Porous tip radiofrequency ablation catheter reduced heart failure-related complications and healthcare resource utilization in paroxysmal atrial fibrillation patients.

Introduction: A 56-hole porous tip radiofrequency catheter was developed to provide more uniform cooling with less fluid delivery than a prior 6-hole irrigated design. This study aimed to evaluate the impact of contact force (CF) ablation with the porous tip on complications (congestive heart failure [CHF] and non-CHF related), healthcare resource utilization, and procedural efficiency in patients undergoing de novo paroxysmal atrial fibrillation (PAF) ablations in a real-world setting. Methods: Consecutive de novo PAF ablations were performed between February 2014 and March 2019 by six operators at a single US academic center. The 6-hole design was used through December 2016 with the 56-hole porous tip adopted in October 2016. The outcomes of interest included symptomatic CHF presentation and CHF-related complications. Results: Of 174 patients who were included, mean age was 61.1 ± 10.8 years, 67.8% were male, and 25.3% had a history of CHF. Ablation with the porous tip catheter significantly decreased fluid delivery (1177 vs. 1912 mL with the 6-hole design; p < .0001). CHF-related complications within 7 days, particularly fluid overload, were substantially reduced with the porous tip (15.2% vs. 5.3% of patients; p = .0281) and the proportion of patients with symptomatic CHF presentation within 30 days postablation was significantly lower (14.7% vs. 32.5%; p = .0058). Conclusion: The 56-hole porous tip led to significantly reduced CHF-related complications and healthcare utilization in PAF patients undergoing CF catheter ablation when compared to the prior 6-hole design. This reduction likely results from the significant decrease in fluid delivery during the procedure.

Drought Analysis Using Standardized Evapotranspiration and Aridity Index at Bilate Watershed: Sub-Basins of Ethiopian Rift Valley.

In Ethiopia, more prevalent drought happenings have been documented in the past century. The problem has gradually expanded from the north to the rest parts with deepened intensity. The study aimed to examine the magnitudes of spatiotemporal patterns of drought at the Bilate watershed from 1981 to 2016. Monthly rainfall and temperature data were used for the analysis. The Standardized Evapotranspiration Indexes (SPEI) at SPEI-03 and SPEI-12 timescales were applied to evaluate the drought patterns. Among different drought indices, the SPEI is the most valuable and preferred Index for drought studies. The SPEI method considers the role of temperature than other indices to compare drought in time and space. The Mann-Kendall test was used for trend analysis. Accordingly, the result revealed that 1988-2016 were years of continuous drought events in both timescales with (SPEI = -2.5 to -1.2) drought value. Drought severity and frequency were highly detected at Wulberag areas (SPEI: -2.5). Durame, Angacha, and Alaba experienced increasing drought trends (Z = -1.96-1.6) and Welayita Sodo is Z = -0.07-0.03. Bilate-Tena and Hossana area of the watershed were less affected by drought than other areas. Spatially, the drought occurrences were observed in all areas of the watershed with varying magnitude. In the SPEI-12 timescale, more frequent drought occurrences were observed than SPEI-03. It was found that severe drought was observed in 1987, 1993/94, 2000-2005, and 2010. Moreover, the watershed experienced an Aridity Index (AI) of 0.43 (43%) and was subjected to potential high evapotranspiration (PET). The highest PET was observed at Bilate-Tena, Angacha, Hosanna, Wulberag, Alaba, Welayita Sodo, and Durame (151.6, 119.6, 119.3, 140.8, 142, 127.5, and 125.7 mm/year, respectively. Hence, the finding of this study could initiate a further inquiry on drought risk management, early warning responses, and local scale planning.

Inhibition of Senescence-Associated Genes Rb1 and Meis2 in Adult Cardiomyocytes Results in Cell Cycle Reentry and Cardiac Repair Post-Myocardial Infarction.

Background Myocardial infarction results in a large-scale cardiomyocyte loss and heart failure due to subsequent pathological remodeling. Whereas zebrafish and neonatal mice have evident cardiomyocyte expansion following injury, adult mammalian cardiomyocytes are principally nonproliferative. Despite historical presumptions of stem cell-mediated cardiac regeneration, numerous recent studies using advanced lineage-tracing methods demonstrated that the only source of cardiomyocyte renewal originates from the extant myocardium; thus, the augmented proliferation of preexisting adult cardiomyocytes remains a leading therapeutic approach toward cardiac regeneration. In the present study we investigate the significance of suppressing cell cycle inhibitors Rb1 and Meis2 to promote adult cardiomyocyte reentry to the cell cycle. Methods and Results In vitro experiments with small interfering RNA-mediated simultaneous knockdown of Rb1 and Meis2 in both adult rat cardiomyocytes, isolated from 12-week-old Fischer rats, and human induced pluripotent stem cell-derived cardiomyocytes showed a significant increase in cell number, a decrease in cell size, and an increase in mononucleated cardiomyocytes. In vivo, a hydrogel-based delivery method for small interfering RNA-mediated silencing of Rb1 and Meis2 is utilized following myocardial infarction. Immunofluorescent imaging analysis revealed a significant increase in proliferation markers 5-ethynyl-2'-deoxyuridine, PH3, KI67, and Aurora B in adult cardiomyocytes as well as improved cell survivability with the additional benefit of enhanced peri-infarct angiogenesis. Together, this intervention resulted in a reduced infarct size and improved cardiac function post-myocardial infarction. Conclusions Silencing of senescence-inducing pathways in adult cardiomyocytes via inhibition of Rb1 and Meis2 results in marked cardiomyocyte proliferation and increased protection of cardiac function in the setting of ischemic injury.