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Introduction: The circular catheter compatible with current cryoballoon system for atrial fibrillation (AF) ablation is exclusively sensed by impedance‐based electro‐anatomical mapping (EAM) system, limiting the accuracy of maps. We aim to investigate the feasibility and safety of a magnetic‐based circular mapping catheter for AF ablation with cryoballoon. Methods: Nineteen consecutive patients who underwent pulmonary vein isolation (PVI) with cryoballoon for paroxysmal or persistent AF were included. EAMs of left atrium (LA) created by the LASSOSTAR™NAV catheter (Lassostar map) before and after PVI were compared to that generated by a high‐density mapping catheter (Pentaray map) from different aspects including structural similarity, PV angle, LA posterior wall (LAPW) and low voltage areas (LVAs), and the amplitude of far field electrograms (FFEs) recorded by catheters. Results: All patients had successful PVI without major complications. With similar mapping time and density, the LA volume calculated from the Pentaray map and Lassostar map were comparable. There were no significant differences in PV angle of all PVs and PW area (16.8 ± 3.2 vs. 17.1 ± 2.8, p =.516) between Pentaray map and Lassostar map. High structural similarity score was observed between two maps (0.783 in RAO/LAO view and 0.791 in PA view). Lassostar map detected lesser but not statistically significant extension of LVA (13.9% vs. 18.3%, p =.07). Amplitude of FFE was larger at the right superior PV on Lassostar map (0.21 ± 0.16 vs. 0.14 ± 0.11 mV, p =.041) compared to that on the Pentaray map. Conclusion: In our initial experience, PVI with cryoballoon and magnetic‐based circular LASSOSTAR™NAV catheter was safe and effective based on the accurate LA geometry it created. [ABSTRACT FROM AUTHOR]

The care of patients with heart rhythm disorders is often dependent on technologies developed to address their unique clinical needs. Although much innovation occurs in the United States, recent decades have seen a significant proportion of early clinical studies performed outside the United States, driven largely by costly and time‐inefficient processes seemingly inherent to the United States research ecosystem. As a result, the goals of early patient access to novel devices to address unmet needs and efficient technology development in the United States remain incompletely realized. This review will introduce key aspects of this discussion, organized by the Medical Device Innovation Consortium, in an effort to broaden awareness and encourage engagement by stakeholders in an effort to address central issues and therefore further a growing effort to shift Early Feasibility Studies to the United States for the benefit of all involved. [ABSTRACT FROM AUTHOR]

Summarizes the results of an investigation which indicate relation of ICD-9-CM codes to uterine rupture (UR) in Massachusetts. UR cases identified based on ICD-9-CM diagnostic codes; Way to identify cases of UR by medical records; Information to identify reason for the use of diagnostic code for UR.

The article presents a report from the U.S. Centers of Disease Control and Prevention (CDC) summarizing an investigation into cases of primary amebic meningoencephalitis (PAM) caused by infection from water containing the living ameba Naegleria fowleri. Six PAM cases were reported to the CDC from Arizona, Florida, and Texas in 2007. All six patients died as a result of the infection. Details from each PAM case are presented. Health officials call for an updated and consistent approach to N. fowleri risk prevention messages, diagnosis, treatment, case reporting and environmental sampling.

In late October 2007, an outbreak of multidrug-resistant Salmonella Newport infections affected 42 case patients in California, Arizona, Idaho, and Nevada. A case-control study implicated ground beef from one chain store. Despite detailed ground beef purchase histories--including shopper card information for several case patients--traceback efforts by both the U.S. Department of Agriculture, Food Safety and Inspection Service and the California Department of Public Health were unable to identify the source of contamination. Case patients consumed multiple types of ground beef products purchased at numerous chain store A retail locations. These stores had received beef products for grinding from multiple beef slaughter-processing establishments. Detailed retail grinding logs and grinding policies that prevent cross-contamination between batches of ground beef products are crucial in the identification of contaminated beef products associated with foodborne illness. [ABSTRACT FROM AUTHOR]

Between 1946 and 1963, federal officials sought to change the national practice of providing mental health care, away from state-run mental institutions and toward outpatient care based in local communities. These policy makers relied on two policy instruments, ideas and inducements. Both instruments contributed to unexpectedly significant changes in federal, state, and local policy. I conclude that a policy instrument framework helps to disentangle the strands of successful public management, and that it is useful to think of ideas as policy instruments that offer leverage on policy outcomes.

In recent years the most popular strategy of reform in the human services arena has been to foster coordination among agencies serving the same populations. The certainty of difficulties in implementing coordination programs and the uncertainty of achieving improvements in service delivery have not dimmed the enthusiasm among policymakers for these programs. This persistent popularity seems to be rooted in the strong symbolic appeal of "coordination," which has overridden attention to evidence about performance.