The downside of cardiac devices insertion
Bibliographic record
Abstract
In the past decade, there has been a significant worldwide increase in the implantation of cardiac devices such as permanent pacemakers, cardiac defibrillators, and biventricular pacemakers, and this trend is likely to continue because of increasing life expectancy. One potential complication following the implantation of such devices is tricuspid valve regurgitation (TR), in which the tricuspid valve does not close properly, causing blood to leak back into the right ventricle of the heart. This is thought to be due to interference of the valve's function by the permanent endocardial leads that control the implanted devices. There is, however, little information about the prevalence of TR, or about the exact mechanisms by which it occurs. Hisham Dokainish of McMaster University in Ontario, Canada, and colleagues are therefore performing a prospective study to determine how prevalent TR is after pacemaker lead insertion, its potential underlying mechanisms, and whether it is of any clinical importance to cardiac patients . So far, the researchers have recruited 300 patients from centres in Canada and Europe. Of these, 154 had a permanent pacemaker implanted, 102 received implantable cardiac defibrillators, and 44 received biventricular pacemakers. The researchers are currently documenting the percentage of time for which each patient is being paced, and the position of the leads attached to their implants, among other clinical factors. Echocardiography will be performed at a mean of one year post-pacemaker insertion to assess whether there is an increase in TR after lead implantation. Given that patient follow-up after pacemaker insertion is still ongoing, it remains unclear whether permanent implantation of a cardiac device increases the risk of TR. The researchers believe that their study should help to answer these questions as patient follow-up is completed. However, if TR is indeed found to be associated with device implantation, this could have a major impact on how these procedures are performed, and could also provide a rationale for developing less invasive treatments for patients with heart rhythm disorders. “Patient follow-up is projected to be complete by end of March 2016,” says Dokainish. “If TR is indeed shown to increase following lead implantation post-pacemaker insertion, and if in some patients the TR is severe and significantly affecting clinical symptoms, corrective surgery could be considered.”Other InformationPublished in: QScience.com Highlights, Published by Nature Research for Hamad bin Khalifa University Press (HBKU Press) License: http://creativecommons.org/licenses/by/4.0
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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 | 0.004 | 0.039 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.004 |
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".