The Future of Long‐Term Monitoring After Catheter and Surgical Ablation for Atrial Fibrillation

Biohybrid printing approaches for cardiac pathophysiological studies

Bioengineered hearts, which include single cardiomyocytes, engineered heart tissue, and chamber-like models, generate various biosignals, such as contractility, electrophysiological, and volume-pressure dynamic signals. Monitoring changes in these signals is crucial for understanding the mechanisms of disease progression and developing potential treatments. However, current methodologies face challenges in the continuous monitoring of bioengineered hearts over extended periods and typically require sacrificing the sample post-experiment, thereby limiting in-depth analysis. Thus, a biohybrid system consisting of living and nonliving components was developed. This system primarily features heart tissue alongside nonliving elements designed to support or comprehend its functionality. Biohybrid printing technology has simplified the creation of such systems and facilitated the development of various functional biohybrid systems capable of measuring or even regulating multiple functions, such as pacemakers, which demonstrates its versatility and potential applications. The future of biohybrid printing appears promising, with the ongoing exploration of its capabilities and potential directions for advancement.

Validation of a Smart Ring Oximeter in Individuals With Dark Skin Pigment

Objective

To evaluate a ring wearable's accuracy in the measurement of oxyhemoglobin saturation measured by pulse oximeter (SpO2) compared to a simultaneous SaO2 obtained from arterial blood gases (ABGs) because oximeters may overestimate oxyhemoglobin saturation in darkly pigmented individuals resulting in occult hypoxemia.

Patients and Methods

Circul+ (Bodimetrics), with a form factor of a ring, measures several variables for cardiorespiratory assessment (SpO2, movement, and heart rate). The design ensures that measurements are made on the palmar surface of the digit, where there is generally less pigment. Twenty-four healthy participants (8 Black, 16 non-Black) had catheters inserted into their radial arteries during the timeframe between August 2020 and January 2022. They were administered nitrogen-rich air that made them hypoxic in steps to an SaO2 of 70%. ABGs was sampled at various levels of hypoxia, and simultaneous readings were obtained from the Circul+. We compared SpO2 from Circul with measurement of ABGs by a medical grade blood gas analyzer.

Results

There was excellent correlation between SaO2 measured by the ring oximeter and ABGs in both Black (y = 1.0174x - 1.573; R 2 = 0.9414) and Non-Black (y = 1.0209x - 2.5607; R 2 = 0.9207) participants. No differences were found in comparing the intercept and slopes of the regressions. At ABG of 70% and 100%, the SaO2 measured by the ring was calculated to be 69.6% and 100.2% for the Black participants and 68.9% and 99.5% for the non-Black participants. Bland-Altman analysis found a bias (deviation from the mean) of 0.0 for the Black participants and -0.7% for the non-Black participants.

Conclusion

Results from this study confirmed that Circul+ oximetry accuracy seems to be independent of skin tone, perhaps because measurements are made on the palmar surface of the digit, where there is generally less pigment.

Stroke Prevention in Atrial Fibrillation

PURPOSE OF REVIEW

Atrial fibrillation is associated with a significant increase in stroke and systemic embolism. This review explores the areas of stroke prevention.

RECENT FINDINGS

In the last decade, NOAC has overtaken warfarin as the anticoagulant of choice for stroke prevention in AF. For patients unable to take anticoagulation, LAA closure has proven to be a valid option. The use of digital devices has led to widespread consumer-directed AF screening. It remains to be determined if all device detect AF pose the same amount of risk as recent studies have shown that short and infrequent episodes of AF may not benefit from anticoagulation. Stroke prevention is paramount in the management of AF. In this review we describe the risk factors contributing to stroke, recent advances in antithrombotic therapies, and the increasing role of digital health in guiding AF detection and stroke prevention.