Insertable cardiac monitor with a long sensing vector: Impact of obesity on sensing quality and safety

BACKGROUND Fat layers in obese patients can impair R-wave detection and diagnostic performance of a subcutaneous insertable cardiac monitor (ICM). We compared safety and ICM sensing quality between obese patients [body mass index (BMI) ≥ 30 kg/m$^{2}$] and normal-weight controls (BMI <30 kg/m$^{2}$) in terms of R-wave amplitude and time in noise mode (noise burden) detected by a long-sensing-vector ICM. MATERIALS AND METHODS Patients from two multicentre, non-randomized clinical registries are included in the present analysis on January 31, 2022 (data freeze), if the follow-up period was at least 90 days after ICM insertion, including daily remote monitoring. The R-wave amplitudes and daily noise burden averaged intraindividually for days 61-90 and days 1-90, respectively, were compared between obese patients (n = 104) and unmatched (n = 268) and a nearest-neighbour propensity score (PS) matched (n = 69) normal-weight controls. RESULTS The average R-wave amplitude was significantly lower in obese (median 0.46 mV) than in normal-weight unmatched (0.70 mV, P < 0.0001) or PS-matched (0.60 mV, P = 0.003) patients. The median noise burden was 1.0% in obese patients, which was not significantly higher than in unmatched (0.7%; P = 0.056) or PS-matched (0.8%; P = 0.133) controls. The rate of adverse device effects during the first 90 days did not differ significantly between groups. CONCLUSION Although increased BMI was associated with reduced signal amplitude, also in obese patients the median R-wave amplitude was >0.3 mV, a value which is generally accepted as the minimum level for adequate R-wave detection. The noise burden and adverse event rates did not differ significantly between obese and normal-weight patients.Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04075084 and NCT04198220

Insertable cardiac monitor with a long sensing vector: Impact of obesity on sensing quality and safety

BackgroundFat layers in obese patients can impair R-wave detection and diagnostic performance of a subcutaneous insertable cardiac monitor (ICM). We compared safety and ICM sensing quality between obese patients [body mass index (BMI) ≥ 30 kg/m2] and normal-weight controls (BMI &lt;30 kg/m2) in terms of R-wave amplitude and time in noise mode (noise burden) detected by a long-sensing-vector ICM.Materials and methodsPatients from two multicentre, non-randomized clinical registries are included in the present analysis on January 31, 2022 (data freeze), if the follow-up period was at least 90 days after ICM insertion, including daily remote monitoring. The R-wave amplitudes and daily noise burden averaged intraindividually for days 61–90 and days 1–90, respectively, were compared between obese patients (n = 104) and unmatched (n = 268) and a nearest-neighbour propensity score (PS) matched (n = 69) normal-weight controls.ResultsThe average R-wave amplitude was significantly lower in obese (median 0.46 mV) than in normal-weight unmatched (0.70 mV, P &lt; 0.0001) or PS-matched (0.60 mV, P = 0.003) patients. The median noise burden was 1.0% in obese patients, which was not significantly higher than in unmatched (0.7%; P = 0.056) or PS-matched (0.8%; P = 0.133) controls. The rate of adverse device effects during the first 90 days did not differ significantly between groups.ConclusionAlthough increased BMI was associated with reduced signal amplitude, also in obese patients the median R-wave amplitude was &gt;0.3 mV, a value which is generally accepted as the minimum level for adequate R-wave detection. The noise burden and adverse event rates did not differ significantly between obese and normal-weight patients.Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04075084 and NCT04198220

Immobility-associated thromboprotection is conserved across mammalian species from bear to human

Venous thromboembolism (VTE) comprising deep venous thrombosis and pulmonary embolism is a major cause of morbidity and mortality. Short-term immobility-related conditions are a major risk factor for the development of VTE. Paradoxically, long-term immobilized free-ranging hibernating brown bears and paralyzed spinal cord injury (SCI) patients are protected from VTE. Here we aimed to identify mechanisms of immobility-associated VTE protection in a cross-species approach. Mass spectrometry-based proteomics revealed an antithrombotic signature in platelets of hibernating brown bears with heat shock protein 47 (HSP47) as most substantially reduced protein. HSP47 downregulation or ablation attenuated immune cell activation and NET formation, contributing to thromboprotection in bears, SCI patients and mice. This cross-species conserved platelet signature may give rise to antithrombotic therapeutics and prognostic markers beyond immobility-associated VTE

Histoire et langage : travaux allemands en lexicologie historique et en histoire conceptuelle

Gumbrecht Hans Ulrich, Lüsebrink Hans-Jürgen, Reichardt Rolf. Histoire et langage : travaux allemands en lexicologie historique et en histoire conceptuelle. In: Revue d’histoire moderne et contemporaine, tome 30 N°2, Avril-juin 1983. pp. 185-195

Civilisation allemande

Produit d’un débat entre germanistes français, spécialistes de « civilisation allemande », et romanistes allemands, spécialistes de « Landeskunde » ou « Landeswissenschaft », cet ouvrage fait le point sur les évolutions de ces disciplines dans les mondes universitaires français et allemand. Une première rencontre en 1988 à Versailles a été suivie d’une autre à Berlin, en 2010. Riche d’une longue tradition dans l’enseignement et la recherche, la « civilisation allemande » est bien établie en France, ses thèmes de recherche sont en pleine évolution. La « Landeskunde » était plutôt perçue en Allemagne comme un domaine auxiliaire de la « Romanistik ». Le terme avec ceux de « Landeswissenschaft » et « Frankreichstudien » (études françaises) ont aujourd’hui presque disparu du profil des postes à pourvoir, ils ont été remplacés par celui de « Kulturwissenschaft », « sciences culturelles », lié à celui de « science littéraire ». Cette combinaison s’est révélée trompeuse : dans la pratique, la « civilisation française » se réfère à un modèle d’enseignement traditionnel de littérature française mâtiné de sciences culturelles là où il devrait s’agir, pour reprendre Helene Harth, d’instaurer « une coopération interdisciplinaire avec d’autres philologies et d’autres disciplines comme l’histoire, la sociologie, l’histoire de l’art et l’histoire médiatique (pour transmettre aux étudiants) un savoir sur les cultures des différents pays européens, qui leur permette de comprendre les différents processus historiques des échanges culturels actuels. » Ces enjeux sont au centre de ce livre sur fond de transformation des sociétés française et allemande

Table1_Insertable cardiac monitor with a long sensing vector: Impact of obesity on sensing quality and safety.docx

BackgroundFat layers in obese patients can impair R-wave detection and diagnostic performance of a subcutaneous insertable cardiac monitor (ICM). We compared safety and ICM sensing quality between obese patients [body mass index (BMI) ≥ 30 kg/m2] and normal-weight controls (BMI 2) in terms of R-wave amplitude and time in noise mode (noise burden) detected by a long-sensing-vector ICM.Materials and methodsPatients from two multicentre, non-randomized clinical registries are included in the present analysis on January 31, 2022 (data freeze), if the follow-up period was at least 90 days after ICM insertion, including daily remote monitoring. The R-wave amplitudes and daily noise burden averaged intraindividually for days 61–90 and days 1–90, respectively, were compared between obese patients (n = 104) and unmatched (n = 268) and a nearest-neighbour propensity score (PS) matched (n = 69) normal-weight controls.ResultsThe average R-wave amplitude was significantly lower in obese (median 0.46 mV) than in normal-weight unmatched (0.70 mV, P ConclusionAlthough increased BMI was associated with reduced signal amplitude, also in obese patients the median R-wave amplitude was >0.3 mV, a value which is generally accepted as the minimum level for adequate R-wave detection. The noise burden and adverse event rates did not differ significantly between obese and normal-weight patients.Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04075084 and NCT04198220.</p