Understanding the impact of gate errors on quantum circuits is crucial to determining the potential applications of quantum computers, especially in the absence of large-scale error-corrected hardware. We put forward analytical arguments, corroborated by extensive numerical and experimental evidence, that Trotterized quantum circuits simulating the time evolution of systems near thermal equilibrium are substantially more robust to both quantum gate errors and Trotter (discretization) errors than is widely assumed. In Quantinuum's trapped-ion computers, the weakly entangling gates that appear in Trotterized circuits can be implemented natively, and their error rate is smaller when they generate less entanglement; from benchmarking, we know that the error for a gate exp[-i(Z (R) Z)r] decreases roughly linearly with r, up to a small offset at r = 0. We provide extensive evidence that this scaling, together with the robustness of near-thermal dynamics to both gate and discretization errors, facilitates substantial improvements in the achievable accuracy of Trotterized dynamics on near-term quantum computers. We make heavy use of a theoretical tool-a statistical ensemble of random product states that approximates a thermal state, which can be efficiently prepared with low noise on quantum computers. We outline how the random product state ensemble can be used to predict, optimize, and design Hamiltonian simulation experiments on near-thermal quantum systems.

The promise of quantum computers hinges on the ability to scale to large system sizes, e.g., to run quantum computations consisting of more than 100 million operations fault-tolerantly. This in turn requires suppressing errors to levels inversely proportional to the size of the computation. As a step towards this ambitious goal, we present experiments on a trapped-ion QCCD processor where, through the use of fault-tolerant encoding and error correction, we are able to suppress logical error rates to levels below the physical error rates. In particular, we entangled logical qubits encoded in the [[7,1,3]] code with error rates 9.8 times to 500 times lower than at the physical level, and entangled logical qubits encoded in a [[12,2,4]] code based on Knill's C4/C6 scheme with error rates 4.7 times to 800 times lower than at the physical level, depending on the judicious use of post-selection. Moreover, we demonstrate repeated error correction with the [[12,2,4]] code, with logical error rates below physical circuit baselines corresponding to repeated CNOTs, and show evidence that the error rate per error correction cycle, which consists of over 100 physical CNOTs, approaches the error rate of two physical CNOTs. These results signify a transition from noisy intermediate scale quantum computing to reliable quantum computing, and demonstrate advanced capabilities toward large-scale fault-tolerant quantum computing.

Abstract Guidelines for permanent pacemaker implantation were established in 1984 by a joint task force of the American Heart Association and American College of Cardiology. The guidelines have been updated multiple times (most recently in 2018). Indications for permanent pacing are divided into 3 classes. The chapter presents the class I, II, and III indications for pacemaker placement for clinical scenarios.

INTRODUCTION:The impact of mRNA-based coronavirus disease-2019 (COVID-19) vaccines on atrial arrhythmias (AA) and ventricular arrhythmias incidence is unknown. METHODS:BIOTRONIK Home Monitoring data and Medicare Claims data were utilized to identify individuals implanted with a cardiac implantable electronic device (CIED) between 2010 and 2020 who received one or more doses of COVID-19 vaccine in 2021. The burden of AA (%) in the 3 months postvaccination was compared to those noted in the preceding 3 months using the Wilcoxon signed rank test. Sub-analyses comparing the effects of the influenza vaccine against the COVID-19 vaccine were also evaluated for individuals who received the influenza vaccine in 2020. A 1:1 propensity score match comparison between COVID-19 vaccine and non-vaccinated patients was also performed. RESULTS:First and second doses of the COVID-19 vaccine were administered to 7757 and 6579 individuals with a CIED (age 76.2 ± 9.0 years, 49% males), respectively. While a small but statistically significant increase in the burden of AA was noted in the 3 months postvaccination compared to the preceding 3 months after the first dose of the COVID-19 vaccine (0.43 ± 9.04%, p = .028) a similar rise in AA was found following the influenza vaccine and for matched patients who did not receive the COVID-19 vaccine. No significant difference in device therapies was seen pre- and postvaccination. CONCLUSIONS:Though we report a small but significant increase in the number of CIED-detected AAs following vaccination for COVID-19 over a 3-month window, we believe these results correlate more with time and the progressive nature of AF rather than the vaccine itself. While these data should not dissuade from the use of these vaccines, increased vigilance and prompt treatment of AF is required for high-risk groups, specifically males over 70 years of age, following vaccination.

Quantum error correction protects logical quantum information against environmental decoherence by encoding logical qubits into entangled states of physical qubits. One of the most important near-term challenges in building a scalable quantum computer is to reach the break-even point, where logical quantum circuits on error-corrected qubits achieve higher fidelity than equivalent circuits on uncorrected physical qubits. Using Quantinuum's H2 trapped-ion quantum processor, we encode the Greenberger-Horne-Zeilinger (GHZ) state in four logical qubits with fidelity 99.5±0.15%≤F≤99.7±0.1% (after postselecting on over 98% of outcomes). Using the same quantum processor, we can prepare an uncorrected GHZ state on four physical qubits with fidelity 97.8±0.2%≤F≤98.7±0.2%. The logical qubits are encoded in a ⟦25,4,3⟧ Tanner-transformed long-range-enhanced surface code. Logical entangling gates are implemented using simple swap operations. Our results are a first step toward realizing fault-tolerant quantum computation with logical qubits encoded in geometrically nonlocal quantum low-density parity check codes.

Quantum state teleportation is commonly used in designs for large-scale quantum computers. Using Quantinuum's H2 trapped-ion quantum processor, we demonstrate fault-tolerant state teleportation circuits for a quantum error correction code-specifically the Steane code. The circuits use up to 30 qubits at the physical level and employ real-time quantum error correction. We conducted experiments on several variations of logical teleportation circuits using both transversal gates and lattice surgery. We measured the logical process fidelity to be 0.975 ± 0.002 for the transversal teleportation implementation and 0.851 ± 0.009 for the lattice surgery teleportation implementation as well as 0.989 ± 0.002 for an implementation of Knill-style quantum error correction.

Understanding patterns of drug-gene interactions (DGIs) is important for advancing the clinical implementation of pharmacogenetics (PGx) into routine practice. Prior studies have estimated the prevalence of DGIs, but few have confirmed DGIs in patients with known genotypes and prescriptions, nor have they evaluated clinician characteristics associated with DGI-prescribing. This retrospective chart review assessed prevalence of DGI, defined as a medication prescription in a patient with a PGx phenotype that has a clinical practice guideline recommendation to adjust therapy or monitor drug response, for patients enrolled in a research genetic biorepository linked to electronic health records (EHRs). The prevalence of prescriptions for medications with pharmacogenetic (PGx) guidelines, proportion of prescriptions with DGI, location of DGI prescription, and clinical service of the prescriber were evaluated descriptively. Seventy-five percent (57,058/75,337) of patients had a prescription for a medication with a PGx guideline. Up to 60% (n = 26,067/43,647) of patients had at least one DGI when considering recommendations to adjust or monitor therapy based on genotype. The majority (61%) of DGIs occurred in outpatient prescriptions. Proton pump inhibitors were the most common DGI medication for 11 of 12 clinical services. Almost 25% of patients (n = 10,706/43,647) had more than one unique DGI, and, among this group of patients, 61% had a DGI with more than one gene. These findings can inform future clinical implementation by identifying key stakeholders for initial DGI prescriptions, helping to inform workflows. The high prevalence of multigene interactions identified also support the use of panel PGx testing as an implementation strategy.

Antitachycardia pacing (ATP) is a programmable therapy in implantable cardiac defibrillator (ICD) devices that has been demonstrated to effectively reduce the need for shocks. Limited data, however, exists on the potential benefits of early ATP delivery in the ventricular fibrillation (VF) zone. While ATP is programmed to be delivered as a first line of therapy for ventricular tachycardia (VT) events, it does so only once the episode meets detection criteria by the ICD. Newer generations of BIOTRONIK ICDs have the ability for earlier delivery of ATP, called Early ATP OneShot, to be programmed in the VF therapy zone.

We consider estimating the magnitude of a monochromatic AC signal that couples to a two-level sensor. For any detection protocol, the precision achieved depends on the signal's frequency and can be quantified by the quantum Fisher information. To study limitations in broadband sensing, we introduce the integrated quantum Fisher information and derive inequality bounds that embody fundamental tradeoffs in any sensing protocol. These inequalities show that sensitivity in one frequency range must come at a cost of reduced sensitivity elsewhere. For many protocols, including those with small phase accumulation and those consisting of $π$-pulses, we find the integrated Fisher information scales linearly with $T$. We also find protocols with substantial phase accumulation can have integrated QFI that grows quadratically with $T$, which is optimal. These protocols may allow the very rapid detection of a signal with unknown frequency over a very wide bandwidth.

The benefits of remote monitoring (RM) have been demonstrated in multiple clinical studies and have become the standard of care for patients with cardiovascular implantable electronic devices (CIEDs). Benefits include fewer hospitalizations, reduction in mortality and improved clinical workflow by reducing in-office visits. As RM utilization increases, the amount of transmitted data can become a resource burden for responsible caregivers.

We compare two different implementations of fault-tolerant entangling gates on logical qubits. In one instance, a twelve-qubit trapped-ion quantum computer is used to implement a non-transversal logical CNOT gate between two five qubit codes. The operation is evaluated with varying degrees of fault tolerance, which are provided by including quantum error correction circuit primitives known as flagging and pieceable fault tolerance. In the second instance, a twenty-qubit trapped-ion quantum computer is used to implement a transversal logical CNOT gate on two [[7,1,3]] color codes. The two codes were implemented on different but similar devices, and in both instances, all of the quantum error correction primitives, including the determination of corrections via decoding, are implemented during runtime using a classical compute environment that is tightly integrated with the quantum processor. For different combinations of the primitives, logical state fidelity measurements are made after applying the gate to different input states, providing bounds on the process fidelity. We find the highest fidelity operations with the color code, with the fault-tolerant SPAM operation achieving fidelities of 0.99939(15) and 0.99959(13) when preparing eigenstates of the logical X and Z operators, which is higher than the average physical qubit SPAM fidelities of 0.9968(2) and 0.9970(1) for the physical X and Z bases, respectively. When combined with a logical transversal CNOT gate, we find the color code to perform the sequence--state preparation, CNOT, measure out--with an average fidelity bounded by [0.9957,0.9963]. The logical fidelity bounds are higher than the analogous physical-level fidelity bounds, which we find to be [0.9850,0.9903], reflecting multiple physical noise sources such as SPAM errors for two qubits, several single-qubit gates, a two-qubit gate and some amount of memory error.

Understanding the nucleon spin structure in the regime where the strong interaction becomes truly strong poses a challenge to both experiment and theory. At energy scales below the nucleon mass of about 1 GeV, the intense interaction among the quarks and gluons inside the nucleon makes them highly correlated. Their coherent behaviour causes the emergence of effective degrees of freedom, requiring the application of non-perturbative techniques such as chiral effective field theory(1). Here we present measurements of the neutron's generalized spin polarizabilities that quantify the neutron's spin precession under electromagnetic fields at very low energy-momentum transfer squared down to 0.035 GeV2. In this regime, chiral effective field theory calculations(2-4) are expected to be applicable. Our data, however, show a strong discrepancy with these predictions, presenting a challenge to the current description of the neutron's spin properties.

BACKGROUND:Cardiac implantable electronic devices (CIED)-ie, pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices-have recently been designed to allow for patients to safely undergo magnetic resonance imaging (MRI) when specific programming is implemented. MRI AutoDetect is a feature that automatically switches CIED's programming into and out of an MR safe mode when exposed to an MRI environment.OBJECTIVE:The purpose was to analyze de-identified daily remote transmission data to characterize the utilization of the MRI AutoDetect feature.METHODS:Home Monitoring transmission data collected from MRI AutoDetect-capable devices were retrospectively analyzed to determine the workflow and usage in patients experiencing an MRI using the MRI AutoDetect feature.RESULTS:Among 48,756 capable systems, 2197 devices underwent an MRI using the MRI AutoDetect feature. In these 2197 devices, the MRI AutoDetect feature was used a total of 2806 times with an average MRI exposure of 40.83 minutes. The majority (88.9%) of MRI exposures occurred on the same day as the MRI AutoDetect programming. A same day post-MRI exposure follow-up device interrogation was performed 8.6% of the time. A device-related complaint occurred within 30 days of the MRI exposure in 0.25% of MRI exposures using MRI AutoDetect but with no adverse clinical outcome.CONCLUSION:As a result of automation in device programming, the MRI AutoDetect feature eliminated post-MRI device reprogramming in 91.4% of MRI exposures and, while less frequent, allowed for pre-MRI interrogations prior to the day of the MRI exposure-reducing resource utilization and creating workflow flexibility.

Hemodynamic consequences of cardiac pacing have evolved dramatically over the past several decades. In practice, with the exception of cardiac resynchronization devices, echocardiographic optimization is rarely performed. Taking the interatrial and intra-atrial delay into consideration and programming the differential atrioventricular (AV) interval accordingly may result in improved hemodynamics. Acute hemodynamic studies suggest that optimal ventricular contractility is further enhanced in individual patients when a patient's specific AV interval is programmed. Many individuals with left ventricle dysfunction have a number of associated comorbidities, such as diabetes mellitus, renal failure, coronary artery disease, hypertension, and chronic obstructive pulmonary disease, amongst others. An early study of the effect of pacing mode on morbidity and mortality paved the way for subsequent clinical trials to examine the effect of pacing mode on morbidity and mortality, as well as the potential adverse effects of VVI pacing.

Understanding cardiac pacing requires an intimate consideration of two key elements: stimulation threshold and sensing. The chronaxie is important in the clinical practice of pacing because it approximates the point of minimum threshold energy required for myocardial depolarization. One can specifically consider the situation of postdefibrillation pacing, when stimulation thresholds may be increased due to tissue ischemia during the preceding tachyarrhythmia or at the time of defibrillation. Certain drugs used in patients with cardiac disease may also increase pacing thresholds. Newer pacemakers and implantable cardioverter-defibrillators that can support higher current drains for capacitor charging and high-rate antitachycardia pacing use lithium–silver oxide–vanadium chemistries. In unipolar pacing systems, the lead tip functions as the cathode and the pulse generator as the anode. In bipolar systems, the lead tip serves as the cathode and a lead ring acts as the anode.

This chapter contains sections titled: Complications related directly to the implant procedure Implant or hardware-related complications that may result in recurrence of preimplantation symptoms (see also Chapter 10, Troubleshooting) References