Spontaneous Documentation of Bidirectional Block During Pulmonary Vein Isolation - Keep an Eye on the Electrograms!

AbstractIn the present case, we describe the abrupt transformation of intra-pulmonary vein activity from rapid firing to dissociated ectopic activity during sinus rhythm, as an easily identifiable, though rare to encounter, sign which documents the achievement of bidirectional block

Association of the 894G>T polymorphism in the endothelial nitric oxide synthase gene with risk of acute myocardial infarction

Background: This study was designed to investigate the association of the 894G>T polymorphism in the eNOS gene with risk of acute myocardial infarction (AMI), extent of coronary artery disease (CAD) on coronary angiography, and in-hospital mortality after AMI. Methods: We studied 1602 consecutive patients who were enrolled in the GEMIG study. The control group was comprised by 727 individuals, who were randomly selected from the general adult population. Results: The prevalence of the Asp298 variant of eNOS was not found to be significantly and independently associated with risk of AMI (RR = 1.08, 95%CI = 0.77–1.51, P = 0.663), extent of CAD on angiography (OR = 1.18, 95%CI = 0.63–2.23, P = 0.605) and in-hospital mortality (RR = 1.08, 95%CI = 0.29–4.04, P = 0.908). Conclusion: In contrast to previous reports, homozygosity for the Asp298 variant of the 894G>T polymorphism in the eNOS gene was not found to be associated with risk of AMI, extent of CAD and in-hospital mortality after AM

Testing moderation effects using non-parametric regressions

Testing moderation effects is highly common in the hospitality literature. Most theories in the field depend on variables that alter the nature and direction of the relationship between two variables. While moderation continues to be heavily used, methods for testing moderation effects are not always robust. One common problem that researchers often face is the need to pre-assign a particular functional form. The aim of this note is to address this problem. We describe three different non-parametric models that offer more flexibility in testing moderating effects without a need to pre-impose a specific functional form. We test the three models on an interesting application involving the moderating role of corporate social responsibility (CSR) on the relationship between advertising and firm value. The results revealed interesting moderating effects that go beyond the simple linear moderation

Effect of Diabetes Mellitus on Atrial Fibrillation Catheter Ablation Outcomes

Patients with diabetes mellitus commonly are suffering from atrial fibrillation since these two conditions share pathophysiological mechanisms. Catheter ablation of atrial fibrillation is the cornerstone therapy for rhythm control in symptomatic patients with paroxysmal or persistent atrial fibrillation. Data regarding the efficacy and safety of catheter ablation from large randomized clinical trials in this population are limited. The only available data from small clinical trials and meta-analyses have shown a superiority of catheter ablation compared to antiarrhythmic drugs although there are some limitations. Rhythmos 2017;12(2):26-28

The dilemma of providing cardioverter/defibrillator back-up for all patients with heart failure eligible for cardiac resynchronization therapy

Cardiac resynchronization therapy (CRT) achieved by biventricular pacing (CRT-P) has been proved to improve symptoms and prognosis of patients with refractory heart failure. Sudden cardiac death is quite common among patients with symptomatic heart failure and implantable cardioverter-defibrillator (ICD) therapy has been proved to effectively reduce sudden deaths in heart failure patients. Given the results of the recently published primary prevention trials and the high incidence of sudden cardiac death among CRT-P recipients, CRT combined with backup defibrillator therapy (CRT-D) seems a logical therapeutic option in patients eligible for CRT. However, the apparent beneficial effects of such an appealing combination do not alleviate the skepticism about the unselected use of CRT-D therapy. This skepticism is largely related to the high cost of this method, to the limited availability of human and financial resources and to our inability to appropriately define the selection criteria for CRT candidates, which are expected to influence the clinicians??? decisions when confronted with the dilemma of providing CRT-D therapy for all patients eligible for CRT

Classical and Non-Classical Indications for Cardiac Resynchronization Therapy

Heart failure (HF) is a medical problem of huge socioeconomic importance, mainly due to the increasing life expectancy in our societies and the strides in the treatment of ischemic heart disease which resulted in improved prognosis of our patients. These medical and socioeconomic issues may explain why HF poses a significant financial burden on our health care systems. It is estimated that acute decompensated HF accounts for 2.9% of all emergency room visits, its prevalence is steadily increasing in epidemic proportions and in age-dependent manner, reaching an incidence of almost 10% in patients aged >65 years

Percutaneous Closure of a Large Atrial Septal Defect: A Simplified Approach

A 44-year-old female patient presented with easy fatigability, dyspnea on exertion and frequent episodes of migraine. Echocardiography revealed a large atrial septal defect (ASD) of the secundum type. This was further visualized with transesophageal echocardiography (TEE) (Figure, Panel A, arrow).The diameter of the ASD at TEE was measured at 1.93 cm. Pulmonary to systematic flow ratio (Qp/Qs) was calculated at 3.3:1, indicating a significant left-to-right shunt across the ASD. Percutaneous closure of the defect was subsequently undertaken. The diameter of the defect was measured intra-procedurally using an intracardiac balloon and it was found to be 2.6 cm (Panel B).An Amplatzer 9-ASD-032 occluder was successfully implanted percutaneously via the right femoral vein (Panel C, arrow). TEE 48 hours after implantation showed that the closure device was in proper place (Panel D, arrows) and the left-to-right shunt was abolished

Autonomous inspection and repair of aircraft composite structures

This paper deals with the development of an innovative approach for inspection and repair of damage in aeronautical composites that took place in the first two years of the H2020 CompInnova project which. The aim is a newly designed robotic platform for autonomous inspection using combined infrared thermography (IRT) and phased array (PA) non-destructive investigation for damage detection and characterization, while integrated with laser repair capabilities. This will affect the increasing societal need for safer aircraft in the lowest possible cost, while new and effective techniques of inspection are needed because of the rapidly expanding use of composites in the aerospace industry