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Implantable loop recorder

Anders Christian Meidahl, Christian K E Moll, Bernadette van Wijk, Alessandro Gulberti, Gerd Tinkhauser, Manfred Westphal, Andreas K Engel, Wolfgang Hamel, Peter Brown, Andrew Sharott
Both phase-amplitude coupling (PAC) and beta-bursts in the subthalamic nucleus have been significantly linked to symptom severity in Parkinson's disease (PD) in humans and emerged independently as competing biomarkers for closed-loop deep brain stimulation (DBS). However, the underlying nature of subthalamic PAC is poorly understood and its relationship with transient beta burst-events has not been investigated. To address this, we studied macro- and micro electrode recordings of local field potentials (LFPs) and single unit activity from 15 hemispheres in 10 PD patients undergoing DBS surgery...
February 9, 2019: Neurobiology of Disease
Monica L Chen, Neal S Parikh, Alexander E Merkler, Dawn O Kleindorfer, Prashant D Bhave, Emily B Levitan, Elsayed Z Soliman, Hooman Kamel
Background Black individuals in the United States experience higher rates of ischemic stroke than other racial groups but have lower rates of clinically apparent atrial fibrillation ( AF ). It is unclear whether blacks truly have less AF or simply more undiagnosed AF . Methods and Results We performed a retrospective cohort study using inpatient and outpatient claims from 2009 to 2015 for a 5% nationally representative sample of Medicare beneficiaries. We included patients aged ≥66 years with at least 1 documented Current Procedural Terminology code for interrogation of an implantable pacemaker, cardioverter-defibrillator, or loop recorder and no documented history of AF , atrial flutter, or stroke before their first device interrogation...
February 19, 2019: Journal of the American Heart Association
Panteleimon E Papakonstantinou, Emmanuel N Simantirakis
Although atrial fibrillation (AF) is an arrhythmia with a variable clinical profile (symptomatic and asymptomatic episodes), the first symptomatic episode leads to its initial diagnosis in most cases. Nowadays, continuous and remote long- term cardiac rhythm monitoring is feasible by the use of implantable loop recorders. The data concerning the AF recurrences and progression after the first ECG- documented clinical AF episode demonstrates that a high percentage of patients may not suffer any other AF recurrence, or may present a low recurrence rate of the arrhythmia in the future...
February 5, 2019: Minerva Cardioangiologica
Silvia Muceli, Wigand Poppendieck, Klaus-Peter Hoffmann, Strahinja Dosen, Julián Benito León, Filipe O Barroso, José Luis Pons, Dario Farina
OBJECTIVE: We propose, design and test a novel thin-film multichannel electrode that can be used for both recording from and stimulating a muscle in acute implants. APPROACH: The system is built on a substrate of polyimide and contains 12 recording and 3 stimulation sites made of platinum. The structure is 420 µm wide, 20 µm thick and embeds the recording and stimulation contacts on the two sides of the polyimide over an approximate length of 2 cm. We show representative applications in healthy individuals as well as tremor patients...
February 5, 2019: Journal of Neural Engineering
Lesley-Anne Bissell, Raluca B Dumitru, Bara Erhayiem, Giuseppina Abignano, Graham Fent, Ananth Kidambi, Helena Donica, Agata Burska, Francesco Del Galdo, John Biglands, David L Buckley, John P Greenwood, Sven Plein, Lee Graham, Maya H Buch
Objectives: To screen for significant arrhythmias with an implantable loop recorder (ILR) in patients with SSc and no known cardiovascular disease, and identify associated disease phenotype, blood and cardiovascular magnetic resonance (CMR) biomarkers. Methods: Twenty patients with SSc with no history of primary SSc heart disease, traditional cardiovascular disease, diabetes or maximum one traditional cardiovascular risk factor underwent clinical assessment, contrast-enhanced CMR and ILR insertion...
January 28, 2019: Rheumatology
Theodoros P Zanos
Our bodies have built-in neural reflexes that continuously monitor organ function and maintain physiological homeostasis. Whereas the field of bioelectronic medicine has mainly focused on the stimulation of neural circuits to treat various conditions, recent studies have started to investigate the possibility of leveraging the sensory arm of these reflexes to diagnose disease states. To accomplish this, neural signals emanating from the body's built-in biosensors and propagating through peripheral nerves must be recorded and decoded to identify the presence or levels of relevant biomarkers of disease...
January 22, 2019: Cold Spring Harbor Perspectives in Medicine
Caroline E Adams, R Anthony DeFazio, Catherine A Christian, Lorin S Milescu, Santiago Schnell, Suzanne M Moenter
Central output of gonadotropin-releasing hormone (GnRH) neurons controls fertility and is sculpted by sex-steroid feedback. A switch of estradiol action from negative to positive feedback initiates a surge of GnRH release, culminating in ovulation. In ovariectomized mice bearing constant-release estradiol implants (OVX+E), GnRH neuron firing is suppressed in the morning (AM) by negative feedback and activated in the afternoon (PM) by positive feedback; no time-of-day dependent changes occur in OVX mice. In this daily surge model, GnRH neuron intrinsic properties are shifted to favor increased firing during positive feedback...
January 17, 2019: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Anish N Bhuva, Peter Kellman, Adam Graham, Manish Ramlall, Redha Boubertakh, Patricia Feuchter, Angela Hawkins, Martin Lowe, Pier D Lambiase, Neha Sekhri, Richard J Schilling, James C Moon, Charlotte H Manisty
BACKGROUND: Myocardial scar assessment using late gadolinium enhancement Cardiovascular Magnetic Resonance (LGE CMR) is commonly indicated for patients with cardiac implantable electronic devices (CIEDs), however metal artifact can degrade images. We evaluated the clinical impact of LGE CMR incorporating a device-dependent metal artifact reduction strategy in patients with CIEDs. METHODS: 136 CMR studies were performed in 133 consecutive patients (age 56 ± 19 years, 69% male) with CIEDs (22% implantable loop recorders [ILRs], 40% permanent pacemakers [PPMs], 38% implantable cardioverter defibrillators [ICDs]; 42% non-MRI conditional) over 2 years, without complication...
January 4, 2019: International Journal of Cardiology
Gunn Marit Traaen, Lars Aakerøy, Tove-Elizabeth Hunt, Britt Øverland, Erik Lyseggen, Pål Aukrust, Thor Ueland, Thomas Helle-Valle, Sigurd Steinshamn, Thor Edvardsen, Hasse Khiabani Zaré, Svend Aakhus, Harriet Akre, Ole-Gunnar Anfinsen, Jan Pål Loennechen, Lars Gullestad
RATIONALE: Atrial fibrillation is associated with increased mortality as well as morbidity. There is strong evidence for an association between atrial fibrillation and sleep apnea. It is not known whether treatment of sleep apnea with continuous positive airway pressure (CPAP) will reduce the burden of atrial fibrillation. OBJECTIVE: The Treatment of Sleep Apnea in Patients with Paroxysmal Atrial Fibrillation study will investigate the effects of CPAP in patients with paroxysmal atrial fibrillation and sleep apnea...
January 14, 2019: Scandinavian Cardiovascular Journal: SCJ
Rosario Cervellione, Massimo Moltrasio, Gabriele Bucca, Massimo Moro, Claudio Tondo
. New generation implantable loop recorders can be safely managed by certified nurses. INTRODUCTION: Implantable loop recorders (ILR) are recommended for several cardiac disorders: the recent miniaturization processes eased their implant and management. AIM: To describe the advantages of the ILR implant, patients' education and remote control performed by expert certified nurses. METHODS: Retrospective analysis of consecutive ILR implants of our centre, preformed between May and December 2016: the complications occurred in patients implanted by doctors and nurses were described...
October 2018: Assistenza Infermieristica e Ricerca: AIR
Liane A Arcinas, William F McIntyre, Christopher J Hayes, Omar A Ibrahim, Adrian M Baranchuk, Colette M Seifer
BACKGROUND: An implantable loop recorder (ILR) assists in the diagnosis of unexplained syncope and atrial fibrillation (AF). Both become prevalent with age. Limited data exist describing the incidence of AF as the diagnostic rhythm underlying syncope in the elderly. This study aims to report the incidence of AF in older adults with ILRs for unexplained syncope and identify clinical characteristics associated with AF in this population. METHODS: Retrospective observational study on patients with unexplained syncope seen in syncope clinics from two Canadian centers...
January 7, 2019: Annals of Noninvasive Electrocardiology
Yue Chen, Chen Gong, Hongwei Hao, Yi Guo, Shujun Xu, Yuhuan Zhang, Guoping Yin, Xin Cao, Anchao Yang, Fangang Meng, Jingying Ye, Hesheng Liu, Jianguo Zhang, Yanan Sui, Luming Li
Deep brain stimulation (DBS) is an established treatment for patients with Parkinson's disease (PD). Sleep disorders are common complications of PD and affected by subthalamic DBS treatment. To achieve more precise neuromodulation, chronic sleep monitoring and closed-loop DBS towards sleep-wake cycles could potentially be utilized. Local field potential (LFP) signals that are sensed by the DBS electrode could be processed as primary feedback signals. This is the first study to systematically investigate sleep stage classification based on LFPs in subthalamic nucleus (STN)...
January 1, 2019: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Eline Verschueren, Ben Somers, Tom Francart
The speech envelope is essential for speech understanding and can be reconstructed from the electroencephalogram (EEG) recorded while listening to running speech. This so-called "neural envelope tracking" has been shown to relate to speech understanding in normal hearing listeners, but has barely been investigated in persons wearing cochlear implants (CI). We investigated the relation between speech understanding and neural envelope tracking in CI users. EEG was recorded in 8 CI users while they listened to a story...
December 14, 2018: Hearing Research
Ivo Roca-Luque, Jaume Francisco-Pascual, Gerard Oristrell, Julián Rodríguez-García, Alba Santos-Ortega, Gabriel Martin-Sanchez, Nuria Rivas-Gandara, Jordi Perez-Rodon, Ignacio Ferreira-Gonzalez, David García-Dorado, Angel Moya-Mitjans
BACKGROUND: Patients with syncope and bundle branch block (BBB) are at risk of atrioventricular block (AVB). Electrophysiological study (EPS) can help in identifying patients at higher risk of AVB but false-negative rate is remarkable. Few data are published about predictors of the need for pacemaker implantation during follow-up. OBJECTIVE: The aim of this study was to analyze the rate of patients that need pacemaker implantation after negative EPS and predictive factors...
December 18, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Cameron Kia, Alex G Dukas, Silas T Marshall, Andreas Voss, Elifho Obopilwe, Bruce D Browner, Augustus D Mazzocca
Background: Olecranon osteotomies are frequently performed to gain access to the distal humeral articular surface. Repair of the osteotomy or fixation of a simple 2-part olecranon fracture with traditional tension band construct is often plagued by complication. Proximal migration and irritation attributed to hardware are common complications of the standard construct of an intramedullary screw with tension band and are causes for reoperation. Purpose: To compare the biomechanical performance, time of implant, and prominence of an intramedullary screw and tension band construct with that of a newer low-profile continuous loop tension band (Olecranon Sled) construct in an olecranon osteotomy model...
December 2018: Orthopaedic Journal of Sports Medicine
Steven Baldassano, Xuelong Zhao, Benjamin Henry Brinkmann, Vaclav Kremen, John Bernabei, Mark J Cook, Timothy J Denison, Gregory A Worrell, Brian Litt
Closed-loop implantable neural stimulators are an exciting treatment option for patients with medically refractory epilepsy, with a number of new devices in or nearing clinical trials. These devices must accurately detect a variety of seizure types in order to reliably deliver therapeutic stimulation. While effective, broadly-applicable seizure detection algorithms have recently been published, these methods are too computationally intensive to be directly deployed in an implantable device. We demonstrate a strategy that couples devices to cloud computing resources in order to implement complex seizure detection methods on an implantable device platform...
December 18, 2018: Journal of Neural Engineering
Kang-Il Song, Sunghee Estelle Park, Dosik Hwang, Inchan Youn
Cuff electrodes have been introduced into functional neuromuscular stimulation systems to either obtain neural signals or elicit limb movements. Multiple electrodes must be implanted to construct a feedback control loop, including one electrode for acquisition and another for stimulation. Existing approaches require too much space inside the body and a complicated surgical procedure. This paper proposes a novel neural interface method that uses a single cuff electrode with multichannel capability to simultaneously acquire multichannel recordings and induce electrical stimulation at the proximal nerve trunk of the sciatic nerve...
December 17, 2018: Annals of Biomedical Engineering
Paul D Judge, Erik Jorgensen, Monica Lopez-Vazquez, Patricia Roush, Thomas A Page, Mary Pat Moeller, J Bruce Tomblin, Lenore Holte, Craig Buchman
OBJECTIVES: To (1) identify the etiologies and risk factors of the patient cohort and determine the degree to which they reflected the incidence for children with hearing loss and (2) quantify practice management patterns in three catchment areas of the United States with available centers of excellence in pediatric hearing loss. DESIGN: Medical information for 307 children with bilateral, mild-to-severe hearing loss was examined retrospectively. Children were participants in the Outcomes of Children with Hearing Loss (OCHL) study, a 5-year longitudinal study that recruited subjects at three different sites...
December 6, 2018: Ear and Hearing
Zhen Ni, Kaviraja Udupa, Mark Hallett, Robert Chen
Deep brain stimulation (DBS) implanted in different basal ganglia nuclei regulates the dysfunctional neuronal circuits and improves symptoms in movement disorders. However, the understanding of the neurophysiological mechanism of DBS is at an early stage. Transcranial magnetic stimulation (TMS) can be used safely in movement disorder patients with DBS, and can shed light on how DBS works. DBS at a therapeutic setting normalizes the abnormal motor cortical excitability measured with motor evoked potentials (MEP) produced by primary motor cortical TMS...
November 30, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
R S S Kort, Y S Tuininga, H A Bosker, M Janssen, R Tukkie
INTRODUCTION: In the care of heart failure patients, telemonitoring is receiving growing attention. The main purpose of this study was to determine the effect of continuous telemonitoring with an implantable loop recorder (ILR, Reveal XT), a novel strategy in the management of stable heart failure patients without a cardiac implantable device. Furthermore, little is known about the incidence of subclinical arrhythmias in this specific group of patients. MATERIALS AND METHODS: Stable heart failure patients, New York Heart Association Class II and III, without recent hospitalisation or upcoming intervention, were included...
December 3, 2018: Netherlands Heart Journal
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