Regional disparities in the care and outcomes of atrial fibrillation patients in a universal health care system: a population-based cohort study.

Introduction: While prior studies have shown regional disparities in patients with myocardial infarction and heart failure within a universal health care, there are limited data on the association between different regions within a universal health care system and outcomes after an atrial fibrillation (AF) diagnosis. In this context, we aimed to assess variations in processes of care and outcomes among patients with the diagnosis of AF presenting to the emergency department (ED).

Methods: We conducted a population-based retrospective cohort study of all adult patients (≥ 18 years) with their first presentation to the ED with AF between April 1, 2012, and March 31, 2022 in Ontario, Canada.

Feasibility study: Characterizing acute lesion dimensions in patients with and without devices using noncontrast (native T-weighted) magnetic resonance imaging after ventricular tachycardia/premature ventricular complex radiofrequency ablation.

Background: Late gadolinium enhancement magnetic resonance imaging (MRI) has been shown to reliably locate radiofrequency ablation (RFA) lesions with microvascular obstruction (MVO) as a broadly accepted signature. However, MVO volume depends on the time elapsed after gadolinium contrast injection. Native T1-weighted (Tw) MRI has recently been shown to accurately characterize RFA lesions in preclinical models.

Ovulatory and anovulatory cycle phase influences on QT interval dynamics during the menstrual cycle.

Background: Ovarian hormones affect cardiovascular health yet few sufficient-sized studies with reliable ovulatory documentation have assessed the QTc-hormonal relationship. This study investigated QTc changes across ovulatory and anovulatory menstrual cycle phases.

Methods: This prospective cohort investigation, a cardiac sub-study of the Menstruation and Ovulation Study 2 (MOS2), involved 62 healthy, regularly menstruating community-dwelling women during spontaneous menstrual cycles.

A Touch Enabled Hemodynamic and Metabolic Monitor.

Accurate health analysis demands real-time tracking of multiple biomarkers and vital signs under dynamic physiological conditions. Current multimodal hybrid platforms provide biochemical and biophysical data but are limited by active sweat collection for biochemical sensing and bulky designs for biophysical sensing. Here a touch-enabled platform is presented that simultaneously monitors vitals and metabolic markers.

Cardiac function evaluation in healthy volunteers and patients with implantable cardioverter-defibrillators using high-bandwidth spoiled gradient-echo cine.

Background: Implantable cardioverter-defibrillators (ICDs) cause banding artifacts around areas of B inhomogeneity in conventional steady-state free precession (SSFP) cine sequences. Alternatively, high-bandwidth gradient-recalled echo (GRE) cine sequences can be used to minimize artifacts in the myocardium. In this study, we assessed the bias and interobserver variability in cardiac volumes and ejection fractions between GRE cines in acquired in the presence of ICDS and ground-truth SSFP cines (without ICDs present) in a population of healthy volunteers.

Relationship Between Social Deprivation and Access to Catheter Ablation for Atrial Fibrillation: A Population-Level Study.

Background: Access to catheter ablation for atrial fibrillation (AF) may vary due to social deprivation.

Objectives: This study sought to characterize the correlation between our outcomes of interest (rates of AF diagnoses, ablation referrals, and procedures) and the association between social deprivation and our outcomes.

Methods: Rates and correlations of AF diagnoses, ablation referrals, and procedures were reported across 49 census divisions in Ontario, Canada.

Biomimetic Cell Membrane Layers for the Detection of Insulin and Glucagon.

The growing need for reliable and rapid insulin testing to enhance glycemic management has spurred intensive exploration of new insulin-binding bioreceptors and innovative biosensing platforms for detecting this hormone, along with glucagon, in biological samples. Here, by leveraging the native protein receptors on the HepG2 cell membrane, we construct a simple and chemical-free biomimetic molecular recognition layer for the detection of insulin and glucagon. Unlike traditional affinity sensors, which require lengthy surface modifications on the electrochemical transducers and use of two different capture antibodies to recognize each analyte, this new biomimetic sensing strategy employs a simple drop-casting of a natural cell membrane recognition layer onto the electrochemical transducer.

Simultaneous and Rapid Detection of Glucose and Insulin: Coupling Enzymatic and Aptamer-Based Assays.

Diabetes management demands precise monitoring of key biomarkers, particularly insulin (I) and glucose (G). Herein, we present a bioelectronic chip device that enables the simultaneous detection of I and G in biofluids within 2 min. This dual biosensor chip integrates aptamer-based insulin sensing with enzymatic glucose detection on a single platform, employing a four-electrode sensor chip.

Coexisting Charge Density Waves in Twisted Bilayer NbSe.

Twisted bilayers of 2D materials have emerged as a tunable platform for studying broken symmetry phases. While most interest has been focused toward emergent states in systems whose constituent monolayers do not feature broken symmetry states, assembling monolayers that exhibit ordered states into twisted bilayers can also give rise to interesting phenomena. Here, we use first-principles density-functional theory calculations to study the atomic structure of twisted bilayer NbSe whose constituent monolayers feature a charge density wave.

Neuromorphic overparameterisation and few-shot learning in multilayer physical neural networks.

Physical neuromorphic computing, exploiting the complex dynamics of physical systems, has seen rapid advancements in sophistication and performance. Physical reservoir computing, a subset of neuromorphic computing, faces limitations due to its reliance on single systems. This constrains output dimensionality and dynamic range, limiting performance to a narrow range of tasks.

Applying Artificial Intelligence for Phenotyping of Inherited Arrhythmia Syndromes.

Inherited arrhythmia disorders account for a significant proportion of sudden cardiac death, particularly among young individuals. Recent advances in our understanding of these syndromes have improved patient diagnosis and care, yet certain clinical gaps remain, particularly within case ascertainment, access to genetic testing, and risk stratification. Artificial intelligence (AI), specifically machine learning and its subset deep learning, present promising solutions to these challenges.

Relationship between wait times and postatrial fibrillation ablation outcomes: A population-based study.

Background: Rhythm control is a cornerstone of atrial fibrillation (AF) management. Shorter time between diagnosis of AF and receipt of catheter ablation is associated with greater rates of therapy success. Previous work considered diagnosis-to-ablation time as a binary or categorical variable and did not consider the unique risk profile of patients after a referral for ablation was made.

Surviving the Shocks: A Contemporary of Short-coupled Ventricular Fibrillation.

A young man presented following successful cardiac resuscitation after an out-of-hospital cardiac arrest. During his admission, he had multiple runs of short-coupled ventricular fibrillation with a similar morphology premature ventricular complex (PVC) trigger. He was brought to the electrophysiology laboratory, and, with a high dose of isoprenaline, the PVC was localised to the moderator band.

Use of a Sheath and Stylet for a Difficult Dorsal Root Ganglion Stimulation Lead Extraction: A Case Report.

Dorsal root ganglion stimulation (DRG-S) is a relatively new neuromodulation technique that has shown promising results in the treatment of chronic pain conditions. We present a case of a difficult lead extraction during the explantation of a DRG-S device. The lead was unable to be removed despite multiple attempts until a sheath and stylet were used to facilitate extraction.

Deep Learning-Augmented ECG Analysis for Screening and Genotype Prediction of Congenital Long QT Syndrome.

Importance: Congenital long QT syndrome (LQTS) is associated with syncope, ventricular arrhythmias, and sudden death. Half of patients with LQTS have a normal or borderline-normal QT interval despite LQTS often being detected by QT prolongation on resting electrocardiography (ECG).

Objective: To develop a deep learning-based neural network for identification of LQTS and differentiation of genotypes (LQTS1 and LQTS2) using 12-lead ECG.

Association of admission serum sodium and outcomes following out-of-hospital cardiac arrest.

Background: The prognostic association between dysnatremia and outcomes in out-of-hospital cardiac arrest (OHCA) is not well understood. Given hypernatremia is associated with poor outcomes in critical illness and hyponatremia may exacerbate cerebral edema, we hypothesized that dysnatremia on OHCA hospital admission would be associated with worse neurological outcomes.

Methods: We studied adults (≥19 years) with non-traumatic OHCA between 2009 and 2016 who were enrolled in the British Columbia Cardiac Arrest Registry and survived to hospital admission at 2 quaternary urban hospitals.