Evidence map›Paper›PMID 34027678›Full record

SynthesisJournal of the American Heart Association2021

Clinical Potential of Beat-to-Beat Diastolic Interval Control in Preventing Cardiac Arrhythmias.

Kanchan Kulkarni, Richard D Walton, Antonis A Armoundas, Elena G Tolkacheva

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Journal of the American Heart Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Targeted Atrial Fibrillation Therapy and Risk Stratification Using Atrial Alternans.Journal of cardiovascular development and disease · 2023
    Review
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Kanchan KulkarniIHU-LIRYC, Electrophysiology and Heart Modeling InstituteFondation Bordeaux Université Pessac, Bordeaux France.
Richard D WaltonIHU-LIRYC, Electrophysiology and Heart Modeling InstituteFondation Bordeaux Université Pessac, Bordeaux France.
Antonis A ArmoundasCardiovascular Research Center Massachusetts General Hospital Boston MA.
Elena G TolkachevaDepartment of Biomedical Engineering University of Minnesota-Twin Cities Minneapolis MN.
Université de Bordeaux · FRMassachusetts General Hospital · USUniversity of Minnesota · US

Funding

Prevention and Treatment of Ventricular TachyarrhythmiasR01HL135335 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI ARMOUNDAS, ANTONIS A · 2017 to 2020
$2.1M
A Medical-Grade Smart-Phone Based Monitoring System (Supplement)R21EB026164 · NIBIB · MASSACHUSETTS GENERAL HOSPITAL · PI ARMOUNDAS, ANTONIS A · 2018 to 2020
$668k
Utility of Vagal Stimulation to Prevent the Onset of Ventricular ArrhythmiasR21HL137870 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI ARMOUNDAS, ANTONIS A · 2017 to 2018
$468k
NHLBI NIH HHS R01 HL135335NHLBI NIH HHS R21 HL137870NIBIB NIH HHS R21 EB026164
6 · The paper itself

Abstract

Life-threatening ventricular arrhythmias and sudden cardiac death are often preceded by cardiac alternans, a beat-to-beat oscillation in the T-wave morphology or duration. However, given the spatiotemporal and structural complexity of the human heart, designing algorithms to effectively suppress alternans and prevent fatal rhythms is challenging. Recently, an antiarrhythmic constant diastolic interval pacing protocol was proposed and shown to be effective in suppressing alternans in 0-, 1-, and 2-dimensional in silico studies as well as in ex vivo whole heart experiments. Herein, we provide a systematic review of the electrophysiological conditions and mechanisms that enable constant diastolic interval pacing to be an effective antiarrhythmic pacing strategy. We also demonstrate a successful translation of the constant diastolic interval pacing protocol into an ECG-based real-time control system capable of modulating beat-to-beat cardiac electrical activity and preventing alternans. Furthermore, we present evidence of the clinical utility of real-time alternans suppression in reducing arrhythmia susceptibility in vivo. We provide a comprehensive overview of this promising pacing technique, which can potentially be translated into a clinically viable device that could radically improve the quality of life of patients experiencing abnormal cardiac rhythms.

Indexed as

AlgorithmsElectrocardiographyArrhythmias, CardiacCardiac Pacing, ArtificialDiastoleHeart RateHumansalternansarrhythmiascontroldiastolic intervalpacing

Identifiers

PMID34027678
PMCPMC8483541
OpenAlexW3164740839

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.