Incidence and Predictors of Infections and All-Cause Death in Patients with Cardiac Implantable Electronic Devices: The Italian Nationwide RI-AIAC Registry

The incidence of infections associated with cardiac implantable electronic devices (CIEDs) and patient outcomes are not fully known. To provide a contemporary assessment of the risk of CIEDs infection and associated clinical outcomes. In Italy, 18 centres enrolled all consecutive patients undergoing a CIED procedure and entered a 12-months follow-up. CIED infections, as well as a composite clinical event of infection or all-cause death were recorded. A total of 2675 patients (64.3% male, age 78 (70-84)) were enrolled. During follow up 28 (1.1%) CIED infections and 132 (5%) deaths, with 152 (5.7%) composite clinical events were observed. At a multivariate analysis, the type of procedure (revision/upgrading/reimplantation) (OR: 4.08, 95% CI: 1.38-12.08) and diabetes (OR: 2.22, 95% CI: 1.02-4.84) were found as main clinical factors associated to CIED infection. Both the PADIT score and the RI-AIAC Infection score were significantly associated with CIED infections, with the RI-AIAC infection score showing the strongest association (OR: 2.38, 95% CI: 1.60-3.55 for each point), with a c-index = 0.64 (0.52-0.75), p = 0.015. Regarding the occurrence of composite clinical events, the Kolek score, the Shariff score and the RI-AIAC Event score all predicted the outcome, with an AUC for the RI-AIAC Event score equal to 0.67 (0.63-0.71) p < 0.001. In this Italian nationwide cohort of patients, while the incidence of CIED infections was substantially low, the rate of the composite clinical outcome of infection or all-cause death was quite high and associated with several clinical factors depicting a more impaired clinical status

An Emergent Echo-Guided Apical Pericardiocentesis for Cardiac Tamponade in a Patient with only the Left Lung

Case repor

An Emergent Echo-Guided Apical Pericardiocentesis for Cardiac Tamponade in a Patient with only the Left Lung

Case repor

Implantable cardioverter defibrillator management: An update

Implantable cardioverter defibrillator (ICD) is the cornerstone of primary and secondary prevention of sudden cardiac death. In 35 years of technologic improvement and clinical trials, there has been a continuous increase in implantation rate. Purpose of this review is to point out and discuss every aspect related to actual ICD management, investigating implantation procedure and predischarge care, office and remote monitoring follow-up, diagnostic evaluations, management of patients with suspected therapies or malfunctions, heart failure, surgery, radiotherapy and endoscopic procedures. Also, ICD backface such as infections and other complications will be discussed. Finally, we will focus on interesting future perspectives for this setting of patients

Investigation of the humidity effects on SnO2-based sensors in CO detection.

An algorithm for compensating H2O vapor pressure in CO detection is proposed here and tested on SnO2 thick-film gas sensors. For each sensor working at a fixed temp., the conductance, G, is fitted by an anal. surface, whose expression can be inverted to det. the CO concn. once the H2O partial pressure is measured. As soon as the rate of H2O-vapor pressure change is slower than .apprx.300 Pa/min, G is a function of the temp., H2O vapor and CO concn. If quicker H2O vapor variations occur instead, the sensing film undergoes a nonnegligible transitory phenomenon during which G assumes different values even at fixed H2O vapor pressure and temp. This phenomenon prevents the compensation from working properly. An explanation of the behavior is offered by the interpretation of kinetics equations at surface

Basic interpretation of thick film gas sensors for atmospheric application

Functional materials for thick film gas sensors have been examined: nanosized powder preparation methods, such as sol–gel and hydrothermal processes, morphological, micro-structural and electrical properties, in particular those depending on average grain dimensions. In this context, a theoretical conduction model, able to determine the characteristic length below which a material can be properly considered as anostructured, has been illustrated. The performances of sensing layers, deposited through screen-printing technology, have been examined, also considering their behaviour in on-site applications. The influence of some ambient parameters changing with time, such as temperature and humidity, have been investigated. Consequently, accurate NOx and CO concentrations were obtained, compensating the sensors responses from the water vapor effect

Cardiac resynchronization therapy guided by multimodality cardiac imaging

Aims: Up to 30–45% of implanted patients are non-responders to CRT. We evaluated the role of a ‘CRT team’ using cardiac magnetic resonance (CMR) and longitudinal myocardial strain to identify the target area defined as the most delayed and viable region for LV pacing. Methods and results: A total of 100 heart failure patients candidates for CRT divided into two groups were enrolled. Group 1 consisted of 50 consecutive patients scheduled for CRT and prospectively included. Group 2 (control) consisted of 50 patients with a CRT device implanted according to standard clinical practice and matched for age, sex, and LVEF with group 1. Patients were evaluated at baseline and at 6-month follow-up. In group 1, patients underwent two-dimensional speckle-tracking assessment of longitudinal myocardial strain and CMR imaging to identify the target area for LV lead pacing. A positive response to CRT was defined as a reduction of ≥15% of the LV end-systolic volume at 6-month follow-up. A total of 39 (78%) patients of group 1 were classified as responders to CRT whilst in group 2, only 28 (56%) were responders (P = 0.019). The ‘CRT team’ identified as target for LV pacing the lateral area in 30 (60%) patients, and the anterolateral or posterolateral areas in 12 (24%) patients. In 8 (16%) patients, the target was far from the lateral area, in the anterior or posterior areas. The patients with concordant position exhibited the highest positive response (93.1%) to CRT. Conclusions: Multimodality cardiac imaging as a guide for CRT implantation is useful to increase response rate

Nanostructured (Sn, Ti, Nb)O2 solid solution for hydrogen sensing.

A novel co-pptn. route for prepn. of a single-phase nanograined (Ti, Sn, Nb)O2 solid soln. was accomplished in the proportions Sn:Ti:Nb 100:42:5. Electron microscopy and x-ray diffraction were adopted to observe the morphol. and the structure. Calcination at 550, 650, 850 or 1050 for 2h, showed rutile-like single-phase. The powders were deposited as thick films through screen-printing technique to achieve gas sensors. SEM anal. of both powders and films showed regularly-shaped nanometric particles, the nanostructure being maintained up to 1050. The sensing layers, obtained from powders calcined at 550, and fired at 650 or 850, were tested vs. several reducing gases showing large responses to H with good selectivity