Effects of Atrioventricular Optimization on Left Ventricular Reverse Remodeling With Cardiac Resynchronization Therapy: Results of the SMART-CRT Trial.

Background: The role of atrioventricular optimization (AVO) to improve cardiac resynchronization therapy outcomes remains controversial. Previous post hoc analyses of a multicenter trial showed that measures of electrical dyssynchrony (right ventricular-left ventricular [LV] or LV electrical delay durations) are associated with patients who benefit from AVO.

Methods: This was a global, multicenter, prospective, randomized trial of de novo cardiac resynchronization therapy implant patients with an right ventricular-LV duration ≥70 ms to determine whether AVO results in greater reverse remodeling.

States' Rights, Gun Violence Litigation, and Tort Immunity.

The devastating toll of gun violence has given rise to hundreds of lawsuits seeking justice on behalf of victims and their families. A significant number of challenges against gun companies, however, are blocked by courts' broad reading of the Protection of Lawful Commerce in Arms Act (PLCAA) - a federal statute often interpreted to shield the gun industry from civil liability. This article reexamines PLCAA in light of the Supreme Court's recent federalism caselaw, which counsels courts to narrowly construe federal laws that could otherwise upset the balance of power between states and the federal government.

The rationale and design of the SMART CRT trial.

Aims: The SMART CRT study will assess the efficacy of an atrioventricular optimization algorithm to improve reverse remodeling among patients undergoing cardiac resynchronization therapy (CRT) in the presence of interventricular electrical delay.

Methods And Results: The SMART CRT study is a global, multicenter, prospective, randomized study of patients undergoing CRT implantation. The primary endpoint of this trial is response rate to CRT, defined as decrease in left ventricular end-systolic volume (LVESV) ≥15% at 6 months compared to preimplant baseline.

Acute performance of a right ventricular automatic pacing threshold algorithm for implantable defibrillators.

Introduction: Automatic pacing threshold (AT) testing with threshold trending and output adjustment may simplify follow-up and improve cardiac rhythm device longevity. The objective of this study was to evaluate the performance of a new right ventricular (RV) AT algorithm for implantable cardioverter defibrillators (ICDs) using RVcoil to Can evoked response sensing.

Method: Patients undergoing ICD, with or without cardiac resynchronization therapy device, implant, replacement, or upgrade were enrolled.