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This article presents an economic analysis of the exploitation of the main mine drainage according to the condition of machines. The study is based on actual operating data obtained during the operation of an underground hard coal mine. Through the selection of state estimators, appropriate sensory systems, as well as a long-term economic approach, operating procedures were developed that allowed for the introduction of significant financial savings. Operating costs are reduced by lowering energy consumption and reducing the costs of current repairs and spare parts. In addition to the classic approach to monitoring the state of a machine, based on the observation of residual processes, a global coefficient, referred to as unit energy consumption, has been proposed. Thanks to this, the operation of the machine occurs not only on the basis of its current dynamic state, but also due to the control processes of the machine's operation. Moreover, the article refers to the area related to water safety and the reliability of the pumping station. [ABSTRACT FROM AUTHOR]

Keywords: Cardiac implantable electrical device; sensors; device diagnostics; heart; failure; remote monitoring EN Cardiac implantable electrical device sensors device diagnostics heart failure remote monitoring 9 12 4 01/12/22 20211202 NES 211202 1. Automatic identification of high HF risk condition in CIED patient According to retrospective data analysis, multiparametric algorithms had been shown to be more efficient than single parameter assessment in HF risk assessment. Combined heart failure device diagnostics identify patients at higher risk of subsequent heart failure hospitalizations: results from PARTNERS HF (program to access and review trending information and evaluate correlation to symptoms in patients with heart failure) study. [Extracted from the article]

Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a “high risk” alert between November 2018 and November 2020. All patients generating a “high risk” HFRS alert were managed within an integrated HF pathway. Alerts were shared with local HF teams, prompting patient contact and appropriate intervention. Outcome data on health care utilisation (HCU) and mortality were collected. A validated questionnaire was completed by the HF teams to obtain feedback. Results: 367 “High risk” alerts were noted in 188 patients. The mean patient age was 70 and 49% had a Charlson Comorbidity Score of >6. Mean number of alerts per patients was 1.95 and 44 (23%) of patients had >3 “high risk” alerts in the follow up period. Overall, 75 (39%) patients were hospitalised in the 4–6-week period of the alert; 53 (28%) were unplanned of which 24 (13%) were for decompensated HF. A total of 33 (18%) patients died in the study period. Having three or more alerts significantly increased the risk of hospitalisation for heart failure (HR 2.5, CI 1.1–5.6 p = 0.03). The feedback on the pathway was positive. Conclusions: Patients with “high risk” alerts are co-morbid and have significant HCU. An integrated approach can facilitate timely risk stratification and intervention. Intervention in these patients is not limited to HF alone and provides the opportunity for holistic management of this complex cohort.

Background Heart failure remains a leading cause of morbidity and mortality. Clinical prediction models provide suboptimal estimates of mortality in this population. We sought to determine the incremental value of implantable device diagnostics over clinical prediction models for mortality. Methods and Results RAFT (Resynchronization/Defibrillation for Ambulatory Heart Failure Trial) patients with implanted devices capable of device diagnostic monitoring were included, and demographic and clinical parameters were used to compute Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) heart failure risk scores. Patients were classified according to MAGGIC score into low (0–16), intermediate (17–24), or high (>24) risk groups. Mortality was evaluated from 6 months postimplant in accordance with the RAFT protocol. In a subset of 1036 patients, multivariable analysis revealed that intermediate and high MAGGIC scores, fluid index, atrial fibrillation, and low activity flags were independent predictors of mortality. A device‐integrated diagnostic parameter that included a fluid index flag and either a positive atrial fibrillation flag or a positive activity flag was able to significantly differentiate higher from lower risk for mortality in the intermediate MAGGIC cohort. The effect was more pronounced in the high‐risk MAGGIC cohort, in which device‐integrated diagnostic–positive patients had a shorter time to death than those who were device‐integrated diagnostic negative. Conclusions Device diagnostics using a combination of fluid index trends, atrial fibrillation burden, and patient activity provide significant incremental prognostic value over clinical heart failure prediction scores in higher‐risk patients. This suggests that combining clinical and device diagnostic parameters may lead to models with better predictive power. Whether this risk is modifiable with early medical intervention would warrant further studies. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00251251.

With size reduction of active elements in microelectronics to tens of nanometers and below, the effect of surface and interface properties on overall device performance becomes crucial. High resolution spectroscopic and imaging techniques provide a metrological route for characterization of these properties relevant to device diagnostics and failure analysis. With its roughly 100 nm spatial resolution, superior surface sensitivity, and approximately 200 meV spectral resolution, scanning photoelectron microscopy (SPEM) stands out as a comprehensive tool to access the surface/interface composition of nanodevices, as well to provide chemical state designations and materials property evolutions upon treatment by thermal, electrical, chemical, radiative and other stimuli. Here we present a SPEM-on-device setup that combines X-ray spectromicroscopy with advanced NIST microhotplate technology to demonstrate new combined analytical and electrical measurements capabilities of this metrology platform for operando nanodevice characterization. Using model integrated SnO 2 nanowire (NW) chemiresistor devices, the chemically induced alterations in the chemical state of the nanowire surface are correlated to the observed conductance changes, thus directly testing the receptor and transduction mechanisms for SnO 2 NW conductometric chemical sensors. • SPEM-on-device setup combines X-ray spectromicroscopy with NIST microhotplate technology. • SnO 2 nanowire chemiresistor used as a model system for operando nanodevice characterization. • Chemical state of the nanowire surface is correlated to the observed conductance changes. • Combined XBIC and SPEM mapping locate electroactive and chemical defects in nanodevice. [ABSTRACT FROM AUTHOR]

Background: Current cardiac devices cannot always differentiate between pacemaker-mediated tachycardia (PMT) and tracking of sinus or atrial tachycardia. We previously derived a novel algorithm for distinguishing the 2 mechanisms based on the specific termination response to postventricular atrial refractory period extension, atrial rates, and changes in atrial electrogram morphology.Objective: The purpose of this study was to evaluate how this algorithm would have performed in a clinical setting based on previously recorded PMT events.Methods: We applied our algorithm to a database of 122 de-identified stored electrograms that were classified as PMT by 43 remotely monitored devices.Results: Of the 122 events stored as "PMT," 3 episodes were excluded because the device recording was consistent with atrial fibrillation. Of the remaining 119 episodes, our algorithm was able to correctly reclassify 92 events (77%) as tracking of sinus or atrial tachycardia rather than true PMT. The VAV response following postventricular atrial refractory period extension, which is specific to tracking of atrial or sinus tachycardia, was seen in 72% of these cases. Changes in atrial rate and atrial electrogram morphology were able to reclassify the remainder of episodes. Finally, we observed that 12 of 83 episodes (14%) misclassified as PMT in cardiac resynchronization devices resulted in loss of cardiac biventricular pacing.Conclusion: Applying a novel diagnostic algorithm to current cardiac devices improves the proper diagnosis of true PMT rather than tracking of atrial or sinus tachycardia. Enhanced accuracy of diagnosis reduces the likelihood of inappropriate clinical decisions. [ABSTRACT FROM AUTHOR]

Background: Decreased intrathoracic impedance has been used in adults to predict heart failure (HF) exacerbations. A commercial algorithm, OptiVol® (Medtronic Inc., Minneapolis, MN, USA), identifies patients with decreased impedance. We sought to determine the specificity, sensitivity, and positive predictive value (PPV) of OptiVol for predicting HF exacerbation or increased arrhythmia burden in pediatric and adult congenital heart disease (CHD) patients. Methods: A multicenter retrospective chart review was undertaken. Inclusion criteria were: (1) <19 years or CHD adults, (2) an implanted device with OptiVol capability, (3) implanted between April 9 and September 6, and (4) follow-up of >30 days postimplant. Clinical events were defined as clinical HF exacerbation/hospital admission, initiation/uptitration of medication, or increased arrhythmia burden. Results: Seventy-two patients (19 ± 9 years) were identified with the following indications: 20% dilated cardiomyopathy (DCM), 11% hypertrophic cardiomyopathy (HCM), 43% CHD, 15% channelopathy, and 11% other. Thirty-nine had 122 OptiVol crossings (median 2, range 1-11); 30% were linked to a cause. The remaining 33 had no crossing, though 17 had 89 clinical events. The clinical event rate was 19% greater in patients with crossings, though not statistically significant (P = 0.4). The algorithm had a 59% sensitivity, 52% specificity, and 62% PPV. Clinical HF exacerbation and arrhythmia burden did not significantly correlate with decreased impedance though uptitration or initiation of HF medication did correlate significantly (P= 0.03). Conclusion: The algorithm sensitivity for pediatric DCM, HCM, CHD, and adult CHD was equivalent to the general adult population. Further studies are warranted to assess whether inaccuracy in prediction is secondary to the algorithm or to differences in the clinical response of pediatric/CHD patients. [ABSTRACT FROM AUTHOR]

Background: Traditional methods of heart failure (HF) management are based on reactive strategies to treat late indicators of decompensated HF. Advances in monitoring methods have become available with the evolution of implantable cardioverter-defibrillators and cardiac-resynchronization therapy devices. These devices provide new diagnostic data and remote monitoring capabilities that allow clinicians to proactively monitor patients for earlier signs of worsening HF. The integration of data obtained from implantable cardioverter-defibrillator and cardiac-resynchronization therapy technology could improve outpatient HF care, potentially leading to decreased readmission rates and improved patient outcomes. Objective: This review will synthesize the literature regarding the efficacy of device diagnostic data and the usability of the data in the clinical setting. Methods: Articles for review were obtained using Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PubMed, and ClinicalTrials.gov. Results: Device diagnostics showed strong correlation with established HF biomarkers and hemodynamic measures. The findings from this review indicate that device diagnostic parameters predict impending HF much earlier than traditional methods of monitoring do. Device diagnostics are also more accurate in the early prediction of HF when compared with noninvasive objective measures, particularly when multiple parameters are combined and monitored for trends. Device diagnostics possess a distinct advantage over traditional methods of monitoring for HF because they allow clinicians to remotely monitor the status of their HF patients without relying on patient compliance for data entry and reporting. Conclusions: Studies regarding the efficacy of device diagnostic parameters suggest that their integration into clinical practice will provide a more accurate and reliable mechanism for assisting clinicians in risk stratifying and predicting potential episodes of decompensated HF. [ABSTRACT FROM AUTHOR]

Abstract: Over the past decade, emerging clinical trial data supported the usefulness of implanted therapeutic cardiac devices (pacemakers and defibrillators) for the treatment of heart failure (HF). Interest has now developed in evaluating the potential of device diagnostics to identify HF patients at risk for clinical events and to be used in the management of HF patients. Initial studies have provided inconsistent results. A number of trial design elements have likely played a role in the lack of positive results, including cohort risk determination, intensity of usual care, intensity of the intervention, and selection of end points for the study. These issues will be important to understand when evaluating future clinical trial results and developing new studies, particularly in other HF patient cohorts such as HF with preserved left ventricular function. [Copyright &y& Elsevier]

Aim: To evaluate use of CIED-generated Heart Failure Risk Score (HFRS) alerts in an integrated, multi-disciplinary approach to HF management. Methods: We undertook a prospective, single centre outcome study of patients implanted with an HFRS-enabled Medtronic CIED, generating a "high risk" alert between November 2018 and November 2020. All patients generating a "high risk" HFRS alert were managed within an integrated HF pathway. Alerts were shared with local HF teams, prompting patient contact and appropriate intervention. Outcome data on health care utilisation (HCU) and mortality were collected. A validated questionnaire was completed by the HF teams to obtain feedback. Results: 367 "High risk" alerts were noted in 188 patients. The mean patient age was 70 and 49% had a Charlson Comorbidity Score of >6. Mean number of alerts per patients was 1.95 and 44 (23%) of patients had >3 "high risk" alerts in the follow up period. Overall, 75 (39%) patients were hospitalised in the 4–6-week period of the alert; 53 (28%) were unplanned of which 24 (13%) were for decompensated HF. A total of 33 (18%) patients died in the study period. Having three or more alerts significantly increased the risk of hospitalisation for heart failure (HR 2.5, CI 1.1–5.6 p = 0.03). The feedback on the pathway was positive. Conclusions: Patients with "high risk" alerts are co-morbid and have significant HCU. An integrated approach can facilitate timely risk stratification and intervention. Intervention in these patients is not limited to HF alone and provides the opportunity for holistic management of this complex cohort. [ABSTRACT FROM AUTHOR]

Modern programmable pacemakers often incorporate features thin allow one to perform a series of diagnostic maneuvers to aid in postimplantation surveillance. These features often include non invasive measurements of thresholds, lead impedance, and intracardiac electrograrn recognition via telemetry circuits. Interindividual differences in these measurements are so great that one must utilize individual comparisons for longitudinal studies of reliability. While these devices allow "fine tuning" of individual units, they require major time-consuming efforts and add to the total device costs. [ABSTRACT FROM AUTHOR]