2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry.

Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management.

2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry.

Ambulatory ECG (AECG) is very commonly employed in a variety of clinical contexts to detect cardiac arrhythmias and/or arrhythmia patterns which are not readily obtained from the standard ECG. Accurate and timely characterization of arrhythmias is crucial to direct therapies that can have an important impact on diagnosis, prognosis or patient symptom status. The rhythm information derived from the large variety of AECG recording systems can often lead to appropriate and patient-specific medical and interventional management.

Parameters associated with one-year mortality and in-hospital adverse events in patients after emergency pacemaker implantation.

Background: Permanent cardiac pacing is the treatment of choice for severe and symptomatic bradycardia. Patients undergoing emergency pacemaker implantation are stabilised earlier by the insertion of a temporary emergency pacing lead, and they experience more comorbidities than with planned admissions.

Aim: To identify the parameters associated with one-year mortality and in-hospital adverse events after emergency permanent pacemaker implantation.

ECG patch monitors for assessment of cardiac rhythm abnormalities.

The primary goal of long-term monitoring is the improvement of diagnostic yield. Despite the clear utility of Holter monitoring in clinical cardiology, issues of relatively low diagnostic yield, cost and inconvenience have motivated the development of ultra-portable devices referred to as ECG patch monitors. Although the "gold standard" for assessing cardiac rhythm abnormalities remains a 12-lead Holter, there is an increasing interest in portable monitoring devices that provide the opportunity for evaluating cardiac rhythm in real-world environments such as the workplace or home.

The subcutaneous defibrillator.

Prevention of sudden cardiac death (SCD) remains an important clinical problem. Currently, therapeutic goals for SCD prevention include identification of high risk patients and aggressively treating comorbidities underlying. However, many patients remain at increased risk despite optimal medical management (eg, coronary artery disease and cardiomyopathy) whereas others have nonmodifiable risk for sudden death (eg, arrhythmogenic right ventricular dysplasia/cardiomyopathy, Brugada syndrome, long QT syndrome, and hypertrophic cardiomyopathy).

New devices for very long-term ECG monitoring.

Present day 24-h Holter monitors have been shown to miss many arrhythmias that may occur infrequently or under specific circumstances. The advancement in electronic and adhesive technologies have enabled the development of first generation wearable long-term 14-day patch ECG monitors that attach directly to the skin and require no electrodes and wires to operate. This new technology is unobtrusive to the patients and offers them unprecedented mobility.

Recent innovations in the development of magnetic resonance imaging conditional pacemakers and implantable cardioverter-defibrillators.

The first generation of magnetic resonance conditional pacemakers and implantable cardioverter-defibrillators has finally arrived in clinical practice after many years of development. These devices have been optimized to properly function within magnetic fields of 1.5 T and ensure safe operation in controlled environments.

New developments in the treatment of severe drug resistant hypertension.

The purpose of this paper is to review the state-of-the-art of renal denervation system technology for treatment of drug resistant hypertension. We describe an investigational device that is currently tested in an on-going clinical trial. The denervation device uses the RF thermal ablation catheter attached to the RF generator.

Subcutaneous implantable cardioverter-defibrillator (S-ICD).

Current state-of-the art implantable cardioverter-defibrillator (ICD) systems have been proven to be safe and effective in treating ventricular arrhythmias leading to cardiac death. ICDs require placement of at least one lead in, or on, the heart. Surgical placement under fluoroscopy and the ongoing presence of the transvenous leads within the patient's heart are associated with a significant proportion of the complications related to this well-established and highly effective therapy.

Integrated heart failure telemonitoring system for homecare.

The integrated telemonitoring system (ITS) for homecare has been designed to improve quality of care as measured by increased nursing productivity, improved patients' clinical and behavioral outcomes and reduction of cost. The system incorporates managerial, organizational, operational and clinical tasks optimized for delivery of quality care through telemonitoring. A secure, multi-modal computer network that integrates homecare nurses, patients and those who care into one seamless environment has been developed.

New material for implantable cardiac leads.

Unlabelled: Cardiac function management devices, including implantable pacemakers and implantable defibrillators, include at least 1 cardiac lead having an electrode for making contact with a portion of the heart. It has been previously shown that the braided multifilament wire electrodes have a high failure rate both for sensing of spontaneous heart activity and for safe heart stimulation. Therefore, it is desirable to have cardiac leads made of materials with mechanical and electrical properties to insure safe pacemaker function.

Biopotential fiber sensor.

Unlabelled: We have developed a new biopotential fiber sensor (BFS) technology as an alternative to traditional wet-gel Ag/AgCl electrodes in long-term monitoring applications. Biopotential fiber sensor technology uses proprietary method of bonding copper sulfide to the surface of acrylic fibers, thus creating an electrically conductive medium (10(-1) ohms/cm). Surface modified bundles of acrylic fibers form stable biopotential sensors when doped with proprietary ink comprising organic acids and nano particles of Ag and AgCl.

State of the art techniques for preservation and reuse of hard copy electrocardiograms.

Baseline examinations and periodic reexaminations in longitudinal population studies, together with ongoing surveillance for morbidity and mortality, provide unique opportunities for seeking ways to enhance the value of electrocardiography (ECG) as an inexpensive and noninvasive tool for prognosis and diagnosis. We used newly developed optical ECG waveform recognition (OEWR) technique capable of extracting raw waveform data from legacy hard copy ECG recording. Hardcopy ECG recordings were scanned and processed by the OEWR algorithm.

Development of a new QT algorithm with heterogenous ECG databases.

An algorithm for automated QT interval assessments has been developed and evaluated using the PhysioNet QT database and the electrocardiogram multilead database (2 collections of electrocardiograms with different characteristics, eg, numbers of leads and expert annotations). QRS onset and coarse T offset detection was based on the definition of a short time window, within which the range of signal amplitudes was calculated and compared to given threshold values. The final position of T offset was based on a combination of 3 methods: decreasing thresholds, multiple tangents, and a model based approach.

Estimation of regional end-systolic wall stress during exercise in coronary artery disease.

Estimating left ventricular wall stress has recognized applications, but formulae for global stress cannot be applied to ischemic ventricles. A mathematic method for estimating regional stress in infarcted ventricles has been described. The hypothesis tested was that exercise-induced ischemia increases end-systolic wall stress.

Echocardiographic design of a multicenter investigation of free-living elderly subjects: the Cardiovascular Health Study.

The Framingham study has shown by M-mode echocardiography that left ventricular hypertrophy is a powerful, independent predictor for the development of coronary heart disease and that increased left atrial dimension has been associated with an increased risk of stroke. No previous population-based study has evaluated the risk factor correlates and predictive value for coronary heart disease and stroke of two-dimensional and Doppler, as well as M-mode, echocardiography. The Cardiovascular Health Study is a multi-year prospective epidemiologic study of 5201 men and women older than 65 recruited from four geographic sites in the United States.