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المؤلفون: Katsuhide Hayashi, Arwa Younis, Thomas Callahan, Bryan Baranowski, David O. Martin, Shady Nakhla, Bruce L. Wilkoff
المصدر: Heart Rhythm. 20:872-878
مصطلحات موضوعية: Physiology (medical), Cardiology and Cardiovascular Medicine
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المؤلفون: Thomas Callahan
المصدر: Journal of Cardiovascular Electrophysiology. 33:1041-1044
مصطلحات موضوعية: Pacemaker, Artificial, Treatment Outcome, Physiology (medical), Humans, Cardiology and Cardiovascular Medicine, Device Removal, Defibrillators, Implantable, Retrospective Studies
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المؤلفون: Mohamed Kanj, David M. Nemer, Divyang Patel, Ayman A. Hussein, Khaldoun G. Tarakji, Bruce L. Wilkoff, Anirudh Kumar, Daniel J. Cantillon, Trejeeve Martyn, Bryan Baranowski, Zachary J. Il'Giovine, Randall C. Starling, Thomas Callahan, Niraj Varma, Eoin Donnellan, W.H. Wilson Tang, Laurie Ann Moennich, Kevin Trulock, John Rickard, Oussama M. Wazni
المصدر: Heart. 108:274-278
مصطلحات موضوعية: medicine.medical_specialty, Anthracycline, Population, Cardiomyopathy, Ventricular Function, Left, Cardiac Resynchronization Therapy, Ventricular Dysfunction, Left, Internal medicine, Humans, Medicine, Anthracyclines, cardiovascular diseases, education, Aged, Retrospective Studies, Heart Failure, Retrospective review, education.field_of_study, Ejection fraction, Ventricular Remodeling, business.industry, Cancer, Stroke Volume, Mean age, Middle Aged, medicine.disease, Defibrillators, Implantable, Treatment Outcome, Heart failure, cardiovascular system, Cardiology, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
الوصف: IntroductionChemotherapy-induced cardiomyopathy has been increasingly recognised as patients are living longer with more effective treatments for their malignancies. Anthracyclines are known to cause left ventricular (LV) dysfunction. While heart failure medications are frequently used, some patients may need consideration for device-based therapies such as cardiac resynchronisation therapy (CRT). However, the role of CRT in anthracycline-induced cardiomyopathy (AIC) is not well understood.MethodsWe performed a retrospective review of all patients undergoing CRT implantation at our centre from 2003 to 2019 with a diagnosis of AIC. The LV remodelling and survival outcomes of this population were obtained and then compared with consecutive patients with other aetiologies of non-ischaemic cardiomyopathy (NICM).ResultsA total of 34 patients underwent CRT implantation with a diagnosis of AIC with a mean age of 60.5±12.7 years, left ventricular ejection fraction (LVEF) of 21.7%±7.4%, and 11.3±7.5 years and 10.2±7.4 years from cancer diagnosis and last anthracycline exposure, respectively. At 9.6±8.1 months after CRT implantation, there was an increase of LVEF from 21.8%±7.6% to 30.4%±13.0% (pConclusionsPatients with AIC undergo LV remodelling with CRT at rates similar to other aetiologies of NICM. Furthermore, AIC post-CRT responders have a favourable long-term mortality compared with non-responders.
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المؤلفون: Khaldoun G. Tarakji, Bruce L. Wilkoff, Thomas Callahan
المصدر: Europace
مصطلحات موضوعية: Pacemaker, Artificial, Technology, medicine.medical_specialty, Prosthesis-Related Infections, Cost effectiveness, medicine.drug_class, Antibiotics, Cardiovascular care, Implantable defibrillator, law.invention, law, Cardiac resynchronization, Physiology (medical), Humans, Medicine, AcademicSubjects/MED00200, Intensive care medicine, High risk populations, Cardiovascular implantable electronic devices, business.industry, Mortality rate, Risk of infection, Reproducibility of Results, Antibiotic Prophylaxis, Anti-Bacterial Agents, Defibrillators, Implantable, Pacemaker, Supplement Papers, Antibiotic envelope, Artificial cardiac pacemaker, Infection, Cardiology and Cardiovascular Medicine, business
الوصف: Cardiovascular implantable electronic devices (CIED) are effective and important components of modern cardiovascular care. Despite the dramatic improvements in the functionality and reliability of these devices, over time patients are at risk for developing several morbidities, the most feared of which are local and systemic infections. Despite significant financial investment and aggressive therapy with hospitalization, intravenous antibiotics, and transvenous lead extraction, the outcomes include a 1-year mortality rate as high as 25%. This risk of infection has increased over time, likely due to the increased complexity of the surgical interventions required to insert and replace these devices. The only way to reduce this morbidity and mortality is to prevent these infections, and other than preoperative antibiotics, there were little data supporting effective therapy until the WRAP-IT trial provided randomized data showing that pocket infections can be reduced by 60% at 12 months and major CIED infections reduced by 40% at 1 year with the use of the absorbable antibiotic eluting envelope in patient CIED procedures at high risk of infection. Not all CIED procedures are at high risk of infection and justify the use of the envelope, but cost-effectiveness data support the use of the antibiotic envelope particularly in patients with defibrillator replacements, revisions, and upgrades, such as to a resynchronization device and in patients with prior CIED infection, history of immunocompromise, two or more prior procedures, or a history of renal dysfunction.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::81915244a993e078c615640d60655f05
https://doi.org/10.1093/europace/euab019 -
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المؤلفون: David O. Martin, Khaldoun G. Tarakji, Oussama M. Wazni, Ayman A. Hussein, Mina K. Chung, Mohamed Diab, Daniel J. Cantillon, Simrat Kaur, Bruce L. Wilkoff, Erika Hutt, Mohamed Kanj, Mark Niebauer, Thomas Callahan, John Rickard, Niraj Varma, Walid Saliba, Thomas Dresing
المصدر: Heart Rhythm. 17:1904-1908
مصطلحات موضوعية: Male, Catheterization, Central Venous, Pacemaker, Artificial, medicine.medical_specialty, Vein injury, 030204 cardiovascular system & hematology, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), medicine, Humans, Fluoroscopy, In patient, Prospective Studies, 030212 general & internal medicine, Lead (electronics), Device Removal, Subclinical infection, medicine.diagnostic_test, business.industry, Middle Aged, Defibrillators, Implantable, nervous system diseases, Transvenous lead, Surgery, Treatment Outcome, nervous system, Equipment Failure, Female, Patient Safety, Cardiology and Cardiovascular Medicine, Complication, business, Follow-Up Studies
الوصف: Subclinical venous injuries are common during transvenous lead extraction (TLE), but their implications for future TLE are unclear. Little is known about whether a prior TLE adds risk or complexity to subsequent extraction procedures.The purpose of this study was to assess procedural profiles and outcomes of TLE based on whether patients had prior extraction procedures.All 3258 consecutive patients undergoing TLE at the Cleveland Clinic (1996-2012) were included. Procedural profiles and outcomes were determined.Of 3258 TLEs, 198 had prior TLE. Median number of leads in place was 2 in both groups, but patients with prior TLE were more likely to have defibrillator leads (47% vs 41%; P = .08) and more likely to be pacemaker-dependent (32% vs 25%; P = .02). The age of oldest lead (median 2134 vs 1902 days; P = .4) and combined age of leads (median 2948 vs 2676 days; P = .6) were comparable. Procedures were longer in those with prior TLE (166 ± 79 minutes vs 149 ± 74 minutes; P = .004) with comparable fluoroscopy times (median 13 vs 11 minutes; P = .07), and successful extraction was more likely to require specialized tools (88% vs 81%; P = .006) with higher likelihood of rescue femoral workstation (12% vs 4%; P.0001). Clinical success rates were comparable in those with prior TLE (99.5% vs 98.9%; P = .8) with similar major (3.0% vs 1.9%; P = .3) and minor (3.0% vs 3.7%; P = .8) complication rates.Extraction procedures were more challenging in patients with prior TLE compared to those without prior TLE but with excellent success and low complication rates.
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المؤلفون: Khaldoun G. Tarakji, Peter A. Rasmussen, Bryan Baranowski, Bruce L. Wilkoff, Daniel J. Cantillon, Mohamed Kanj, Henry Hilow, Thomas Callahan, Walid Saliba, Divyang Patel, Mandeep Bhargava, Oussama M. Wazni, Thomas Dresing, Megan Eppich, Patrick J. Tchou, Ayman A. Hussein, Peter T Hu
المصدر: Heart Rhythm. 17:1779-1783
مصطلحات موضوعية: Male, medicine.medical_specialty, Telemedicine, Office visits, Telehealth, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Outpatients, Health care, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective survey, Aged, business.industry, Arrhythmias, Cardiac, Digital health, Patient Satisfaction, Monitoring data, Physical therapy, Female, Level of care, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
الوصف: Background Virtual visits (VVs) are a modality for delivering health care services remotely through videoconferencing tools. Data about patient and physician experience in using VVs are limited. Objective The purpose of this study was to assess patient and physician experience with the use of VVs in cardiac electrophysiology. Methods We performed a prospective survey of cardiac electrophysiology patients and physicians who participated in an outpatient VV from December 2018 to July 2019. Results One-hundred consecutive VVs were included. Sixty-four patients elected to complete a survey. Patients rated their experience as either excellent/very good in scheduling a VV (87%), seeing their physician of choice (100%), transmitting arrhythmia data (88%), rating their physician's ability to communicate (98%), asking all questions (98%), rating the level of care received (98%), paying for the cost of a VV (67%), and rating their overall level of satisfaction (98%). Thirty-eight of 64 patients (59.4%) preferred a VV for their next visit, 12 of 64 (18.8%) preferred an in-office visit, 13 of 64 (20.3%) responded that their decision for a virtual or office visit depended on indication, and 1 of 64 (1.6%) had no preference. A total of 14 cardiac electrophysiologists participated in 100 VVs. Nine visits were not included due to technical difficulty. Physician responses to survey questions were rated as excellent/very good in the ability to communicate (92%), accessing monitoring data (95%), and overall level of satisfaction (98%). Conclusion In our small study population, most patients and physicians prefer VVs. Convenience, cost, and reason for follow-up were important determinants that affected both patient and physician preference.
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المؤلفون: Johnny Chahine, Mohamed Kanj, Mark Niebauer, Bryan Baranowski, Ayman A. Hussein, Niraj Varma, Walid Saliba, Khaldoun G. Tarakji, Daniel J. Cantillon, John Rickard, Mandeep Bhargava, Mina K. Chung, Mohamed M. Gad, Bruce L. Wilkoff, Mohamed Diab, Oussama M. Wazni, Thomas Callahan, Patrick J. Tchou, Thomas Dresing
المصدر: Heart Rhythm. 17:1298-1303
مصطلحات موضوعية: Male, medicine.medical_specialty, Ventricular lead, medicine.medical_treatment, Perforation (oil well), Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, Coronary Angiography, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Cardiac tamponade, medicine, Humans, In patient, Cardiac Resynchronization Therapy Devices, 030212 general & internal medicine, Coronary sinus, Aged, Retrospective Studies, Heart Failure, business.industry, Prognosis, medicine.disease, Coronary Vessels, Electrodes, Implanted, Surgery, Dissection, Heart Injuries, Female, Cardiology and Cardiovascular Medicine, Lead Placement, business, Follow-Up Studies
الوصف: Background Injury to the cardiac venous structures can complicate left ventricular lead placement for cardiac resynchronization therapy (CRT). Little is known about the outcomes of coronary sinus (CS) dissection with or without perforation. Objective The purpose of this study was to determine the outcomes in patients who had a CS injury during CRT implantation. Methods All patients undergoing procedures for CRT implantation at the Cleveland Clinic (2001–2018) were enrolled in a prospectively maintained registry for procedural profiles and complications. All patients with cardiac venous injuries during the procedures were included. Results CS injury occurred in 35 of 5011 patients (0.7%; 6 perforations (17.1%), 29 dissections without perforation (82.9%)). In patients with dissection in the absence of perforation, attempts at CS lead placement after dissection were successful in 21 of 29 patients (72.4%). In those with perforation (n=6, 17.1%), CS lead placement was successful in one of them (16.7%). Cardiac tamponade occurred in 2 patients (5.7%), and the procedure was aborted in both of them. Overall, CS lead placement failed in 13 patients (37%) but 9 (25.7%) underwent subsequent CRT with CS lead placement (n=6, 17.1%; median 58 days later) or epicardial leads (n=3, 8.6%). Three of the remaining 4 patients (8.6%) refused to undergo further procedures, and the fourth (2.9%) died of a complicated course. Conclusion CS injury is not common during CRT implantation procedures and did not preclude successful lead placement in 23 of 35 patients (65.7%) during the index procedure and 6 of 6 (100%) during the subsequent attempted procedures. A low rate of mortality was observed in such patients, but CS injury was associated with increased morbidity.
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المؤلفون: Rory Hachamovitch, Joseph Parambil, Joseph E. Khabbaza, Allison Wimer, Emer Joyce, Kristin B. Highland, Manuel L. Ribeiro Neto, Debasis Sahoo, Christine Jellis, Thomas Callahan, Akhil Bindra, Aman Pande, Daniel A. Culver, Brian D. Southern
المصدر: American Heart Journal. 223:106-109
مصطلحات موضوعية: medicine.medical_specialty, business.industry, Concordance, Retrospective cohort study, Cardiac sarcoidosis, 030204 cardiovascular system & hematology, medicine.disease, Heart Rhythm, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, In patient, 030212 general & internal medicine, Sarcoidosis, Cardiology and Cardiovascular Medicine, business, Reference standards, Cardiac imaging
الوصف: Background The diagnosis of cardiac sarcoidosis (CS) is challenging. Because of the current limitations of endomyocardial biopsy as a reference standard, physicians rely on advanced cardiac imaging, multidisciplinary evaluation, and diagnostic criteria to diagnose CS. Aims To compare the 3 main available diagnostic criteria in patients clinically judged to have CS. Methods We prospectively included patients clinically judged to have CS by a multidisciplinary sarcoidosis team from November 2016 to October 2017. We included only incident cases (diagnosis of CS within 1 year of inclusion). We applied retrospectively the following diagnostic criteria: the World Association of Sarcoidosis and Other Granulomatous Diseases (WASOG), the Heart Rhythm Society (HRS), and the Japanese Circulation Society (JCS) 2016 criteria. Results We identified 69 patients. Diagnostic criteria classified patients as follows: WASOG as highly probable (1.4%), probable (52.2%), possible (0%), some criteria (40.6%), and no criteria (5.8%); HRS as histological diagnosis (1.4%), probable (52.2%), some criteria (40.6%), and no criteria (5.8%); JCS as histological diagnosis (1.4%), clinical diagnosis (58%), some criteria (39.1%), and no criteria (1.4%). Concordance was high between WASOG and HRS (κ = 1) but low between JCS and the others (κ = 0.326). Conclusions A high proportion of patients clinically judged to have CS are unable to be classified according to the 3 main diagnostic criteria. There is low concordance between JCS criteria and the other 2 criteria (WASOG and HRS).
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المؤلفون: Ayman A. Hussein, Thomas Callahan, Thomas Dresing, Patrick J. Tchou, Mandeep Bhargava, John Rickard, John O Lopez, Shunsuke Kuroda, Bryan Baranowski, Koji Higuchi, Hiroshi Nakagawa, Khaldoun G. Tarakji, Oussama M. Wazni, Walid Saliba, Daniel J. Cantillon, Elad Anter, Henry Hilow
المصدر: Journal of Cardiovascular Electrophysiology.
مصطلحات موضوعية: Tachycardia, Electroanatomic mapping, business.industry, medicine.medical_treatment, Catheter ablation, Pattern recognition, 030204 cardiovascular system & hematology, Data mapping, 03 medical and health sciences, 0302 clinical medicine, Software, Physiology (medical), medicine, Standard algorithms, 030212 general & internal medicine, Artificial intelligence, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Lead (electronics), Kappa
الوصف: Background Activation maps of scar-related atrial tachycardias (AT) can be challenging to interpret due to difficulty in inaccurate annotation of electrograms, and an arbitrarily predefined mapping window. A novel mapping software integrating vector data and applying an algorithmic solution taking into consideration global activation pattern has been recently described (Coherent™, Biosense Webster "Investigational"). Objective We aimed to assess the investigational algorithm to determine the mechanism of AT compared with the standard algorithm. Methods This study included patients who underwent ablation of scar-related AT using the Carto 3 and the standard activation algorithm. The mapping data was analyzed retrospectively using the investigational algorithm, and the mechanisms were evaluated by two independent electrophysiologists. Results A total of 77 scar-related AT activation maps were analyzed (89.6% left atrium, median tachycardia cycle length of 273 milliseconds). Of those, 67 cases with confirmed mechanism of the arrhythmia were used to compare the activation software. The actual mechanism of the arrhythmia was more likely to be identified with the investigational algorithm (67.2% vs 44.8%, P=0.009). In 5 patients with dual-loop circuits, 3/5 (60%) were correctly identified by the investigational algorithm compared to 0/5 (0%) with the standard software. The reduced atrial voltage was prone to lead to less capable identification of mechanism (P for trend: 0.05). The investigational algorithm showed higher inter-reviewer agreement (Cohen's kappa 0.62 vs 0.47). Conclusions In patients with scar-related ATs, activation mapping algorithms integrating vector data and "best-fit" propagation solution may help in identifying the mechanism and the successful site of termination. This article is protected by copyright. All rights reserved.
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المؤلفون: Clifford V. Harding, Syed Quadri, Francis Murgatroyd, Mina K. Chung, Konstantinos C. Siontis, David H. Birnie, Davendra Mehta, Thomas Crawford, Jagmeet P. Singh, Logan Vincent, Paul Leis, Christine Jellis, Frank Bogun, Lavanya Bellumkonda, Ashley Bock, Peter Zimetbaum, Johan Grunewald, Christopher Maulion, Edward J. Miller, Jordana Kron, Marc A. Judson, Richard Cheng, Timm Dickfeld, Kenneth A. Ellenbogen, Jerry D. Estep, Edwin T. Zishiri, Ben A. Lin, Jose A. Joglar, Ron Blankstein, Pavan Bhat, Thomas Callahan, Steven Kalbfleish, Lynda E. Rosenfeld, Elizabeth S. Kaufman, Jason Appelbaum, William H. Sauer, Paul Cremer, Daniel A. Culver, Deborah H Kwon, Kristen K. Patton, Paolo Spagnolo, David R. Okada, Jonathan Chrispin, Maryjane Farr
المصدر: Circ Arrhythm Electrophysiol
مصطلحات موضوعية: Bradycardia, Tachycardia, medicine.medical_specialty, Sarcoidosis, heart failure, Disease, Arrhythmias, 030204 cardiovascular system & hematology, tachycardia, bradycardia, Article, defibrillator, 03 medical and health sciences, 0302 clinical medicine, Heart Conduction System, Heart Rate, Cardiac magnetic resonance imaging, Physiology (medical), medicine, Humans, atrial fibrillation, 030212 general & internal medicine, Intensive care medicine, medicine.diagnostic_test, sarcoidosis, Arrhythmias, Cardiac, Cardiomyopathies, business.industry, Atrial fibrillation, medicine.disease, Positron emission tomography, Heart failure, cardiovascular system, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Cardiac
الوصف: Cardiac sarcoidosis is a component of an often multiorgan granulomatous disease of still uncertain cause. It is being recognized with increasing frequency, mainly as the result of heightened awareness and new diagnostic tests, specifically cardiac magnetic resonance imaging and18F-fluorodeoxyglucose positron emission tomography scans. The purpose of this case-based review is to highlight the potentially life-saving importance of making the early diagnosis of cardiac sarcoidosis using these new tools and to provide a framework for the optimal care of patients with this disease. We will review disease mechanisms as currently understood, associated arrhythmias including conduction abnormalities, and atrial and ventricular tachyarrhythmias, guideline-directed diagnostic criteria, screening of patients with extracardiac sarcoidosis, and the use of pacemakers and defibrillators in this setting. Treatment options, including those related to heart failure, and those which may help clarify disease mechanisms are included.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e6ddb1da4f1638f2d4c05997c670781b
https://doi.org/10.1161/circep.120.009203
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