First long-term outcome data for the MicraVR™ transcatheter pacing system: data from the largest prospective German cohort.

AIMS: The MicraVR™ transcatheter pacing system (TPS) has been implemented into clinical routine for several years. The primary recipients are patients in need for VVI pacing due to bradycardia in the setting of atrial fibrillation (AF). Implantation safety and acute success have been proven in controlled studies and registries. So far only few long-term real-life data on TPS exist. We report indication, procedure and outcome data from two high-volume implanting German centers. METHODS: Between 2016 and 2019, 188 (of 303) patients were included. During follow-up (FU), TPS interrogation was performed after 4 weeks and thereafter every 6 months. RESULTS: Indication for TPS implantation in 159/188 (85%) patients was permanent or intermittent AV block III° in the setting of atrial fibrillation. The mean procedure duration was 50 min [35.0-70.0]. The average acute values after system release were: thresholds: 0.5V [0.38-0.74]/0.24ms; R-wave sensing: 10.0mV [8.1-13.5]; impedance: 650 Ohm [550-783]; RV-pacing demand: 16.9% [0.9-75.9]; and battery status: 3.15 V [3.12-3.16]. During FU of 723.4 ± 597.9 days, neither pacemaker failure nor infections were reported. Long-term FU revealed: thresholds: 0.5V [0.38-0.63]/0.24 ms; sensing: 12.3mV [8.9-17.2]; impedance: 570 Ohm [488-633]; RV-pacing demand: 87.1% [29.5-98.6]; and battery status 3.02 V [3.0-3.1]. Forty-three patients died from not-device-related causes. CONCLUSION: This to date largest German long-term dataset for MicraVR™ TPS implantation revealed stable device parameter. Foremost, battery longevity seems to fulfill predicted values despite a significant increase in RV-pacing demand over time and even in patients with consecutive AV-node ablation. Of note, no infections or system failure were observed.

Mobility of electrostatically and sterically stabilized gold nanoparticles (AuNPs) in saturated porous media.

The stability of gold nanoparticles (AuNPs) stabilized electrostatically with citrate or (electro)sterically by commercially available amphiphilic block copolymers (PVP-VA or PVA-COOH) was studied under various physicochemical conditions. Subsequently, the mobility of the AuNPs in porous media (sand) was investigated in column studies under environmental relevant physicochemical conditions. Electrostatically stabilized AuNPs were unstable under most physicochemical conditions due to the compression of the electrical double layer. Consequently, aggregation and deposition rapidly immobilized the AuNPs. Sterically stabilized AuNPs showed significantly less sensitivity towards changes in the physicochemical conditions with high stability, high mobility with negligible retardation, and particle deposition rate coefficients ranging an order of magnitude (1.5 × 10-3 to 1.5 × 10-2 min-1) depending on the type and amount of stabilizer, and thereby the surface coverage and attachment affinity. The transport of sterically stabilized AuNPs is facilitated by reversible deposition in shallow energy minima with continuous reentrainment and blocking of available attachment sites by deposited AuNPs. The stability and mobility of NPs in the environment will thereby be highly dependent on the specific stabilizing agent and variations in the coverage on the NP. Under the given experimental conditions, transport distances of the most mobile AuNPs of up to 20 m is expected. Due to their size-specific plasmonic properties, the easily detectable AuNPs are proposed as potential model or tracer particles for studying transport of various stabilized NPs under environmental conditions.

In situ SU-8 silver nanocomposites.

Nanocomposite materials containing metal nanoparticles are of considerable interest in photonics and optoelectronics applications. However, device fabrication of such materials always encounters the challenge of incorporation of preformed nanoparticles into photoresist materials. As a solution to this problem, an easy new method of fabricating silver nanocomposites by an in situ reduction of precursors within the epoxy-based photoresist SU-8 has been developed. AgNO3 dissolved in acetonitrile and mixed with the epoxy-based photoresist SU-8 forms silver nanoparticles primarily during the pre- and post-exposure soft bake steps at 95 °C. A further high-temperature treatment at 300 °C resulted in the formation of densely homogeneously distributed silver nanoparticles in the photoresist matrix. No particle growth or agglomeration of nanoparticles is observed at this point. The reported new in situ silver nanocomposite materials can be spin coated as homogeneous thin films and structured by using UV lithography. A resolution of 5 µm is achieved in the lithographic process. The UV exposure time is found to be independent of the nanoparticle concentration. The fabricated silver nanocomposites exhibit high plasmonic responses suitable for the development of new optoelectronic and optical sensing devices.

A preliminary study on the short-term efficacy of chairside computer-aided design/computer-assisted manufacturing- generated posterior lithium disilicate crowns.

The purpose of this preliminary study was to evaluate the clinical performance of chairside-generated crowns over a preliminary time period of 24 months. Forty-one posterior crowns made of a machinable lithium disilicate ceramic for full-contour crowns were inserted in 34 patients using a chairside computer-aided design/computer-assisted manufacturing technique. The crowns were evaluated at baseline and after 6, 12, and 24 months according to modified United States Public Health Service criteria. After 2 years, all reexamined crowns (n = 39) were in situ; one abutment exhibited secondary caries and two abutments received root canal treatment. Within the limited observation period, the crowns revealed clinically satisfying results.

Femoral bone tunnel placement using the transtibial tunnel or the anteromedial portal in ACL reconstruction: a radiographic evaluation.

Correct placement of the tibial and femoral bone tunnel is prerequisite to a successful anterior cruciate ligament (ACL) reconstruction. This study compares the resulting radiographic femoral bone tunnel position of two commonly used techniques for arthroscopically assisted drilling of the femoral bone tunnel: the transtibial approach or drilling through the anteromedial arthroscopy portal. The resulting bone tunnel position was assessed in postoperative knee radiographs of 70 patients after ACL reconstruction. Three independent observers identified the femoral bone tunnel and determined its position in the lateral and A-P view. Differences in femoral tunnel position between transtibial and anteromedial drilling were evaluated. In the sagittal plane, significantly more femoral bone tunnels were positioned close to the reference value using an anteromedial drilling technique (86%) when compared to transtibial drilling (57%). Drilling through the transtibial tunnel resulted in a significantly more anterior position of the femoral tunnel. In the frontal plane, femoral bone tunnels which were placed through the anteromedial arthroscopy portal displayed a significantly greater angulation towards the lateral condylar cortex (50.92 degrees ) when compared to transtibial drilling (58.82 degrees ). In conclusion, drilling the femoral tunnel through the anteromedial arthroscopy portal results in a radiographic femoral bone tunnel position which is suggested to allow stabilization of both anterior tibial translation and rotational instability when using a single bundle reconstruction technique. Further studies may evaluate if there are any clinical advantages using the anteromedial portal technique.