New-onset atrial fibrillation following left bundle branch area pacing vs. right ventricular pacing: a two-centre prospective cohort study.

AIMS: To investigate whether left bundle branch area pacing (LBBAP) can reduce the risk of new-onset atrial fibrillation (AF) compared with right ventricular pacing (RVP). METHODS AND RESULTS: Patients with indications for dual-chamber pacemaker implant and no history of AF were prospectively enrolled if they underwent successful LBBAP or RVP. The primary endpoint was time to the first occurrence of AF detected by pacemaker programming or surface electrocardiogram. Follow-up at clinic visit was performed and multivariate Cox regression models were applied to evaluate the effect of LBBAP on new-onset AF. The final analysis included 527 patients (mean age 65.3 ± 12.6, male 47.3%), with 257 in the LBBAP and 270 in the RVP groups. During a mean follow-up of 11.1 months, LBBAP resulted in significantly lower incidence of new-onset AF (7.4 vs. 17.0%, P < 0.001) and AF burden (3.7 ± 1.9 vs. 9.3 ± 2.2%, P < 0.001) than RVP. After adjusting for confounding factors, LBBAP demonstrated a lower hazard ratio for new-onset AF compared with RVP {hazard ratio (HR) [95% confidence interval (CI)]: 0.278 (0.156, 0.496), P < 0.001}. A significant interaction existed between pacing modalities and the percentage of ventricular pacing (VP%) (P for interaction = 0.020). In patients with VP ≥ 20%, LBBAP was associated with decreased risk of new-onset AF compared with RVP [HR (95% CI): 0.199 (0.105, 0.378), P < 0.001]. The effect of pacing modalities was not pronounced in patients with VP < 20% [HR (95% CI): 0.751 (0.309, 1.823), P = 0.316]. CONCLUSION: Left bundle branch area pacing demonstrated a reduced risk of new-onset AF compared with RVP. Patients with a high ventricular pacing burden might benefit from LBBAP.

A Deep Learning Image Reconstruction Algorithm for Improving Image Quality and Hepatic Lesion Detectability in Abdominal Dual-Energy Computed Tomography: Preliminary Results.

This study aimed to compare the performance of deep learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASIR-V) in improving image quality and diagnostic performance using virtual monochromatic spectral images in abdominal dual-energy computed tomography (DECT). Sixty-two patients [mean age ± standard deviation (SD): 56 years ± 13; 30 men] who underwent abdominal DECT were prospectively included in this study. The 70-keV DECT images in the portal phase were reconstructed at 5-mm and 1.25-mm slice thicknesses with 40% ASIR-V (ASIR-V40%) and at 1.25-mm slice with deep learning image reconstruction at medium (DLIR-M) and high (DLIR-H) levels and then compared. Computed tomography (CT) attenuation, SD values, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured in the liver, spleen, erector spinae, and intramuscular fat. The lesions in each reconstruction group at 1.25-mm slice thickness were counted. The image quality and diagnostic confidence were subjectively evaluated by two radiologists using a 5-point scale. For the 1.25-mm images, DLIR-M and DLIR-H had lower SD, higher SNR and CNR, and better subjective image quality compared with ASIR-V40%; DLIR-H performed the best (all P values < 0.001). Furthermore, the 1.25-mm DLIR-H images had similar SD, SNR, and CNR values as the 5-mm ASIR-V40% images (all P > 0.05). Three image groups had similar lesion detection rates, but DLIR groups exhibited higher confidence in diagnosing lesions. Compared with ASIR-V40% at 70 keV, 70-keV DECT with DLIR-H further reduced image noise and improved image quality. Additionally, it improved diagnostic confidence while ensuring a consistent lesion detection rate of liver lesions.

Elevated audiovisual temporal interaction in patients with migraine without aura.

BACKGROUND: Photophobia and phonophobia are the most prominent symptoms in patients with migraine without aura. Hypersensitivity to visual stimuli can lead to greater hypersensitivity to auditory stimuli, which suggests that the interaction between visual and auditory stimuli may play an important role in the pathogenesis of migraine. However, audiovisual temporal interactions in migraine have not been well studied. Therefore, our aim was to examine auditory and visual interactions in migraine. METHODS: In this study, visual, auditory, and audiovisual stimuli with different temporal intervals between the visual and auditory stimuli were randomly presented to the left or right hemispace. During this time, the participants were asked to respond promptly to target stimuli. We used cumulative distribution functions to analyze the response times as a measure of audiovisual integration. RESULTS: Our results showed that audiovisual integration was significantly elevated in the migraineurs compared with the normal controls (p < 0.05); however, audiovisual suppression was weaker in the migraineurs compared with the normal controls (p < 0.05). CONCLUSIONS: Our findings further objectively support the notion that migraineurs without aura are hypersensitive to external visual and auditory stimuli. Our study offers a new quantitative and objective method to evaluate hypersensitivity to audio-visual stimuli in patients with migraine.

[A statistical analysis and perspective of headache-related papers covered in 2011 PubMed].

OBJECTIVE: To investigate the distribution and hot spots of literatures on headache by bibliometric analysis in order to provide reference for further study. METHODS: Literatures that contained headache or migraine in text words published in 2011 in PubMed databases (www.ncbi.nlm.nih.gov/Pubmed) were searched. Journals, countries and subjects were bibliometrically analysed. RESULTS: There were 3683 papers involved to headache published in PubMed in 2011, of which 1527 papers were on headache research. The number of papers on headache research published by USA was the most followed by Italy and Germany (USA 23.25%, Italy 10.74%, Germany 5.83%). The mainly studied subjects were therapy (29.60%), pathophysiology (18.66%) and etiology (16.31%). 14.86% papers published in Cephalalgia, which is one of the most important journals, reported negative results. CONCLUSION: The emphasis of headache research was on migraine. Therapy, pathophysiology and etiology were the hot spot. Literatures with negative result attracted authors to give the more attention.

Effects of UCMS-induced depression on nociceptive behaviors induced by electrical stimulation of the dura mater.

The comorbidity between migraine and depression not only provides a major treatment challenge, but also represents a heavy burden on society. However, the relationship between depression and migraine and their molecular biological mechanisms remain unclear. This study investigated the effects of depression elicited by unpredictable chronic mild stress (UCMS) on trigeminovascular nociception in conscious rats and detected a concentration of calcitonin gene-related peptide (CGRP) and substance P (SP) in the external jugular vein. We divided the rats into four groups: control-stimulated (C/S), control-nonstimulated (C/NS), UCMS-stimulated (U/S), and UCMS-nonstimulated (U/NS). We stimulated the dura mater adjacent to the superior sagittal sinus of rats in the C/S and U/S groups and observed their nociceptive behaviors. We found significant differences between the UCMS and control groups in weight, sucrose preference, and locomotor behavior. Nociceptive behaviors (number of head flicks and head-turning time) were significantly increased in the U/S compared with the C/S group, and head-turning time correlated with depressive-like behaviors. The plasma level of SP was increased significantly in the U/NS compared with the C/NS group. However, no significant differences involving the other groups were observed. UCMS-induced depression can exacerbate trigeminovascular nociception, making rats more sensitive to pain.