atrial flutter : Clinical course after isthmus ablation].

Ablation of the cavotricuspid isthmus (CTI) to create bidirectional isthmus blockade is the most effective way to achieve rhythm control in typical atrial flutter. Compared with drug therapy, ablation reduces cardiovascular mortality, all-cause mortality, stroke risk, and the risk of cardiac decompensation. Concomitant arrhythmia of atrial flutter is atrial fibrillation (AF); therefore the duration of oral anticoagulation should be adapted according to the risk of stroke and bleeding.

Electroanatomical Conduction Characteristics of Pig Myocardial Tissue Derived from High-Density Mapping.

Background: Ultra-high-density mapping systems allow more precise measurement of the heart chambers at corresponding conduction velocities (CVs) and voltage amplitudes (VAs). Our aim for this study was to define and compare a basic value set for unipolar CV and VA in all four heart chambers and their separate walls in healthy, juvenile porcine hearts using ultra-high-density mapping.

Methods: We used the Rhythmia Mapping System to create electroanatomical maps of four pig hearts in sinus rhythm.

A functional near-infrared spectroscopy study on the prefrontal correlates of cognitive offloading via a personal knowledge assistant.

The saving of previously encoded information boosts both memory for subsequent information (saving-enhanced memory; SEM) as well as cognitive performance in general (saving-enhanced performance; SEP). These findings have been replicated in a setting that involves the assistance by an intelligent software that automatically structures and saves work content in an interactive sidebar. It is assumed that beneficial effects on cognitive performance due to (automatic) saving are caused by a reduction in current workload by means of cognitive offloading.

Self-advocate perspectives on COVID-19 in Urban Los Angeles: impacts on autonomy and access to supports.

Background: Adults with disabilities in low-income communities of colour are disproportionately affected by the COVID-19 pandemic.

Method: We interviewed 14 self-advocates with intellectual and developmental disabilities (IDD) to learn more about their experiences during the peak of infections, hospitalisations, and deaths in Los Angeles, between December 2020 and March 2021.

Results: A modified grounded theory analysis revealed major themes of family, making choices & going places, formal services, and employment, which are discussed in relation to the participants' sense of autonomy and access to goods and services.

Potential of remote monitoring to prevent sensing and detection failures in implantable cardioverter defibrillators.

Background: Sensing malfunction and misinterpretation of intracardiac electrograms (IEGMs) in patients with implantable cardioverter defibrillators (ICDs) may lead to inadequate device activity such as inappropriate shock delivery or unnecessary mode-switching. Remote monitoring has the potential for early detection of sensing malfunction or misclassification and may thus prevent adverse device activity. Therefore, the authors analyzed the amount, nature, and distribution of misclassification in current ICD and cardiac resynchronization therapy defibrillator technology using the device transmissions of the IN-TIME study population.

[Clinical differential indication : Wearables vs implantables].

In order to document arrhythmias, indicated due to symptoms or for prognostic purposes, both invasive and noninvasive possibilities for ECG monitoring are available. The choice of the device for monitoring depends mainly on the frequency of arrhythmias. If they occur less than once a month, long-term monitoring becomes necessary which either continuously monitors the rhythm by an implantable device (implantables) or by wearable systems (wearables) which usually register the ECG discontinuously.

[Implantable ECG monitors].

Implantable loop recorders are a diagnostic tool for detecting cardiac arrhythmias and are independent of the patient's compliance. Automatic algorithms lead to a preselection of arrhythmic events that are transferred by telemonitoring to the cardiac specialists. This article describes the available loop recorders on the market, the respective implantation techniques, the indication, and reimbursement.

Ticagrelor and Rivaroxaban Elimination With CytoSorb Adsorber Before Urgent Off-Pump Coronary Bypass.

CytoSorb hemoadsorption (CytoSorbents Inc, Monmouth Junction, NJ) was performed shortly before an urgent off-pump coronary artery bypass operation in a 58-year-old man at high risk of bleeding as a result of treatment of coronary artery disease with ticagrelor and treatment of atrial fibrillation with rivaroxaban. The patient experienced dissection of the left anterior descending artery during a percutaneous coronary intervention. Preoperatively, CytoSorb hemoadsorption was applied to eliminate the coagulative active medications.

Somatic gene editing ameliorates skeletal and cardiac muscle failure in pig and human models of Duchenne muscular dystrophy.

Frameshift mutations in the DMD gene, encoding dystrophin, cause Duchenne muscular dystrophy (DMD), leading to terminal muscle and heart failure in patients. Somatic gene editing by sequence-specific nucleases offers new options for restoring the DMD reading frame, resulting in expression of a shortened but largely functional dystrophin protein. Here, we validated this approach in a pig model of DMD lacking exon 52 of DMD (DMDΔ52), as well as in a corresponding patient-derived induced pluripotent stem cell model.

Preparation of PCI Balloons: What Is the Best Method to Avoid Air in the Balloon? A Comparison of Different Methods of Connecting PCI Balloons and the Inflation Syringe while Removing Air from the Balloon.

As the techniques to connect percutaneous coronary intervention (PCI) balloons and the inflation syringe vary in the instructions for use and in practice, we measured the amount of air in PCI balloons after testing three connection methods to an inflation syringe. Following the preparation using one of the three methods, 114 balloons and stent balloons were tested four times. Method 1 connected the syringe and the balloon catheter directly after purging and filling the lumen, while method 3 omitted the purging and filling process.

[Catheter ablation of atrial fibrillation : Status quo].

Catheter ablation of atrial fibrillation (AF) is a standard part of treatment with respect to rhythm control. In this article, the authors provide a review of the state-of-the-art knowledge of AF catheter ablation including current indications, possible energy forms, procedural methods and endpoints as well as follow-up and further anticoagulation.

[Dizziness As A Symptom Of Cardiac Diseases].

Dizziness is a symptom that may be of cardiac origin. Diagnosis and treatment of cardiac diseases is of important prognostic impact. Dizziness may be caused due to two different cardiac disorders: (1) as symptom of a cardioembolic event or (2) as a symptom of a low cardiac output leading to an intermittent global cerebral hypoperfusion.

Pulmonary vein reconnections or substrate in the left atrium: what is the reason for atrial fibrillation recurrences? A dialogue on a pressing clinical situation.

Pulmonary vein isolation (PVI) has long been held as the cornerstone for atrial fibrillation (AF) ablation. There are patients who do not have successful AF ablations though, especially among those with persistent AF. At the same time, the evidence suggests that ablating beyond the pulmonary veins does not improve success rates.

Exclusion of left atrial thrombus by dual-source cardiac computed tomography prior to catheter ablation for atrial fibrillation.

Objectives: Thromboembolic complications during atrial fibrillation (AF) ablation due to mobilisation of a pre-existing thrombus formation (TF) in the left atrium (LA) are devastating. The gold standard to exclude LA TF is transesophageal echocardiography (TEE). The present study compares sensitivity and specificity of a dual-source cardiac-computed tomography (DS-CT) with TEE for TF exclusion prior to AF ablation.

[Exposure Therapy with the Help of a Wearable Defibrillator Device used in the Treatment of Severe Obsessive-Compulsive Disorder and Congenital LQTS - An Example for Interdisciplinary Treatment].

We report on a case of a young female suffering from both obsessive-compulsive disorder (OCD) and a severe underlying cardiac disease. Due to the somatic comorbidity, treatment according to guidelines with exposure and reaction prevention was not initially conducted, due to potentially fatal risks to the patient. However, through collaboration with a cardiology clinic, we were able to find an innovative solution which allowed for the continuation of the exposure therapy.

[Current indications for left atrial appendage occlusion].

Among patients with atrial fibrillation, the bleeding risk is linked to the stroke risk. Left atrial appendage (LAA) occlusion may reduce bleeding risk in high-risk patients. On the basis of a literature analysis and the Consensus Document of European Heart Rhythm Association (EHRA), the indications for a LAA occluder are clarified and a clear decision strategy for daily clinical practice is presented.