SummaryBackground Uptake of self-testing and self-management of oral anticoagulation has remained inconsistent, despite good evidence of their eff ectiveness. To clarify the value of self-monitoring of oral anticoagulation, we did a metaanalysis of individual patient data addressing several important gaps in the evidence, including an estimate of the eff ect on time to death, fi rst major haemorrhage, and thromboembolism.

Two reviewers independently extracted the data from each study. Quality was assessed with the quality assessment for diagnostic accuracy studies. A random effects model was used to obtain a summary correlation coefficient and the bivariate model for diagnostic meta-analysis was used to obtain summary sensitivity and specificity values. Results 29 studies were included in the meta-analysis.The summary correlation coefficient between systolic pulmonary arterial pressure estimated from echocardiography versus measured by right heart catheterisation was 0.70 (95% CI 0.67 to 0.73; n=27).The summary sensitivity and specificity for echocardiography for diagnosing pulmonary hypertension was 83% (95% CI 73 to 90) and 72% (95% CI 53 to 85;n=12), respectively. The summary diagnostic OR was 13(95% CI 5 to 31).Conclusions Echocardiography is a useful and noninvasive modality for initial measurement of pulmonary pressures but due to limitations, right heart catheterisation should be used for diagnosing and monitoring pulmonary hypertension.

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CCTA appears to be a feasible alternative to transoesophageal echocardiography for post-LAA device surveillance to evaluate for device thrombus, residual leak, embolization, position, and pericardial effusion.

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Cardiac rehabilitation programs across Canada have suspended inperson services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and R ESUM E Cardiac rehabilitation (CR) programs across Canada have suspended in-person, centre-based cardiac rehabilitation (CBCR) services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. CBCR has unequivocally demonstrated reductions in hospital readmissions, secondary events, and mortality in patients with cardiovascular disease. 1 Significant

Edwards Lifesciences and Abbott Vascular; and has served as a consultant to Edwards Lifesciences, Medtronic, Abbott Vascular, and Boston Scientific. Dr. Mahmud has served as a consultant for Abiomed, Medtronic, and Boston Scientific; has received clinical trial support from Corindus; has served as Chairman of the Data Safety Monitoring Board for CAD III and CAD IV studies sponsored by Shockwave, Inc.; and has served as Chairman of the Data Safety Monitoring Board for the EluNIR-HBR Study sponsored by Medinol. Dr. Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.

We demonstrated the feasibility to determine a MAPOPT using cerebral oximetry in patients after cardiac arrest.