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1دورية أكاديمية
المؤلفون: Jose Aguilera, Erika Hutt, Ruth Madden, Mohamed Kanj, Walid Saliba, John Rickard, Jakub Sroubek, Thomas Callahan, Mina Chung, Brian Baranowski, David Martin, Thomas Dresing, Oussama M. Wazni, Ayman Hussein, Daniel Cantillon, Divyang Patel, Shady Nakhla, Tyler Taigen
المصدر: Heliyon, Vol 9, Iss 11, Pp e22178- (2023)
مصطلحات موضوعية: Atrial fibrillation, Catheter ablation, Pulmonary vein isolation, Same day discharge, Patients outcome, Science (General), Q1-390, Social sciences (General), H1-99
الوصف: Background: Atrial fibrillation (AF) catheter ablation has become an increasingly effective and safe strategy for the management of AF. With increased safety of catheter ablation, same-day discharge (SDD) is a potential way to minimize health care resource utilization and improve patient experience. Objective: To evaluate the safety and patient satisfaction of SDD after contemporary AF ablation. Methods: Consecutive patient undergoing AF ablation at our institution between 1/2020 and 10/2021 were enrolled in registry for clinical, quality, procedural and outcomes data. Patients were considered for SDD per physician discretion and patients’ preference based upon clinical evaluation. Adjudicated ninety-day major complications, thirty-day adverse events, and thirty-day re-admissions were collected in a prospective registry for all patients. Results: A total of 2142 consecutive patients underwent elective AF ablation during the study period. After excluding cases with missing data, 1830 patients were included in the analysis. Of those, 350 (19 %) patients were discharged the same day (SDD group) and 1480 (81 %) stayed overnight. Patients in the SDD group compared to overnight stay group were younger, more likely to be male, White patients, lower CHA2DS2-VASc score and to be on lower rates of warfarin as an anticoagulation strategy. After propensity score matching, SDD was associated with lower rate of major complications and higher patient satisfaction. The majority of life-treating complications occurred interprocedurally or within 6 h of procedure termination. Conclusion: The present study demonstrated that SDD after contemporary AF ablation is feasible, safe and associated with higher patient satisfaction using a proposed SDD pathway and criteria.
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: David T. Huang, Igor Gosev, Katherine L. Wood, Hima Vidula, William Stevenson, Frank Marchlinski, Gregory Supple, Sandip K. Zalawadiya, J. Peter Weiss, Roderick Tung, Wendy S. Tzou, Joshua D. Moss, Krishna Kancharla, Sunit‐Preet Chaudhry, Parin J. Patel, Arfaat M. Khan, Claudio Schuger, Guy Rozen, Michael S. Kiernan, Gregory S. Couper, Marzia Leacche, Ezequiel J. Molina, Anand D. Shah, Michael Lloyd, Jakub Sroubek, Edward Soltesz, Kalyanam Shivkumar, Casey White, Sinan Tankut, Brent A. Johnson, Scott McNitt, Valentina Kutyifa, Wojciech Zareba, Ilan Goldenberg
المصدر: Annals of Noninvasive Electrocardiology, Vol 28, Iss 5, Pp n/a-n/a (2023)
مصطلحات موضوعية: ablation, left ventricular assist device, ventricular tachycardia, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Abstract Background The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra‐operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant. Methods We designed a prospective, multicenter, open‐label, randomized‐controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra‐operative VTA ablation (n = 50) versus conventional medical management (n = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life. Conclusion The primary aim of this first‐ever randomized trial is to assess the efficacy of intra‐operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA.
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Divyang Patel, MD, David Nemer, MD, David Martin, MD, Patrick Tchou, MD, FHRS, Jakub Sroubek, MD, PhD
المصدر: HeartRhythm Case Reports, Vol 8, Iss 6, Pp 398-401 (2022)
مصطلحات موضوعية: Atrial fibrillation, Surgical ablation, Pacemaker, Cox-maze, Mitral valve surgery, Diseases of the circulatory (Cardiovascular) system, RC666-701
وصف الملف: electronic resource
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المؤلفون: Medhat Farwati, Mustapha Amin, Walid I. Saliba, Hiroshi Nakagawa, Khaldoun G. Tarakji, Mohamed Diab, Anna Scandinaro, Ruth Madden, Patricia Bouscher, Shunsuke Kuroda, Mohamed Kanj, Thomas J. Dresing, Thomas D. Callahan, Mandeep Bhargava, Jakub Sroubek, Bryan Baranowski, John Rickard, Daniel J. Cantillon, Patrick J. Tchou, Oussama M. Wazni, Ayman A. Hussein
المصدر: Journal of Cardiovascular Electrophysiology. 34:54-61
مصطلحات موضوعية: Physiology (medical), Cardiology and Cardiovascular Medicine
الوصف: Catheter ablation for atrial fibrillation (AF) is frequently used for the purpose of rhythm control and improved quality of life (QoL). Although success rates are high, a significant proportion of patients require redo ablation. Data are scarce on patient-centered outcomes and QoL in patients undergoing redo AF ablation. We aimed to assess QoL and clinical outcomes using a large prospectively maintained patient-reported outcomes (PRO) registry.All patients undergoing redo AF ablation (2013-2016) at our center were enrolled in a prospective registry for outcomes and assessed for QoL using automated PRO surveys (baseline, 3 and 6 months after ablation, every 6 months thereafter). Data were collected over 3 years of follow-up. The atrial fibrillation symptom severity scale (AFSSS) was used as the main measure for QoL. Additional variables included patient-reported improvement, AF burden, and AF-related healthcare utilization including emergency room (ER) visits and hospitalizations.A total of 848 patients were included (28% females, mean age 63.8, 51% persistent AF). By automated PRO, significant improvement in QoL was noted (baseline median AFSSS of 12 [5-18] and ranged between 2 and 4 on subsequent assessments; p .0001), with ≥70%of patients reported remarkable improvement in their AF-related symptoms. The proportion of patients in AF at the time of baseline survey was 36%, and this decreased to8% across all time points during follow-up (p .0001). AF burden was significantly reduced (including frequency and duration of episodes; p .0001), with an associated decrease in healthcare utilization after 6 months from the time of ablation (including ER visits and hospitalizations; p .0001). The proportion of patients on anticoagulants or antiarrhythmics decreased on follow-up across all time points (p .0001 for all variables).Most patients derive significant QoL benefit from redo AF ablation; with reduction of both AF burden and healthcare utilization.
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المؤلفون: Brett M. Johnson, Oussama M. Wazni, Medhat Farwati, Walid I. Saliba, Pasquale Santangeli, Ruth Madden, Patricia Bouscher, Mina Chung, Mohamed Kanj, Thomas J. Dresing, Thomas D. Callahan, Mandeep Bhargava, Bryan Baranowski, John Rickard, Daniel J. Cantillon, Patrick J. Tchou, Jakub Sroubek, Hiroshi Nakagawa, Ayman A. Hussein
المصدر: Circulation: Arrhythmia and Electrophysiology.
مصطلحات موضوعية: Physiology (medical), Cardiology and Cardiovascular Medicine
الوصف: BACKGROUND: Ablation is used for both rhythm control and improved quality of life (QoL) in atrial fibrillation (AF). It has been suggested that young adults may experience high recurrence rates after ablation and data remain lacking regarding QoL benefits. We aimed to investigate AF ablation outcomes and QoL benefits in young adults undergoing AF ablation using a large prospectively maintained registry and automated patient-reported outcomes (PRO). METHODS: All patients undergoing AF ablation (2013–2016) at our center were prospectively enrolled. Patients aged 50 years or younger were included. For PROs, QoL measures and symptoms were assessed at baseline, 3 months after ablation, and every 6 months thereafter. The AF severity score served as the main assessment of QoL. RESULTS: A total of 241 young adults (age, 16–50 years) were included (17% female, 40.3% persistent AF). In all, 77.2% of patients remained arrhythmia-free during the first year of follow-up (80% in nonstructural AF and 66% in structural AF). Using PROs, 90% of patients reported improvement in QoL throughout all survey time points up to 5 years postablation ( P P P CONCLUSIONS: Ablation remains an effective rhythm-control strategy in young adults with AF. Young adults also experience significant improvement in QoL with reduction of the frequency and duration of AF episodes and AF-related healthcare utilization.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::7f86c8bcd9b8d5b2ac4836d8be6b0cfd
https://doi.org/10.1161/circep.122.011565 -
6
المؤلفون: Jakub Sroubek, Ramya Vajapey, Joseph Sipko, Edward Soltesz, Aaron Weiss, Elad Anter, Thomas D. Callahan, Thomas J. Dresing, Ayman A. Hussein, Mohamed Kanj, John Rickard, Walid I. Saliba, Oussama M. Wazni, Pasquale Santangeli
المصدر: Heart Rhythm.
مصطلحات موضوعية: Physiology (medical), Cardiology and Cardiovascular Medicine
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المؤلفون: Jakub Sroubek, Ramya Vajapey, Joseph J. Sipko, Edward G. Soltesz, Aaron J. Weiss, Mandeep Bhargava, Ayman A. Hussein, Mohamed Kanj, Walid I. Saliba, Tyler L. Taigen, Oussama M. Wazni, Pasquale Santangeli
المصدر: Journal of the American College of Cardiology.
مصطلحات موضوعية: Cardiology and Cardiovascular Medicine
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8
المؤلفون: Ramzi Ibrahim, Jakub Sroubek, Shady Nakhla, Justin Z. Lee
المصدر: Journal of Cardiovascular Electrophysiology. 34:465-467
مصطلحات موضوعية: Physiology (medical), Cardiology and Cardiovascular Medicine
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9
المؤلفون: Koji Higuchi, Hagai D. Yavin, Jakub Sroubek, Arwa Younis, Israel Zilberman, Elad Anter
المصدر: Heart Rhythm. 19:1067-1073
مصطلحات موضوعية: Electrocardiography, Physiology (medical), Catheter Ablation, Humans, Cardiology and Cardiovascular Medicine, Ventricular Premature Complexes, Endocardium
الوصف: Local activation time is often determined by the maximal negative of the extracellular unipolar potential (-dV/dTThe purpose of this study was to examine the relationship between bipolar and unipolar electrograms for selecting successful ablation sites of endocardial (superficial) vs intramural (deep) ventricular premature contractions (VPCs).This cohort consisted of 66 patients with VPCs presenting for ablation in a bigeminy, trigeminy, or quadrigeminy pattern. VPCs were classified as endocardial if ablation at the earliest endocardial site resulted in immediate suppression (10 seconds) or as intramural if ablation resulted in delayed suppression (≥10 seconds), required multiple applications, or was not achieved. Unipolar and bipolar electrograms were analyzed.In endocardial VPCs, the first rapid bipolar deflection corresponded with unipolar -dV/dTMapping of VPCs should be guided by the first rapid bipolar deflection that corresponds to a similarly early unipolar deflection but not with -dV/dT
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المؤلفون: Chadi Tabaja, Arwa Younis, Pasquale Santageli, Medhat Farwati, Lorenzo Braghieri, Hiroshi Nakagawa, Walid I. Saliba, Ruth Madden, Patricia Bouscher, Mohamed Kanj, Thomas D. Callahan, David Martin, Mandeep Bhargava, Mina Chung, Bryan Baranowski, Shady Nakhla, Jakub Sroubek, Justin Lee, Tyler Taigen, Patrick J. Tchou, Oussama M. Wazni, Ayman A. Hussein
الوصف: BackgroundObesity is a well-known risk factor for atrial fibrillation (AF).ObjectiveTo evaluate the effect of baseline obesity on procedural complications, AF recurrence, and symptoms following catheter ablation (CA).MethodsA total of 5841 patients undergoing AF ablation (2013-2021) were enrolled in a prospectively maintained registry. Primary endpoint was AF recurrence based on electrocardiographic documentation. Patients were categorized into 5 groups according to their baseline body mass index (BMI). Patients survey at baseline and at follow-up were used to calculate AF severity score (AFSS) as well as AF burden.ResultsMajor procedural complications were low (1.5%) among BMI sub-groups. At 3 years AF recurrence was highest in Class III obesity patients (48%) followed by Class II (43%), whereas Class I, normal, and overweight had similar results with lower recurrence (35%). In multivariable analyses, Class III obesity was independently associated with increased risk for AF recurrence (HR=1.30, P=0.01), whereas other groups had similar risk in comparison to normal weight. Baseline AFSS was lowest in normal weight, and highest in Obesity-III, median [interquartile range] 10 [5-16] vs 15 [10-21]. In all groups, CA resulted in improvement in their AFSS with a similar magnitude among the groups. At follow-up, AF burden was minimal and did not differ significantly between the groups.ConclusionAF ablation is safe with a low complication rate across all BMI groups. Morbid obesity (BMI ≥40) was significantly associated with reduced AF ablation success. However, ablation resulted in improvement in QOL including reduction of the AFSS, and AF burden.What is known?Obesity is an independent risk factor of atrial fibrillation (AF)Catheter ablation (CA) has emerged as a standard of care in arrhythmia management, leading to improvements in quality of life, reductions in hospitalizations, and potential reductions in major adverse clinical outcomes.More obese patients are being referred to catheter ablation of AF.What is new?AF ablation is safe with low complication rates across all BMI sub-groups (Morbid obesity (BMI ≥40) was associated with increased risk of AF recurrence after ablationUsing patient reported outcomes, AF Ablation resulted in improvement of quality of life regardless of BMI
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::37ae55d665f890403aaf7334100d9cc6
https://doi.org/10.1101/2023.03.21.23287551
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