Electromechanically Optimized Right Ventricular Pacing for Obstructive Hypertrophic Cardiomyopathy (EMORI-HCM).

Background: Many patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) have devices capable of right ventricular pacing (RVP). Although pacing can reduce left ventricular outflow tract gradient (LVOTg), it can also reduce cardiac output, so its net effect is variable.

Objective: We tested whether electromechanical optimisation of the programmed atrio-ventricular delay (AVD) allows RVP to achieve a net benefit on symptoms.

High-Precision Hemodynamic and Echocardiographic Assessment of Pacing in Obstructive Hypertrophic Cardiomyopathy.

Background: Left ventricular outflow obstruction drives symptoms and outcomes in obstructive hypertrophic cardiomyopathy (oHCM). Right ventricular pacing (RVP) can desynchronize the left ventricle to relieve this and allows control of atrioventricular delay (AVD) but may impair ventricular function. We used high-precision assessment to quantify the hemodynamic and echocardiographic effects of RVP in oHCM.

An in silico guide for ventriculo-ventricular delay programming for left bundle branch-optimized cardiac resynchronization therapy.

Aims: Left bundle branch pacing (LBBP)-optimized cardiac resynchronization therapy (LOT-CRT) can improve left ventricular (LV) activation when LBBP alone or conventional biventricular pacing are ineffective. However, the optimal programming settings for ventriculo-ventricular delay (VVD) for LOT-CRT are unknown. We aim to investigate how to optimally program VVD for LOT-CRT in the presence of various LV conduction substrates using computational modelling.

Catheter Ablation for Ventricular Tachycardia After MI: A Reconstructed Individual Patient Data Meta-analysis of Randomised Controlled Trials.

Background: The prognostic impact of ventricular tachycardia (VT) catheter ablation is an important outstanding research question. We undertook a reconstructed individual patient data meta-analysis of randomised controlled trials comparing ablation to medical therapy in patients developing VT after MI.

Methods: We systematically identified all trials comparing catheter ablation to medical therapy in patients with VT and prior MI.

Smartphone-Based Remote Monitoring for Chronic Heart Failure: Mixed Methods Analysis of User Experience From Patient and Nurse Perspectives.

Background: Community-based management by heart failure specialist nurses (HFSNs) is key to improving self-care in heart failure with reduced ejection fraction. Remote monitoring (RM) can aid nurse-led management, but in the literature, user feedback evaluation is skewed in favor of the patient rather than nursing user experience. Furthermore, the ways in which different groups use the same RM platform at the same time are rarely directly compared in the literature.

Catheter ablation improves cardiovascular outcomes in patients with atrial fibrillation and heart failure: a meta-analysis of randomized controlled trials.

Aims: The effect of atrial fibrillation catheter ablation on cardiovascular outcomes in heart failure is an important outstanding research question. We undertook a meta-analysis of randomized controlled trials comparing ablation to medical therapy in patients with AF and heart failure.

Methods And Results: We systematically identified all trials comparing catheter ablation to medical therapy in patients with heart failure and atrial fibrillation.

Improving out-of-hours surgical patient care.

Purpose: The Royal College of Surgeons recognises patient handover as the point at which patients are collectively at their most vulnerable. Concerns were raised in a London teaching hospital surgical department regarding an unstructured handover system, poor access to relevant clinical information, and inadequate weekend staffing. A quality improvement programme was designed and implemented to respond to these concerns and improve patient safety.

Maternal heart rate during the first 48h postpartum: a retrospective cross sectional study.

Objectives: 1) Describe the distribution of heart rate in the first 48h postpartum in women with no evidence of sepsis, anaemia or haemorrhage. 2) Investigate the relationship between postpartum heart rate and other maternal factors.

Study Design: A retrospective cross-sectional study of postpartum women who delivered between July 2012 and June 2015 in a tertiary hospital.