MVA planimetry is feasible in the majority of patients with RhMS using 3DTEE, with excellent reproducibility, and compares favorably with established methods. Three-dimensional transesophageal echocardiography allows excellent assessment of commissural fusion.

Compared with an historical control group, pulmonary vein isolation using open irrigated tip catheters was superior to ablation with conventional 4 mm tip catheters. Patients undergoing ablation with an irrigated tip catheter were less likely to experience symptomatic recurrences of atrial fibrillation or require further therapy for post-procedural arrhythmias.

A 35-year-old woman was referred for further cardiovascular assessment after an incidental finding of a systolic murmur and symptoms of exertional chest tightness. On examination, she had an anacrotic pulse with an aortic ejection systolic murmur. Two-dimensional (2D) transthoracic echocardiogram (TTE) demonstrated normal left ventricular (LV) size and systolic function with a thickened and calcified bicuspid aortic valve. The mean gradient was 47 mm Hg, and valve area was 0.8 cm 2 , consistent with severe aortic stenosis. There was mild coarctation of the aorta with a peak velocity of 2.5 m/s. The mitral valve appeared structurally abnormal (Figures 1 and 2 and online-only Data Supplement Movies I and II). However, 2D TTE images were suboptimal. Therefore, 2D transesophageal echocardiography (TEE) was performed. This confirmed a bicuspid aortic valve with severe aortic stenosis and mild aortic regurgitation with no associated aortopathy. The images were suggestive of 2 separate mitral valve orifices (Figure 3 and online-only Data Supplement Movie III) without stenosis (mean gradient, 2 mm Hg) and only trivial mitral regurgitation. Real-time 3-dimensional (3D) TEE was performed with the use of the Philips X72T probe for further clarification. This clearly demonstrated division of the mitral valve into 2 separate orifices, each with its own leaflets and subvalvular apparatus, consistent with a double-orifice mitral valve (DOMV) (Figures 4 and 5 and online-only Data Supplement Movies IV and V) and coexisting bicuspid aortic valve ( Figure 6 and onlineonly Data Supplement Movie VI). The images demonstrated

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The cardiac axis in a structurally normal heart is influenced by a number of factors. We investigated the anatomical and electrical cardiac axes in middle-aged individuals without structural heart disease and compared this with age-matched obese and older individuals without structural heart disease. A retrospective study of controls included those between 30 and 60 years old with a normal body mass index (BMI), who were then compared with obese individuals between 30 and 60 years old and with individuals more than 60 years old with a normal BMI. The anatomical cardiac axis was determined along the long axis by cardiac computed tomography (CT) and correlated with the electrical cardiac axis on a surface electrocardiogram (ECG) in the frontal plane. A total of 124 patients were included. In the controls (n = 59), the mean CT axis was 38.1° ± 7.8° whilst the mean ECG axis was 51.8° ± 26.6°, Pearson r value 0.12 (P = 0.365). In the obese (n = 36), the mean CT axis was 25.1° ± 6.2° whilst the mean ECG axis was 20.1° ± 23.9°, Pearson r value 0.05 (P = 0.808). In the older group (n = 29), the mean CT axis was 34.4° ± 9.1° whilst the mean ECG axis was 34.4° ± 30.3°, Pearson r value 0.26 (P = 0.209). Obese individuals have a more leftward rotation of both axes than age-matched normals (P <0.0001), which could be secondary to elevation of the diaphragm. Older individuals have a more leftward rotation only of their electrical cardiac axis (P = 0.01), which could be a normal variant or reflect underlying conduction disturbances in this age group.

There are two classes of generative art approaches: neural, where a deep model is trained to generate samples from a data distribution, and "symbolic" or algorithmic, where an artist designs the primary parameters and an autonomous system generates samples within these constraints. In this work, we propose a new hybrid genre: neuro-symbolic generative art. As a preliminary study, we train a generative deep neural network on samples from the symbolic approach. We demonstrate through human studies that subjects find the final artifacts and the creation process using our neurosymbolic approach to be more creative than the symbolic approach 61% and 82% of the time respectively.

We present a scalable approach for learning open-world object-goal navigation (ObjectNav) -the task of asking a virtual robot (agent) to find any instance of an object in an unexplored environment (e.g., "find a sink"). Our approach is entirely zero-shot -i.e., it does not require ObjectNav rewards or demonstrations of any kind. Instead, we train on the image-goal navigation (ImageNav) task, in which agents find the location where a picture (i.e., goal image) was captured. Specifically, we encode goal images into a multimodal, semantic embedding space to enable training semantic-goal navigation (SemanticNav) agents at scale in unannotated 3D environments (e.g., HM3D). After training, SemanticNav agents can be instructed to find objects described in free-form natural language (e.g., "sink," "bathroom sink," etc.) by projecting language goals into the same multimodal, semantic embedding space. As a result, our approach enables open-world ObjectNav. We extensively evaluate our agents on three ObjectNav datasets (Gibson, HM3D, and MP3D) and observe absolute improvements in success of 4.2% -20.0% over existing zero-shot methods. For reference, these gains are similar or better than the 5% improvement in success between the Habitat 2020 and 2021 ObjectNav challenge winners. In an open-world setting, we discover that our agents can generalize to compound instructions with a room explicitly mentioned (e.g., "Find a kitchen sink") and when the target room can be inferred (e.g., "Find a sink and a stove"). * equal contribution Preprint. Under review.

Pulmonary vein isolation is an effective curative treatment for a broad group of patients with atrial fibrillation. However, the procedure is only suitable for patients with problematic atrial fibrillation resistant to other therapies because of the small risk of serious complications.