National health expenditure per capita is associated with CRT implantation practice: findings from the ESC CRT Survey II with 11 088 patients.

Aims: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in selected patients with heart failure (HF) and electrical dyssynchrony. This treatment receives class IA recommendations in European Society of Cardiology (ESC) guidelines. However, despite these strong recommendations, CRT implantation practice varies greatly in Europe.

Real-time pulmonary artery pressure monitoring in heart failure patients: an updated cost-effectiveness analysis.

Aims: Previous cost-effectiveness analysis suggests that CardioMEMS is cost-effective compared with usual care for patients with persistent New York Heart Association class III symptoms and at least one heart failure (HF) hospitalization within 12 months. The aim of the paper is to perform an update of the cost-effectiveness analysis of CardioMEMS using the most recent data from the published literature.

Methods And Results: A Microsoft Excel Markov model from a previous UK cost-effectiveness study of CardioMEMS was updated using the clinical effectiveness of pulmonary artery pressure (PAP)-guided treatment derived from the pivotal trials.

Economic value of narrow-band imaging versus white light endoscopy for the diagnosis and surveillance of Barrett's esophagus: Cost-consequence model.

Barrett's esophagus (BE) is an abnormality arising from gastroesophageal reflux disease that can progressively evolve into a sequence of dysplasia and adenocarcinoma. Progression of Barrett's esophagus into dysplasia is monitored with endoscopic surveillance. The current surveillance standard requests random biopsies plus targeted biopsies of suspicious lesions under white-light endoscopy, known as the Seattle protocol.

Economic value of narrow band imaging versus white light endoscopy for the characterization of diminutive polyps in the colon: systematic literature review and cost-consequence model.

Aims: To demonstrate the economic implication of adopting narrow-band imaging (NBI) for the characterization of diminutive polyps in the colon from an English payer perspective.

Materials And Methods: A decision-tree model was undertaken to perform a cost-consequence and budget impact analysis from the NHS England perspective in the UK, over a 7-year time horizon. Clinical inputs came from the published literature (both randomized controlled trials and meta-analyses) identified through a systematic literature review, and cost inputs came from national list prices and unpublished internal market data.

Economic Value of the Transurethral Resection in Saline System for Treatment of Benign Prostatic Hyperplasia in England and Wales: Systematic Review, Meta-analysis, and Cost-Consequence Model.

Context: Monopolar transurethral resection of the prostate (M-TURP) is the current UK surgical standard of care for benign prostatic hyperplasia, a condition estimated to affect >2 million men in the United Kingdom. Although M-TURP efficacy in prostate resection is established, potential perioperative complications and associated costs remain a concern.

Objective: To present up-to-date and robust evidence in support of bipolar transurethral resection in saline (TURis) as an alternative surgical option to M-TURP.

Difference in percentage of ventricular pacing between two algorithms for minimizing ventricular pacing: results of the IDEAL RVP (Identify the Best Algorithm for Reducing Unnecessary Right Ventricular Pacing) study.

Aims: Managed ventricular pacing (MVP) and Search AV+ are representative dual-chamber pacing algorithms for minimizing ventricular pacing (VP). This randomized, crossover study aimed to examine the difference in ability to reduce percentage of VP (%VP) between these two algorithms.

Methods And Results: Symptomatic bradyarrhythmia patients implanted with a pacemaker equipped with both algorithms (Adapta DR, Medtronic) were enrolled.

Quantitative assessment of dyssynchrony using ECG-gated SPECT myocardial perfusion imaging prior to and following cardiac resynchronization therapy.

Cardiac resynchronization therapy (CRT) assists patients with advanced heart failure (HF) by improving left ventricular (LV) dyssynchrony, but there are significant numbers of non-responders, 1 reason being that the QRS duration is used as the only surrogate determinant of mechanical dyssynchrony, so an effective indicator of LV dyssynchrony is required. The present patient, who had HF, underwent CRT and showed clinical improvement with marked LV reverse remodeling. The regional contraction timing in the LV was assessed with software developed in an application on ECG-gated SPECT myocardial perfusion imaging that depicts the time-volume relationship of the segmented ventricular myocardium and the dispersion of time to end-systole as an expression of dyssynchrony.

Adaptation of the standard 12-lead electrocardiogram system dedicated to the analysis of atrial fibrillation.

Objective: The objective of the study was to design a lead system aimed at studying atrial fibrillation (AF), while being anchored to the standard 12-lead system.

Methods: The location of 4 of the 6 precordial electrodes was optimized while leaving the remaining 5 of the 9 electrodes of the standard 12-lead system in place. The analysis was based on episodes of 11 different variants of AF simulated by a biophysical model of the atria positioned inside an inhomogeneous thorax.

Vectorcardiographic lead systems for the characterization of atrial fibrillation.

Objective: The aim of the study was to design a vectorcardiographic lead system dedicated to the analysis of atrial fibrillation (AF).

Methods: Body surface potentials during AF were simulated by using a biophysical model of the human atria and thorax. The XYZ components of the equivalent dipole were derived from the Gabor-Nelson equations.

Atrial repolarization as observable during the PQ interval.

Objective: We aimed to study the involvement of atrial repolarization in body surface potentials.

Methods: Electrocardiograms of healthy subjects were recorded using a 64-lead system. The data analysis focused on the PQ intervals while devoting special attention to the low-amplitude signals during the PQ segment: the segment from the end of the P wave until onset QRS.

Study of unipolar electrogram morphology in a computer model of atrial fibrillation.

Introduction: Electrograms exhibit a wide variety of morphologies during atrial fibrillation (AF). The basis of these time courses, however, is not completely understood. In this study, data from computer models were studied to relate features of the signals to the underlying dynamics and tissue substrate.