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This meta‐analysis aims to evaluate the performance of atrial sensing dipole in single lead implantable cardioverter defibrillator (VDD‐ICD) recipients in particular diagnosing new‐onset atrial high‐rate episodes (AHREs) defined as rate threshold of 200 beats per minute, or subclinical atrial fibrillation (SCAF) defined as device‐detected AF without symptoms. We comprehensively searched PubMed, Embase, and ClinicalTrials.gov. Studies comparing contemporary single‐ and dual‐chamber ICD (VVI‐/DDD‐ICD) versus VDD‐ICD were included. Restricted maximum likelihood method for random effect model and Mantel‐Haenszel method for fixed effect model were used to estimate the effect size of new‐onset AHREs, or SCAF detection in each group. Three prospective studies were identified and total of 991 participants were included. There were 330 (33.3%) in VDD‐ICD and 661 (66.7%) in VVI‐/DDD‐ICD. Most (78%) participants were men. Median follow‐up was from 365 days to 847 days. VDD‐ICD has a higher likelihood of detecting AHREs or SCAF as compared to VVI‐/DDD‐ICD [(OR random effect : 2.6; 95% CI: 1.2, 5.8; p =.018); I‐squared = 67.8%, p =.019]. This difference was more apparently seen in the comparison between VDD‐ICD and VVI‐ICD [(OR random effect: 3.8; 95% CI: 2.1, 6.6, p <.001), I‐squared = 0.0%, p =.518]. The result is same as fixed effect. Rate of AHREs detection observed in VDD‐ICD was not statistically different when compared to the only group with DDD‐ICD from SENSE trial. In conclusion, this meta‐analysis reveals that the use of floating atrial sensing dipole in VDD‐ICD increases the detection of new‐onset AHREs or SCAF when compared to VVI‐ICD, with similar atrial sensing performance to DDD‐ICD. [ABSTRACT FROM AUTHOR]

Background: Heralded as a teaching, assessment and reflective tool, and increasingly as a longitudinal and holistic perspective of the educator's development, medical educator's portfolios (MEP)s are increasingly employed to evaluate progress, assess for promotions and career switches, used as a reflective tool and as a means of curating educational activities. However, despite its blossoming role, there is significant dissonance in the content and structure of MEPs. As such, a systematic scoping review (SSR) is proposed to identify what is known of MEPs and its contents. Methods: Krishna's Systematic Evidenced Based Approach (SEBA) was adopted to structure this SSR in SEBA of MEPs. SEBA's constructivist approach and relativist lens allow data from a variety of sources to be considered to paint a holistic picture of available information on MEPs. Results: From the 12 360 abstracts reviewed, 768 full text articles were evaluated, and 79 articles were included. Concurrent thematic and content analysis revealed similar themes and categories including: (1) Definition and Functions of MEPs, (2) Implementing and Assessing MEPs, (3) Strengths and limitations of MEPs and (4) electronic MEPs. Discussion: This SSR in SEBA proffers a novel 5-staged evidence-based approach to constructing MEPs which allows for consistent application and assessment of MEPs. This 5-stage approach pivots on assessing and verifying the achievement of developmental milestones or 'micro-competencies' that facilitate micro-credentialling and effective evaluation of a medical educator's development and entrust-ability. This allows MEPs to be used as a reflective and collaborative tool and a basis for career planning. [ABSTRACT FROM AUTHOR]