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In patients with persistent atrial fibrillation, rates of recurrent atrial fibrillation at 18 months were not significantly different when linear ablation or ablation of complex fractionated electrograms was performed along with pulmonary-vein isolation. Percutaneous catheter ablation is an effective treatment for paroxysmal atrial fibrillation, 1 – 3 particularly in cases that are refractory to antiarrhythmic medications. 4 – 6 Most triggers for paroxysmal atrial fibrillation come from the pulmonary veins, so ablation involves creating circumferential lesions around the veins to electrically isolate them from the rest of the left atrium. 7 Catheter ablation for persistent atrial fibrillation is more challenging and is associated with less favorable outcomes. 8 , 9 To improve outcomes, ablation targeting the substrate that maintains fibrillation (i.e., substrate modification) is often added to pulmonary-vein isolation. 10 , 11 The two most common techniques for substrate modification are the . . .

In patients with cryptogenic stroke, undetected paroxysmal atrial fibrillation may be a cause of the stroke. In this randomized trial, an insertable cardiac monitor was superior to conventional cardiac monitoring for detecting atrial fibrillation in patients with cryptogenic stroke. Ischemic stroke is among the leading causes of death and disability. 1 The cause remains unexplained after routine evaluation in 20 to 40% of cases, resulting in the classification, by exclusion, of cryptogenic stroke. 2 – 6 Atrial fibrillation is a well-recognized cause of ischemic stroke, 7 though the risk is markedly reduced by anticoagulation 7 , 8 Documentation of atrial fibrillation is required to initiate anticoagulant therapy after ischemic stroke. 8 In the absence of documented atrial fibrillation, antiplatelet agents are recommended. 7 Given the often paroxysmal and asymptomatic nature of atrial fibrillation, it may not be detected with the use of traditional monitoring techniques. 9 – 12 Strategies . . .

This study investigates visual fatigue in a real-world pharmaceutical packaging environment, where operators perform repetitive inspection and packing tasks under frequently suboptimal lighting conditions. A human-centered methodology was adopted, combining adapted self-report questionnaires, high-frequency eye-tracking data collected with Tobii Pro Glasses 3, and lux-level measurements. Key eye-movement metrics—including fixation duration, visit patterns, and pupil diameter—were analyzed within defined work zones (Areas of Interest). To reduce data complexity and uncover latent patterns of visual behavior, Principal Component Analysis was applied. Results revealed a progressive increase in visual fatigue across the workweek and throughout shifts, particularly during night work, and showed a strong association with inadequate lighting. Tasks involving high physical workload under poor illumination emerged as critical risk scenarios. This integrated approach not only confirmed the presence of visual fatigue but also identified high-risk conditions in the workflow, enabling targeted ergonomic interventions. The findings provide a practical framework for improving operator well-being and inspection performance through sensor-based monitoring and environment-specific design enhancements, in alignment with the goals of Industry 5.0.

Patients with symptomatic, paroxysmal, untreated atrial fibrillation were randomly assigned to antiarrhythmic drug therapy or cryoablation. At 1 year, there was a significantly lower rate of recurrence of atrial fibrillation with cryoablation than with drug therapy.

Chagas disease (CD) is a major public health concern in Latin America and a potentially serious emerging threat in non-endemic countries. Although the association between CD and cardiac abnormalities is widely reported, study design diversity, sample size and quality challenge the information, calling for its update and synthesis, which would be very useful and relevant for physicians in non-endemic countries where health care implications of CD are real and neglected. We performed to systematically review and meta-analyze population-based studies that compared prevalence of overall and specific ECG abnormalities between CD and non-CD participants in the general population. Six databases (EMBASE, Ovid Medline, Web of Science, Cochrane Central, Google Scholar and Lilacs) were searched systematically. Observational studies were included. Odds ratios (OR) were computed using random-effects model. Forty-nine studies were selected, including 34,023(12,276 CD and 21,747 non-CD). Prevalence of overall ECG abnormalities was higher in participants with CD (40.1%; 95%CIs=39.2-41.0) compared to non-CD (24.1%; 95%CIs=23.5-24.7) (OR=2.78; 95%CIs=2.37-3.26). Among specific ECG abnormalities, prevalence of complete right bundle branch block (RBBB) (OR=4.60; 95%CIs=2.97-7.11), left anterior fascicular block (LAFB) (OR=1.60; 95%CIs=1.21-2.13), combination of complete RBBB/LAFB (OR=3.34; 95%CIs=1.76-6.35), first-degree atrioventricular block (A-V B) (OR=1.71; 95%CIs=1.25-2.33), atrial fibrillation (AF) or flutter (OR=2.11; 95%CIs=1.40-3.19) and ventricular extrasystoles (VE) (OR=1.62; 95%CIs=1.14-2.30) was higher in CD compared to non-CD participants. This systematic review and meta-analysis provides an update and synthesis in this field. This research of observational studies indicates a significant excess in prevalence of ECG abnormalities (40.1%) related to T. cruzi infection in the general population from Chagas endemic regions, being the most common ventricular (RBBB and LAFB), and A-V B (first-degree) node conduction abnormalities as well as arrhythmias (AF or flutter and VE). Also, prevalence of ECG alterations in children was similar to that in adults and suggests earlier onset of cardiac disease.

A cohort of 2580 patients with pacemakers or defibrillators were monitored for 3 months to detect subclinical atrial tachyarrhythmias. Patients with subclinical atrial tachyarrhythmias had a significantly increased risk of subsequent ischemic stroke. Atrial fibrillation may be asymptomatic and consequently subclinical. 1 , 2 Epidemiologic studies indicate that many patients with atrial fibrillation on screening electrocardiograms had not previously received a diagnosis of atrial fibrillation. 3 About 15% of strokes are attributable to documented atrial fibrillation, and 50 to 60% to documented cerebrovascular disease, 4 – 7 but in about 25% of patients who have ischemic strokes, no etiologic factor is identified. 4 , 8 , 9 Subclinical atrial fibrillation is often suspected to be the cause of stroke in these patients. 10 However, the prevalence and prognostic value of subclinical atrial fibrillation has been difficult to assess. 8 , 9 , 11 , 12 An . . .

Chagas disease caused by Trypanosoma cruzi is a complex disease that is endemic and an important problem in public health in Latin America. The T. cruzi parasite is classified into six discrete taxonomic units (DTUs) based on the recently proposed nomenclature (TcI, TcII, TcIII, TcIV, TcV and TcVI). The discovery of genetic variability within TcI showed the presence of five genotypes (Ia, Ib, Ic, Id and Ie) related to the transmission cycle of Chagas disease. In Colombia, TcI is more prevalent but TcII has also been reported, as has mixed infection by both TcI and TcII in the same Chagasic patient. The objectives of this study were to determine the T. cruzi DTUs that are circulating in Colombian chronic Chagasic patients and to obtain more information about the molecular epidemiology of Chagas disease in Colombia. We also assessed the presence of electrocardiographic, radiologic and echocardiographic abnormalities with the purpose of correlating T. cruzi genetic variability and cardiac disease. Molecular characterization was performed in Colombian adult chronic Chagasic patients based on the intergenic region of the mini-exon gene, the 24Sα and 18S regions of rDNA and the variable region of satellite DNA, whereby the presence of T.cruzi I, II, III and IV was detected. In our population, mixed infections also occurred, with TcI-TcII, TcI-TcIII and TcI-TcIV, as well as the existence of the TcI genotypes showing the presence of genotypes Ia and Id. Patients infected with TcI demonstrated a higher prevalence of cardiac alterations than those infected with TcII. These results corroborate the predominance of TcI in Colombia and show the first report of TcIII and TcIV in Colombian Chagasic patients. Findings also indicate that Chagas cardiomyopathy manifestations are more correlated with TcI than with TcII in Colombia.

Chronic Chagas Cardiomyopathy (CCM) is a unique form of cardiomyopathy compared to other etiologies of heart failure. In CCM, risk prediction based on biomarkers has not been well-studied. We assessed the prognostic value of a biomarker panel to predict a composite outcome (CO), including the need for heart transplantation, use of left ventricular assist devices, and mortality. During a median follow-up of 52 months, the mortality rate was 20%, while the CO was observed in 25% of the patients. Four biomarkers (NT-proBNP, hs-cTnT, sST2, and Cys-C) were associated with the CO; concentrations of NT-proBNP and hs-cTnT were associated with the highest AUC (85.1 and 85.8, respectively). Combining these two biomarkers above their selected cut-off values significantly increased risk for the CO (HR 3.18; 95%CI 1.31-7.79). No events were reported in the patients in whom the two biomarkers were under the cut-off values, and when both levels were above cut-off values, the CO was observed in 60.71%. The combination of NT-proBNP and hs-TnT above their selected cut-off values is associated with a 3-fold increase in the risk of the composite outcome among CCM patients. The use of cardiac biomarkers may improve prognostic evaluation of patients with CCM.

Human factors play a relevant role in the dynamic work environments of the manufacturing sector in terms of production efficiency, safety, and sustainable performance. This is particularly relevant in assembly lines where humans are widely employed alongside automated and robotic agents. In this situation, operators’ ability to adapt to different levels of task complexity and variability in each workstation has a strong impact on the safety, reliability, and efficiency of the overall production process. This paper presents an application of a theoretical and empirical method used to assess the matching of different workers to various workstations based on a quantified comparison between the workload associated with the tasks and the human capability of the workers that can rotate among them. The approach allowed for the development of an algorithm designed to operationalise indicators for workload and task complexity requirements, considering the skills and capabilities of individual operators. This led to the creation of human performance (HP) indices. The HP indices were utilized to ensure a good match between requirements and capabilities, aiming to minimise the probability of human error and injuries. The developed and customised model demonstrated encouraging results in the specific case studies where it was applied but also offers a generalizable approach that can extend to other contexts and situations where job rotations can benefit from effectively matching operators to suitable task requirements.