Heart Rhythm O2最新文献

{"title":"A deep learning modular ECG approach for cardiologist assisted adjudication of atrial fibrillation and atrial flutter episodes","authors":"Quentin Fleury MSc ,&nbsp;Rémi Dubois PhD ,&nbsp;Sylvain Christophle-Boulard MSc ,&nbsp;Fabrice Extramiana MD, PhD ,&nbsp;Pierre Maison-Blanche MD","doi":"10.1016/j.hroo.2024.09.007","DOIUrl":"10.1016/j.hroo.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Detection of atrial tachyarrhythmias (ATA) on long-term electrocardiogram (ECG) recordings is a prerequisite to reduce ATA-related adverse events. However, the burden of editing massive ECG data is not sustainable. Deep learning (DL) algorithms provide improved performances on resting ECG databases. However, results on long-term Holter recordings are scarce.</div></div><div><h3>Objective</h3><div>We aimed to build and evaluate a DL modular software using ECG features well known to cardiologists with a user interface that allows cardiologists to adjudicate the results and drive a second DL analysis.</div></div><div><h3>Methods</h3><div>Using a large (n = 187 recordings, 249,419 one-minute samples), beat-to-beat annotated, two-lead Holter database, we built a DL algorithm with a modular structure mimicking expert physician ECG interpretation to classify atrial rhythms. The DL network includes 3 modules (cardiac rhythm regularity, electrical atrial waveform, and raw voltage by time data) followed by a decision network and a long-term weighting factor. The algorithm was validated on an external database.</div></div><div><h3>Results</h3><div>F1 scores of our classifier were 99% for ATA detection, 95% for atrial fibrillation, and 90% for atrial flutter. Using the external Massachusetts Institute of Technology database, the classifier obtains an F1-score of 97% for the normal sinus rhythm class and 96% for the ATA class. Residual errors could be corrected by manual deactivation of 1 module in 7 of 15 of the recordings, with an accuracy &lt; 90%.</div></div><div><h3>Conclusion</h3><div>A DL modular software using ECG features well known to cardiologists provided an excellent overall performance. Clinically significant residual errors were most often related to the classification of the atrial arrhythmia type (fibrillation vs flutter). The modular structure of the algorithm helped to edit and correct the artificial intelligence–based first-pass analysis and will provide a basis for explainability.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 862-872"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial fibrillation catheter ablation decreases the duration of antiarrhythmic drug treatment for United States active-duty military personnel","authors":"Andrea N. Keithler DO,&nbsp;Matthew A. Tunzi DO,&nbsp;Andrew S. Wilson DO,&nbsp;Kelvin N.V. Bush MD","doi":"10.1016/j.hroo.2024.10.002","DOIUrl":"10.1016/j.hroo.2024.10.002","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 960-963"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventricular tachycardia ablation across age groups: Outcomes, trends and demographics. Insights from the National Inpatient Sample Database","authors":"Ramez Morcos MD, MBA ,&nbsp;Saad Malik MD ,&nbsp;Peter Hanna MD, PhD ,&nbsp;Amr Barakat MD ,&nbsp;Haider Al Taii MD ,&nbsp;Luigi Di Biase MD, PhD ,&nbsp;Jeff Winterfield MD ,&nbsp;Pugazhendhi Vijayaraman MD, FHRS ,&nbsp;Parash Pokharel MD","doi":"10.1016/j.hroo.2024.09.014","DOIUrl":"10.1016/j.hroo.2024.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Ventricular tachycardia ablation (VTA) is an important treatment option for ventricular tachycardia, with increasing use across all age groups. However, age-related differences in outcomes remain a concern.</div></div><div><h3>Objective</h3><div>This study aimed to investigate age-related trends in VTA procedures and their associated adverse events across the United States from 2011 to 2021. The primary objective was to analyze VTA outcomes across different age groups. Secondary objectives included examining variation in VTA rate by sex and geographic region.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of the National Inpatient Sample, focusing on adult patients (≥18 years of age) hospitalized with a primary diagnosis of ventricular tachycardia. Patients were divided into 3 age groups: ≤59, 60 to 79, and ≥80 years. We evaluated VTA frequency, in-hospital mortality, and complications using propensity score matching to control for confounders. Secondary analyses examined sex and geographic differences.</div></div><div><h3>Results</h3><div>The study included 95,913 VTA procedures. The mean age of patients undergoing VTA increased over time, with a growing proportion of procedures performed in older patients. While overall adverse events did not significantly differ across age groups, specific outcomes such as mortality and hemorrhage were significantly higher in patients ≥80 years of age. In-hospital mortality was highest in the ≥80 years age group (5.1%), compared with 1.6% in the ≤59 years age group and 2.7% in the 60 to 79 years age group. Significant differences by sex and region were also observed.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that while the overall incidence of adverse events with VTA did not significantly increase with age, specific severe outcomes, such as in-hospital mortality and hemorrhage, were more prevalent in older patients. These findings suggest that VTA can be safely performed across age groups, but careful consideration is essential for elderly patients. Future research should focus on understanding the impact of age-related physiological changes and comorbidities on VTA outcomes.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 900-909"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction: Cardiorhythm-Virtual 2024","authors":"Muzahir H. Tayebjee MD ,&nbsp;Hani Assaad MD ,&nbsp;Mervat Aboulmaaty MD","doi":"10.1016/j.hroo.2024.10.019","DOIUrl":"10.1016/j.hroo.2024.10.019","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Page S1"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VO-02 ACCURACY AND CONFIDENCE OF ELECTROCARDIOGRAM INTERPRETATION AMONG DOCTORS WORKING AT THE EMERGENCY MEDICINE DEPARTMENT OF A TERTIARY HOSPITAL IN TANZANIA","authors":"Emmanuel Mmbando,&nbsp;Said Kilindimo,&nbsp;Alphonce Simbila,&nbsp;Evelyne Mapunda,&nbsp;Peter Kisenge,&nbsp;Reuben Mutagaywa","doi":"10.1016/j.hroo.2024.10.013","DOIUrl":"10.1016/j.hroo.2024.10.013","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Page S3"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right anterolateral abdominal wall hematoma following a concealed left anterolateral accessory pathway ablation","authors":"Salah H. Alahwany MD, PhD,&nbsp;Munveer Thind MD,&nbsp;Shunsuke Uetake MD, PhD,&nbsp;Bantayehu Sileshi MD,&nbsp;Harikrishna Tandri MD","doi":"10.1016/j.hroo.2024.09.006","DOIUrl":"10.1016/j.hroo.2024.09.006","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 957-959"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty-day unplanned readmissions following hospitalization for atrial fibrillation in a tertiary Syrian center: A real-world observational cohort study","authors":"Ibrahim Antoun PhD ,&nbsp;Alkassem Alkhayer MSc ,&nbsp;Majed Aljabal MBBS ,&nbsp;Yaman Mahfoud MD ,&nbsp;Alamer Alkhayer MD ,&nbsp;Peter Simon MD ,&nbsp;Ahmed Kotb MSc ,&nbsp;Joseph Barker MRCP ,&nbsp;Akash Mavilakandy BSc ,&nbsp;Rita Hani MSc ,&nbsp;Riyaz Somani PhD ,&nbsp;G. André Ng PhD ,&nbsp;Mustafa Zakkar PhD","doi":"10.1016/j.hroo.2024.05.010","DOIUrl":"10.1016/j.hroo.2024.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) is the most common arrhythmia worldwide. Data regarding 30-day readmission following index admission for AF in the developing world are poorly described.</div></div><div><h3>Objectives</h3><div>The study aimed to assess the rate, predictors, and trends of 30-day readmission after index admission for AF in Syria.</div></div><div><h3>Methods</h3><div>We included adult patients who had an index admission with AF to Latakia’s tertiary center between June 2021 and October 2023. Patients were monitored for readmission for 30 days after index discharge. Data were taken from patients’ medical notes.</div></div><div><h3>Results</h3><div>A total of 661 patients were included in the final analysis, of which 282 (43%) were readmitted to hospital within 30 days following index admission. Cardiac causes were the most common cause of readmission in 72% of patients, of which 60% were AF. Readmitted patients had a higher median age (62 years vs 57 years, <em>P =</em> .001), and there were fewer males (58% vs 51%, <em>P =</em> .001). In multivariate analysis, factors that independently increased 30-day readmission risk were older age (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1–1.9), female sex (HR 1.3, 95% CI 1.02–1.4), diabetes mellitus (HR 1.7, 95% CI 1.3–2.3), and congestive heart failure (HR 2.2, 95% CI 1.7–2.9). Most cardiac readmissions happened during the first 15 days (79%).</div></div><div><h3>Conclusion</h3><div>Almost 1 in 2 patients were readmitted within 30 days after an index admission for AF. Female sex, advancing age, diabetes mellitus, and congestive heart failure were independently associated with an increased risk of 30-day readmission.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 854-859"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 HRS perspective on advancing workflows for CIED remote monitoring","authors":"David J. Slotwiner MD, FHRS ,&nbsp;Gerald A. Serwer MD, FHRS ,&nbsp;James D. Allred MD, FHRS ,&nbsp;Deepak Bhakta MD, MBA, FHRS, CCDS ,&nbsp;Richard Clark FHRS, CCDS ,&nbsp;Julien Durand ,&nbsp;Martha G. Ferrara DNP, FNP, FHRS, CCDS ,&nbsp;Jason Hale ,&nbsp;Chris Irving ,&nbsp;Andy Iverson MSc ,&nbsp;Maobing Jin ,&nbsp;Jens B. Johansen MD, PhD ,&nbsp;Matthew Kalscheur MD ,&nbsp;Dennis Krisjnen ,&nbsp;Robert Lerman MD ,&nbsp;Neal Lippman MD, FHRS ,&nbsp;G. Stuart Mendenhall MD ,&nbsp;Ryan Michael ,&nbsp;Steven Nichols ,&nbsp;Ratika Parkash MD, MS, FHRS ,&nbsp;Manish Wadhwa MD","doi":"10.1016/j.hroo.2024.09.012","DOIUrl":"10.1016/j.hroo.2024.09.012","url":null,"abstract":"<div><div>Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature. This effort has harmonized terminology, aligning diverse terms with single terms approved by the Institute of Electrical and Electronics Engineers. With this foundational work complete, attention now turns to developing technical standards for interoperability, which would enable the smooth communication of CIED data between information technology systems used in clinical practice. In this article, by leveraging Health Level 7 Fast Healthcare Interoperability Resources, we present a road map for the technical committee to guide this endeavor. We identify critical data exchange points between remote transceivers, electronic health records, and third-party platforms commonly used for CIED patient data management. Our objective is to establish bidirectional communication among these resources, ensuring the accuracy, timeliness, and accessibility of clinical data for clinicians. We also anticipate substantial benefits for both clinical research and administrative efficiency through the implementation of this interoperability framework.</div></div>","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Pages 845-853"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VO-04 ATRIAL FIBRILLATION IS ASSOCIATED WITH COGNITIVE IMPAIRMENT AMONG PATIENTS WITH RHEUMATIC HEART DISEASE ATTENDED AT JAKAYA KIKWETE CARDIAC INSTITUTE, DAR ES SALAAM, TANZANIA","authors":"Reuben Mutagaywa,&nbsp;Moses Mlawa,&nbsp;Henry Mayala,&nbsp;Peter Kisenge","doi":"10.1016/j.hroo.2024.10.015","DOIUrl":"10.1016/j.hroo.2024.10.015","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Page S4"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143179715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presenting the abstracts from Cardiorhythm-Virtual 2024","authors":"Jeanne E. Poole MD, FHRS","doi":"10.1016/j.hroo.2024.10.010","DOIUrl":"10.1016/j.hroo.2024.10.010","url":null,"abstract":"","PeriodicalId":29772,"journal":{"name":"Heart Rhythm O2","volume":"5 12","pages":"Page S2"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}