ORCID Profile
0000-0001-6610-3473
Current Organisations
Institutet för rymdfysik
,
University of Adelaide
,
SA Health
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Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JELECTROCARD.2022.05.008
Abstract: Little data exists on electrogram sensing in current generation of miniaturized insertable cardiac monitors (ICMs). To compare the sensing capability of ICM with different vector length: Medtronic Reveal LINQ (~40 mm) vs. Biotronik Biomonitor III (BM-III, ~70 mm). De-identified remote monitoring transmissions from n = 40 patients with BM-III were compared with n = 80 gender and body mass index (BMI)-matched patients with Reveal LINQ. Digital measurement of P- and R-wave litude from calibrated ICM electrograms was undertaken by 3 investigators independently. Further, we evaluated the impact of BMI and gender on P-wave visibility. Patients in both groups were well matched for gender and BMI (53% male, mean BMI 26.7 kg/m2, both p = NS). Median P- and R-wave litude were 97% & 56% larger in the BM-III vs. LINQ [0.065 (IQR 0.039-0.10) vs. 0.033 (IQR 0.022-0.050) mV, p < .0001 & 0.78 (IQR 0.52-1.10) vs. 0.50 (IQR 0.41-0.89) mV, p = .012 respectively). The P/R-wave ratio was 36% greater with the BM-III (p < .001). The 25th percentile of P-wave litude for all 120 patients was .026 mV. Logistic regression analysis showed BM-III was more likely than LINQ to have P-wave litude ≥.026 mV (OR 7.47, 95%CI 1.965-29.42, p = .003), and increasing BMI was negatively associated with P-wave litude ≥.026 mV (OR 0.84, 95%CI 0.75-0.95, p = .004). However, gender was not significantly associated with P-wave litude ≥.026 mV (p = .37). The longer ICM sensing vector of BM-III yielded larger overall P- and R- wave litude than LINQ. Both longer sensing vector and lower BMI were independently associated with greater P-wave visibility.
Publisher: American Geophysical Union (AGU)
Date: 31-07-2023
DOI: 10.1029/2023SW003540
Abstract: Despite the growing importance of planetary Space Weather forecasting and radiation protection for science and robotic exploration and the need for accurate Space Weather monitoring and predictions, only a limited number of spacecraft have dedicated instrumentation for this purpose. However, every spacecraft (planetary or astronomical) has hundreds of housekeeping sensors distributed across the spacecraft, some of which can be useful to detect radiation hazards produced by solar particle events. In particular, energetic particles that impact detectors and subsystems on a spacecraft can be identified by certain housekeeping sensors, such as the Error Detection and Correction (EDAC) memory counters, and their effects can be assessed. These counters typically have a sudden large increase in a short time in their error counts that generally match the arrival of energetic particles to the spacecraft. We investigate these engineering datasets for scientific purposes and perform a feasibility study of solar energetic particle event detections using EDAC counters from seven European Space Agency Solar System missions: Venus Express, Mars Express, ExoMars‐Trace Gas Orbiter, Rosetta, BepiColombo, Solar Orbiter, and Gaia. Six cases studies, in which the same event was observed by different missions at different locations in the inner Solar System are analyzed. The results of this study show how engineering sensors, for ex le, EDAC counters, can be used to infer information about the solar particle environment at each spacecraft location. Therefore, we demonstrate the potential of the various EDAC to provide a network of solar particle detections at locations where no scientific observations of this kind are available.
Publisher: American Physiological Society
Date: 15-09-2012
DOI: 10.1152/JAPPLPHYSIOL.00361.2012
Abstract: The purpose of this study was to use paired-pulse transcranial magnetic stimulation (TMS) to examine the effect of eccentric exercise on short-interval intracortical inhibition (SICI) after damage to elbow flexor muscles. Nine young (22.5 ± 0.6 yr mean ± SD) male subjects performed maximal eccentric exercise of the elbow flexor muscles until maximal voluntary contraction (MVC) force was reduced by ∼40%. TMS was performed before, 2 h after, and 2 days after exercise under Rest and Active (5% MVC) conditions with motor-evoked potentials (MEPs) recorded from the biceps brachii (BB) muscle. Peripheral electrical stimulation of the brachial plexus was used to assess maximal M-waves, and paired-pulse TMS with a 3-ms interstimulus interval was used to assess changes in SICI at each time point. The eccentric exercise resulted in a 34% decline in strength ( P 0.001), a 41% decline in resting M-wave ( P = 0.01), changes in resting elbow joint angle (10°, P 0.001), and a shift in the optimal elbow joint angle for force production (18°, P 0.05) 2 h after exercise. This was accompanied by impaired muscle strength (27%, P 0.001) and increased muscle soreness ( P 0.001) 2 days after exercise, which is indicative of muscle damage. When the test MEP litudes were matched between sessions, we found that SICI was reduced by 27% in resting and 23% in active BB muscle 2 h after exercise. SICI recovered 2 days after exercise when muscle pain and soreness were present, suggesting that delayed onset muscle soreness from eccentric exercise does not influence SICI. The change in SICI observed 2 h after exercise suggests that eccentric muscle damage has widespread effects throughout the motor system that likely includes changes in motor cortex.
Publisher: Springer Science and Business Media LLC
Date: 04-05-2022
DOI: 10.1186/S12872-022-02633-6
Abstract: Atrial fibrillation (AF) is the most common cardiac tachyarrhythmia and has a rising global prevalence. Given the increasing burden of AF-related symptoms and complications, new approaches to management are required. Anemia and iron deficiency are common conditions in patients with AF. Furthermore, emerging evidence suggests that the presence of anemia may be associated with worse outcome in these patients. The role of anemia and iron deficiency has been extensively explored in other cardiovascular states, such as heart failure and ischemic heart disease. In particular, the role of iron repletion amongst patients with heart failure is now an established treatment modality. However, despite the strong bidirectional inter-relationship between AF and heart failure, the implications of anemia and iron-deficiency in AF have been scarcely studied. This area is of mechanistic and clinical relevance given the potential that treatment of these conditions may improve symptoms and prognosis in the increasing number of in iduals with AF. In this review, we summarise the current published literature on anemia and iron deficiency in patients with AF. We discuss AF complications such as stroke, bleeding, and heart failure, in addition to AF-related symptoms such as exercise intolerance, and the potential impact of anemia and iron deficiency on these. Finally, we summarize current research gaps on anemia, iron deficiency, and AF, and underscore potential research directions.
Publisher: Wiley
Date: 02-02-2021
DOI: 10.1111/JCE.14898
Publisher: Elsevier BV
Date: 04-2022
Publisher: Elsevier BV
Date: 04-2021
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.HRTHM.2021.09.040
Abstract: Although previous studies have demonstrated a U-shaped relationship between alcohol and sudden cardiac death (SCD), there is a paucity of evidence on the role of alcohol specifically on incident ventricular arrhythmias (VAs). The purpose of this study was to characterize associations of total and beverage-specific alcohol consumption with incident VA and SCD using data from the UK Biobank. Alcohol consumption reported at baseline was calculated as UK standard drinks (8 g of alcohol) per week. Outcomes were assessed through hospitalization and death records. Alcohol consumption was modeled as restricted cubic splines in multivariate Cox regression models and corrected for regression dilution bias. We studied 408,712 middle-aged in iduals (52.1% female) over a median follow-up time of 11.5 years. A total of 1733 incident VA events and 2044 SCDs occurred. For incident VA, no clear association was seen with total alcohol consumption. Although consumption of greater amounts of spirits was associated with increased VA risk, no other significant beverage-specific associations were observed. For SCD, a U-shaped association was seen for total alcohol consumption, such that consumption of <26 drinks per week was associated with lowest risk. Consumption of greater amounts of beer, cider, and spirits was potentially associated with increasing SCD risk, whereas increasing red and white wine intake was associated with reduced risk. In this predominantly white cohort, no association of total alcohol consumption was observed with VA, whereas a U-shaped association was present for SCD. Additional studies utilizing accurately defined VA and SCD events are required to provide further insights into these contrasting findings.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.HLC.2022.10.005
Abstract: Most modern cardiac implantable electronic device (CIED) systems are now compatible with magnetic resonance imaging (MRI) scans. The requirement for both pre- and post-MRI CIED checks imposes significant workload to the cardiac electrophysiology service. Here, we sought to determine the burden of CIED checks associated with MRI scans. We identified all CIED checks performed peri-MRI scans at our institution over a 3-year period between 1 July 2017 to 30 June 2020, comprising three separate financial years (FY). Device check reports, MRI scan reports and clinical summaries were collated. The workload burden was determined by assessing the occasions and duration of service. Analysis was performed to determine cost burden rojections for this service and identify factors contributing to the workload. A total of 739 CIED checks were performed in the peri-MRI scan setting (370 pre- and 369 post-MRI scan), including 5% (n=39) that were performed outside of routine hours (weekday 5 pm, and weekends). MRIs were performed for 295 patients (75±13 years old, 64% male) with a CIED (88% permanent pacemaker, and 12% high voltage device), including 49 who had more than one MRI scan. The proportion of total MRI scans for patients with a CIED in-situ increased each FY (from 0.5% of all MRIs in FY1, to 0.9% in FY2, to 1.0% in FY3). The weekly workload increased (R There is an increasing workload burden and expense associated with CIED checks in the peri-MRI setting. Appropriate budgeting, staff allocation and standardisation of automated CIED pre-programming features among manufacturers are urgently needed.
Publisher: Elsevier BV
Date: 10-2022
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.JACEP.2021.05.013
Abstract: This study sought to characterize associations of total and beverage-specific alcohol consumption with incident atrial fibrillation (AF). Although binge drinking and moderate to high consumption of alcohol are both established risk factors for AF, comparatively less is known about the effect of low alcohol consumption and whether associations differ by specific alcoholic beverages. Using data from the UK Biobank, total and beverage-specific alcohol consumption was calculated as UK standard drinks (8 g alcohol) per week. Past drinkers and those with a history of AF were excluded. Incident AF events were assessed through hospitalization and death records, and dose-response associations were characterized using Cox regression models with correction for regression dilution bias. We studied 403,281 middle-aged in iduals (52.4% female). Over a median follow-up time of 11.4 years (IQR: 10.7-12.3 years), a total of 21,312 incident AF events occurred. A J-shaped association of total alcohol consumption was observed, with lowest risk of AF with fewer than 7 drinks/week. Beverage-specific analyses demonstrated harmful associations of beer/cider consumption with any consumption. In contrast, consumption of red wine, white wine, and spirits up to 10, 8, and 3 drinks/week, respectively, was not associated with increased risk. In this predominantly White population, low levels of alcohol consumption (<7 U.K. standard drinks [56 g alcohol]/week) were associated with lowest AF risk. Low consumption of red and white wine and very low consumption of spirits may not be associated with increased AF risk, whereas any consumption of beer/cider may be associated with harm. These findings may have important implications for the primary prevention of AF that should be explored in future studies.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Oxford University Press (OUP)
Date: 30-01-2020
Abstract: There is growing evidence that magnetic resonance imaging (MRI) scanning in patients with non-conditional cardiac implantable electronic devices (CIEDs) can be performed safely. Here, we aim to assess the safety of MRI in patients with non-conditional CIEDs. English scientific literature was searched using PubMed/Embase/CINAHL with keywords of ‘magnetic resonance imaging’, ‘pacemaker’, ‘implantable defibrillator’, and ‘cardiac resynchronization therapy’. Studies assessing outcomes of adverse events or significant changes in CIED parameters after MRI scanning in patients with non-conditional CIEDs were included. References were excluded if the MRI conditionality of the CIEDs was undisclosed number of patients enrolled was & or studies were case reports/series. 35 cohort studies with a total of 5625 patients and 7196 MRI scans (0.5–3 T) in non-conditional CIEDs were included. The overall incidence of lead failure, electrical reset, arrhythmia, inappropriate pacing and symptoms related to pocket heating, or torque ranged between 0% and 1.43%. Increase in pacing lead threshold & .5 V and impedance & Ω was seen in 1.1% [95% confidence interval (CI) 0.7–1.8%] and 4.8% (95% CI 3.3–6.4%) respectively. The incidence of reduction in P- and R-wave sensing by & % was 1.5% (95% CI 0.6–2.9%) and 0.4% (95% CI 0.06–1.1%), respectively. Battery voltage reduction of & .04 V was reported in 2.2% (95% CI 0.2–6.1%). This meta-analysis affirms the safety of MR imaging in non-conditional CIEDs with no death or implantable cardioverter-defibrillator shocks and extremely low incidence of lead or device-related complications.
Publisher: Elsevier BV
Date: 06-2021
Publisher: Research Square Platform LLC
Date: 12-11-2020
DOI: 10.21203/RS.3.RS-28096/V3
Abstract: Background: Clinical trials and laboratory studies from around the world have shown that GC Tooth Mousse Plus® (TMP) is effective in protecting teeth from tooth decay and erosion, buffering dental plaque pH, remineralising white spot lesions and reducing dentine hypersensitivity. However, no other study has assessed the experiences of oral health, before, during and after in iduals becoming regular users of TMP. Aim: To identify how participants’ oral health status changed after introducing TMP into their oral hygiene routine.Methods: A qualitative study using Charmaz’s grounded theory methodology was conducted. Fifteen purposively s led regular users of TMP were interviewed. Transcripts were analysed after each interview. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation.Results: Participants described their experiences of oral health and disease, before, during and after introducing TMP into their daily oral hygiene routine, together with the historical, biological, financial, psychosocial, and habitual dimensions of their experiences. Before becoming a regular user of TMP, participants described themselves as having a damaged mouth with vulnerable teeth, dry mouth, and sensitivity. Various aspects of participants’ histories were relevant, such as, family history and history of oral disease. Having a damaged mouth with vulnerable teeth, dry mouth and sensitivity was explained by those elements. Despite some initial barriers, once being prescribed TMP by a dental professional, a three-fold process of change was initiated: starting a new oral hygiene routine, persevering daily, and experiencing reinforcing outcomes. This process led to a fundamental lifestyle change. Participants transitioned from having a damaged mouth with vulnerable teeth to having a comfortable mouth with strong teeth at the same time participants felt empowered by this newly found status of being able to keep their teeth for life. Barriers and facilitators for incorporating TMP on daily oral hygiene routine were also identified.Conclusions: Participants valued having a comfortable mouth with strong teeth, which did not require repeated restorations. Seeing concrete results in their mouths and experiencing a more comfortable mouth boosted adherence to daily applications of TMP, which was maintained over time.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 05-2021
Publisher: JMIR Publications Inc.
Date: 19-05-2021
DOI: 10.2196/24470
Abstract: Atrial fibrillation (AF) screening using mobile single-lead electrocardiogram (ECG) devices has demonstrated variable sensitivity and specificity. However, limited data exists on the use of such devices in low-resource countries. The goal of the research was to evaluate the utility of the KardiaMobile device’s (AliveCor Inc) automated algorithm for AF screening in a semirural Ethiopian population. Analysis was performed on 30-second single-lead ECG tracings obtained using the KardiaMobile device from 1500 TEFF-AF (The Heart of Ethiopia: Focus on Atrial Fibrillation) study participants. We evaluated the performance of the KardiaMobile automated algorithm against cardiologists’ interpretations of 30-second single-lead ECG for AF screening. A total of 1709 single-lead ECG tracings (including repeat tracing on 209 occasions) were analyzed from 1500 Ethiopians (63.53% [953/1500] male, mean age 35 [SD 13] years) who presented for AF screening. Initial successful rhythm decision (normal or possible AF) with one single-lead ECG tracing was lower with the KardiaMobile automated algorithm versus manual verification by cardiologists (1176/1500, 78.40%, vs 1455/1500, 97.00% P .001). Repeat single-lead ECG tracings in 209 in iduals improved overall rhythm decision, but the KardiaMobile automated algorithm remained inferior (1301/1500, 86.73%, vs 1479/1500, 98.60% P .001). The key reasons underlying unsuccessful KardiaMobile automated rhythm determination include poor quality/noisy tracings (214/408, 52.45%), frequent ectopy (22/408, 5.39%), and tachycardia ( bpm 167/408, 40.93%). The sensitivity and specificity of rhythm decision using KardiaMobile automated algorithm were 80.27% (1168/1455) and 82.22% (37/45), respectively. The performance of the KardiaMobile automated algorithm was suboptimal when used for AF screening. However, the KardiaMobile single-lead ECG device remains an excellent AF screening tool with appropriate clinician input and repeat tracing. Australian New Zealand Clinical Trials Registry ACTRN12619001107112 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378057& isReview=true
Publisher: Elsevier BV
Date: 08-2020
DOI: 10.1016/J.HLC.2019.11.006
Abstract: Studies have shown that suboptimal anticoagulation quality, as measured by time in therapeutic range (TTR), affects a significant percentage of patients with atrial fibrillation (AF). However, TTR has not been previously characterised in Indigenous Australians who experience a greater burden of AF and stroke. Indigenous and non-Indigenous Australians with AF on warfarin anticoagulation therapy were identified from a large tertiary referral centre between 1999 and 2012. Time in therapeutic range was calculated as a proportion of daily international normalised ratio (INR) values between 2 and 3 for non-valvular AF and 2.5 to 3.5 for valvular AF. INR values between tests were imputed using the Rosendaal technique. Linear regression models were employed to characterise predictors of TTR. Five hundred and twelve (512) patients with AF on warfarin were included (88 Indigenous and 424 non-Indigenous). Despite younger age (51±13 vs 71±12 years, p<0.001), Indigenous Australians had greater valvular heart disease, diabetes, and alcohol excess compared to non-Indigenous Australians (p<0.05 for all). Time in therapeutic range was significantly lower in Indigenous compared to non-Indigenous Australians (40±29 vs 50±31%, p=0.006). Univariate predictors of poorer TTR included Indigenous ethnicity, younger age, diuretic use, and comorbidities, such as valvular heart disease, heart failure and chronic obstructive pulmonary disease (p<0.05 for all). Valvular heart disease remained a significant predictor of poorer TTR in multivariate analyses (p=0.004). Indigenous Australians experience particularly poor warfarin anticoagulation quality. Our data also suggest that many non-Indigenous Australians spend suboptimal time in therapeutic range. These findings reinforce the importance of monitoring warfarin anticoagulation quality to minimise stroke risk.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Copernicus GmbH
Date: 23-09-2022
Abstract: & & & strong& Mars Express& /strong& & & & & With almost two decades of Mars observation behind it, Mars Express remains a dependable and highly productive mission.& & & & Recent science highlights include (1) continued mapping of subsurface reflectors beneath the south polar layered ice deposits, and associated work to explain the cause of these reflections (2) a global map of minerals on Mars with 200 m x resolution, obtained from analysis of infrared spectra (3) release of 50 m resolution Digital Elevation Models based on HRSC stereo topography for quadrangles covering an ever-increasing proportion of the global surface (4) detailed characterization of the landing sites of the ESA, NASA and Chinese rovers (5) a global climatology of ozone and water from both nadir and occultation observations and its relation to atmospheric dust (6) transient atmospheric phenomena, such as a recurrent orographic cloud feature at Arsia Mons (7) detailed investigation of the ionospheric structure, its variability, and coupling to the lower atmosphere (8) continued monitoring of both the upstream solar wind conditions and of downstream escaping ions (9) detailed study of Phobos during flybys at altitudes as low as 50 km.& & & & Spacecraft and instrument teams continue to implement new and improved observation modes. One ex le is new MARSIS instrument software which now allows raw data to be returned from much longer subsurface sounding passes, improving the search for basal reflectors beneath polar ice caps another ex le is mutual radio occultation observations between Mars Express and ExoMars Trace Gas Orbiter, potentially providing vertical profiles of ionospheric electron content with good spatial and temporal coverage.& & & & & & & & & & strong& ExoMars Trace Gas Orbiter& /strong& & & & & & TGO has now completed two full Martian years of observations.& & & & Highlights include (1) continuing non-detection of methane, with upper limits as low as 20 ppt by volume. Reconciling this continued non-detection by TGO with the background levels of several hundred ppt in Gale crater by MSL remains an enigma, stimulating further research. (2) detection of HCl, the first reported halogen-containing species in the atmosphere of Mars. (3) further detail of the transport of water to high altitudes, a critical step in the escape of water from Mars. (4) mapping of atomic hydrogen in the top 1-2 m of regolith, indicative of water ice and hydrated minerals, suggesting surprisingly high abundances of subsurface water ice in low latitude regions including one in central Valles Marineris and (5) continued acquisition of 5 m colour imagery and digital elevation models over a wide range of terrain and target types, including landing site characterization.& & & & & & & & & & strong& Future plans:& /strong& Mission extension cases for both missions have been submitted for the years 2023-2025 and 2026-2028. The extension of the observations would allow several new and optimized observation types in particular, it will allow many collaborative observation opportunities with other missions and with ground- and space-based observatories. Of particular note are joint observations with James Webb Space Telescope, for which dedicated observations of Mars are due to be conducted in 2022-2023. Science goals include mapping of the water D/H ratio, search for trace gases including methane, and mapping of thermospheric structure using 4.3 & #956 m CO2 emission the full-disk views provided by JWST are highly complementary to the vertical profiling and long temporal coverage provided by MEx and TGO.& & & & & strong& & & /strong& & &
Publisher: Wiley
Date: 18-01-2021
DOI: 10.1111/PACE.14161
Abstract: To characterize contemporary pacemaker procedure trends. Nationwide analysis of pacemaker procedures and costs between 2008 and 2017 in Australia. The main outcome measures were total, age- and gender-specific implant, replacement, and complication rates, and costs. Pacemaker implants increased from 12,153 to 17,862. Implantation rates rose from 55.3 to 72.6 per 100,000, a 2.8% annual increase (incidence rate ratio [IRR] 1.028 95% CI, 1.02-1.04 p < .001). Pacemaker implants in the 80+ age group were 17.37-times higher than the < 50 group (95% CI 16.24-18.59 p < .001), and in males were 1.48-times higher than in females (95% CI 1.42-1.55 p < .001). However, there were similar increases according to age (p = .10) and gender (p = .68) over the study period. Left ventricular lead rates were stable (IRR 0.995 95% CI 0.98-1.01 p = .53). Generator replacements decreased from 20.5 to 18.3 per 100,000 (IRR 0.975 95% CI 0.97-0.98 p < .001). Although procedures for generator-related complications were stable (IRR 0.995 95% CI 0.98-1.01 p = .54), those for lead-related complications decreased (IRR 0.985 95% CI 0.98-0.99 p < .001). Rates for all pacemaker procedures were consistently greater in males (p < .001). Although annual costs of all pacemaker procedures increased from $178 million to $329 million, inflation-adjusted costs were more stable, rising from $294 million to $329 million. Increasing demand for pacemaker implants is driven by the ageing population and rising rates across all ages, while replacement and complication procedure rates appeared more stable. Males have consistently greater pacemaker procedure rates than females. Our findings have significant clinical and public health implications for healthcare resource planning.
Publisher: BMJ
Date: 02-2017
Publisher: Oxford University Press (OUP)
Date: 11-2020
DOI: 10.1093/EHJCI/EHAA946.0708
Abstract: P-wave visibility is useful for diagnosis of atrial arrhythmias via insertable cardiac monitors (ICM). To compare the sensing capability of ICM with different vector length: Medtronic REVEAL LINQ (45mm) vs. Biotronik Biomonitor BMIII (75mm). We accessed de-identified remote monitoring transmissions from n=40 patients with BMIII from Biotronik for comparison with n=80 gender- and body mass index (BMI)-matched patients with REVEAL LINQ. Digital measurement of calibrated ICM electrograms was performed using DigitizeIt© (V2.3.3, Germany) of 5 consecutive P-QRS complexes by 3 investigators independently. P-wave litude was measured from baseline to peak and R-wave litude was measured from peak-to-peak. Further, we evaluated the impact of BMI on P-wave visibility. Patients in both groups are well matched for gender and BMI (53% male, mean BMI 26.7 kg/m2 both p=NS). P-wave and R-wave litude were 89% & 20% larger in the BMIII vs. LINQ (0.072±0.039 vs. 0.038±0.022mV, p=0.0001 & 0.83±0.42 vs. 0.69±0.45mV, p=0.095 respectively Figure). Consequently, the P/R-wave ratio was 44% greater for the BMIII (p=0.002). Multivariate regression analysis showed that increasing BMI, female gender and LINQ were independently associated with lower P-wave litude (all P& .001). Inter-operator reproducibility of P-wave measures was very good (ICC 0.91, P& .001). The longer ICM sensing vector of BMIII yielded considerable larger P-wave litude than LINQ, that was not impacted by increasing BMI. Better P-wave visibility may improve clinical decision-making after device-detected arrhythmias while further studies are needed to determine its impact on clinical outcomes. P-wave visibility comparison of ICMs Type of funding source: None
Publisher: JMIR Publications Inc.
Date: 21-09-2020
Abstract: trial fibrillation (AF) screening using mobile single-lead electrocardiogram (ECG) devices has demonstrated variable sensitivity and specificity. However, limited data exists on the use of such devices in low-resource countries. he goal of the research was to evaluate the utility of the KardiaMobile device’s (AliveCor Inc) automated algorithm for AF screening in a semirural Ethiopian population. nalysis was performed on 30-second single-lead ECG tracings obtained using the KardiaMobile device from 1500 TEFF-AF (The Heart of Ethiopia: Focus on Atrial Fibrillation) study participants. We evaluated the performance of the KardiaMobile automated algorithm against cardiologists’ interpretations of 30-second single-lead ECG for AF screening. total of 1709 single-lead ECG tracings (including repeat tracing on 209 occasions) were analyzed from 1500 Ethiopians (63.53% [953/1500] male, mean age 35 [SD 13] years) who presented for AF screening. Initial successful rhythm decision (normal or possible AF) with one single-lead ECG tracing was lower with the KardiaMobile automated algorithm versus manual verification by cardiologists (1176/1500, 78.40%, vs 1455/1500, 97.00% i P /i & .001). Repeat single-lead ECG tracings in 209 in iduals improved overall rhythm decision, but the KardiaMobile automated algorithm remained inferior (1301/1500, 86.73%, vs 1479/1500, 98.60% i P /i & .001). The key reasons underlying unsuccessful KardiaMobile automated rhythm determination include poor quality/noisy tracings (214/408, 52.45%), frequent ectopy (22/408, 5.39%), and tachycardia (& bpm 167/408, 40.93%). The sensitivity and specificity of rhythm decision using KardiaMobile automated algorithm were 80.27% (1168/1455) and 82.22% (37/45), respectively. he performance of the KardiaMobile automated algorithm was suboptimal when used for AF screening. However, the KardiaMobile single-lead ECG device remains an excellent AF screening tool with appropriate clinician input and repeat tracing. ustralian New Zealand Clinical Trials Registry ACTRN12619001107112 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378057& isReview=true
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 02-2019
Publisher: Elsevier BV
Date: 08-2022
DOI: 10.1016/J.HLC.2022.03.004
Abstract: Requests from the emergency department (ED) for cardiac implantable electronic device (CIED) checks constitute a large workload for cardiac electrophysiology services. We sought to determine the yield of, and clinical characteristics associated with, clinically relevant (remarkable) issues from ED CIED checks. Consecutive CIED checks from our ED over a 12-month period were studied. A remarkable issue (RI) was defined as arrhythmia relating to the presentation or device/lead issue requiring reprogramming or intervention. The association between the presenting complaint and an RI was assessed using regression analysis. Multivariable regression model was used to identify pre-specified patient-level characteristics that were predictive of a RI. A RI was found in 28% (n=98) of 354 ED CIED checks for 306 patients (76±16 yrs 59% male). Most patients had no RI (n=224 73%). One third of checks occurred after-hours and these had a higher yield of RIs than those during routine clinic hours (35% vs 23% p=0.018). Presenting with a perceived ICD shock was predictive of a RI (odds ratio [OR] 6.0 95% CI=1.8-20.0). Syncope resyncope was five-fold less likely to be predictive of a RI (OR 0.19 95% CI=0.13-0.28) despite being the most common indication for CIED check (51% n=180 checks). Only history of AF was predictive of RI while advancing age was predictive of not finding a RI. Almost three-quarters of ED CIED checks did not yield any RI. Patient-reported ICD shock and history of AF were predictive of RI, while syncope resyncope was not. New models of care especially during after-hours, may help to reduce the burden on cardiac electrophysiology services and health care costs.
No related grants have been discovered for Bradley Pitman.