Cardiovascular digital health journal最新文献

英文中文

Evaluation of an adaptive, rule-based dosing algorithm to maintain therapeutic anticoagulation during atrial fibrillation ablation 评估基于规则的自适应剂量算法，以在心房颤动消融过程中维持治疗性抗凝血功能

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-12-01 DOI: 10.1016/j.cvdhj.2023.11.001

Matthew M. Kalscheur MD, FHRS , Matthew R. Martini MD , Marcus Mahnke BS , Fauzia Osman MPH , Daniel S. Modaff MD , Blake E. Fleeman MD , Ryan T. Kipp MD, FHRS , Jennifer M. Wright MD, FHRS , Joshua E. Medow MD, PhD

Background

Cerebral thromboembolism during atrial fibrillation (AF) ablation is an infrequent (0.17%) complication in part owing to strict adherence to intraprocedural anticoagulation. Failure to maintain therapeutic anticoagulation can lead to an increase in events, including silent cerebral ischemia.

Objective

To evaluate a computerized, clinical decision support system (CDSS) to dose intraprocedural anticoagulation and determine if it leads to improved intraprocedural anticoagulation outcomes during AF ablation.

Methods

The Digital Intern dosing algorithm is an adaptive, rule-based CDSS for heparin dosing. The initial dose is calculated from the patient’s weight, baseline activated clotting time (ACT), and outpatient anticoagulant. Subsequent recommendations adapt based on individual patient ACT changes. Outcomes from 50 cases prior to algorithm introduction were compared to 139 cases using the algorithm.

Results

Procedures using the dosing algorithm reached goal ACT (over 300 seconds) faster (17.6 ± 11.1 minutes vs 33.3 ± 23.6 minutes pre-algorithm, P < .001). ACTs fell below goal while in the LA (odds ratio 0.20 [0.10–0.39], P < .001) and rose above 400 seconds less frequently (odds ratio 0.21 [0.07–0.59], P = .003). System Usability Scale scores were excellent (96 ± 5, n = 7, score >80.3 excellent). Preprocedure anticoagulant, weight, baseline ACT, age, sex, and renal function were potential predictors of heparin dose to achieve ACT >300 seconds and final infusion rate.

Conclusion

A heparin dosing CDSS based on rules and adaptation to individual patient response improved maintenance of therapeutic ACT during AF ablation and was rated highly by nurses for usability.

背景心房颤动（房颤）消融过程中的脑血栓栓塞是一种不常见（0.17%）的并发症，部分原因是严格遵守术中抗凝治疗。方法 "数字实习生剂量算法 "是一种用于肝素剂量的自适应、基于规则的 CDSS。初始剂量根据患者的体重、基线活化凝血时间（ACT）和门诊抗凝剂计算得出。随后的建议会根据患者个体活化凝血时间（ACT）的变化进行调整。结果使用剂量算法的手术更快达到目标 ACT（300 秒以上）（17.6 ± 11.1 分钟 vs 33.3 ± 23.6 分钟，P < .001）。在LA中，ACT低于目标值（几率比0.20 [0.10-0.39]，P = .001），超过400秒的情况较少（几率比0.21 [0.07-0.59]，P = .003）。系统易用性量表评分为优秀（96 ± 5，n = 7，评分>80.3优秀）。手术前抗凝剂、体重、基线 ACT、年龄、性别和肾功能是达到 300 秒 ACT 的肝素剂量和最终输注率的潜在预测因素。

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引用次数: 0

DETECTION OF MYOCARDIAL SCAR AMONG CARDIAC SARCOIDOSIS PATIENTS ON CMR IMAGING USING DEEP LEARNING ON ECG SIGNALS 心电信号深度学习CMR成像检测心肌结节病患者心肌瘢痕

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.006

Ishan Vatsaraj, Shane Loeffler, Eugene G. Kholmovski, Jonathan Chrispin, Natalia A. Trayanova

引用次数: 0

USING REMOTE MONITORING OF CPAP USE AND COMPLIANCE TO MANAGE PATIENTS WITH OBSTRUCTIVE SLEEP APNEA AND ATRIAL FIBRILLATION 应用远程监测cpap的使用和依从性来管理阻塞性睡眠呼吸暂停和心房颤动患者

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.009

Leah Sarang Park, Nicolle Sara Milstein, Kerry Limberg, Alexandra Musat, Owen Les, Advay G. Bhatt, Mohammadali Habibi, Mark W. Preminger, Tina C. Sichrovsky, Dan L. Musat, Suneet Mittal

引用次数: 0

CONTEXTUALLY TAILORED TEXT MESSAGES TO AUGMENT CARDIAC REHABILITATION: THE VIRTUAL APPLICATION-SUPPORTED ENVIRONMENT TO INCREASE EXERCISE (VALENTINE) STUDY 情境定制短信增强心脏康复:虚拟应用支持环境增加锻炼(valentine)研究

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.010

Kashvi Gupta, Jieru Shi, Walter Dempsey, Bhramar Mukherjee, Sachin Kheterpal, Predrag Klasnja, Brahmajee K. Nallamothu, Jessica Golbus

引用次数: 0

Thank you Reviewers 谢谢审稿人

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/S2666-6936(23)00064-6

引用次数: 0

ARTIFICIAL INTELLIGENCE-BASED WALL THICKNESS ANALYSIS TO PREDICT ARRHYTHMOGENIC MYOCARDIAL SUBSTRATE 基于人工智能的壁厚分析预测致心律失常心肌底物

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.008

Christian D. Marton, Christopher Villongco, David Krummen, Gordon Ho

引用次数: 0

Episodes of Atrial Fibrillation and Symptoms: A Temporal Analysis 心房颤动发作与症状：时间分析。

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.06.004

Hamid Ghanbari MD, MPH, FHRS , Daniel Whibley PhD , H. Immo Lehmann MD, PhD , Zhi Li PhD , Anna Kratz PhD , Daniel J. Clauw MD , Brahmajee K. Nallamothu MD, MPH

Background

Data on the relationship between symptoms and atrial fibrillation (AF) episodes are limited.

Objective

The objective of this study was to determine the strength of temporal association between AF episodes and symptoms.

Methods

This cross-sectional ambulatory assessment study was performed in a tertiary care center between June 2018 and December 2021. Patients with paroxysmal AF (1 episode of AF, burden not exceeding 95%) who used a mobile application and continuous wearable electrocardiogram monitor for 21 days were enrolled. The primary outcome was worse symptoms (symptoms above the mean score) over the study period. The association between worse symptoms and the presence of AF was evaluated for different time epochs. Multilevel mixed-effects models were used to quantify associations after accounting for confounders.

Results

Worse symptoms were more likely to be associated with the presence of AF episodes 15 minutes prior to the reporting of palpitations (OR, 2.8 [95% CI, 1.6–5.0]; P < .001), shortness of breath (OR, 2.2 [95% CI, 1.3–3.7]; P = .003), dizziness/lightheadedness (OR, 2.0 [95% CI, 1.0–3.7]; P = .04), and fatigue (OR, 1.7 [95% CI, 1.0–2.9]; P = .03). The correlation between the severity of symptoms and AF lessened as the time interval from AF events to symptoms increased.

Conclusion

There is a significant relationship between onset of AF episodes and reporting of symptoms. This association diminishes over time and varies across different symptoms. If confirmed in larger studies, these findings may inform AF interventions that target symptoms just in time prior to a clinical visit.

背景：关于症状与心房颤动（AF）发作之间关系的数据有限。目的：本研究的目的是确定房颤发作与症状之间的时间相关性。方法：这项横断面动态评估研究于2018年6月至2021年12月在一家三级护理中心进行。入选使用移动应用程序和连续可穿戴心电图监测仪21天的阵发性房颤患者（1次房颤，负荷不超过95%）。主要结果是在研究期间出现更严重的症状（症状高于平均分）。评估了不同时期症状恶化与房颤存在之间的相关性。在考虑混杂因素后，使用多级混合效应模型来量化关联。结果：更严重的症状更有可能与心悸（OR，2.8[95%CI，1.6-5.0]；P<.001）、呼吸急促（OR，2.2[95%CI、1.3-3.7]；P=.003）、头晕/头晕（OR，2.0[95%CI；1.0-3.7]；P=0.04）前15分钟出现房颤发作有关，和疲劳（OR，1.7[95%CI，1.0-2.9]；P=0.03）。随着AF事件到症状的时间间隔增加，症状严重程度与AF之间的相关性降低。结论：房颤发作与症状报告之间存在显著关系。这种关联会随着时间的推移而减弱，并因不同症状而有所不同。如果在更大规模的研究中得到证实，这些发现可能会在临床就诊前及时为针对症状的房颤干预提供信息。

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引用次数: 0

TRANSFORMING OUR POST-ATRIAL FIBRILLATION ABLATION FOLLOW UP PATIENT PATHWAY USING FIBRICHECK: A SMARTPHONE DIGITAL APP USED FOR REMOTE MONITORING 使用fibricheck改变我们房颤消融后随访患者路径:用于远程监测的智能手机数字应用程序

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.003

Sharon Toora, Ajay Sharma, Neil T. Srinivasan, Paula McAuley

引用次数: 0

FEASIBILITY OF REMOTE MONITORING FOR FATAL CORONARY HEART DISEASE FROM SINGLE LEAD ECG 单导联心电图远程监测致死性冠心病的可行性

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.002

Liam Butler, Turgay Celik, Ibrahim Karabayir, Lokesh Chinthala, Mohammad Samie Tootooni, David D. McManus, David Herrington, Oguz Akbilgic

引用次数: 0

Validity and reliability of seismocardiography for the estimation of cardiorespiratory fitness 地震心动图评估心肺功能的有效性和可靠性。

Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular digital health journal

Pub Date : 2023-10-01 DOI: 10.1016/j.cvdhj.2023.08.020

Mikkel T. Hansen MSc , Tue Rømer MSc , Amalie Højgaard BM , Karina Husted PhD , Kasper Sørensen PhD , Samuel E. Schmidt PhD, AP , Flemming Dela MD , Jørn W. Helge PhD

Background

Low cardiorespiratory fitness (ie, peak oxygen consumption [ $\dot{V}$ O₂peak]) is associated with cardiovascular disease and all-cause mortality and is recognized as an important clinical tool in the assessment of patients. Cardiopulmonary exercise test (CPET) is the gold standard procedure for determination of $\dot{V}$ O₂peak but has methodological challenges as it is time-consuming and requires specialized equipment and trained professionals. Seismofit is a chest-mounted medical device for estimating $\dot{V}$ O₂peak at rest using seismocardiography.

Objective

The purpose of this study was to investigate the validity and reliability of Seismofit $\dot{V}$ O₂peak estimation in a healthy population.

Methods

On 3 separate days, 20 participants (10 women) underwent estimations of $\dot{V}$ O₂peak with Seismofit (×2) and Polar Fitness Test (PFT) in randomized order and performed a graded CPET on a cycle ergometer with continuous pulmonary gas exchange measurements.

Results

Seismofit $\dot{V}$ O₂peak showed a significant bias of –3.1 ± 2.4 mL·min^–1·kg^–1 (mean ± 95% confidence interval) and 95% limits of agreement (LoA) of ±10.8 mL·min^–1·kg^–1 compared to CPET. The mean absolute percentage error (MAPE) was 12.0%. Seismofit $\dot{V}$ O₂peak had a coefficient of variation of 4.5% ± 1.3% and an intraclass correlation coefficient of 0.95 between test days and a bias of 0.0 ± 0.4 mL·min^–1·kg^–1 with 95% LoA of ±1.6 mL·min^–1·kg^–1 in test–retest. In addition, Seismofit showed a 2.4 mL·min^–1·kg^–1 smaller difference in 95% LoA than PFT compared to CPET.

Conclusion

The Seismofit is highly reliable in its estimation of $\dot{V}$ O₂peak. However, based on the measurement error and MAPE >10%, the Seismofit $\dot{V}$ O₂peak estimation model needs further improvement to be considered for use in clinical settings.

背景：低心肺功能（即峰值耗氧量[V.O2peak]）与心血管疾病和全因死亡率有关，被认为是评估患者的重要临床工具。心肺运动试验（CPET）是测定V.O2峰值的金标准程序，但由于耗时且需要专业设备和训练有素的专业人员，因此在方法上存在挑战。Seismfit是一种安装在胸部的医疗设备，用于使用地震心动图估计静息时的V.O2峰值。目的：本研究旨在探讨健康人群中Seismfit V.O2峰值估计的有效性和可靠性。方法：在3个不同的日子里，20名参与者（10名女性）按照随机顺序接受了Seismfit（×2）和Polar Fitness Test（PFT）对V.O2峰值的估计，并在循环测力计上进行了分级CPET，并进行了连续的肺气体交换测量。结果：与CPET相比，Seismfit V.O2峰值显示出-3.1±2.4 mL·min-1·kg-1的显著偏差（平均±95%置信区间）和±10.8 mL·min-1.kg-1的95%一致性极限（LoA）。平均绝对百分比误差（MAPE）为12.0%。Seismfit V.O2peak在测试日之间的变异系数为4.5%±1.3%，组内相关系数为0.95，在重新测试中的偏差为0.0±0.4 mL·min-1·kg-1，95%LoA为±1.6 mL·min-1·kg-1。此外，与CPET相比，Seismofit在95%LoA方面的差异比PFT小2.4 mL·min-1·kg-1。

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引用次数: 0

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Cardiovascular digital health journal

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