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

Relation: http://www.sciencedirect.com/science/article/pii/S2405844023093866; https://doaj.org/toc/2405-8440

URL الوصول: https://doaj.org/article/456e8532994a4a6791c5c40fae07c977

المؤلفون: Toshiaki Isogai, MD, MPH, Shashank Shekhar, MD, Anas M. Saad, MD, Omar M. Abdelfattah, MD, Khaldoun G. Tarakji, MD, MPH, Oussama M. Wazni, MD, Ankur Kalra, MD, James J. Yun, MD, PhD, Amar Krishnaswamy, MD, Grant W. Reed, MD, MSc, Samir R. Kapadia, MD, Rishi Puri, MBBS, PhD

المصدر: Structural Heart, Vol 6, Iss 3, Pp 100019- (2022)

مصطلحات موضوعية: Complete heart block, Length of stay, Permanent pacemaker, Temporary pacemaker, Transcatheter aortic valve implantation, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background: In the absence of randomized data, an expert panel recently proposed an algorithm for conduction disturbance management in transcatheter aortic valve implantation (TAVI) recipients. However, external validations of its recommendations are limited. Methods: We retrospectively identified 808 patients without a pre-existing pacing device who underwent transfemoral TAVI with the Sapien 3 valve at our institution in 2018-2019. Patients were grouped based on pre-existing conduction disturbance and immediate post-TAVI electrocardiogram. Timing of temporary pacemaker (TPM) removal and hospital discharge were compared with those of the expert panel recommendations to evaluate the associated risk of TPM reinsertion and permanent pacemaker (PPM) implantation. Results: In most group 1 patients (no electrocardiogram changes without pre-existing right bundle branch block), the timing of TPM removal and discharge were concordant with those of the expert panel recommendations, with low TPM reinsertion (0.8%) and postdischarge PPM (0.8%) rates. In the majority of group 5 patients (procedural high-degree/complete atrioventricular block), TPM was maintained, followed by PPM implantation, compatible with the expert panel recommendations. In contrast, in groups 2-4 (pre-existing/new conduction disturbances), earlier TPM removal than recommended by the expert panel (mostly, immediately after procedure) was feasible in 97.5%-100% of patients, with a low TPM reinsertion rate (0.0%-1.8%); earlier discharge was also feasible in 50.0%-65.5%, with a low 30-day postdischarge PPM rate (0.0%-2.8%) and no 30-day death. Conclusions: Early TPM removal and discharge after TAVI appear safe and feasible in the majority of cases. These data may provide a framework for an early, streamlined hospital discharge plan for TAVI recipients, optimizing both cost savings and patient safety.

وصف الملف: electronic resource

Relation: http://www.sciencedirect.com/science/article/pii/S2474870622012696; https://doaj.org/toc/2474-8706

URL الوصول: https://doaj.org/article/db8632f8aa594cc3afeef50133eb24ab

المؤلفون: Toshiaki Isogai, Ankit Agrawal, Anas M. Saad, Shunsuke Kuroda, Shashank Shekhar, Abdelrahman I. Abushouk, Oussama M. Wazni, Ayman A. Hussein, Amar Krishnaswamy, Samir R. Kapadia

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)

مصطلحات موضوعية: complication, left atrial appendage closure, paroxysmal atrial fibrillation, persistent atrial fibrillation, stroke, Diseases of the circulatory (Cardiovascular) system, RC666-701

وصف الملف: electronic resource

Relation: https://doaj.org/toc/2047-9980

URL الوصول: https://doaj.org/article/9980329823bd42bda37e73da9192f6f3

المؤلفون: Ayman A. Hussein, Oussama M. Wazni, Bruce L. Wilkoff

المصدر: Journal of the American College of Cardiology. 81:1726-1728

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::ca3c812ac297d694049e85d891b8dfc9
https://doi.org/10.1016/j.jacc.2023.02.043

المؤلفون: Omar M. Abdelfattah, Ahmed Sayed, Malak Munir, Salma Almotawally, Karim Wilson, Mohamed M. Gad, Abdelrahman I. Abushouk, Mahmoud Elsayed, Oussama M. Wazni, Walid I. Saliba, Islam Y. Elgendy, Hani Jneid, Samir Kapadia

المصدر: The American Journal of Cardiology. 186:117-125

مصطلحات موضوعية: Cardiology and Cardiovascular Medicine

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::e999b33701a8bb7d19ab69c6860a8b0a
https://doi.org/10.1016/j.amjcard.2022.08.012

المؤلفون: Hiroshi, Nakagawa, Atsushi, Ikeda, Katsuaki, Yokoyama, Yoshimori, An, Ayman A, Hussein, Walid I, Saliba, Oussama M, Wazni, Quim, Castellvi

المصدر: Cardiac Electrophysiology Clinics. 14:757-767

مصطلحات موضوعية: Physiology (medical), Catheter Ablation, Humans, Arrhythmias, Cardiac, Heart, Cardiology and Cardiovascular Medicine, Cryosurgery, Coronary Vessels

الوصف: Current ablation systems rely on thermal energy to produce ablation lesions (heating: RF, laser and ultrasound, and cooling: cryo-thermia). While thermal ablation has been proven to be effective, there are several limitations: 1) relatively long procedural times; 2) high recurrence rate of ventricular arrhythmias; and 3) excessive heating potentially leading to serious complications, including steam pop (perforation), coronary arterial injury and thrombo-embolism. Pulsed field ablation (PFA)/irreversible electroporation (IRE) offers a unique non-thermal ablation strategy which has the potential to overcome these limitations. Recent pre-clinical studies suggest that PFA/IRE might be effective and safe for the treatment of cardiac arrhythmias.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::328d6f569e87457becd9a8f7de26a35f
https://doi.org/10.1016/j.ccep.2022.08.003

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.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c87d87fd6f466135c926f18cd2a6f304
https://doi.org/10.1111/jce.15710

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

المؤلفون: Arwa Younis, Sanah Ali, Eileen Hsich, Ido Goldenberg, Scott McNitt, Bronislava Polonsky, Mehmet K. Aktas, Valentina Kutyifa, Oussama M. Wazni, Wojciech Zareba, Ilan Goldenberg

المصدر: medRxiv

مصطلحات موضوعية: Article

الوصف: BackgroundBlack Americans have a higher risk of non-ischemic cardiomyopathy (NICM) than White Americans. We aimed to evaluate racial disparities in the risk of tachyarrhythmias among patients with an implantable cardioverter defibrillator (ICD).MethodsThe study population comprised 3,895 ICD recipients enrolled in the U.S. in primary prevention ICD trials. Outcome measures included first and recurrent ventricular tachy-arrhythmia (VTA) and atrial tachyarrhythmia (ATA), derived from adjudicated device data, and death. Outcomes were compared between self-reported Black vs. White patients with a cardiomyopathy (ischemic [ICM] and NICM).ResultsBlack patients were more likely to be female (35% vs 22%) and younger (57±12 vs 62±12) with a higher frequency of comorbidities. Blacks patients with NICM compared with Whites patients had a higher rate of first VTA, fast VTA, ATA, appropriate-, and inappropriate-ICD-therapy (VTA≥170bpm: 32% vs. 20%; VTA≥200bpm: 22% vs. 14%; ATA: 25% vs. 12%; appropriate 30% vs 20%; and inappropriate: 25% vs. 11%; pburdenof VTA, ATA, ICD therapies, and a higher risk of death (HR=1.86; p=0.014). In contrast, in ICM, the risk of all types of tachyarrhythmia, ICD therapy, or death was similar between Black and White patients.ConclusionsAmong NICM patients with an ICD for primary prevention, Black compared with White patients had a high risk and burden of VTA, ATA, and ICD therapies.Clinical PerspectiveWhat Is New?Black patients have a higher risk of developing non-ischemic cardiomyopathy (NICM) but are under-represented in clinical trials of implantable cardioverter defibrillators (ICD). Therefore, data on disparities in the presentation and outcomes in this population are limited.This analysis represents the largest group of self-identified Black patients implanted in the U.S. with an ICD for primary prevention with adjudication of all arrhythmic events.What Are the Clinical Implications?In patients with a NICM, self-identified Black compared to White patients experienced an increased incidence and burden of ventricular tachyarrhythmia, atrial tachyarrhythmia, and ICD therapies. These differenced were not observed in Black vs White patients with ischemic cardiomyopathy (ICM).Although Black patients with NICM were implanted at a significantly younger age (57±12 vs 62±12 years), they experienced a 2-fold higher rate of all-cause mortality during a mean follow up of 3 years compared with White patients.These findings highlight the need for early intervention with an ICD, careful monitoring, and intensification of heart failure and antiarrhythmic therapies among Black patients with NICM.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::11c080720720bff7e32622091f724f95
https://europepmc.org/articles/PMC10187345/

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

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::a4c7e98cbd7477622c535c158c5de0bb
https://doi.org/10.1016/j.hrthm.2023.04.050