Feasibility of fast ventricular tachycardia mapping using the Rhythmia ™ system in a patient with an Impella ™.

Use of 3D navigation systems may be sometimes impossible in patients with left ventricular assist devices because of major electromagnetical interferences with some 3D systems based on magnetic localization. Mapping with the Rhythmia ™ system in patients implanted with an Impella ™ is described to be non feasible. We relate how to overcome this technical issues in this case.

Creation of sinus rhythm and paced maps using a single acquisition step: the "one acquisition-two maps" technique-a feasibility study.

PURPOSE: Scars and abnormal electrograms may significantly differ according to the activation wavefront. We propose a new fast technique for reliable comparison between sinus rhythm and ventricular pacing using a single map acquisition and the Rhythmia™ 3D mapping system. METHODS: A special programming of the external stimulator was assuring full stable regular paced-beat bigeminy during spontaneous rhythm. A first map was acquired for the spontaneous cardiac beat. Then the window of detection was moved to the following paced beat, and a second map was available after recalculation by the system, depicting activation and voltage of the paced cardiac beat at the same locations, with an exactly the same number of beats in both maps. RESULTS: Thirty patients with structural heart disease referred for ablation of ventricular tachycardia underwent this protocol, who were compared with 19 similar patients undergoing repeated maps. Duration of the mapping was significantly shorter compared to controls (34 ± 12 vs 57 ± 14 min, p < 0.0001) without differences in the number of electrograms (6978 ± 7067 vs 9554 ± 4424 for sinus rhythm map and 6610 ± 7240 vs 7783 ± 3804 for paced map, p = ns for both). The technique cannot be completed in five patients (17%), because of arrhythmogenicity, mechanical right bundle branch block, hemodynamical impairment, or bradycardia. CONCLUSION: We propose a novel technique for performing maps during sinus rhythm and ventricular pacing using a single acquisition. Beside time saving, this will allow more strict comparisons between different activation wavefronts.

Fibronectin-based multilayer thin films.

Thin films mimicking the structure and composition of the extra-cellular matrix (ECM) are potentially attractive as biomaterials for cell contacting applications. Layer-by-layer (LbL) assembly of a biological polycation, poly(l-lysine) (PLL), and a common ECM protein, fibronectin (Fn), was employed here to construct nanoscale, ECM mimicking films. Incremental film thickness and interfacial charge magnitude are observed to diminish with layer number, resulting in sub-linear film growth scaling and saturation after about 10 layers. Infrared spectroscopy and electron microscopy together reveal the formation of Fn containing aggregates, whose presence correlates with diminished charge reversal and suppressed LbL assembly. PLL-Fn films induce a significantly greater murine MC3T3-E1 pre-osteoblastic cell proliferation, while maintaining a much higher proportion of Fn in the molecular (as opposed to fibrillar) state, compared to a Fn monolayer, suggesting the enhanced Fn content of these ECM-mimicking films to significantly, and positively, affect cell behavior.