1.7 W holmium-doped fluoroindate fiber laser at 3920 nm.

A monolithic fiber laser emitting 1.7 W at 3920 nm is experimentally demonstrated in a Ho3+:InF3 fiber. The cavity comprises a pair of highly reflective fiber Bragg gratings written in the active fiber with the femtosecond phase-mask scanning technique and is spliced to the pump diode with a robust silica-to-fluoride fiber splice. This work is an important step toward high-power all-fiber laser operating in the vicinity of 4 µm.

Ultra-Low-Temperature Cryoablation for Ventricular Tachycardia: An Early Single-Centre Report of Acute Results.

Background: Endocardial catheter ablation for ventricular tachycardia (VT) may fail because of the inability to deliver transmural lesions. Ultra-low-temperature cryoablation (ULTC) uses near-critical nitrogen and can generate temperatures as low as -196 °C. We report a series of 18 patients who underwent ULTC at the McGill University Health Centre (MUHC), representing the largest single-centre experience to date. Methods: Eighteen patients with monomorphic drug-refractory VT underwent VT ablation with ULTC at our institution as part of the first-in-human CryoCure-VT trial (NCT04893317). After voltage map, the mapping catheter was replaced with the ULTC catheter, and lesions were applied over a fixed duration of time (60-180 seconds), followed by a 60-second thaw and another application at the original duration (freeze-thaw-freeze). Duration of ablation time was selected depending on the wall thickness of the left ventricle monitored with intracardiac echo to achieve tissue depths of 4.5 to 7.5 mm. Results: Baseline left ventricular ejection fraction was 32%, mean age 71 years, 94% were male. A total of 32 sustained VTs were induced in 16 of 18 patients. A total of 177 cryoablation lesions were delivered (9.8 lesions per patient). Of the 16 patients with inducible VT, 15 (94%) were rendered noninducible postablation, and 1 was inducible only for a nonclinical VT. Complications included 1 pericardial effusion that required drainage. From 18 patients, 16 (89%) were discharged within the first 24 hours postablation. Conclusions: ULTC is feasible and permits acute control of monomorphic VT during VT ablation procedures in drug-refractory patients.

Contexte: L'ablation endocardique par cathéter pour traiter la tachycardie ventriculaire (TV) peut être un échec, en raison de l'incapacité à créer des lésions transmurales. La cryoablation à ultra-basse température (ULTC, pour ultra-low-temperature cryoablation) réalisée au moyen d'azote près de son point critique liquide-vapeur peut produire des températures aussi basses que ­196 °C. Nous faisons état d'une série de 18 patients ayant subi une ULTC au Centre universitaire de santé McGill (CUSM), ce qui représente la plus importante expérience menée dans un seul établissement jusqu'à ce jour. Méthodologie: Au total, 18 patients atteints de TV monomorphe pharmacorésistante ont subi une ablation de la TV par ULTC à notre établissement, dans le cadre du premier essai mené chez l'humain sur la guérison par cryothérapie de la TV (NCT04893317). Après l'obtention de la carte électrophysiologique, le cathéter de cartographie a été remplacé par le cathéter d'ULTC, qui a permis de créer des lésions par l'application de froid pendant une durée fixe (de 60 à 180 secondes), suivie d'une période de dégel de 60 secondes, puis d'une autre application de froid pendant la même durée que la première application (cycle gel-dégel-gel). La durée de l'ablation a été déterminée en fonction de l'épaisseur de la paroi du ventricule gauche surveillée par échocardiographie endocavitaire afin d'obtenir des profondeurs tissulaires de 4,5 à 7,5 mm. Résultats: La fraction d'éjection du ventricule gauche initiale était de 32 %, l'âge moyen des sujets était de 71 ans et 94 % d'entre eux étaient de sexe masculin. Au total, 32 TV soutenues ont été induites chez 16 patients sur 18. Dans l'ensemble, 177 lésions de cryoablation ont été créées (soit 9,8 lésions par patient). Après l'ablation, nous avons été incapables d'induire une TV chez 15 (94 %) des 16 patients chez qui nous en avions induit avant l'intervention et, chez le patient restant, nous avons pu induire une TV non clinique seulement. Les complications comprenaient un cas d'épanchement péricardique ayant nécessité un drainage. Au total, 16 (89 %) des 18 patients ont reçu leur congé de l'hôpital dans les 24 heures suivant l'ablation. Conclusions: L'ULTC est réalisable et permet une maîtrise rigoureuse de la TV monomorphe lors des interventions d'ablation de la TV chez les patients dont la TV est pharmacorésistante.

High-efficiency radiation-balanced Yb-doped silica fiber laser with 200-mW output.

The focus of this study was the development of a second generation of fiber lasers internally cooled by anti-Stokes fluorescence. The laser consisted of a length of a single-mode fiber spliced to fiber Bragg gratings to form the optical resonator. The fiber was single-moded at the pump (1040 nm) and signal (1064 nm) wavelengths. Its core was heavily doped with Yb, in the initial form of CaF2 nanoparticles, and co-doped with Al to reduce quenching and improve the cooling efficiency. After optimizing the fiber length (4.1 m) and output-coupler reflectivity (3.3%), the fiber laser exhibited a threshold of 160 mW, an optical efficiency of 56.8%, and a radiation-balanced output power (no net heat generation) of 192 mW. On all three metrics, this performance is significantly better than the only previously reported radiation-balanced fiber laser, which is even more meaningful given that the small size of the single-mode fiber core (7.8-µm diameter). At the maximum output power (∼2 W), the average fiber temperature was still barely above room temperature (428 mK). This work demonstrates that with anti-Stokes pumping, it is possible to induce significant gain and energy storage in a small-core Yb-doped fiber while keeping the fiber cool.

Femtosecond Mamyshev oscillator at 920 nm.

A femtosecond all-PM-fiber Mamyshev oscillator (MO) at 920 nm is presented. It is based on a neodymium-doped fiber with a W-type index profile that effectively suppresses the emission around 1064 nm. The linear cavity is bounded by two near-zero dispersion fiber Bragg gratings with Gaussian reflectivity profiles. The laser is self-starting and generates up to 10-nJ pulses at a repetition rate of 41 MHz. The pulses can be compressed to 53 fs with a grating-pair compressor. To our knowledge, this is the first Mamyshev oscillator and also the highest energy femtosecond fiber oscillator demonstrated in this spectral region.

Cardioneuroablation as a strategy to prevent pacemaker implantation in young patients with vasovagal syncope.

Background: Cardioneuroablation (CNA) is an ablation technique that targets epicardial ganglionic plexi to reduce syncope burden and avoid pacemaker implantation in patients with cardioinhibitory vasovagal syncope (VVS). This study aims to demonstrate feasibility and safety of CNA in high-risk refractory VVS patients using continuous monitoring with an implantable loop recorder (ILR). Methods: Data was collected prospectively for patients undergoing CNA. Patients were required to have recurrent syncope with documented asystole, refractory to conservative measures. Ganglionic plexi (GPs) were identified by fragmented signals and high frequency stimulation (HFS). Ablation was performed until loss of positive response to HFS, Wenckebach cycle shortening was achieved, or an increase in sinus rate of > 20 bpm. Follow-up was performed through remote and clinic follow-up of their ILRs. Results: Between December 2020 and July 2023 six patients (mean age 29 ± 3, 67 % female)underwent CNA. The baseline heart rate and Wenckebach cycle length was 63.2 ± 15 bpm and 582 ms before and 91 ± 5 bpm and 358 ms after ablation respectively. During a median follow-up of 13.4 months, 3/5 patients had no further syncopal episodes, 1 had a recurrence, underwent repeat CNA with no further episodes at 1 year, and 1 had 5 syncopal events, which was a dramatic reduction from nearly daily episodes pre-CNA. There were no procedure related complications. Conclusions: A dramatic reduction in documented pauses and syncope burden was noted post CNA. Appropriate patient selection with rigorous objective follow-up in an experienced center is necessary. Larger studies are required to confirm these findings.

Multi-point calorimeter using distributed fiber Bragg gratings for small field dosimetry in radiotherapy.

BACKGROUND: The interest of using fiber Bragg gratings (FBGs) dosimeters in radiotherapy (RT) lies in their (i) microliter detection volume, (ii) customizable spatial resolution, (iii) multi-point dose measurement, (iv) real-time data acquisition and (v) insensitivity to Cherenkov light. These characteristics could prove very useful for characterizing dose distributions of small and nonstandard fields with high spatial resolution. PURPOSE: We developed a multi-point FBGs dosimeter customized for small field RT dosimetry with a spatial resolution of ∼ $\sim$ 1 mm. METHODS: The 3 cm-long multi-point dosimeter is made by embedding a 80 µ m $\umu{\rm {m}}$ silica fiber containing an array of thirty (30) co-located ∼ $\sim$ 1 mm-long fs-written FBGs inside a plastic cylinder with an UV curing optical adhesive. With its higher thermal expansion coefficient, the plastic cylinder increases the sensitivity of the dosimeter by stretching the fiber containing the FBGs when the temperature rises slightly due to radiation energy deposition. Irradiations (2000 MU at 600 MU/min) were performed with a Varian TrueBeam linear accelerator. RESULTS: The dose profile of a 2  × $ \times$ 2 cm 2 $^{2}$ 6 MV beam was measured with a mean relative difference of 1.8% (excluding the penumbra region). The measured output factors for a 6 MV beam are in general agreement with the expected values within the experimental uncertainty (except for the 2  × $\,\times $ 2 cm 2 $^{2}$ field). The detector response to different energy of photon and electron beams is within 5% of the mean response ( 0.068 ± 0.002 $0.068\pm 0.002$  pm/Gy). The calorimeter's post-irradiation thermal decay is in agreement with the theory. CONCLUSIONS: An energy-independent small field calorimeter that allows dose profile and output factor measurements for RT using FBGs was developed, which, to our knowledge, has never been done before. This type of detector could prove really useful for small field dosimetry, but also potentially for MRI-LINAC since FBGs are insensitive to magnetic fields and for FLASH since FBGs have been used to measure doses up to 100 kGy.

Selection of summer feeding sites and food resources by female migratory caribou (Rangifer tarandus) determined using camera collars.

Migratory caribou (Rangifer tarandus) is a socioeconomically and culturally key species for northern communities in the Arctic, and most of its populations are experiencing a sharp decline. Female migratory caribou depend on the availability of summer habitat resources to meet the needs associated with lactation and the accumulation of fat reserves to survive when resources are less abundant. Because of the large scales at which habitat and resource data are usually available, information on how female migratory caribou select habitat and resources at fine scales in the wild is lacking. To document selection of summer feeding sites, we equipped 60 female caribou with camera collars from 2016 to 2018. We collected a total of 65,150 10-sec videos between June 1st and September 1st for three years with contrasted spring phenology. We determined the selection at the feeding site scale (3rd scale of Johnson) and food item scale (4th scale of Johnson) using resource selection probability functions. Wetlands were highly selected as feeding sites in June and July while they were avoided in August. Shrublands were mostly selected in July and August. At the resources scale, lichen, birch, willow, and mushrooms were the most strongly selected resources. Our results provide precise and novel information on habitat selection at feeding sites and food resources selected by female caribou in the wild. This information will help understand foraging patterns and habitat selection behavior of female migratory caribou and will contribute to the management and conservation of its declining populations.

Towards real-time active imaging of greenhouse gases using tunable mid-infrared all-fiber lasers.

We report a tunable all-fiber laser emitting a maximum output power of 2.55 W around 3240 nm. The fiber laser cavity based on a fluoride fiber doped with dysprosium ions yields an efficiency of 42% according to the in-band launched pump power at 2825 nm. Due to a custom piezoelectric fiber Bragg grating (FBG) package, mechanical strains applied to the narrowband FBG used as the input cavity coupler allowed for fast tuning of the emission wavelength over a spectral range of 1.5 nm. This laser was deployed in the field in northern Québec (Canada) to assess its performances for remote sensing of methane in the presence of a significant amount of water vapor, i.e., over a hydroelectric reservoir. The preliminary results acquired during this field campaign confirm the great potential of the proposed approach for the development of a real-time active imaging system of greenhouse gases.

Visible femtosecond fiber laser.

Femtosecond fiber lasers have revolutionized the industry of laser technology by providing ultrashort pulses of high brightness through compact, affordable, and reliable setups. In this work, we extend the scope of application of such sources by reporting, to our knowledge, the first femtosecond fiber laser operating in the visible spectrum. The passively mode-locked ring cavity is based on nonlinear polarization evolution in a single-mode Pr3+-doped fluoride fiber and runs in an all-normal dispersion regime. Compressed pulses at 635 nm have a duration of 168 fs, a peak power of 0.73 kW, and a repetition rate of 137 MHz.

Demonstration of Type A volume Bragg gratings inscribed with a femtosecond Gaussian-Bessel laser beam.

To our knowledge, we report on the first demonstration of Type A VBGs inscribed in silver-containing phosphate glasses by femtosecond laser writing. The gratings are inscribed plane-by-plane by scanning the voxel of a 1030 nm Gaussian-Bessel inscription beam. This results in a refractive-index modification zone, induced by the appearance of silver clusters, extending over a much larger depth than those obtained with standard Gaussian beams. As a result, a high diffraction efficiency of 95% at 632.8 nm is demonstrated for a 2-µm period transmission grating with a 150-µm effective thickness indicating a strong refractive-index modulation of 1.78 × 10-3. Meanwhile, a refractive-index modulation of 1.37 × 10-3 was observed at a wavelength of 1.55 µm. Thus, this work opens the avenue for highly effective femtosecond-written VBGs suitable for industrial applications.

Femtosecond writing of intra-phase-mask volume Bragg gratings.

In this Letter, we report the first, to the best of our knowledge, femtosecond inscription of volume Bragg gratings (VBGs) directly inside phase-mask substrates. This approach showcases enhanced robustness as both the interference pattern generated by the phase mask and the writing medium are inherently bonded together. The technique is employed with 266-nm femtosecond pulses loosely focused by a 400-mm focal length cylindrical mirror inside fused-silica and fused-quartz phase-mask samples. Such a long focal length reduces the aberrations induced by the refractive-index mismatch at the air/glass interface which allows to inscribe a refractive-index modulation simultaneously over a glass depth reaching 1.5 mm. A decreasing gradient of the modulation amplitude from 5.9 × 10-4 at the surface to 1 × 10-5 at a 1.5-mm depth is observed. This technique has therefore the potential of increasing significantly the inscription depth of femtosecond-written VBGs.

Toward low-loss mid-infrared Ga2O3-BaO-GeO2 optical fibers.

The development of efficient and compact photonic systems in support of mid-infrared integrated optics is currently facing several challenges. To date, most mid-infrared glass-based devices are employing fluoride or chalcogenide glasses (FCGs). Although the commercialization of FCGs-based optical devices has rapidly grown during the last decade, their development is rather cumbersome due to either poor crystallization and hygroscopicity resilience or poor mechanical-thermal properties of the FCGs. To overcome these issues, the parallel development of heavy-metal oxide optical fiber from the barium-germanium-gallium oxide vitreous system (BGG) has revealed a promising alternative. However, over 30 years of fiber fabrication optimization, the final missing step of drawing BGG fibers with acceptable losses for meters-long active and passive optical devices had not yet been reached. In this article, we first identify the three most important factors that prevent the fabrication of low-loss BGG fibers i.e., surface quality, volumic striae and glass thermal-darkening. Each of the three factors is then addressed in setting up a protocol enabling the fabrication of low-loss optical fibers from gallium-rich BGG glass compositions. Accordingly, to the best of our knowledge, we report the lowest losses ever measured in a BGG glass fiber i.e., down to 200 dB km-1 at 1350 nm.

Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence: The AWARE Randomized Clinical Trial.

Importance: Recurrent atrial fibrillation (AF) commonly occurs after catheter ablation and is associated with patient morbidity and health care costs. Objective: To evaluate the superiority of an augmented double wide-area circumferential ablation (WACA) compared with a standard single WACA in preventing recurrent atrial arrhythmias (AA) (atrial tachycardia, atrial flutter, or atrial fibrillation [AF]) in patients with paroxysmal AF. Design, Setting, and Participants: This was a pragmatic, multicenter, prospective, randomized, open, blinded end point superiority clinical trial conducted at 10 university-affiliated centers in Canada. The trial enrolled patients 18 years and older with symptomatic paroxysmal AF from March 2015 to May 2017. Analysis took place between January and April 2022. Analyses were intention to treat. Interventions: Patients were randomized (1:1) to receive radiofrequency catheter ablation for pulmonary vein isolation with either a standard single WACA or an augmented double WACA. Main Outcomes and Measures: The primary outcome was AA recurrence between 91 and 365 days postablation. Patients underwent 42 days of ambulatory electrocardiography monitoring after ablation. Secondary outcomes included need for repeated catheter ablation and procedural and safety variables. Results: Of 398 patients, 195 were randomized to the single WACA (control) arm (mean [SD] age, 60.6 [9.3] years; 65 [33.3%] female) and 203 to the double WACA (experimental) arm (mean [SD] age, 61.5 [9.3] years; 66 [32.5%] female). Overall, 52 patients (26.7%) in the single WACA arm and 50 patients (24.6%) in the double WACA arm had recurrent AA at 1 year (relative risk, 0.92; 95% CI, 0.66-1.29; P = .64). Twenty patients (10.3%) in the single WACA arm and 15 patients (7.4%) in the double WACA arm underwent repeated catheter ablation (relative risk, 0.72; 95% CI, 0.38-1.36). Adjudicated serious adverse events occurred in 13 patients (6.7%) in the single WACA arm and 14 patients (6.9%) in the double WACA arm. Conclusions and Relevance: In this randomized clinical trial of patients with paroxysmal AF, additional ablation by performing a double ablation lesion set did not result in improved freedom from recurrent AA compared with a standard single ablation set. Trial Registration: ClinicalTrials.gov Identifier: NCT02150902.

Real-Time Temperature Correction of Medical Range Fiber Bragg Gratings Dosimeters.

The interest in fiber Bragg gratings dosimeters for radiotherapy dosimetry lies in their (i) submillimeter size, (ii) multi-points dose measurements, and (iii) customizable spatial resolution. However, since the radiation measurement relies on the thermal expansion of the surrounding polymer coating, such sensors are strongly temperature dependent, which needs to be accounted for; otherwise, the errors on measurements can be higher than the measurements themselves. In this paper, we test and compare four techniques for temperature compensation: two types of dual grating techniques using different coatings, a pre-irradiation and post-irradiation temperature drift technique, which is used for calorimetry, and finally, we developed a real-time interpolated temperature gradient for the multi-points dosimetry technique. We show that, over these four tested techniques, the last one outperforms the others and allows for real-time temperature correction when an array of 13 fiber Bragg gratings spatially extending over the irradiation zone is used. For a 20 Gy irradiation, this technique reduces the measurement errors from 200% to about 10%, making it suitable for a radiotherapy dose range. Temperature correction for medical low-dose range dosimetry is a first in our field and is essential for clinical FBG dosimetry applications.

Monolithic silica fiber laser operating at 585 nm.

We report, to the best of our knowledge, the first monolithic silica fiber laser operating in the visible. The laser cavity is based on a dysprosium-doped aluminosilicate fiber bounded by a pair of fiber Bragg gratings operating at 585 nm. The yellow laser signal reaches a record output power of 147 mW. Although the pump irradiation causes photodarkening, significant reduction of the photoinduced absorption losses is demonstrated via a photobleaching process with visible light.

Fatigue Performance of Type I and Type II Fibre Bragg Gratings Fabricated by Femtosecond Laser Inscription through the Coating.

Strain sensing technology using fibre Bragg grating (FBG) sensors is an attractive capability for aerospace structural health monitoring (SHM) and assessment because they offer resistance to harsh environments, low maintenance, and potential for high density and high strain sensing. The development of FBG inscription techniques through the fibre polymer coating using infrared (IR) lasers has overcome the mechanical weaknesses introduced by removal of the fibre coating, which is typically required for conventional UV laser inscription of FBGs. Type I and Type II femtosecond gratings are fabricated using through-coating inscription techniques, but the higher laser energy used for Type II gratings damages the glass fibre core, impacting mechanical performance. This paper investigates the fatigue performance of Type I and Type II through-coating FBG sensors with different fibre geometries and photosensitisation approaches to evaluate their overall reliability and durability, with a view to assess their performance for potential use in civil and defence SHM applications. The fatigue performance of FBG sensors was assessed under high-strain and high-frequency mechanical loading conditions by using a custom-designed electro-dynamically actuated loading assembly. In addition, pre- and post-fatigue microscopic analyses and high-resolution reflection spectrum characterisation were conducted to investigate the failure regions of the fibres and the effect of fatigue loading on reflection spectrum features. As expected, Type I gratings had a significantly higher fatigue life compared to Type II gratings. However, Type II gratings performed significantly better than conventional UV laser-inscribed FBGs and electrical foil strain gauges. Type II gratings withstand higher temperatures, and are therefore more suitable for application in harsh environments.

Large area Bragg grating for pump recycling in cladding-pumped multicore erbium-doped fiber amplifiers.

We demonstrate for the first time that a Bragg grating can be written over a large area inside the cladding of a multicore erbium-doped fiber amplifier to increase the power conversion efficiency (PCE) by recycling the output pump power. Our results indicate that a Bragg grating covering ∼25% of the cladding area allows us to recycle 19% of the output pump power which leads to a relative increase of the PCE by 16% for an input pump power of 10.6 W in the specific case of an eight-core erbium-doped fiber with a length of 20.3 m and one core loaded with an input signal power of 1.5 dBm.

Femtosecond inscription of large-area fiber Bragg gratings for high-power cladding pump reflection.

A new, to the best of our knowledge, method for inscribing fiber Bragg gratings inside a fiber's cladding based on the motorized rotation of the fiber is reported. By minimizing the aberrations induced by the fiber curvature on the femtosecond writing beam, this technique based on a phase mask allows to cover large transverse areas of a standard high-power fiber's cladding. With this approach, a first-order Bragg grating was inscribed in the pure-silica inner cladding of a 20/400-µm fiber. It was then implemented as a pump reflector at the end of a 36-m-long Yb-doped fiber laser reaching 600 W of output power, confirming the power handling capabilities of such a component. Comparison of the laser performances with and without the pump reflector showcases its great potential for increasing pump absorption inside cladding-pumped fiber lasers, which paves the way for significantly reducing their active fiber length.