bluuebunny/crossref_metadata_2025_split huggingface dataset:
P968Impact of contact force sensing catheters on fluoroscopy time in left-sided atrial procedures
Authors: Blessberger H , Fiedler L , Balsam P , De Potter T , Buchta P , Nahler A , Hoenig S , Hrncic D , Lambert T , Schoenbauer R , Pfeffer M , Roithinger F X , Steinwender C , Kosiuk J 
Published: June 2020

Abstract

Funding Acknowledgements
None.

OnBehalf
Go for Zero Fluoroscopy Project investigators
Background Contact force sensing catheters provide electrophysiologists with direct feedback and therefore improve safety and help to generate more effective lesions. The use of contact force may also reduce fluoroscopy and procedure times.
Purpose The aim of this study was to systematically evaluate the impact of using contact force sensing catheters (CFSCs) on fluoroscopy times and procedure times in left-sided atrial procedures.
Methods In this multinational, multicenter study, data from 622 left-sided procedures (142 without and 480 with CFSCs) of 25 participating European centers were prospectively collected with a structured questionnaire. Examinations comprised 393 pulmonary vein isolations (PVIs, group 1[G1]), 122 PVIs with linear lesions (group 2[G2]), 65 left-sided accessory pathway ablations (group 3 [G3]) and 42 ablations for left atrial tachycardia (group 4 [G4]). Fluoroscopy and procedure times were compared with respect to the use of CFSCs, procedure type, and level of operator experience as possible confounders. A Mann-Whitney U-test was applied for comparison, and a p-value &lt;0.05 was considered statistically significant.
Results With the use of CFSCs, fluoroscopy time was significantly reduced when performing pulmonary vein isolations (G1 median [IQR]: 19 [11.0-33.7] vs. 7.2 [4.0-13.0] min., p &lt; 0.001, G2: 45.3 [34.9-61.8] vs. 7.3 [5.0-14.0], p &lt; 0.001, respectively). For groups G3 and G4, no difference could be detected. Procedure times were shortened for pulmonary vein isolations with additional lesions only (G4: 210 [180-240] vs. 153 [127-200] min., p &lt; 0.001). When assessing the effect of operator experience, all left-sided atrial procedures were combined. Significantly shorter fluoroscopy times with contact force were found at all career levels (early career &lt; 5 years: median -6 min., p = 0.024, mid-career 5-15 years: -15 min., p &lt; 0.001, mentor status with experience &gt; 15 years: -6.5 min., p &lt; 0.001). The use of contact force proved to be especially beneficial in reducing fluoroscopy time in operators performing one to 19 procedures per month (1-9: median -15.8 min., p &lt; 0.001, 10-19: -15.9 min., p &lt; 0.001), whereas it lost its statistical significance when more than 20 procedures per month were performed (20-39: - 3.2 min., p = 0.100, &gt;40: -1.5 min., p = 0.346).
Conclusion Contact force sensing catheters can help to reduce fluoroscopy times, especially when performing pulmonary vein isolations. This effect could be demonstrated for all career levels. However, it diminished with the operator"s caseload. A shortening of procedure time was found for PVIs with additional linear lesions.
305Pacemaker therapy after cardiac valve replacement surgery: impact on heart failure hospitalizations
Authors: Zegard A , Qiu T , Mcnulty D , Evison F , Okafor O , Marshall H , Gasparini M , Leyva F 
Published: June 2020

Abstract

Background
Left ventricular (LV) function is a major determinant of long-term outcomes after valve replacement surgery. Although conventional (right ventricular) pacemaker therapy is life-saving, it may cause heart failure (HF).

Aims
To determine whether permanent pacemaker implantation (PPI) confers a risk of HF in surgical valve recipients.

Methods
The primary endpoint of HF hospitalization and the secondary endpoints of total mortality and total mortality / HF hospitalizations were compared in valve recipients with and without PPI. Traditional as well as multi-state, multivariable modelling was used to assess the influence of PPI on clinical outcomes.

Results
Amongst patients (n = 135,242) undergoing a first aortic (AVR; n = 111,674), mitral (MVR; n = 18,402) valve replacement, or AVR + MVR (n = 5,166) over 14 years in 176 centre, 12,952 (10.6%) had a PPI at any time during follow-up and 5,805 (4.3%) underwent PPI postoperatively. After 3.9 yrs (median, interquartile range: 6.1), heart failure (HF) hospitalizations (HR: 1.47, 95% C.I. 1.36-1.59), total mortality (HR: 1.10, 95% C.I. 1.05-1.16) and total mortality or HF hospitalizations (HR: 1.17, 95% C.I. 1.12-1.22; see figure) were higher in patients with post-operative PPI than in patients without. Multi-state modelling revealed that the transition hazard from PPI at any time to HF hospitalizations was markedly higher (transition hazard rate: 0.29, 95% C.I. 0.24-0.36) than from valve replacement surgery to HF hospitalization.

Conclusions
After valve replacement surgery, PPI is associated with increased HF hospitalization and total mortality, particularly after dual valve replacements.
Abstract Figure.
P1133Impact of mid-septal versus apical pacing on the right ventricle performance of patients with right bundle branch block undergoing pacemaker implantation
Authors: Minati M , Bencivenga S , De Ruvo E , Bressi E , Cicogna F , Martino A M , De Luca L , Fagagnini A , Bruni G , Grieco D , Borrelli A , Scara A , Milo M , Lino S , Calo" L 
Published: June 2020

Abstract

Background
pacemaker induced cardiomyopathy or transient impairment of the left ventricle (LV) function could be common collateral effects of the prolonged right ventricle (RV) pacing in patients with a pacemaker (PM) and pre-existing intra-ventricular conduction disturbances. However, the impact of RV pacing-site on RV performance of patients with right bundle branch block(RBBB) is still under-investigated.

Purpose
to study the effects of RV pacing in the mid-septal versus apical site on the morpho-functional performance of RV in patients undergoing permanent PM implantation.

Methods
We prospectively enrolled consecutive patients with a pre-existent complete RBBB and undergoing dual-chamber PM implantation in our institution. We randomized the patients 1:1 to receive the RV catheter fixed either in the apex or in the mid-septal position. Patients with LV systolic dysfunction (LVEF &lt;50%), severe valvulopathies, left bundle branch block (LBBB), or preserved intraventricular conduction were excluded. Patients who received PM implantation were evaluated both at baseline and after two months with a 12-lead ECG, 2D, and 3D echocardiogram with analysis focused on RV performance according to the guidelines of the European Association of Cardiovascular Imaging.

Results
a total of 22 patients were randomized in the study, 11 (50%) received RV catheter positioned in the apex and 11 (50%) in the mid-septum, respectively. No baseline differences were recorded between the two groups in clinical characteristics, ECG and echocardiographic parameters. At 2 months follow up, there were no statistically significant difference in the % of RV pacing between the two groups. Nonetheless, RV mid-septal group showed significantly shorter duration of the stimulated QRS (146 ± 12 msec vs. 161 ± 20 msec, p = 0.05), significantly reductions in the RV dimensions (pre: 42 ± 8 mm vs. post: 37 ± 7 mm, p = 0.05) telediastolic area (pre: 12 ± 3 cm2/m2 vs post: 9 ± 4 cm2/ m2, p = 0.02) telediastolic volume (pre: 55 ± 16 ml/m2 vs post: 50 ± 17 ml/m2, p = 0.02) and a significant improvement of RV ejection fraction (pre: 54 ± 9% vs post: 57 ± 11%, p = 0.02) than patients in the RV-apical group. Moreover, patients in the RV-apical group showed significant lowering in the GLS of the LV (pre: -16 ± 3% vs post: -11.7 ± 3%, p &lt;0.001) and in the TAPSE (pre: 23 ± 5 mm vs post: 21 ± 2, p = 0.07) at follow up.

Conclusions
In this study, mid-septal pacing seems associated with a better morpho-functional RV performance than apical pacing in patients with pre-existent RBBB undergoing permanent PM implantation.
P1491Cardiac contractility modulation in patients with chronic heart failure and atrial fibrillation: 6 months of follow-up
Authors: Sapelnikov O , Uskach T M , Cherkashin D I , Grishin I R , Ardus D F , Nikolaeva O A , Safiullina A A , Merzlikina J O , Tereschenko S N , Akchurin R S 
Published: June 2020

Abstract

Background
Heart failure is developed in 30% of patients with atrial fibrillation (AF). It significantly worsens the prognosis and evaluates the fatal risks for patients. Cardiac Contractility Modulation (CCM) is a new therapeutic device for heart failure, which is used in patients with narrow QRS complexes who are refractory to medical therapy.

Purpose
The aim of current study is to demonstrate the effects of CCM on patients with heart failure and AF, influencing on NT-proBNP dynamics and 6 min walk test (6-MWT).

Methods
Fourty patients (40) with symptomatic heart failure (II-III NYHA class), persistent/paroxysmal AF and reduced left ventricular ejection fraction (LVEF ≤ 40%) were included. The average age was 60 ± 6 years. MeanLA-volume was 120± 22 ml and NT-proBNP level was 1336 ± 278pg/ml.A 6-MWT was 246 ± 33 m. All patients were implanted with a CCM Optimizer according to the protocol of implantation without an atrial lead. The study compared the mean state changes from baseline to 6 months’ follow-up.

Results
In 6 months’ follow-up we observed a significant improvement in functional and symptomatic parameters. NT-proBNP level was 1021 ± 153 pg/ml and mean 6 MWT values were 300 ± 26 m. NYHA improved by at least 1 functional class. MeanLA-volume after 6 months of follow-up was 104,5± 18 ml.

Conclusions
CCM is an effective and safe technology for patients with symptomatic HF. It significantly improves functional parameters, including a 6-minute walk test and NYHA functional class. CCM may prevent HF progression and may influence the outcome.
P963Recurrence of atrial fibrillation after cryoballoon pulmonary vein isolation in overweight and obese patients - does weight matter?
Authors: Weinmann K , Gillmeister S , Aktolga D , Bothner C , Rattka M , Rottbauer W , Dahme T , Pott A 
Published: June 2020

Abstract

Funding Acknowledgements
Karolina Weinmann was supported by the Hertha-Nathorff fellowship from Ulm University
Background - Obesity is a known risk factor for the incidence and persistence of atrial fibrillation. Many interventional studies proved losing weight correlates with less atrial fibrillation (AF) burden.
Purpose – We investigated the influence of overweight and obesity on baseline characteristics, procedural values and outcome after cryoballoon pulmonary vein isolation (cryoballoon PVI).
Methods – We investigated 575 patients undergoing cryoballoon PVI at our Medical Center. 142 patients were classified as normal with a body mass index (BMI) of 18.5 – 24.9 kg/m², 239 patients presented overweight with a BMI of 25.0 – 29.9 kg/m² and 194 patients were obese with a BMI over 30.0. We compared the baseline characteristics, the procedural and outcome data of these patients.
Results – Comparing baseline characteristics of overweight and obese patients to normal weight patients, obese show the highest portion in hypertension (obese vs. normal: 86.1% vs. 68.3%, p &lt; 0.001), diabetes (26.8% vs. 14.8%, p &lt; 0.05), OSAS (17.0% vs. 2.1%, p &lt; 0.001) and left atrial (LA) diameter (44.6 ± 10.8mm vs. 41.3 ± 12.7mm, p &lt; 0.05). Comparison of procedure duration, fluoroscopy time and area dose product (Gy*cm²), only the area dose product shows a significantly higher value in the overweight and obese patients (p &lt; 0.001). Moreover, comparing the duration of ablation, time to isolation per pulmonary vein between the three groups, the overweight and obese patients show a significantly longer duration of ablation at the RSPV and the time to isolation is significantly higher at the LSPV.
Mean follow-up period in our cohort is 517.3 ± 461.3 days (1.4 ± 1.3 years). Kaplan-Meier estimation shows no significant difference between freedom from AT/AF recurrence comparing normal weight, overweight and obese patients (Log-rank p = 0.6). After one year follow-up, 70% of normal weight patients show freedom from atrial arrhythmia recurrence and 69% of overweight patients. Obese patients have a fraction of 75% of freedom from AT/AF recurrence after one year. Comparing the two years follow-up values 56% of the normal BMI patients, 54% of the overweight patients and 62% of obese patients are free from arrhythmia recurrence.
Conclusion – Cryoballoon PVI procedure in obese and overweight patients is a feasible treatment, however the radiation exposure is higher compared to normal weight. Evaluating outcomes, no difference in recurrence of AF was detected between normal, overweight and obese patients after cryoballoon PVI.
Low-voltage bridge strategy to guide cryoablation of typical and atypical atrioventricular nodal re-entry tachycardia in children: mid-term outcomes in a large cohort of patients
Authors: Drago Fabrizio , Calvieri Camilla , Russo Mario Salvatore , Remoli Romolo , Pazzano Vincenzo , Battipaglia Irma , Gimigliano Fabrizio , Allegretti Greta , Silvetti Massimo Stefano 
Published: June 2020

Abstract

Aims
In the current literature, results of the low-voltage bridge (LVB) ablation strategy for the definitive treatment of atrioventricular nodal re-entry tachycardia (AVNRT) seem to be encouraging also in children. The aims of this study were (i) to prospectively evaluate the mid-term efficacy of LVB ablation in a very large cohort of children with AVNRT, and (ii) to identify electrophysiological factors associated with recurrence.

Methods and results
One hundred and eighty-four children (42% male, mean age 13 ± 4 years) with AVNRT underwent transcatheter cryoablation guided by voltage mapping of the Koch’s triangle. Acute procedural success was 99.2% in children showing AVNRT inducibility at the electrophysiological study. The overall recurrence rate was 2.7%. The presence of two LVBs, a longer fluoroscopy time and the presence of both typical and atypical AVNRT, were found to be significantly associated with an increased recurrence rate during mid-term follow-up. Conversely, there was no significant association between recurrences and patient’s age, type of LVB, lesion length, number of cryolesions or catheter tip size.

Conclusion
The LVB ablation strategy is very effective in AVNRT treatment in children. Recurrences are related to the complexity of the arrhythmogenic substrate.
The Mechanism of High-Output Cardiac Hypertrophy Arising From Potassium Channel Gain-of-Function in Cantú Syndrome
Authors: McClenaghan Conor , Huang Yan , Matkovich Scot J , Kovacs Attila , Weinheimer Carla J , Perez Ron , Broekelmann Thomas J , Harter Theresa M , Lee Jin-Moo , Remedi Maria S , Nichols Colin G 
Published: June 2020

Abstract
Dramatic cardiomegaly arising from gain-of-function (GoF) mutations in the ATP-sensitive potassium (KATP) channels genes, ABCC9 and KCNJ8, is a characteristic feature of Cantú syndrome (CS). How potassium channel over-activity results in cardiac hypertrophy, as well as the long-term consequences of cardiovascular remodeling in CS, is unknown. Using genome-edited mouse models of CS, we therefore sought to dissect the pathophysiological mechanisms linking KATP channel GoF to cardiac remodeling. We demonstrate that chronic reduction of systemic vascular resistance in CS is accompanied by elevated renin–angiotensin signaling, which drives cardiac enlargement and blood volume expansion. Cardiac enlargement in CS results in elevation of basal cardiac output, which is preserved in aging. However, the cardiac remodeling includes altered gene expression patterns that are associated with pathological hypertrophy and are accompanied by decreased exercise tolerance, suggestive of reduced cardiac reserve. Our results identify a high-output cardiac hypertrophy phenotype in CS which is etiologically and mechanistically distinct from other myocardial hypertrophies, and which exhibits key features of high-output heart failure (HOHF). We propose that CS is a genetically-defined HOHF disorder and that decreased vascular smooth muscle excitability is a novel mechanism for HOHF pathogenesis.
Seismic moment tensors from synthetic rotational and translational ground motion: Green’s functions in 1-D versus 3-D
Authors: Donner S , Mustać M , Hejrani B , Tkalčić H , Igel H 
Published: June 2020

SUMMARY
Seismic moment tensors are an important tool and input variable for many studies in the geosciences. The theory behind the determination of moment tensors is well established. They are routinely and (semi-) automatically calculated on a global scale. However, on regional and local scales, there are still several difficulties hampering the reliable retrieval of the full seismic moment tensor. In an earlier study, we showed that the waveform inversion for seismic moment tensors can benefit significantly when incorporating rotational ground motion in addition to the commonly used translational ground motion. In this study, we test, what is the best processing strategy with respect to the resolvability of the seismic moment tensor components: inverting three-component data with Green’s functions (GFs) based on a 3-D structural model, six-component data with GFs based on a 1-D model, or unleashing the full force of six-component data and GFs based on a 3-D model? As a reference case, we use the inversion based on three-component data and 1-D structure, which has been the most common practice in waveform inversion for moment tensors so far. Building on the same Bayesian approach as in our previous study, we invert synthetic waveforms for two test cases from the Korean Peninsula: one is the 2013 nuclear test of the Democratic People’s Republic of Korea and the other is an Mw  5.4 tectonic event of 2016 in the Republic of Korea using waveform data recorded on stations in Korea, China and Japan. For the Korean Peninsula, a very detailed 3-D velocity model is available. We show that for the tectonic event both, the 3-D structural model and the rotational ground motion, contribute strongly to the improved resolution of the seismic moment tensor. The higher the frequencies used for inversion, the higher is the influence of rotational ground motions. This is an important effect to consider when inverting waveforms from smaller magnitude events. The explosive source benefits more from the 3-D structural model than from the rotational ground motion. Nevertheless, the rotational ground motion can help to better constraint the isotropic part of the source in the higher frequency range.
Construction and Preclinical Evaluation of 211At Labeled Anti-mesothelin Antibodies as Potential Targeted Alpha Therapy Drugs
Authors: Wang Xudong , Ma Wenzong , Liu Weihao , Ma Huan , Yang Yuanyou , Wang Yugang , Liu Ning , Yang Gen 
Published: June 2020

ABSTRACT
Targeted alpha therapy (TAT) is a promising tumor therapy that can specifically transport α particle to the vicinity of tumor cells while the normal cells are only slightly irradiated. Mesothelin is a highly promising molecular signature for many types of solid tumors including malignant mesothelioma, pancreatic cancer, ovarian cancer and lung adenocarcinoma etc., while the expression in normal human tissues are limited, thus making mesothelin a promising antigen for TAT. Previously we developed a theoretical model that could predict and optimize in vitro screening of potential TAT drugs. The aim of the study is construction and preclinical evaluation of 211At labeled anti-mesothelin antibodies as potential TAT drugs. Mesothelin expression of two tumor cell lines were confirmed by flow cytometry, and their radiosensitivities were also evaluated. We used two kinds of anti-mesothelin antibodies, ET210–6 and ET210–28, to construct TAT drugs. Then, radiochemical purity, stability in vitro, affinity of the conjugates and mesothelin expression level were assessed. The specific killing of mesothelin-positive cancer cells treated by 211At-ET210–28 and 211At-ET210–6 were studied via Cell Counting Kit-8 assay and colony formation assay. 211At-ET210–28 and 211At-ET210–6 revealed excellent affinity and stability in both phosphate buffer saline and fetal bovine serum environment. Radiolabeled antibody conjugates bound specifically to mesothelin-positive cells in vitro. Both 211At-ET210–28 and 211At-ET210–6 could specifically kill mesothelin-positive cells with negligible damages to mesothelin-negative cells. Our findings provide initial proof-of-concept for the potential use of 211At labeled ET210–28/ET210–6 anti-mesothelin antibody in specific killings of mesothelin-positive tumor cells.
Surface dynamics, equilibrium points and individual lobes of the Kuiper Belt object (486958) Arrokoth
Authors: Amarante A , Winter O C 
Published: June 2020

ABSTRACTThe New Horizons space probe led the first close flyby of one of the most primordial and distant objects left over from the formation of the Solar system, the contact binary Kuiper Belt object (486958) Arrokoth. This is composed of two progenitors, the lobes called Ultima and Thule. In the current work, we investigate Arrokoth’s surface in detail to identify the location of equilibrium points and also we explore each lobe’s individual dynamic features. We assume that Arrokoth’s irregular shape is a homogeneous polyhedra contact binary. We explore its dynamic characteristics numerically by computing its irregular binary geopotential in order to study its quantities, such as geometric height, oblateness, ellipticity and zero-power curves. The stability of Arrokoth Hill was also explored through zero-velocity curves. Arrokoth’s external equilibrium points have no radial symmetry due to its highly irregular shape. We identified even equilibrium points concerning its shape and spin rate: i.e. four unstable external equilibrium points and three inner equilibrium points, where two points are linearly stable, with an unstable central point that has a slight offset from its centroid. Moreover, the large and small lobes each have five equilibrium points with different topological structures from those found in Arrokoth. Our results also indicate that the equatorial region of Arrokoth’s lobes is an unstable area due to the high rotation period, while its polar locations are stable resting sites for surface particles. Finally, the zero-power curves indicate the locations around Arrokoth where massless particles experience enhancing and receding orbital energy.
Optical and X-ray study of the peculiar high-mass X-ray binary XMMU J010331.7−730144
Authors: Monageng I M , Coe M J , Buckley D A H , McBride V A , Kennea J A , Udalski A , Evans P A , Clark J S , Negueruela I 
Published: June 2020

ABSTRACT
For a long time XMMU J010331.7−730144 was proposed as a high-mass X-ray binary candidate based on its X-ray properties, however, its optical behaviour was unclear – in particular previous observations did not reveal key Balmer emission lines. In this paper, we report on optical and X-ray variability of the system. XMMU J010331.7–730144 has been monitored with the Optical Gravitational Lensing Experiment (OGLE) in the I and V bands for the past 9 yr where it has shown extremely large amplitude outbursts separated by long periods of low-level flux. During its most recent optical outburst we obtained spectra with the Southern African Large Telescope (SALT) where, for the first time, the H α line is seen in emission, confirming the Be nature of the optical companion. The OGLE colour–magnitude diagrams also exhibit a distinct loop that is explained by changes in mass-loss from the Be star and mass outflow in its disc. In the X-rays, XMMU J010331.7−730144 has been monitored by the Neil Gehrels Swift Observatory through the S-CUBED programme. The X-ray flux throughout the monitoring campaign shows relatively low values for a typical Be/X-ray binary system. We show, from the analysis of the optical data, that the variability is due to the Be disc density and opacity changing rather than its physical extent as a result of efficient truncation by the NS. The relatively low X-ray flux can then be explained by the neutron star normally accreting matter at a low rate due to the small radial extent of the Be disc.