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Aim/Purpose: The purpose of this study is to propose a curriculum development model for the integration of technology, organization, and environment (TOE) framework into enterprise resource planning (ERP) systems education. The study investigated the relationships between the three factors of the TOE framework and student learning outcomes from their ERP systems study. Background: As the demand for ERP systems grew and spread to diverse organizations, educational institutions have attempted to integrate the ERP systems into their curriculum. Yet, lacking a conforming framework to the systems results in a considerable gap between the integrated curriculum and student learning outcomes. A pedagogical framework to bridge the gap between educators and students is needed for the ERP systems education. Methodology: The study identified eight propositions from literature reviews and conceptualized a model with corresponding constructs to the propositions. The constructs comprise the seven predictor variables from the TOE contextual factors and one predictive variable for student learning. These constructs provide more details on the TOE factors and eight survey questions in the study. The study analyzed 133 survey responses of four semesters with a SPSS multiple linear regression. Contribution: The study contributes to the emerging body of ERP systems education and research by integrating the TOE framework to the technology curriculum development. The study model provides a structured approach for the selection of appropriate pedagogical contents to achieve a variety of student learning outcomes. Findings: The findings of the study indicate the use of the TOE framework enhances student learning of ERP systems. All the three factors of the framework were found to be statistically significant predictors in the ERP systems learning. The eight propositions depicting the relationships between the seven constructs of the TOE factors and student learning outcomes are all supported. Recommendations for Practitioners: The study recommends a practical guideline to ERP systems educators to utilize the TOE framework in their curriculum development. The guideline is aligned with typical teaching objectives for ERP systems courses. Recommendation for Researchers: Further studies are necessary by various scholars who have noted limited research pertaining to ERP systems and information technology education. The TOE framework demonstrates a practical application of a proven theory to student learning outcomes as a feasible approach to deliberate the use of the systems education and research. Impact on Society: This study will have a valuable impact on educators for their technology curriculum development and software vendors for their investment decisions on enterprise-wide system products. Future Research: Relying solely on student self-reported survey responses may be prone to response bias. For future work, researchers can extend this study and undertake similar research to empirically validate the efficacy of various teaching practices for student ERP systems learning. This could include objective measures of student learning by qualitatively coding behaviors at student project meetings or from hands-on ERP system exercise results.

Describes the contents, requirements, and pedagogy of a course in information resources management at the College of Business at Eastern Michigan University. Highlights include types of required assignments; how assignments are graded; assessment techniques; class structure; and student attitudes regarding the course. (Author/LRW)

Electronic commerce has intensified conflict between businesses' need to collect data and customers' desire to protect privacy. Web-based privacy tools and legislation could add to the costs of e-commerce and reduce profitability. Business models not based on profiling customers may be needed. (SK)

Provides a framework for examining the programs required to meet the challenges of information management education along five dimensions: area of study; faculty and school base; core programs; education and orientation of coprofessionals and managers; and management education and orientation. Approaches for improving the value of information management and use are outlined. (12 references) (Author/MES)

Background: Aveir DR (Abbott, Abbott Park, IL) is a dual-chamber leadless pacemaker (LP) system with distinct atrial and ventricular LPs (ALP, VLP) that communicate wirelessly to deliver atrioventricular synchronous pacing. Success rates of these implant-to-implant (i2i) transmissions have not been systematically evaluated., Objective: This study aims to evaluate chronic i2i success rates in a clinical setting., Methods: Patients meeting standard dual-chamber pacing indications were enrolled and implanted with dual-chamber LP systems as part of a prospective international clinical trial (Aveir DR i2i Study). The percent of successful i2i transmissions from ALP-to-VLP (A-to-V) and VLP-to-ALP (V-to-A) were interrogated from LPs in de novo patients using the device programmer at implant, discharge, and at 1, 3, and 6 months postimplant (1M, 3M, 6M)., Results: A total of 399 patients completed device implant and i2i diagnostic interrogation (62% male; age 69 years; 65% sinus node dysfunction, 32% atrioventricular [AV] block). Median A-to-V and V-to-A i2i success rates exceeded 90% of beats at all time-points from implant to 6M. The minority of patients with A-to-V or V-to-A i2i success in <70% of beats at implant (A-to-V: 19% of patients, V-to-A: 31% of patients) showed roughly 40% improvement by 1M, with this minority dropping to roughly 5% of patients by 6M. Improvement in i2i communication success may be attributed to reprogramming of i2i setting levels, natural changes in dominant posture, and device stabilization., Conclusion: Wireless implant-to-implant communication in the new dual-chamber leadless pacemaker system demonstrated successful transmissions in >90% of beats throughout the 6-month evaluation period. Communication success improved significantly over time postimplant for specific subgroups., Clinical Trial Registration: Aveir DR i2i Study, ClinicalTrials.gov ID NCT05252702., Competing Interests: Disclosures Dr Doshihas has received consulting fees from Abbott and serves as a steering committee member for Abbott. Dr Ip has received consulting fees from Abbott and Medtronic, serves as a steering committee member of Abbott, and is a data safety monitoring committee member of Boston Scientific. Dr Defaye has received research grants from Abbott, Boston Scientific, and Medtronic. Dr Exner has received consulting fees and research grants from Abbott and Medtronic, and—unrelated to this manuscript—has received consulting fees and research grants from Boston Scientific and GE Healthcare as well equity in CorVista, Clarius, eMurmur, HelpWear, and ProtonIntel. Dr Reddy is a consultant to Abbott and—unrelated to this manuscript—he serves as a consultant, for and has equity in, Ablacon, Acutus Medical, Affera-Medtronic, Apama Medical-Boston Scientific, Anumana, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, Laminar, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, Valcare; unrelated to this work, he has served as a consultant for AtriAN, Biosense Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, and Pulse Biosciences and has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. Dr Hindricks serves as a steering committee member for Abbott. Dr Canby has received consulting fees from Medtronic. Dr Shode serves as a steering committee member for Abbott. Dr Bongiorni serves as a steering committee member for Abbott. Dr Callahan has received consulting fees and honoraria from Abbott. Dr Badie and Dr Ligon are employees of Abbott and contributed to preparing and reviewing the manuscript for technical accuracy. Dr Knops has received research grants, consulting fees, and serves as a steering committee member of Abbott and Boston Scientific and has received speaking fees from Medtronic. The remaining author has no conflicts of interest to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: The first dual-chamber leadless pacemaker (DC-LP) system consists of 2 separate atrial and ventricular devices that communicate to maintain synchronous atrioventricular pacing and sensing. The initial safety and efficacy were previously reported., Objective: The purpose of this study was to evaluate the chronic electrical performance of the DC-LP system., Methods: Patients meeting standard dual-chamber pacing indications were enrolled and implanted with the DC-LP system (Aveir DR, Abbott), including right atrial and ventricular helix-fixation LPs (atrial leadless pacemaker [ALP], ventricular leadless pacemaker [VLP]). Pacing capture threshold, sensed amplitude, and pacing impedance were collected using the device programmer at prespecified timepoints from 0-6 months postimplant., Results: De novo devices were successfully implanted in 381 patients with complete 6-month data (62% male; age 69 ± 14 years; weight 82 ± 20 kg; 65% sinus nodal dysfunction, 30% atrioventricular block). ALPs were implanted predominantly in the right atrial appendage anterior base and VLPs primarily at the mid-to-apical right ventricular septum. From implant to 1 month, pacing capture thresholds (0.4-ms pulse width) improved in both ALPs (2.4 ± 1.5 V to 0.8 ± 0.8 V; P <.001) and VLPs (0.8 ± 0.6 V to 0.6 ± 0.4 V; P <.001). Sensed amplitudes improved in both ALPs (1.8 ± 1.3 mV to 3.4 ± 1.9 mV; P <.001) and VLPs (8.8 ± 4.0 mV to 11.7 ± 4.2 mV; P <.001). Impedances were stable in ALPs (334 ± 68 Ω to 329 ± 52 Ω; P = .17) and reduced in VLPs (789 ± 351 Ω to 646 ± 190 Ω; P <.001). Electrical measurements remained relatively stable from 1-6 months postimplant. No differences in electrical metrics were observed among ALP or VLP implant locations., Conclusion: This first in-human evaluation of the new dual-chamber leadless pacemaker system demonstrated reliable electrical performance throughout the initial 6-month evaluation period., Competing Interests: Disclosures Dr Rahul Doshi, Dr Derek V. Exner, Dr Vivek Y. Reddy, Dr Reinoud E. Knops, Dr Petr Neužil, Dr Thomas Callahan, Dr Sri Sundaram, and Dr James E. Ip report Abbott consulting fees. Dr Pascal Defaye, Dr Derek V. Exner, and Dr Reinoud E. Knops report Abbott research grants. Dr Derek V. Exner, Dr Thomas Callahan, and Dr Sri Sundaram report Abbott honoraria. Dr Gerhard Hindricks, Dr Rahul Doshi, Dr Reinoud E. Knops, Dr Morio Shoda, Dr Maria Grazia Bongiorni, and Dr James E. Ip serve as Abbott steering committee members. Dr Nima Badie is an Abbott employee. Additional Disclosures unrelated to this manuscript: Dr Petr Neužil reports research grants from Boston Scientific and Medtronic. Dr Derek V. Exner serves as a consultant for Boston Scientific, Medtronic, and GE Healthcare; and has equity in Clarius, CorVista eMurmur, HelpWear, and ProtonIntel. Dr Vivek Y. Reddy serves as a consultant for and has equity in Ablacon, Acutus Medical, Affera-Medtronic, Apama Medical-Boston Scientific, Anumana, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, Laminar Medical, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, Valcare. Dr Vivek Y. Reddy has served as a consultant for Adagio Medical, AtriAN, Biosense-Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, Pulse Biosciences; and has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. Dr Reinoud E. Knops reports research grants, consulting fees, and serves as a steering committee member of Boston Scientific; and reports speaking fees from Medtronic. Dr Robert Canby reports consulting fees from Medtronic. Dr Thomas Callahan reports speaking and consulting feeds from Medtronic, Philips, Boston Scientific, and ShockWave. Dr Sri Sundaram holds an unrelated patent with Abbott. Dr James E. Ip reports consulting fees from Medtronic and serves as a data safety monitoring committee member of Boston Scientific. All other authors have no conflicts of interest to disclose., (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Background: Roughly one in six patients receiving conventional transvenous pacemaker systems experience significant complications within 1 year of implant, mainly due to the transvenous lead and subcutaneous pocket. A new helix-fixation single-chamber ventricular leadless pacemaker (LP) system capable of pre-deployment exploratory electrical mapping is commercially available. Such an LP may mitigate complications while streamlining the implantation. In this study, the initial real-world implant experience of the helix-fixation LP was evaluated following its commercial release., Methods: In patients indicated for single-chamber right ventricular pacing, helix-fixation Aveir VR LPs (Abbott, Abbott Park, IL) were implanted using the dedicated loading tool, introducer, and delivery catheter. Implant procedural characteristics, electrical parameters, and any 30-day procedure-related adverse events of consecutive implant attempts were retrospectively evaluated., Results: A total of 167 patients with Class I indication for permanent pacing received implants in four North American centers (57% male, 70 years old). Pre-fixation electrical mapping of potential sites allowed repositioning to be avoided in 95.7% of patients. Median [interquartile range] LP procedure and fluoroscopy durations were 25.5 min [20.0, 35.0] and 5.7 min [4.0, 9.2], respectively. Pacing capture threshold, sensed R-wave amplitude, and impedance were 0.8 V [0.5, 1.3], 9.0 mV [6.0, 12.0], and 705 Ω [550, 910], respectively. Implantation was successful in 98.8% of patients, with 98.2% free from acute adverse events., Conclusions: The initial, real-world experience of the helix-fixation ventricular leadless pacemaker demonstrated safe and efficient implantation with minimal repositioning, viable electrical metrics, and limited acute complications., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: A dual-chamber leadless pacemaker system has been designed for atrioventricular synchronous pacing using wireless, beat-to-beat, implant-to-implant (i2i) communication between distinct atrial and ventricular leadless pacemakers. The atrioventricular synchrony achieved across various ambulatory scenarios has yet to be systematically evaluated., Methods: A prospective, single-arm, unblinded, multicenter, international clinical trial of the leadless pacemaker system was conducted in patients with a conventional dual-chamber pacing indication enrolled from February 2022 to March 2023. Leadless pacemaker systems were implanted, and 12-lead Holter electrocardiographic recordings were collected 3 months after implantation over various postures/activities: sitting, supine, left lateral recumbent, right lateral recumbent, standing, normal walk, and fast walk. An independent Holter core laboratory performed a manual adjudication of the percent of atrioventricular synchronous beats using the standard 300-millisecond PR interval limit. Atrium-to-ventricle and ventricle-to-atrium i2i communication success rates were also assessed. Post hoc summary statistics describing the relationships between atrioventricular synchrony and i2i success, posture/activity, implantation indication, atrioventricular event, and heart rate were calculated., Results: In the evaluable population (n=384 of 464 enrolled [83%]; 61% male; age, 70 years; weight, 82 kg; 60% ejection fraction; 95% of beats evaluable), the mean atrioventricular synchrony of 98% of beats observed across all postures using the standard 300-millisecond limit was greater than both atrial-to-ventricular i2i (94%) and ventricular-to-atrial i2i (94%; P <0.001), exceeding both i2i values in 95% of patients. Atrioventricular synchrony was achieved in >95% of evaluable beats across all postures/activities, implantation indications, atrioventricular paced/sensed event combinations, and heart rate ranges (including >100 bpm)., Conclusions: This dual-chamber leadless pacemaker system demonstrated atrioventricular synchrony in 98% of evaluable beats at 3 months after implantation. Atrioventricular synchrony was maintained across postures/activities and remained robust for heart rates >100 bpm., Competing Interests: Dr Ip reports consulting fees from Abbott and Medtronic and serves as a Steering Committee member for Abbott and a Data Safety Monitoring Committee member for Boston Scientific. Dr Rashtian reports research grants and consulting fees from Abbott. Dr Exner reports consulting fees and research grants from Abbott and Medtronic and, unrelated to this article, reports consulting fees and research grants from Boston Scientific and GE Healthcare, as well equity in CorVista, Clarius, eMurmur, HelpWear, and ProtonIntel. Dr Reddy is a consultant to Abbott. Unrelated to this article, he serves as a consultant for and has equity in Ablacon, Acutus Medical, Affera-Medtronic, Apama Medical-Boston Scientific, Anumana, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/ AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, Laminar, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, and Valcare; unrelated to this work, has served as a consultant for AtriAN, Biosense Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, Pulse Biosciences; and he has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. Dr Doshi reports consulting fees from Abbott and serves as a steering committee member for Abbott. Dr Badie, J.R. Nevo, and A. Goil are employees of Abbott. Dr Defaye reports research grants from Abbott, Boston Scientific, and Medtronic. Dr Canby reports consulting fees from Medtronic. Dr Grazia Bongiorni serves as a steering committee member for Abbott. Dr Shoda serves as a Steering Committee member for Abbott. Dr Hindricks serves as a Steering Committee member for Abbott. Dr Knops reports research grants, consulting fees, and serving as a Steering Committee member for Abbott and Boston Scientific and speaking fees from Medtronic.

Recognizing humans' unmatched robustness, adaptability, and learning abilities across anthropomorphic movements compared to robots, we find inspiration in the simultaneous development of both morphology and cognition observed in humans. We utilize optimal control principles to train a muscle-actuated human model for both balance and squat jump tasks in simulation. Morphological development is introduced through abrupt transitions from a 4 year-old to a 12 year-old morphology, ultimately shifting to an adult morphology. We create two versions of the 4 year-old and 12 year-old models- one emulating human ontogenetic development and another uniformly scaling segment lengths and related parameters. Our results show that both morphological development strategies outperform the non-development path, showcasing enhanced robustness to perturbations in the balance task and increased jump height in the squat jump task. Our findings challenge existing research as they reveal that starting with initial robot designs that do not inherently facilitate learning and incorporating abrupt changes in their morphology can still lead to improved results, provided these morphological adaptations draw inspiration from biological principles., (Creative Commons Attribution license.)

Background: The clinical utilization of leadless pacemakers (LPs) as an alternative to traditional transvenous pacemakers is likely to increase with the advent of dual-chamber LP systems. Since device retrieval to allow LP upgrade or replacement will become an important capability, the first such dual-chamber, helix-fixation LP system (Aveir DR; Abbott, Abbott Park, IL) was specifically designed to allow catheter-based retrieval. In this study, the preclinical performance and safety of retrieving chronically implanted dual-chamber LPs was evaluated., Methods: Atrial and ventricular LPs were implanted in the right atrial appendage and right ventricular apex of 9 healthy ovine subjects. After ≈2 years, the LPs were retrieved using a dedicated transvenous retrieval catheter (Aveir Retrieval Catheter; Abbott) by snaring, docking, and unscrewing from the myocardium. Comprehensive necropsy/histopathology studies were conducted to evaluate device- and procedure-related outcomes., Results: At a median of 1.9 years postimplant (range, 1.8-2.6), all 18 of 18 (100%) LPs were retrieved from 9 ovine subjects without complications. The median retrieval procedure duration for both LPs, from first-catheter-in to last-catheter-out, was 13.3 minutes (range, 2.5-36.4). Postretrieval, all right atrial, and right ventricular implant sites demonstrated minimal tissue disruption, with intact fibrous tissue limited to the distal device body. No significant device-related trauma, perforation, pericardial effusion, right heart or tricuspid valve injury, or chronic pulmonary thromboembolism were observed at necropsy., Conclusions: This preclinical study demonstrated the safe and effective retrieval of chronically implanted, helix-fixation, dual-chamber LP systems, paving the way for clinical studies of LP retrieval., Competing Interests: Disclosures Dr Banker reports consulting fees and research support from Abbott, Boston Scientific, and Medtronic. Dr Rippy reports consulting fees from Abbott. Dr Neužil reports consulting fees from Abbott. Dr Exner reports consulting fees and research grants from Abbott, Boston Scientific, and Medtronic. Dr Nair reports consulting fees, honoraria, research grants and support from and serving on advisory boards for Abbott, Adagio Medical, Biosense Webster, Boston Scientific, and Medtronic. Dr Knops reports consulting fees, research grants, and honoraria from Abbott, Boston Scientific, and Medtronic. Dr Ip reports honoraria, serving as a consultant and on a steering committee for Abbott; and consulting fees and honoraria for Medtronic; and serving on a data safety monitoring committee for Boston Scientific. Dr Doshi reports consulting fees and fellowship support from Abbott, Boston Scientific, and Medtronic. Dr Rashtian reports consulting fees and research grants from Abbott. Dr Reddy has served as a consultant to Abbott; in addition, unrelated to this article, Dr Reddy has served as a consultant for and has equity in Ablacon, Acutus Medical, Affera-Medtronic, Anumana, Apama Medical-Boston Scientific, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, Dinova-Hangzhou DiNovA EP Technology, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, Valcare; unrelated to this work, has served as a consultant for AtriAN, Biosense-Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, Pulse Biosciences; and has equity in Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. N. Cooper, D.F. Booth, D. Ligon, Dr Badie, and M. Krans are all employees of Abbott. The other author report no conflicts.

Introduction: Insertable cardiac monitors (ICMs) are commonly used to diagnose cardiac arrhythmias. False detections in the latest ICM systems remain an issue, primarily due to inaccurate R-wave sensing. New discrimination algorithms were developed and tested to reduce false detections of atrial fibrillation (AF), pause, and tachycardia episodes in ICMs., Methods: Stored electrograms (EGMs) of AF, pause, and tachycardia episodes detected by Abbott Confirm Rx™ ICMs were extracted from the Merlin.net™ Patient Care Network, and manually adjudicated to establish independent training and testing datasets. New discrimination algorithms were developed to reject false episodes due to inaccurate R-wave sensing, P-wave identification, and R-R interval patterns. The performance of these new algorithms was quantified by false positive reduction (FPR) and true positive maintenance (TPM), relative to the existing algorithms., Results: The new AF detection algorithm was trained on 5911 EGMs from 744 devices, resulting in 66.9% FPR and 97.8% TPM. In the testing data set of 1354 EGMs from 119 devices, this algorithm achieved 45.8% FPR and 97.0% TPM. The new pause algorithm was trained on 7178 EGMs from 1490 devices, resulting in 70.9% FPR and 98.7% TPM. In the testing data set of 1442 EGMs from 340 devices, this algorithm achieved 74.4% FPR and 99.3% TPM. The new tachycardia algorithm was trained on 520 EGMs from 204 devices, resulting in 57.0% FPR and 96.6% TPM. In the testing data set of 459 EGMs from 237 devices, this algorithm achieved 57.9% FPR and 96.5% TPM., Conclusion: The new algorithms substantially reduced false AF, pause, and tachycardia episodes while maintaining the majority of true arrhythmia episodes detected by the Abbott ICM algorithms that exist today. Implementing these algorithms in the next-generation ICM systems may lead to improved detection accuracy, in-clinic efficiency, and device battery longevity., (© 2023 Wiley Periodicals LLC.)

Background: Dual-chamber leadless pacemakers (LPs) require robust communication between distinct right atrial (RA) and right ventricular (RV) LPs to achieve atrioventricular (AV) synchrony., Objective: The purpose of this preclinical study was to evaluate a novel, continuous implant-to-implant (i2i™) communication methodology for maintaining AV-synchronous, dual-chamber DDD(R) pacing by the 2 LPs., Methods: RA and RV LPs were implanted and paired in 7 ovine subjects (4 with induced complete heart block). AV synchrony (% AV intervals <300 ms) and i2i communication success (% successful i2i transmissions between LPs) were evaluated acutely and chronically. During acute testing, 12-lead electrocardiographic and LP diagnostic data were collected from 5-minute recordings, in 4 postures and 2 rhythms (AP-VP and AS-VP, or AP-VS and AS-VS) per subject. Chronic i2i performance was evaluated through 23 weeks postimplant (final i2i evaluation period: week 16-23)., Results: Acute AV synchrony and i2i communication success across multiple postures and rhythms were median [interquartile range] 100.0% [100.0%-100.0%] and 99.9% [99.9%-99.9%], respectively. AV synchrony and i2i success rates did not differ across postures (P = .59, P = .11) or rhythms (P = 1, P = .82). During the final i2i evaluation period, the overall i2i success was 98.9% [98.1%-99.0%]., Conclusion: Successful AV-synchronous, dual-chamber DDD(R) leadless pacing using a novel, continuous, wireless communication modality was demonstrated across variations in posture and rhythm in a preclinical model., (Copyright © 2023. Published by Elsevier Inc.)

Aims: Cardiac resynchronization therapy programmed to dynamically fuse pacing with intrinsic conduction using atrioventricular (AV) timing algorithms (e.g. SyncAV) has shown promise; however, mechanistic data are lacking. This study assessed the impact of SyncAV on electrical dyssynchrony across various pacing modalities using non-invasive epicardial electrocardiographic imaging (ECGi)., Methods and Results: Twenty-five patients with left bundle-branch block (median QRS duration (QRSd) 162.7 ms) and intact AV conduction (PR interval 174.0 ms) were prospectively enrolled. ECGi was performed acutely during biventricular pacing with fixed nominal AV delays (BiV) and using SyncAV (optimized for the narrowest QRSd) during: BiV + SyncAV, LV-only single-site (LVSS + SyncAV), MultiPoint pacing (MPP + SyncAV), and LV-only MPP (LVMPP + SyncAV). Dyssynchrony was quantified via ECGi (LV activation time, LVAT; RV activation time, RVAT; LV electrical dispersion index, LVEDi; ventricular electrical uncoupling index, VEU; and biventricular total activation time, VVtat). Intrinsic conduction LVAT (124 ms) was significantly reduced by BiV pacing (109 ms) (P = 0.001) and further reduced by LVSS + SyncAV (103 ms), BiV + SyncAV (103 ms), LVMPP + SyncAV (95 ms), and MPP + SyncAV (90 ms). Intrinsic RVAT (93 ms), VVtat (130 ms), LVEDi (36 ms), VEU (50 ms), and QRSd (163 ms) were reduced by SyncAV across all pacing modes. More patients exhibited minimal LVAT, VVtat, LVEDi, and QRSd with MPP + SyncAV than any other modality., Conclusion: Dynamic AV delay programming targeting fusion with intrinsic conduction significantly reduced dyssynchrony, as quantified by ECGi and QRSd for all evaluated pacing modes. MPP + SyncAV achieved the greatest synchrony overall but not for all patients, highlighting the value of pacing mode individualization during fusion optimization., Competing Interests: Conflict of interest: N.B., L.C.M., and J.O.M. are employees of Abbott., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)