Time-to-effect guided pulmonary vein isolation utilizing the third-generation versus second generation cryoballoon: One year clinical success

Background: The second-generation cryoballoon (CB2) provides effective and durable pulmonary vein isolation (PVI) associated with encouraging and reproducible clinical outcome data. The latest- -generation cryoballoon (CB3) incorporates a 40% shorter distal tip, thus allowing for an increased rate of PVI real-time signal recording and facilitating individualized ablation strategies taking the time-to- -effect (TTE) into account. However, whether this characteristic translates into favorable clinical success has not been evaluated yet. Herein was investigated 1-year clinical success after CB3 in comparison to CB2 based-PVI. Methods: One hundred and ten consecutive patients with paroxysmal or short-standing persistent atrial fibrillation (AF) underwent CB2 (n = 55 patients) -or CB3 (n = 55 patients) -based PVI. The freeze-cycle duration was set to TTE + 120 s if TTE could be recorded, otherwise a fixed freeze-cycle duration of 180 s was applied. Results: A total of 217/218 (99%, CB3) and 217/217 (100%, CB2) pulmonary veins (PV) were successfully isolated. The real-time PVI visualization rate was 69.2% (CB3) and 54.8% (CB2; p = 0.0392). The mean freeze-cycle duration was 194 ± 77 s (CB3) and 206 ± 85 s (CB2; p = 0.132), respectively. During a median follow-up of 409 days (interquartile range [IQR] 378–421, CB3) and 432 days (IQR 394–455, CB2) 73.6% (CB3) and 73.1% of patients (CB2) remained in stable sinus rhythm after a single procedure (p = 0.806). Conclusions: A higher rate of real-time electrical PV recordings was seen using the CB3 as compared to CB2. There was no difference in 1-year clinical follow-up

Une approche générique pour capitaliser l'expérience en conception et en optimisation

peer reviewedAs design changes in the production phase can be hundreds of times more costly than in the design phase, it is crucial to make sure that the designed product is actually manufacturable before start of production. To this aim nowadays often many manual iterations are needed between the designers and manufacturing experts, which leads to an inefficient design process and delayed time-to-market that in turn are detrimental for company competitiveness. Here we present the outline of a research effort to realize a substantially more integrated design process tailored towards both performance aspects and manufacturability. Key to this is the formalisation of Design for Manufacturing (DfM) rules within the functional CAD design stage. The traditional design approach is exemplified further in this work for the design of a gearbox housing for electric vehicle transmission systems. To realize substantial weight reduction without compromising performance, a novel multi-material design is proposed, constituting of both aluminum, to ensure structural integrity, and high performance polymer for additional structural integrity and leak-tightness under operating condition. Results shown include Topology Optimization (TO) under realistic loading conditions, scrutinizing material volume fraction boundary conditions and mesh sensitivity. Finally, some DfM rules and considerations in order to come to a manufacturable CAD design, are highlighted.Lightvehicle 202

Time-to-effect guided pulmonary vein isolation utilizing the third-generation versus second generation cryoballoon: One year clinical success

The second-generation cryoballoon (CB2) provides effective and durable pulmonary vein isolation (PVI) associated with encouraging and reproducible clinical outcome data. The latest-generation cryoballoon (CB3) incorporates a 40% shorter distal tip, thus allowing for an increased rate of PVI real-time signal recording and facilitating individualized ablation strategies taking the time-to-effect (TTE) into account. However, whether this characteristic translates into favorable clinical success has not been evaluated yet. Herein was investigated one-year clinical success after CB3 in comparison to CB2 based-PVI

Investigations of low-frequency noise of GaN based heterostructure field-effect transistors

NRC publication: Ye