This study suggests that hematoma formation after PPM or ICD implantation is rare, even among those who are anticoagulated. There were more patients with hematoma on DAPT than warfarin therapy and half of these patients with this complication needed pocket revision for evacuation. (PACE 2010; 385-388).

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The results of our staged imaging approach suggest that ICE has a complimentary value in re-screening the LA/LAA for thrombus after a recent negative or equivocal TEE. The presence of SEC during TEE increases the probability of finding a thrombus with ICE, which could potentially be dislodged during catheter manipulation.

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The cardiac bidomain model is a popular approach to study electrical behavior of tissues and simulate interactions between the cells by solving partial differential equations. The iterative and data parallel model is an ideal match for the parallel architecture of Graphic Processing Units (GPUs). In this study, we evaluate the effectiveness of architecture-specific optimizations and fine grained parallelization strategies, completely port the model to GPU, and evaluate the performance of single-GPU and multi-GPU implementations. Simulating one action potential duration (350 msec real time) for a 256 × 256 × 256 tissue takes 453 hours on a high-end general purpose processor, while it takes 664 seconds on a four-GPU based system including the communication and data transfer overhead. This drastic improvement (a factor of 2460×) will allow clinicians to extend the time-scale of simulations from milliseconds to seconds and minutes; and evaluate hypotheses in a shorter amount of time that was not feasible previously.

Although radiofrequency ablation has revolutionized the management of tachyarrhythmias, the rate of arrhythmia recurrence is a large drawback. Successful substrate identification is paramount to abolishing arrhythmia, and bipolar voltage electrogram’s narrow field of view can be further reduced for increased sensitivity. In this report, we perform cardiac mapping with monophasic action potential (MAP) amplitude. We hypothesize that MAP amplitude (MAPA) will provide more accurate infarct sizes than other mapping modalities via increased sensitivity to distinguish healthy myocardium from scar tissue. Using the left coronary artery ligation Sprague-Dawley rat model of ischemic heart failure, we investigate the accuracy of in vivo ventricular epicardial maps derived from MAPA, MAP duration to 90% repolarization (MAPD90), unipolar voltage amplitude (UVA), and bipolar voltage amplitude (BVA) compared with gold standard histopathological measurement of infarct size. Numerical analysis reveals discrimination of healthy myocardium versus scar tissue using MAPD90 ( P = 0.0158) and UVA ( P < 0.001, n = 21). MAPA and BVA decreased between healthy and border tissue ( P = 0.0218 and 0.0015, respectively) and border and scar tissue ( P = 0.0037 and 0.0094, respectively). Contrary to our hypothesis, BVA mapping performed most accurately regarding quantifying infarct size. MAPA mapping may have high spatial resolution for myocardial tissue characterization but was quantitatively less accurate than other mapping methods at determining infarct size. BVA mapping’s superior utility has been reinforced, supporting its use in translational research and clinical electrophysiology laboratories. MAPA may hold potential value for precisely distinguishing healthy myocardium, border zone, and scar tissue in diseases of disseminated fibrosis such as atrial fibrillation. NEW & NOTEWORTHY Monophasic action potential mapping in a clinically relevant model of heart failure with potential implications for atrial fibrillation management.

The in vivo rat model of CHF combined with EP analysis could be used to determine the arrhythmogenic potential of new treatments for CHF.

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