Adults with Congenital Heart Disease: At Long Last, Guidelines for Arrhythmia Management
Bibliographic record
Abstract
Beginning with the first successful surgical closure of a patent ductus arteriosus in 1938, to open heart repair of septal defects in 1955 and into the current era, children born with potentially fatal congenital heart defects are now surviving and attaining adulthood in numbers not previously envisioned.The concept of "long term" survival, originally meaning 10 years postrepair, has been superseded by survival beyond 20 and even 40 years.At the current time, population estimates indicate that there are now nearly 3 million adults with congenital heart disease (ACHD) in the United States, Canada, and Europe; and that number is growing.Since a "repaired" congenital heart does not imply "normal," most of these patients will experience some complications, requiring lifelong medical care (Fig. 1).Prominent among these complications are arrhythmias that contribute to impaired quality of life, morbidity, and mortality.And although expert consensus guidelines dealing with various aspects of arrhythmia identification and patient management have been published since the 1980s, dealing primarily with ischemic heart disease, none fully apply to this growing ACHD population.At the recent 35th Scientific Sessions of the Heart Rhythm Society, the Pediatric and Congenital Electrophysiology Society (PACES) presented the first-ever expert consensus arrhythmia management guidelines that focus specifically on the ACHD patient, taking into consideration specific cardiac anatomies, surgical repairs, and their sequelae, including heart failure. 1 The 22member, multidisciplinary and international writing committee included representatives from, and the publication was endorsed by, the American College of Cardiology, American Heart Association, Heart Rhythm Society, European Heart Rhythm Association, Canadian Heart Rhythm Conflict of Interest: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.020 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.010 | 0.023 |
| Insufficient payload (model declined to judge) | 0.005 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".