Atrial fibrillation (AF) is a very common arrhythmia that mainly affects older individuals. The mechanism of atrial fibrillation is complex and is related to the pathogenesis of trigger activation and the perpetuation of arrhythmia. The pulmonary veins in the left atrium arei confirm that onfirm the most common triggers due to their distinct anatomical and electrophysiological properties. As a result, their electrical isolation by ablation is the cornerstone of invasive AF treatment. Multiple factors and comorbidities affect the atrial tissue and lead to myocardial stretch. Several neurohormonal and structural changes occur, leading to inflammation and oxidative stress and, consequently, a fibrotic substrate created by myofibroblasts, which encourages AF perpetuation. Several mechanisms are implemented into daily clinical practice in both interventions in and the medical treatment of atrial fibrillation.

Ventricular sensing relies on the analysis of a local intracardiac electrogram in reference to the QRS on the surface electrocardiogram. If both signals do not coincide in time, there is a delay in sensing intrinsic ventricular activity. We evaluated possible differences in the electrical delay between the mid-septum and apex as determined by the right ventricular (RV) lead position using a pacing system analyzer (PSA) during conventional pacemaker implantation. Patients without significant heart disease and intrinsic atrioventricular conduction underwent their first Medtronic (Minneapolis, MN, USA) or Abbott (Chicago, IL, USA) dual-chamber pacemaker implantation with the RV lead first positioned at the apex and then subsequently at the mid-septum. Real-time ventricular sensing data were obtained through PSA to determine the electrical delay Q-VS value as the time difference between the QRS and the released RV-sensed event marker "VS." Among 212 patients, 139 had narrow QRS and 73 had complete right bundle branch block (RBBB). Overall, both narrow QRS and RBBB patients exhibited shorter Q-VS lengths at the mid-septum compared to the apex (50.4 ± 24.2 ms and 66.7 ± 32.3 ms vs. 63.9 ± 27.6 ms and 71.7 ± 32.2 ms; P < .0001 and P < .001, respectively). The Q-VS in patients with Abbott devices was significantly shorter compared to that in patients with Medtronic devices at both the mid-septum and the apex in both patient groups (P < .0001). In conclusion, RV lead positioning at the mid-septum is associated with a shorter electrical delay compared to positioning at the apex in both narrow QRS and RBBB patients.

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Pacemaker’s ventricular sensing function relies on the analysis of the intracardiac electrogram (EGM) including the timing of the intrinsic detection. The phenomenon of ventricular sensing latency refers to the gap of time by which the intrinsic signal gets delayed to be detected compared with the surface electrogram (ECG). A pacing system analyzer (PSA) unit is needed to record the EGM during pacemaker operation, which is expected to correspond to those taken following implantation. Purpose We sought to determine the latency period for sensing EGM by the right ventricular (RV) lead, either through the PSA or through the implanted pacemaker on the same patient. Methods Patients without significant heart disease and intrinsic atrioventricular conduction underwent conventional dual-chamber Medtronic or Abbott pacemaker implantation with the RV lead positioned on mid-septum. Real time sensing data was obtained through PSA and after pacemaker implantation. The RV lead sensing latency was defined as the time interval Q-VS measured from the beginning of QRS on ECG to the released ventricular sensed (VS) event marker on either device. Results Of 157 patients, 105 had narrow QRS (<120 ms) and 52 had wide QRS (≥120 ms) of right bundle branch block (RBBB). Both narrow QRS and RBBB patients had longer sensing latency through PSA (50.9 ± 24.2 ms and 67.8 ± 32.9 ms, respectively) than through pacemaker (18.2 ± 12.8 ms and 31.2 ± 14.8 ms, respectively, both p<0.001). RBBB patients had longer sensing latency compared with narrow QRS patients, either through PSA or through pacemaker (p<0.001). The sensing latency of Medtronic recipients was longer than those of Abbott in narrow QRS, but not in RBBB (p=0.03 and p=0.08, respectively). Conclusion We demonstrated longer RV lead sensing latency (1) through PSA than through the implanted pacemaker, (2) in RBBB than in narrow QRS, (3) in Medtronic pacemakers compared with Abbott pacemakers. Knowledge of the RV lead sensing latency helps optimization of atrioventricular delay and reduces unnecessary ventricular pacing.

Purpose This paper aims to examine whether corporate social responsibility (CSR) is related to management sales forecast accuracy. Design/methodology/approach Use KLD measures of corporate responsibility combined with forecast accuracy regression model, including controls for management skills and expertise. Findings Socially responsible firms commit forecast errors of lower magnitude and sales forecast accuracy is positively related to the level of CSR. Research limitations/implications A strong motive for research on the field of CSR topic under the scope of reporting quality. Future research could focus on alternative measures of CSR; such as announcements included into the financial statements or separately disclosed expenses. Examine the magnitude of confirmed relation, among different economies worldwide. Practical implications CSR effect on manager sales forecasting activity, highlight the impact of brand awareness and customer loyalty, as created by implementing CSR strategies, on firm growth and sales expansion. Social implications The research enhances the era towards more socially responsible firms, presenting evidence of such an adoption on corporate fundamentals. Originality/value To the knowledge there is no prior research examining the implications of CSR on sales forecast accuracy.

Abstract Background Pacemaker implantation involves intraoperative testing of ventricular sensing using a device called a pacing system analyzer (PSA). The value obtained is expected to correspond to those taken by the pacemaker after its implantation. This study determined the latency period for sensing intracardiac electrogram (EGM) by the right ventricular (RV) lead. Methods Patients without significant heart disease and underlying intrinsic atrioventricular (AV) conduction underwent Medtronic or Abbott dual‐chamber pacemaker implantation with the RV lead positioned on the mid‐septum. Real‐time sensing data were obtained through PSA and after pacemaker implantation to evaluate latency as the time interval Q‐VS between the onset of QRS on surface electrocardiogram and the sensed EGM by the RV lead. Results Of 157 patients, 105 had narrow QRS (<120 ms) and 52 had wide QRS of complete right bundle branch block (RBBB). Both narrow‐QRS and RBBB patients had longer sensing latency through PSA (50.9 ± 24.2 and 67.8 ± 32.9 ms, respectively) than through pacemaker (18.2 ± 12.8 and 31.2 ± 14.8 ms, respectively, both p < 0.001). RBBB patients had longer sensing latency compared with narrow QRS patients, either through PSA or through pacemaker (p < 0.001). The sensing latency of Medtronic recipients was longer than those of Abbott in narrow‐QRS (p < 0.05), but not in RBBB. Conclusion We demonstrated longer RV lead sensing latency (1) through PSA than through pacemaker, (2) in RBBB than in narrow‐QRS, and (3) in Medtronic pacemakers compared with Abbott pacemakers. Knowledge of sensing latency helps the optimization of the AV delay.

Future CardiologyVol. 17, No. 7 Clinical SnapshotVentricular activation during transcutaneous and transvenous pacingFani Zagkli, Christina Jachrista, Panagiotis Chronopoulos & John ChiladakisFani ZagkliDepartment of Cardiology, University Hospital of Patras, Rion, Greece, Christina JachristaDepartment of Cardiology, University Hospital of Patras, Rion, Greece, Panagiotis ChronopoulosDepartment of Cardiology, University Hospital of Patras, Rion, Greece & John Chiladakis *Author for correspondence: Tel.: +30 2610 99071; E-mail Address: chil@otenet.grhttps://orcid.org/0000-0002-5930-5226Department of Cardiology, University Hospital of Patras, Rion, GreecePublished Online:14 Apr 2021https://doi.org/10.2217/fca-2020-0209AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInReddit View articleKeywords: cardiac imagingcardiopulmonary resuscitationelectroanatomic mappingpacingReferences1. Neumar RW, Otto CW, Link MS et al. Part 8: adult advanced cardiovascular life support: 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122(3 Suppl. 18), 729–767 (2010).Crossref, Medline, Google Scholar2. Kusumoto FM, Schoenfeld MH, Barrett C et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. Circulation 140(8), e382–e482 (2019).Medline, Google Scholar3. Zagkli F, Georgakopoulou A, Chiladakis J. The electrocardiogram of ventricular capture during transcutaneous cardiac pacing. J. Electrocardiol. 58, 119–124 (2020).Crossref, Medline, Google ScholarFiguresReferencesRelatedDetailsCited ByClinical Snapshot: viewing the future in Future CardiologyJulia Titova & Laura Dormer14 April 2021 | Future Cardiology, Vol. 17, No. 7 Vol. 17, No. 7 Follow us on social media for the latest updates Metrics Downloaded 41 times History Received 28 November 2020 Accepted 26 February 2021 Published online 14 April 2021 Published in print October 2021 Information© 2021 Future Medicine LtdKeywordscardiac imagingcardiopulmonary resuscitationelectroanatomic mappingpacingFinancial & competing interests disclosureThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.No writing assistance was utilized in the production of this manuscript.Informed consent disclosureThe authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this clinical snapshot.PDF download

Ιn a 76-year old man with a dual-chamber ICD implanted five years ago, dizzy spells and significant bradycardia on Holter were not initially recognized as inhibition of bradycardia pacing, due to oversensing. Hospital admission was deemed necessary only after repetitive ICD shocks attributed to right ventricular pace-sense lead fracture. The need to ensure adequate ICD antibradycardia backup pacing in pacing-dependent patients when deleterious sensing errors occur, cannot be overemphasized.

We investigate the implications of voluntary forecasting activity on the persistence of actual reported figures. We further explore the impact of managements’ error direction (i.e. pessimistic versus optimistic manager) on the persistence of actual reported figures. We finally explore whether forecasting activity can be used as a vehicle useful in obtaining profitable investment strategies. The empirical evidence supports the intuition that management forecasts indicate actual accounting figures of higher reporting quality. Moreover, pessimistic managers provide more persistent accounting figures than optimistic managers. Finally, the evidence suggests that forecasting activity occurrence indicates different quality implications for Forecasters relative to non-Forecasters, creating thus ground for creating profitable investment portfolio combinations.

Poster: ECR 2012 / C-2527 / Thyroid nodules evaluation from radiologists in trainning: TIRADS vs FNA guidelines by: V. PAVLIDIS, P. Papantoniou, D. Nikolaou, M. Kabassakali, P. ARGYRIOU, P. Chronopoulos; Athens/GR