478 results on '"Amin, Al-Ahmad"'
Search Results
2. Impact of digital monitoring on compliance and outcome of lifestyle-change measures in patients with coexistent atrial fibrillation and obesity
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Sanghamitra Mohanty, MD, FHRS, Chintan Trivedi, MD, MPH, FHRS, Domenico Giovanni Della Rocca, MD, Carola Gianni, MD, Bryan MacDonald, MD, Angel Mayedo, MD, SaiShishir Shetty, DPharm, MHI, Eleanora Natale, HSGrad, John D. Burkhardt, MD, FHRS, Mohamed Bassiouny, MD, G. Joseph Gallinghouse, MD, Rodney Horton, MD, Amin Al-Ahmad, MD, FHRS, and Andrea Natale, MD, FACC, FHRS, FESC
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Digital monitoring ,App ,Lifestyle change ,Weight loss ,Atrial fibrillation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Medical technology ,R855-855.5 - Abstract
Introduction: Obesity, a known risk factor for atrial fibrillation (AF), is potentially reversible through lifestyle changes, including diet and physical activity. However, lack of compliance is a major obstacle in attaining sustained weight loss. We investigated the impact of patient engagement using a digital monitoring system on compliance for lifestyle-change measures and subsequent outcome. Methods: A total of 105 consecutive patients with coexistent AF and obesity (body mass index ≥28) were classified into 2 groups based on the monitoring method: group 1, use of digital platform (n = 20); group 2, conventional method (n = 85). Group 1 used the RFMx digital monitoring platform (smartphone app) that sets weekly goals for exercise and weight loss, tracks patient compliance data continuously, and sends regular text reminders. Conventional method included monitoring patients’ adherence to diet and change in weight during in-person clinic visits or monthly phone calls from staff. Results: Baseline characteristics of groups 1 and 2 were comparable. At 6 months of follow-up, 12 (60%) and 28 (33%) from group 1 and 2, respectively, were compliant with the physician instructions regarding diet and exercise (P = .025). Weight loss was observed in 9 of 12 (75%) from group 1 and 11 of 28 (39%) from group 2 (P = .038) and mean reduction in weight was 9.9 ± 8.9 lb and 4.0 ± 2.1 lb (P = .042). Conclusion: In this series, continuous digital monitoring was seen to be associated with significant improvement in compliance through better patient engagement, resulting in more weight loss compared to the conventional method.
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- 2022
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3. Implantable cardioverter-defibrillator–related procedures and associated complications in continuous flow left ventricular assist device recipients: A multicenter experience
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Ashwin Ravichandran, MD, Naga Venkata K. Pothineni, MD, Jaimin R. Trivedi, MD, MPH, Henri Roukoz, MD, Mustafa M. Ahmed, MD, Adarsh Bhan, MD, Geetha Bhat, MD, Jennifer Cowger, MD, Amin Al Ahmad, MD, FHRS, Andrea Natale, MD, FHRS, Luigi Di Biase, MD, FHRS, Mark S. Slaughter, MD, Dhanunjaya Lakkireddy, MD, FHRS, and Rakesh Gopinathannair, MD, MA, FHRS
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Cardiac implantable electronic device ,Generator change ,Heart failure ,ICD ,Left ventricular assist device ,Procedures ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Limited data exist regarding complication rates of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy devices (CRT-D) in patients with left ventricular assist devices (LVAD). Objective: We describe the incidence and characteristics of ICD- and CRT-D-related procedures and complications in a multicenter LVAD cohort. Methods: A total of 537 LVAD patients with a pre-existing ICD or CRT-D from 5 centers were included. Details on device type, device therapies, procedural complications, and long-term survival were analyzed. Results: Of 537 patients, 280 had a CRT-D and 257 had ICD only. During a median follow-up of 538 days, 126 patients underwent generator replacement with significantly higher rate in the CRT group (79 [28.2%] vs 47 [18.3%], P = .0006). Device-related complications occurred in 36 (13%) CRT-D and 20 (8%) ICD patients (P = .06). Incidence of pocket hematoma (3.2% vs 2.7%), infection (4.3% vs 1.6%), and lead malfunction (3.1% vs 2.8%) was similar in both groups, with no effect of device complication on long-term survival (log-rank P = .7). There was a higher incidence of post-LVAD antitachycardia pacing for ventricular arrhythmias in the CRT-D group compared to the ICD group (35% vs 26%, P = .03). Conclusion: Cardiac implantable electronic device–related procedures are common in LVAD patients. Compared to ICD only, continued CRT-D therapy post-LVAD results in a significantly higher number of generator changes and a trend towards higher device- or lead-related complications. Device-related complications were not associated with reduced survival.
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- 2021
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4. Amiodarone Use and All‐Cause Mortality in Patients With a Continuous‐Flow Left Ventricular Assist Device
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Rakesh Gopinathannair, Naga Venkata K. Pothineni, Jaimin R. Trivedi, Henri Roukoz, Jennifer Cowger, Mustafa M. Ahmed, Adarsh Bhan, Ashwin K. Ravichandran, Geetha Bhat, Amin Al Ahmad, Andrea Natale, Luigi Di Biase, Mark S. Slaughter, and Dhanunjaya Lakkireddy
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amiodarone ,arrhythmias ,left ventricular assist device ,mortality ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Atrial and ventricular arrhythmias are commonly encountered in patients with advanced heart failure, with amiodarone being the most commonly used antiarrhythmic drug in continuous‐flow left ventricular assist device (CF‐LVAD) recipients. The purpose of this study was to assess the impact of amiodarone use on long‐term all‐cause mortality in ptients with a CF‐LVAD. Methods and Results A retrospective multicenter study of CF‐LVAD was conducted at 5 centers including all CF‐LVAD implants from 2007 to 2015. Patients were stratified based on pre–CF‐LVAD implant amiodarone use. Additional use of amiodarone after CF‐LVAD implantation was also evaluated. Primary outcome was all‐cause mortality during long‐term follow‐up. Kaplan‐Meier curves were used to assess survival outcomes. Multivariable Cox regression was used to identify predictors of outcomes. Propensity matching was done to address baseline differences. A total of 480 patients with a CF‐LVAD (aged 58±13 years, 81% men) were included. Of these, 170 (35.4%) were on chronic amiodarone therapy at the time of CF‐LVAD implant, and 310 (64.6%) were not on amiodarone. Rate of all‐cause mortality over the follow‐up period was 32.9% in the amiodarone group compared with 29.6% in those not on amiodarone (P=0.008). Similar results were noted in the propensity‐matched group (log‐rank, P=0.04). On multivariable Cox regression analysis, amiodarone use at baseline was independently associated with all‐cause mortality (hazard ratio, 1.68 [95% CI, 1.1–2.5]; P=0.01). Conclusions Amiodarone use was associated with significantly increased rates of all‐cause mortality in CF‐LVAD recipients. Earlier interventions for arrhythmias to avoid long‐term amiodarone exposure may improve long‐term outcomes in CF‐LVAD recipients and needs further study.
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- 2022
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5. The Subtle Journey of a Right Atrial Lead
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Carola Gianni, MD, Robert C. Canby, MD, Alisara Anannab, MD, Domenico G. Della Rocca, MD, Andrea Natale, MD, and Amin Al-Ahmad, MD
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atrial lead ,cardiac pacemaker ,hemothorax ,perforation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
We report an unusual case of subacute right atrial perforation by a screw-in pacemaker lead that migrated into the right lung causing hemopneumothorax 2 weeks after the procedure. After transvenous simple manual traction and minithoracotomy repair of the right atrial wall, the lead was repositioned without any complications. (Level of Difficulty: Beginner.)
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- 2020
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6. Provocation and ablation of non–pulmonary vein triggers in nonparoxysmal atrial fibrillation: Role of the coronary sinusTest your knowledge!
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Domenico G. Della Rocca, MD, Carola Gianni, MD, PhD, Omer Gedikli, MD, Qiong Chen, MD, Andrea Natale, MD, FHRS, and Amin Al-Ahmad, MD, FHRS
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Atrial fibrillation ,Catheter ablation ,Coronary sinus ,Esophagus ,Left atrial appendage ,Outcomes ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2020
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7. Racial and Ethnic Differences in the Management of Atrial Fibrillation
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Kamala P. Tamirisa, MD, Sana M. Al-Khatib, MD, MHS, Sanghamitra Mohanty, MD, Janet K. Han, MD, Andrea Natale, MD, Dhiraj Gupta, MD, Andrea M. Russo, MD, Amin Al-Ahmad, MD, Anne M. Gillis, MD, and Kevin L. Thomas, MD
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Atrial fibrillation (AF) is the most common clinical arrhythmia, and it results in adverse outcomes and increased healthcare costs. Racial and ethnic differences in AF management, although recognized, are poorly understood. This review summarizes racial differences in AF epidemiology, genetics, clinical presentation, and management. In addition, it highlights the underrepresentation of racial and ethnic populations in AF clinical trials, especially trials focused on stroke prevention. Specific strategies are proposed for future research and initiatives that have potential to eliminate racial and ethnic differences in the care of patients with AF. Addressing racial and ethnic disparities in healthcare access, enrollment in clinical trials, resource allocation, prevention, and management will likely narrow the gaps in the care and outcomes of racial and ethnic minorities suffering from AF. Résumé: La fibrillation auriculaire (FA) est la forme clinique d’arythmie la plus fréquente, et elle entraîne des résultats défavorables ainsi qu’une augmentation du coût des soins de santé. Les différences liées à la race et à l’origine ethnique qui existent dans la prise en charge de la FA, bien que reconnues, sont mal comprises. Le présent article de synthèse résume les différences liées à la race observées sur le plan de l’épidémiologie, de la génétique, du tableau clinique et de la prise en charge de la FA. En outre, il met en lumière la sous-représentation de groupes raciaux et ethniques dans les études cliniques sur la FA, en particulier celles axées sur la prévention des accidents vasculaires cérébraux. Des stratégies ad hoc sont proposées pour que la recherche et les initiatives futures favorisent l’éradication des différences liées à la race et à l’origine ethnique dans les soins prodigués aux patients atteints de FA. Le fait de s’attaquer aux disparités liées à la race et à l’origine ethnique qui touchent l’accès aux soins de santé, l’inscription aux essais cliniques, l’allocation des ressources, la prévention et la prise en charge des patients permettra probablement de réduire les lacunes en matière de soins et de résultats chez les personnes atteintes de FA issues de minorités raciales et ethniques.
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- 2021
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8. Natural History of Arrhythmia After Successful Isolation of Pulmonary Veins, Left Atrial Posterior Wall, and Superior Vena Cava in Patients With Paroxysmal Atrial Fibrillation: A Multi‐Center Experience
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Sanghamitra Mohanty, Chintan Trivedi, Pamela Horton, Domenico G. Della Rocca, Carola Gianni, Bryan MacDonald, Angel Mayedo, Javier Sanchez, G. Joseph Gallinghouse, Amin Al‐Ahmad, Rodney P. Horton, J. David Burkhardt, Antonio Dello Russo, Michela Casella, Claudio Tondo, Sakis Themistoclakis, Giovanni Forleo, Luigi Di Biase, and Andrea Natale
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catheter ablation ,late recurrence ,left atrial appendage ,paroxysmal atrial fibrillation ,pulmonary vein isolation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background We evaluated long‐term outcome of isolation of pulmonary veins, left atrial posterior wall, and superior vena cava, including time to recurrence and prevalent triggering foci at repeat ablation in patients with paroxysmal atrial fibrillation with or without cardiovascular comorbidities. Methods and Results A total of 1633 consecutive patients with paroxysmal atrial fibrillation that were arrhythmia‐free for 2 years following the index ablation were classified into: group 1 (without comorbidities); n=692 and group 2 (with comorbidities); n=941. We excluded patients with documented ablation of areas other than pulmonary veins, the left atrial posterior wall, and the superior vena cava at the index procedure. At 10 years after an average of 1.2 procedures, 215 (31%) and 480 (51%) patients had recurrence with median time to recurrence being 7.4 (interquartile interval [IQI] 4.3–8.5) and 5.6 (IQI 3.8–8.3) years in group 1 and 2, respectively. A total of 201 (93.5%) and 456 (95%) patients from group 1 and 2 underwent redo ablation; 147/201 and 414/456 received left atrial appendage and coronary sinus isolation and 54/201 and 42/456 had left atrial lines and flutter ablation. At 2 years after the redo, 134 (91.1%) and 391 (94.4%) patients from group 1 and 2 receiving left atrial appendage/coronary sinus isolation remained arrhythmia‐free whereas sinus rhythm was maintained in 4 (7.4%) and 3 (7.1%) patients in respective groups undergoing empirical lines and flutter ablation (P
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- 2021
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9. Impact of Oral Anticoagulation Therapy Versus Left Atrial Appendage Occlusion on Cognitive Function and Quality of Life in Patients With Atrial Fibrillation
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Sanghamitra Mohanty, Prasant Mohanty, Chintan Trivedi, Joanna Assadourian, Angel Quintero Mayedo, Bryan MacDonald, Domenico G. Della Rocca, Carola Gianni, Rodney Horton, Amin Al‐Ahmad, Mohamed Bassiouny, John D. Burkhardt, Luigi Di Biase, M. Edip Gurol, and Andrea Natale
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AFEQT ,atrial fibrillation (AF) ,cognition ,left atrial appendage occlusion (LAAO) ,MoCA ,oral anticoagulation (OAC) ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background We compared the cognitive status and quality of life in patients with atrial fibrillation undergoing left atrial appendage occlusion (LAAO) or remaining on oral anticoagulation (OAC) after atrial fibrillation ablation. Methods and Results Cognition was assessed by the Montreal Cognitive Assessment (MoCA) survey at baseline and follow‐up. Consecutive patients receiving LAAO or OAC after atrial fibrillation ablation were screened, and patients with a score of ≤17 were excluded from the study. Quality of life was measured at baseline and 1 year using the Atrial Fibrillation Effect on Quality of Life survey. A total of 50 patients (CHA2DS2‐VASc [congestive heart failure, hypertension, age≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65–74 years, sex category] score: 3.30±1.43) in the LAAO group and 48 (CHA2DS2‐VASc score 2.73±1.25) in the OAC group were included in this prospective study. Mean baseline MoCA score was 26.18 and 26.08 in the LAAO and OAC groups, respectively (P=0.846). At 1 year, scores were 26.94 and 23.38 in the respective groups. MoCA score decreased by an estimated −2.74 (95% CI, −3.61 to −1.87; P
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- 2021
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10. Longstanding Persistent Atrial Fibrillation Ablation: How Do You Perform It?
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Carola Gianni, Andrea Natale, and Amin Al-Ahmad
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Atrial fibrillation ,Radiofrequency ablation ,Catheter ablation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Longstanding-persistent atrial fibrillation is one of the most challenging arrhythmias to treat. While radiofrequency catheter ablation is highly effective in paroxysmal atrial fibrillation, pulmonary vein antral isolation (including posterior wall isolation) alone is not enough for nonparoxysmal atrial fibrillation, other targets should be sought in this population. In this case report, we will describe our approach in a typical patient presenting for a first-time ablation procedure for longstanding persistent atrial fibrillation.
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- 2020
11. Long-term Outcome of Pulmonary Vein Isolation Versus Amiodarone Therapy in Patients with Coexistent Persistent AF and Congestive Heart Failure
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Michela Faggioni, Domenico G Della Rocca, Sanghamitra Mohanty, Chintan Trivedi, Ugur Canpolat, Carola Gianni, Amin Al-Ahmad, Rodney Horton, Gerald Joseph Gallinghouse, John David Burkhardt, and Andrea Natale
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Although pharmacological rhythm control of AF in patients with heart failure with reduced ejection fraction (HFrEF) does not seem to provide any benefit over rate control, catheter ablation of AF has been shown to improve clinical outcomes. These results can be explained with higher success rates of catheter ablation in restoring and maintaining sinus rhythm compared with antiarrhythmic drugs. In addition, pharmacotherapy is not void of side-effects, which are thought to offset its potential antiarrhythmic benefits. Therefore, efforts should be made towards optimisation of ablation techniques for AF in patients with HFrEF.
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- 2020
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12. Takotsubo Syndrome Following Catheter Ablation for Atrial Fibrillation
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Sanghamitra Mohanty, Carola Gianni, Angel Mayedo, Bryan MacDonald, Amin Al-Ahmad, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney Horton, John D. Burkhardt, and Andrea Natale
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- 2023
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13. Impact of Colchicine Monotherapy on the Risk of Acute Pericarditis Following Atrial Fibrillation Ablation
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Sanghamitra Mohanty, Prasant Mohanty, Danielle Kessler, Carola Gianni, Karim K. Baho, Trevor Morris, Tuna Yildiz, Angel Quintero Mayedo, Bryan MacDonald, Domenico G. Della Rocca, Amin Al-Ahmad, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney Horton, John D. Burkhardt, Luigi di Biase, and Andrea Natale
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- 2023
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14. Risk Assessment and Management of Patients Undergoing Left Atrial Appendage Isolation
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Carola Gianni, Domenico Della Rocca, Bryan C. MacDonald, Angel Quintero Mayedo, Sanghamitra Mohanty, Mohamed A. Bassiouny, J. David Burkhardt, Rodney P. Horton, G. Joseph Gallinghouse, Javier E. Sanchez, Andrea Natale, and Amin Al-Ahmad
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Pharmacology ,Pharmacology (medical) - Published
- 2022
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15. Endocardial Scar-Homogenization With vs Without Epicardial Ablation in VT Patients With Ischemic Cardiomyopathy
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Sanghamitra Mohanty, Chintan Trivedi, Luigi Di Biase, John D. Burkhardt, Domenico Giovanni Della Rocca, Carola Gianni, Bryan MacDonald, Angel Mayedo, Sai Shishir Shetty, Will Zagrodzky, Faiz Baqai, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney Horton, Amin Al-Ahmad, and Andrea Natale
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Cicatrix ,Treatment Outcome ,Catheter Ablation ,Myocardial Ischemia ,Tachycardia, Ventricular ,Humans ,Cardiomyopathies ,Endocardium - Abstract
In this study, the authors investigated the ablation success of scar homogenization with combined (epicardial + endocardial) vs endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up.Best ablation approach to achieve long-term success rate in VT patients with ICM is not known yet.Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial + epicardial scar homogenization and group 2: endocardial scar homogenization. Patients with previous open heart surgery were excluded. Epicardial ablation was performed despite being noninducible after endocardial ablation in all group 1 patients. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue1.5 mV and severe scar 0.5 mV. Noninducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up every 4 months for 5 years with implantable device interrogations.A total of 361 patients (group 1: n = 70 and group 2: n = 291) were included in the study. At 5 years, 81.4% (n = 57/70) patients from group 1 and 66.3% (n = 193/291) from group 2 were arrhythmia-free (P = 0.01) Of those patients, 26 of 57 (45.6%) and 172 of 193 (89.1%) from group 1 and group 2 respectively were on anti-arrhythmic drugs (AAD) (log-rank P0.001). After adjusting for age, sex, and obstructive sleep apnea, endo-epicardial scar homogenization was associated with a significant reduction in arrhythmia-recurrence (HR: 0.48; 95% CI: 0.27-0.86; P = 0.02).In this series of patients with ICM and VT, epicardial substrate was detected in all group 1 patients despite being noninducible after endocardial ablation. Moreover, combined endo-epicardial scar homogenization was associated with a significantly higher success rate at 5 years of follow-up and a substantially lower need for antiarrhythmic drugs after the procedure compared with the endocardial ablation alone.
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- 2022
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16. Catheter Ablation of Life-Threatening Ventricular Arrhythmias in Athletes
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Nicola Tarantino, Domenico G. Della Rocca, Nicole S. De Leon De La Cruz, Eric D. Manheimer, Michele Magnocavallo, Carlo Lavalle, Carola Gianni, Sanghamitra Mohanty, Chintan Trivedi, Amin Al-Ahmad, Rodney P. Horton, Mohamed Bassiouny, J. David Burkhardt, G. Joseph Gallinghouse, Giovanni B. Forleo, Luigi Di Biase, and Andrea Natale
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athletes ,catheter ablation ,sports cardiology ,ventricular arrhythmia ,ventricular tachycardia ,Medicine (General) ,R5-920 - Abstract
A recent surveillance analysis indicates that cardiac arrest/death occurs in ≈1:50,000 professional or semi-professional athletes, and the most common cause is attributable to life-threatening ventricular arrhythmias (VAs). It is critically important to diagnose any inherited/acquired cardiac disease, including coronary artery disease, since it frequently represents the arrhythmogenic substrate in a substantial part of the athletes presenting with major VAs. New insights indicate that athletes develop a specific electro-anatomical remodeling, with peculiar anatomic distribution and VAs patterns. However, because of the scarcity of clinical data concerning the natural history of VAs in sports performers, there are no dedicated recommendations for VA ablation. The treatment remains at the mercy of several individual factors, including the type of VA, the athlete’s age, and the operator’s expertise. With the present review, we aimed to illustrate the prevalence, electrocardiographic (ECG) features, and imaging correlations of the most common VAs in athletes, focusing on etiology, outcomes, and sports eligibility after catheter ablation.
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- 2021
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17. The AF-FICIENT magnetic resonance imaging and endoscopy safety substudy: A visually guided radiofrequency balloon ablation catheter for pulmonary vein isolation
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Matthew Daly, Michael Hurrell, Iain Melton, Gary Lim, Audrius Aidietis, Gediminas Rackauskas, Amin Al-Ahmad, and Ian Crozier
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Early experience with a novel multielectrode saline-irrigated radiofrequency balloon (RFB) catheter with an integrated camera system found that it was safe and effective in performing single-shot pulmonary vein isolation (PVI) for atrial fibrillation.The purpose of this study was to further assess potential treatment risks by looking for subclinical events.The study was performed at 2 sites. Patients underwent PVI by RFB. A control group underwent conventional point-by-point radiofrequency ablation. Stroke scale questionnaire and brain magnetic resonance imaging (MRI) were performed before and after the ablation procedure, and esophageal endoscopy was performed after the procedure in RFB patients only.We enrolled 27 patients in the RFB group and 15 patients in the control group. The RFB and control groups were well matched [predominantly male: 62% vs 53%; CHAAn increased rate of clinically silent cerebral events was seen in the RFB group. A low rate of esophageal thermal injury was observed.
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- 2022
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18. Sinus Node Sparing Hybrid Thoracoscopic Ablation Outcomes in Patients with Inappropriate Sinus Tachycardia (SUSRUTA-IST) Registry
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Ken Frazier, Poojita Shivamurthy, Dhanunjaya Lakkireddy, Rangarao Tummala, Gian-Battista Chierchia, Chandra Vasamreddy, Amin Al-Ahmad, Rakesh Gopinathannair, Scott Koerber, Mark LaMeier, Andrea Natale, Peter J. Park, Alap Shah, Jalaj Garg, Carlo DeAsmundis, Ahmed Romeya, Donita Atkins, Yashi Awasthi, Luigi Di Biase, Justin Vanmeetren, Sudha Bommana, Clinical sciences, Heartrhythmmanagement, Vascular surgery, Surgical clinical sciences, and Cardiac Surgery
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Epicardial Mapping ,Male ,Reoperation ,medicine.medical_specialty ,medicine.medical_treatment ,Postural orthostatic tachycardia ,sinus node ,Inferior vena cava ,surgery ,Young Adult ,Postoperative Complications ,Arrhythmias ablation ,Superior vena cava ,Physiology (medical) ,Heart rate ,medicine ,Humans ,Prospective Studies ,Registries ,Sinus (anatomy) ,hybrid ablation ,business.industry ,Thoracoscopy ,Hybrid therapy ,medicine.disease ,Ablation ,Inappropriate sinus tachycardia ,inappropriate sinus tachycardia ,Surgery ,Tachycardia, Sinus ,medicine.anatomical_structure ,medicine.vein ,Catheter Ablation ,Female ,Cardiology and Cardiovascular Medicine ,business ,Crista terminalis ,Complication - Abstract
BACKGROUND: Medical treatment of inappropriate sinus tachycardia (IST) remains suboptimal. Radiofrequency sinus node (RF-SN) ablation has poor success and higher complication rates. OBJECTIVE: We aimed to compare clinical outcomes of the novel SN sparing hybrid ablation technique with those of RF-SN modification for IST management. METHODS: This is a multicenter prospective registry comparing the SN sparing hybrid ablation strategy with RF-SN modification. The hybrid procedure was performed using an RF bipolar clamp, isolating superior vena cava/inferior vena cava with the creation of a lateral line across the crista terminalis while sparing the SN region (identified by endocardial 3-dimensional mapping). RF-SN modification was performed by endocardial and/or epicardial mapping and ablation at the site of earliest atrial activation. RESULTS: Of the 100 patients (hybrid ablation group, n = 50; RF-SN group, n = 50), 82% were women, and the mean age was 22.8 years. Normal sinus rhythm and rate were restored in all patients in the hybrid group (vs 84% in the RF-SN group; P = .006). Hybrid ablation was associated with significantly better improvement in mean daily heart rate and peak 6-minute walk heart rate compared with RF-SN ablation. The RF-SN group had a significantly higher rate of redo procedures (100% vs 8%; P < .001), phrenic nerve injury (14% vs 0%; P = .012), lower acute pericarditis (48% vs 92%; P < .0001), permanent pacemaker implantation (50% vs 4%; P < .0001) than did the hybrid ablation group. CONCLUSION: The novel sinus node sparing hybrid ablation procedure appears to be more efficacious and safer in patients with symptomatic drug-resistant IST with long-term durability than RF-SN ablation.
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- 2022
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19. Best ablation strategy in patients with premature ventricular contractions with multiple morphology: a single-centre experience
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Sanghamitra Mohanty, John D Burkhardt, Luigi Di Biase, Prasant Mohanty, Sai Shishir Shetty, Carola Gianni, Domenico G Della Rocca, Karim K Baho, Trevor Morris, Angel Mayedo, Bryan MacDonald, Amin Al-Ahmad, Mohamed Bassiouny, Gerald Joseph Gallinghouse, Rodney Horton, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
AimsThis study aimed to examine the clinical benefits of targeted ablation of all Premature ventricular complex (PVC) morphologies vs. predominant PVC only.Methods and resultsA total of 171 consecutive patients with reduced left ventricular ejection fraction (LVEF) and ≥2 PVC morphology with high burden (>10%/day) undergoing their first ablation procedure were included in the analysis. At the initial procedure, prevalent PVC alone was ablated in the majority. However, at the redo, all PVC morphologies were targeted for ablation. : At the first procedure, 152 (89%) patients received ablation of the dominant PVC only. In the remaining 19 (11%) patients, all PVC morphologies were ablated. At two years, high PVC burden was detected in 89 (52%) patients. Repeat procedure was performed in 78 of 89, where all PVC morphologies were ablated. At 5 years after the repeat procedure, 71 (91%) had PVC burden of ConclusionIn this observational series, ablation of all PVC morphologies was associated with significantly lower PVC burden and improvement of LVEF at long-term follow-up, compared with ablation of the dominant morphology only.
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- 2023
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20. PO-03-160 TRANS-FABRIC APPROACH TO ACHIEVE PERI-DEVICE LEAK CLOSURE FOLLOWING INCOMPLETE WATCHMAN LEFT ATRIAL APPENDAGE OCCLUSION
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Carola Gianni, Rodney P. Horton, Domenico G. Della Rocca, Vincenzo Mirco La Fazia, Sanghamitra Mohanty, Amin Al-Ahmad, Mohamed A. Bassiouny, J. David Burkhardt, G. Joseph Gallinghouse, Patrick M. Hranitzky, Javier E. Sanchez, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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21. PO-05-035 FASCICULAR SUBSTRATE MODIFICATION TO TREAT HUMAN VENTRICULAR FIBRILLATION: A MULTICENTER STUDY
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Weeranun D. Bode, Sanghamitra Mohanty, John D. Burkhardt, Prem G. Torlapati, Carola Gianni, Vincenzo Mirco La Fazia, Domenico G. Della Rocca, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney P. Horton, Amin Al-Ahmad, Xiaodong Zhang, Fengwei Zou, Luigi Di Biase, Pasquale Santangeli, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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22. PO-01-102 RISK FACTORS FOR PROGRESSION OF PAROXYSMAL TO PERSISTENT ATRIAL FIBRILLATION FOLLOWING PV ISOLATION
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Sanghamitra Mohanty, Carola Gianni, Bryan MacDonald, Angel Quintero Mayedo, Vincenzo Mirco La Fazia, Prem Geeta Torlapati, Domenico G. Della Rocca, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Xiaodong Zhang, Fengwei Zou, Luigi Di Biase, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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23. PO-03-168 IMPORTANCE OF COMPRESSION RATE DURING LEFT ATRIAL APPENDAGE CLOSURE WITH WATCHMAN FLX
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Vincenzo Mirco La Fazia, Carola Gianni, Sanghamitra Mohanty, Bryan MacDonald, Angel Quintero Mayedo, Domenico G. Della Rocca, Nethuja Salagundla, Prem Geeta Torlapati, Mohamed A. Bassiouny, G. Joseph Gallinghouse, J. David Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Luigi Di Biase, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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24. AB-452654-2 EASY AF: ESOPHAGUS DEVIATION DURING RADIOFREQUENCY ABLATION OF ATRIAL FIBRILLATION
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Jose Osorio, Devi G. Nair, Luis E. Aguinaga Arrascue, Luis A. Arabia, Raul Weiss, Diego F. Alcivar Franco, Gustavo X. Morales, Amin Al Ahmad, Ammar M. Killu, Gery F. Tomassoni, Omar R. Kahaly, Rohit Mehta, Satish K. Misra, Dilesh Patel, Benjamin B. Holmes, and Gokulakrishnan Balasubramanian
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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25. AB-452663-3 DISTRIBUTION OF TRIGGERS IN THE LEFT ATRIAL POSTERIOR WALL IN AF PATIENTS UNDERGOING CATHETER ABLATION
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Sanghamitra Mohanty, Pasquale Santangeli, Carola Gianni, Bryan MacDonald, Angel Quintero Mayedo, Vincenzo Mirco La Fazia, Prem Geeta Torlapati, Domenico G. Della Rocca, Rami Helmy, mohanad Elchouemi, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Xiaodong Zhang, Fengwei Zou, Luigi Di Biase, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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26. PO-01-002 ASSOCIATION OF NOVEL COMBINED GENETIC POLYMORPHISMS WITH RISK OF THROMBOEMBOLISM IN PATIENTS WITH ATRIAL FIBRILLATION
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Sanghamitra Mohanty, Amitabh C. Pandey, Bryan MacDonald, Angel Quintero Mayedo, Carola Gianni, Prem Geeta Torlapati, Vincenzo Mirco La Fazia, Domenico G. Della Rocca, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Kristi C. Pangborn, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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27. PO-02-056 REAL-TIME VIDEO ASSISTED THORACOSCOPIC SURGERY IN HIGH-RISK TRANSVENOUS LEAD EXTRACTION
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Naga Venkata K. Pothineni, Adnan Ahmed, Danish Bawa, Rangarao V. Tummala, Nicholas Pham, Douglas Darden, Scott Koerber, Jalaj Garg, Rajesh Kabra, Justin Van Meeteren, Robert C. Canby, Amin Al-Ahmad, Luigi Di Biase, Yoaav S. Krauthammer, Andrea Natale, Dhanunjaya R. Lakkireddy, and Rakesh Gopinathannair
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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28. PO-01-089 ARRHYTHMIA PROFILE IN FEMALE ATRIAL FIBRILLATION PATIENTS WITH VERSUS WITHOUT AUTOIMMUNE DISORDERS
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Sanghamitra Mohanty, Carola Gianni, Bryan MacDonald, Angel Quintero Mayedo, Prem Geeta Torlapati, Vincenzo Mirco La Fazia, Domenico G. Della Rocca, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Xiaodong Zhang, Fengwei Zou, Luigi Di Biase, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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29. Radiofrequency Energy Applications Targeting Significant Residual Leaks After Watchman Implantation
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Andrea Natale, Subramaniam C. Krishnan, Dhanunjaya Lakkireddy, Krishna Akella, J. David Burkhardt, Rodney Horton, Rakesh Gopinathannair, Giovanni B. Forleo, Javier Sanchez, Nicola Tarantino, Domenico G. Della Rocca, Ghulam Murtaza, Chintan Trivedi, Armando Del Prete, Amin Al-Ahmad, Jorge Romero, Carola Gianni, Shephal K. Doshi, G. Joseph Gallinghouse, Carlo Lavalle, Michele Magnocavallo, Mohamed Bassiouny, Sanghamitra Mohanty, Luigi Di Biase, Veronica Natale, and Philip J. Patel
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Leak ,Percutaneous ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,Transesophageal echocardiogram ,medicine.disease ,Left atrial ,Occlusion ,Medicine ,Nuclear medicine ,business ,Stroke ,Radiofrequency energy - Abstract
Objectives The aim of this study was to evaluate the efficacy of radiofrequency (RF) energy applications targeting the atrial side of a significant residual leak in patients with acute and chronic evidence of incomplete percutaneous left atrial appendage (LAA) occlusion. Background RF applications have been proved to prevent recanalization of intracranial aneurysms after coil embolization, thereby favoring complete sealing. From a mechanistic standpoint, in vitro and in vivo experiments have demonstrated that RF promotes collagen deposition and tissue retraction. Methods Forty-three patients (mean age 75 ± 7 years mean CHA2DS2-VASc score 4.6 ± 1.4, mean HAS-BLED score 4.0 ± 1.1) with residual leaks ≥4 mm after Watchman implantation were enrolled. Procedural success was defined as complete LAA occlusion or presence of a mild or minimal (1- to 2-mm) peridevice leak on follow-up transesophageal echocardiography (TEE), which was performed approximately 45 days after the procedure. Results RF-based leak closure was performed acutely after Watchman implantation in 19 patients (44.2%) or scheduled after evidence of significant leaks on follow-up TEE in 24 others (55.8%). The median leak size was 5 mm (range: 4-7 mm). On average, 18 ± 7 RF applications per patient (mean maximum contact force 16 ± 3 g, mean power 44 ± 2 W, mean RF time 5.1 ± 2.5 minutes) were performed targeting the atrial edge of the leak. Post-RF median leak size was 0 mm (range: 0-1 mm). A very low rate (2.3% [n = 1]) of major periprocedural complications was observed. Follow-up TEE revealed complete LAA sealing in 23 patients (53.5%) and negligible residual leaks in 15 (34.9%). Conclusions RF applications targeting the atrial edge of a significant peri-Watchman leak may promote LAA sealing via tissue remodeling, without increasing complications. (RF Applications for Residual LAA Leaks [REACT]; NCT04726943 )
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- 2021
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30. Half-Dose Direct Oral Anticoagulation Versus Standard Antithrombotic Therapy After Left Atrial Appendage Occlusion
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Nicola Tarantino, J. David Burkhardt, Armando Del Prete, Carlo Lavalle, Carola Gianni, Giovanni B. Forleo, G. Joseph Gallinghouse, Dhanunjaya Lakkireddy, Veronica Natale, Domenico G. Della Rocca, David F. Briceno, Chintan Trivedi, Mohamed Bassiouny, Amin Al-Ahmad, Andrea Natale, Sanghamitra Mohanty, Javier Sanchez, Douglas N. Gibson, Jorge Romero, Luigi Di Biase, Michele Magnocavallo, Rodney Horton, and Christoffel J. van Niekerk
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medicine.medical_specialty ,Aspirin ,business.industry ,medicine.medical_treatment ,Watchman ,antiplatelet therapy ,aspirin ,left atrial appendage ,oral anticoagulation ,stroke ,thromboembolism ,medicine.disease ,Thrombosis ,Left atrial appendage occlusion ,Interquartile range ,Heart failure ,Internal medicine ,Antithrombotic ,medicine ,Cardiology ,Liver function ,Cardiology and Cardiovascular Medicine ,business ,Stroke ,medicine.drug - Abstract
Objectives This study evaluated the long-term efficacy of a standard antithrombotic strategy versus half-dose direct oral anticoagulation (DOAC) after Watchman implantation. Background No consensus currently exists on the selection of the most effective antithrombotic strategy to prevent device-related thrombosis (DRT) in patients undergoing endocardial left atrial appendage closure. Methods After successful left atrial appendage closure, consecutive patients were prescribed a standard antithrombotic strategy (SAT) or long-term half-dose DOAC (hdDOAC). The primary composite endpoint was DRT and thromboembolic (TE) and bleeding events. Results Overall, 555 patients (mean age 75 ± 8 years, 63% male; median CHA2DS2-VASc [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack or thromboembolism, vascular disease, age 65-74 years, sex category] score 4 [interquartile range (IQR): 3-6]; median HAS-BLED [hypertension, abnormal renal or liver function, stroke, bleeding, labile international normalized ratio, elderly, drugs or alcohol] score 3 [IQR: 2-4]) were included. Patients were categorized into 2 groups (SAT: n = 357 vs hdDOAC: n = 198). Baseline clinical characteristics were similar between groups. The median follow-up duration was 13 months (IQR: 12-15 months). DRT occurred in 12 (2.1%) patients, all in the SAT group (3.4% vs 0.0%; log-rank P = 0.009). The risk of nonprocedural major bleeding was significantly more favorable in the hdDOAC group (0.5% vs. 3.9%; log-rank P = 0.018). The rate of the primary composite endpoint of DRT and TE and major bleeding events was 9.5% in SAT patients and 1.0% in hdDOAC patients (HR: 9.8; 95% CI: 2.3-40.7; P = 0.002). Conclusions After successful Watchman implantation, long-term half-dose DOAC significantly reduced the risk of the composite endpoint of DRT and TE and major bleeding events compared with a standard, antiplatelet-based, antithrombotic therapy.
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- 2021
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31. Evaluation of a novel cardiac signal processing system for electrophysiology procedures: The PURE EP 2.0 study
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J. David Burkhardt, Christopher J. McLeod, Amin Al-Ahmad, Moussa Mansour, G. Joseph Gallinghouse, Bradley P. Knight, Deepak Padmanabhan, Omar Yasin, Mohammed Bassiouny, Wendy S. Tzou, Andrea Natale, Robert D. Schaller, and Jason Zagrodzky
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Signal processing ,medicine.medical_specialty ,business.industry ,Heart ,Signal Processing, Computer-Assisted ,Audiology ,Signal ,Intracardiac injection ,Data set ,Electrophysiology ,3d mapping ,Rating scale ,Physiology (medical) ,Catheter Ablation ,medicine ,Humans ,Cardiac Electrophysiology ,Prospective Studies ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business ,Intracardiac Electrogram - Abstract
BACKGROUND Intracardiac electrogram data remain one of the primary diagnostic inputs guiding complex ablation procedures. However, the technology to collect, process, and display intracardiac signals has known shortcomings and has not advanced in several decades. OBJECTIVE The purpose of this study was to evaluate a new signal processing platform, the PURE EP™ system (PURE), in a multi-center, prospective study. METHODS Intracardiac signal data of clinical interest were collected from 51 patients undergoing ablation procedures with PURE, the signal recording system, and the 3D mapping system at the same time stamps. The samples were randomized and subjected to blinded, controlled evaluation by three independent electrophysiologists to determine the overall quality and clinical utility of PURE signals when compared to conventional sources. Each reviewer assessed the same (92) signal sample sets and responded to (235) questions using a 10-point rating scale. If two or more reviewers rated the PURE signal higher than the control, it was deemed superior. RESULTS A total of 93% of question responses showed consensus amongst the blinded reviewers. Based on the ratings for each pair of signals, a cumulative total of 164 PURE signals out of 218 (75.2%) were statistically rated as Superior for this data set (p
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- 2021
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32. Same-day discharge following catheter ablation and venous closure with VASCADE MVP: A postmarket registry
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Zayd A. Eldadah, Amin Al‐Ahmad, T. Jared Bunch, David B. Delurgio, Rahul N. Doshi, Bruce G. Hook, Patrick M. Hranitzky, Charles A. Joyner, Suneet Mittal, Christopher Porterfield, Javier E. Sanchez, Senthil K. Thambidorai, Oussama M. Wazni, and H. Thomas McElderry
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Early and safe ambulation can facilitate same-day discharge (SDD) following catheter ablation, which can reduce resource utilization and healthcare costs and improve patient satisfaction. This study evaluated procedure success and safety of the VASCADE MVP venous vascular closure system in patients with atrial fibrillation (AF).The AMBULATE SDD Registry is a two-stage series of postmarket studies in patients with paroxysmal or persistent AF undergoing catheter ablation followed by femoral venous access-site closure with VASCADE MVP. Efficacy endpoints included SDD success, defined as the proportion of patients discharged the same day who did not require next-day hospital intervention for procedure/access site-related complications, and access site sustained success within 15 days of the procedure.Overall, 354 patients were included in the pooled study population, 151 (42.7%) treated for paroxysmal AF and 203 (57.3%) for persistent AF. SDD was achieved in 323 patients (91.2%) and, of these, 320 (99.1%) did not require subsequent hospital intervention based on all study performance outcomes. Nearly all patients (350 of 354; 98.9%) achieved total study success, with no subsequent hospital intervention required. No major access-site complications were recorded. Patients who had SDD were more likely to report procedure satisfaction than patients who stayed overnight.In this study, 99.7% of patients achieving SDD required no additional hospital intervention for access site-related complications during follow-up. SDD appears feasible and safe for eligible patients after catheter ablation for paroxysmal or persistent AF in which the VASCADE MVP is used for venous access-site closure.
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- 2022
33. Prevalence of atrial fibrillation and procedural outcome in patients undergoing catheter ablation for premature ventricular complexes
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Fengwei Zou, Luigi Di Biase, Sanghamitra Mohanty, Xiaodong Zhang, Sai Shishir Shetty, Carola Gianni, Domenico G. Della Rocca, Aung Lin, Roberto Arosio, Marco Schiavone, Giovanni Forleo, Angel Mayedo, Bryan MacDonald, Amin Al‐Ahmad, Mohamed Bassiouny, G. Joseph Gallinghouse, Rodney Horton, John D. Burkhardt, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Atrial fibrillation (AF) and premature ventricular complexes (PVC) are common arrhythmias. We aimed to investigate AF prevalence in patients with PVC and its impact on PVC ablation outcomes.Consecutive patients undergoing PVC ablation at a single institution between 2016 and 2019 were included and prospectively followed for 2 years. Patients with severe valvular heart disease, hyperthyroidism, malignancy, alcohol use disorder and advanced renal/hepatic diseases were excluded. Twelve-lead electrocardiograms were used to diagnose AF and assess PVC morphology. All PVCs were targeted for ablation using 4-mm irrigated-tip catheters at standardized radiofrequency power guided by 3-D mapping and intracardiac echocardiography. Patients were followed with remote monitoring, device interrogations and office visits every 6 months for 2 years. Detection of any PVCs in follow-up was considered as recurrence.A total of 394 patients underwent PVC ablation and 96 (24%) had concurrent AF. Patients with PVC and AF were significantly older (68.2 ± 10.8 vs. 58.3 ± 15.8 years, p .001), had lower LV ejection fraction (43.3 ± 13.3% vs. 49.6 ± 12.4%, p .001), higher CHAAF was documented in 1/4 of patients undergoing PVC ablation and was associated with lower procedural success at long-term follow-up. This was likely attributed to older age, worse LV function and higher prevalence of multiple PVC morphologies in patients with concurrent AF.
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- 2022
34. Towards Guidance of Electrophysiological Procedures with Real-Time 3D Intracardiac Echocardiography Fusion to C-arm CT.
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Wolfgang Wein, Estelle Camus, Matthias John 0001, Mamadou Diallo, Christophe Duong, Amin Al-Ahmad, Rebecca Fahrig, Ali Khamene, and Chenyang Xu 0001
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- 2009
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35. Intracardiac echocardiography‐ versus transesophageal echocardiography‐guided left atrial appendage occlusion with Watchman FLX
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Domenico G. Della Rocca, Carola Gianni, Rodney Horton, Mohamed Bassiouny, J. David Burkhardt, Javier Sanchez, Amin Al-Ahmad, G. Joseph Gallinghouse, Sanghamitra Mohanty, Patrick Hranitzky, and Andrea Natale
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Cardiac Catheterization ,medicine.medical_specialty ,Intracardiac echocardiography ,business.industry ,medicine.medical_treatment ,Fluoroscopy dose ,medicine.disease ,Left atrial appendage occlusion ,Thrombosis ,Cohort Studies ,Treatment Outcome ,Embolism ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,Cardiology ,Humans ,Medicine ,Atrial Appendage ,Cardiology and Cardiovascular Medicine ,business ,human activities ,Echocardiography, Transesophageal ,Ultrasonography, Interventional - Abstract
Introduction Watchman FLX has been recently approved for left atrial appendage occlusion (LAAO) in the US. Intracardiac echocardiography (ICE) - which is already commonly used to guide trans-septal access - can serve as an alternative to TEE, simplifying the procedure and reducing associated costs. Herein, we report our experience with ICE-guided LAAO with Watchman FLX. Methods and results This cohort study included the first 190 consecutive patients who underwent LAAO with Watchman FLX in our center. LAAO was successful in all patients without significant peri-procedural, device-related complications in either group. Compared to TEE, we observed a significant reduction in procedural times when using ICE. In addition, there was a potentially clinically relevant reduction in fluoroscopy dose, mainly secondary to fewer cine acquisition runs. At follow-up, no cases of device embolism were noted, whereas the rate of device-related thrombosis and peri-device leaks were comparable between groups. Conclusion ICE-guided LAAO with Watchman FLX is safe and feasible, with a significant reduction in procedural time and potential reduction in fluoroscopy dose when compared to TEE.
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- 2021
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36. Decreased biventricular pacing with high burden PVCs, what is the cause?
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Carola Gianni, J. David Burkhardt, Andrea Natale, and Amin Al-Ahmad
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medicine.medical_specialty ,business.industry ,Cardiac Pacing, Artificial ,medicine.disease ,Ventricular Premature Complexes ,Cardiac Resynchronization Therapy ,Electrocardiography ,Atrial Flutter ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Atrial flutter - Published
- 2021
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37. Fusion of Intracardiac Ultrasound with 3D Cardiac C-Arm CT from Animal Data for Electrophysiology.
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Matthias John 0001, Yiyong Sun, Samuel Kadoury, Wolfgang Wein, Yong Li 0010, Jeff Resnick, Gerry Plambeck, Ann Dempsey, Amin Al-Ahmad, Rebecca Fahrig, and Frank Sauer
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- 2007
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38. Intracardiac Echocardiography to Guide Catheter Ablation of Atrial Fibrillation
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Javier Sanchez, Carola Gianni, Rodney Horton, Domenico G. Della Rocca, Amin Al-Ahmad, Andrea Natale, and Luigi Di Biase
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medicine.medical_specialty ,Standard of care ,Intracardiac echocardiography ,Cardiac anatomy ,medicine.medical_treatment ,Ablation of atrial fibrillation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,030212 general & internal medicine ,Guide catheter ,business.industry ,Atrial fibrillation ,medicine.disease ,Ablation ,Surgery, Computer-Assisted ,Echocardiography ,Catheter Ablation ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,human activities - Abstract
Intracardiac echocardiography (ICE) is a valuable tool and should be standard of care in any modern electrophysiology laboratory. Through real-time imaging of cardiac anatomy, ICE is used to guide electrophysiology procedures and monitor for complications. This article is a short overview of the application of real-time ICE imaging during atrial fibrillation ablation procedures.
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- 2021
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39. Atrial pacing above the lower rate limit: What is the cause?
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Amin Al-Ahmad, Domenico G. Della Rocca, Carola Gianni, and Anna Sarcon
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medicine.medical_specialty ,Atrial pacing ,business.industry ,Cardiac Pacing, Artificial ,Ventricular tachycardia ,medicine.disease ,Electrocardiography ,Physiology (medical) ,Internal medicine ,Cardiology ,Humans ,Medicine ,Heart Atria ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
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40. Surviving sudden cardiac arrest—successes, challenges, and opportunities
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Valentina Kutyifa, Dhanunjaya Lakkireddy, Luigi Di Biase, Win Kuang Shen, Bharath Rajagopalan, Rakesh Gopinathannair, Andrea Natale, Kristin Patton, and Amin Al-Ahmad
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business.industry ,medicine.medical_treatment ,Big data ,Sudden cardiac arrest ,030204 cardiovascular system & hematology ,Public access defibrillator ,EMS response ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Common cause and special cause ,Physiology (medical) ,Medicine ,030212 general & internal medicine ,Cardiopulmonary resuscitation ,Medical emergency ,Knowledge dissemination ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Sudden cardiac arrest (SCA) is the most common cause of death in the world. This manuscript highlights the various challenges in prevention and early management of SCA and also discusses the current state of SCA awareness. The manuscript also outlines the various national and international initiatives in improving SCA awareness and their impact on improving outcomes in SCA. Various campaigns have strived for widespread dissemination of cardiopulmonary resuscitation training and advocated for broader public access defibrillator availability. Finally, the manuscript describes future directions including harnessing technology with voice command and artificial intelligence to allow lay person deliver effective CPR, to improve EMS response times, and to allow wider CPR knowledge dissemination in schools and places of employment. Future research should be focused on optimizing SCA outcomes among vulnerable populations and minorities. Advancements in resuscitation science and use of big data for improvement of EMS services will improve outcomes in SCA.
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- 2021
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41. PO-03-005 BEST ANTICOAGULATION STRATEGY FOR STROKE PROPHYLAXIS IN ATRIAL FIBRILLATION PATIENTS WITH AMYLOIDOSIS
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Andrea Natale, Carola Gianni, Bryan MacDonald, Angel Quintero Mayedo, Vincenzo Mirco La Fazia, Prem Geeta Torlapati, Domenico G. Della Rocca, Rami Helmy, Mohanad Elchouemi, Mohamad Bassiouny, G. Joseph Gallinghouse, John D. burkhardt, Rodney P. Horton, Luigi Di Biase, Amin Al-Ahmad, and Sanghamitra Mohanty
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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42. PO-04-065 THREE-DIMENSIONAL INTRACARDIAC ECHOCARDIOGRAPHY FOR LEFT ATRIAL APPENDAGE SIZING AND PERCUTANEOUS OCCLUSION GUIDANCE
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Domenico G. Della Rocca, Michele Magnocavallo, Carola Gianni, Sanghamitra Mohanty, Amin Al-Ahmad, G. Joseph Gallinghouse, Mohamed Bassiouny, Javier E. Sanchez, Gian Battista Chierchia, Carlo de Asmundis, Pasquale Santangeli, Luigi Di Biase, David J. Burkhardt, Rodney P. Horton, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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43. PO-03-192 INTRA-DEVICE LEAKS ON POST LEFT ATRIAL APPENDAGE OCCLUDER FOLLOW UP TOMOGRAPHIC IMAGING – TRUE LEAK OR MERE INCOMPLETE ENDOTHELIALIZATION
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Adnan Ahmed, Danish Bawa, Henry Ukwu, Ria Singh, Fady Botrous, Vasvi Singh, Naga Venkata K. Pothineni, Jalaj Garg, Rajesh Kabra, Douglas Darden, Luigi Di Biase, Amin Al-Ahmad, Andrea Natale, Rakesh Gopinathannair, and Dhanunjaya R. Lakkireddy
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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44. PO-02-093 IMPACT OF ABLATION OUTCOME ON COGNITIVE FUNCTION IN PATIENTS WITH ATRIAL FIBRILLATION
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Sanghamitra Mohanty, Angel Quintero Mayedo, Bryan MacDonald, Carola Gianni, VincenzoMirco La Fazia, Domenico G. Della Rocca, Prem Geeta Torlapati, Mohamed A. Bassiouny, G. Joseph Gallinghouse, John D. Burkhardt, Rodney P. Horton, Amin Al-Ahmad, Xiaodong Zhang, Fengwei zou, Luigi Di Biase, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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45. PO-03-161 INTRA-PROCEDURAL CROSSOVER OF LEFT ATRIAL APPENDAGE OCCLUSION DEVICES, A SINGLE CENTER EXPERIENCE
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Carola Gianni, Rodney P. Horton, Domenico G. Della Rocca, Vincenzo Mirco La Fazia, Sanghamitra Mohanty, Amin Al-Ahmad, Mohamed A. Bassiouny, J. David Burkhardt, G. Joseph Gallinghouse, Patrick M. Hranitzky, Javier E. Sanchez, and Andrea Natale
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
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46. A Novel Temperature-Controlled Radiofrequency Catheter Ablation System Used to Treat Patients With Paroxysmal Atrial Fibrillation
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Frank Cuoco, William Maddox, B. Judson Colley, Darren S. Sidney, H. Thomas McElderry, Zdenek Starek, Jean-Paul Albenque, Amin Al-Ahmad, Petr Neuzil, Shufeng Liu, Srinivas R. Dukkipati, Michael K. Getman, Josef Kautzner, Andrea Natale, and Herve Poty
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medicine.medical_specialty ,Catheters ,Paroxysmal atrial fibrillation ,medicine.medical_treatment ,Population ,Catheter ablation ,030204 cardiovascular system & hematology ,law.invention ,Pulmonary vein ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Atrial Fibrillation ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Adverse effect ,education ,education.field_of_study ,business.industry ,Temperature ,Atrial fibrillation ,Ablation ,medicine.disease ,Treatment Outcome ,Catheter Ablation ,Quality of Life ,Cardiology ,business - Abstract
DIAMOND-AF (DiamondTemp™ Ablation System for the Treatment of Paroxysmal Atrial Fibrillation) was a prospective, multicenter, noninferiority, randomized trial that compared the safety and effectiveness of the DTA system versus those of a force-sensing RF ablation system (control) for the treatment of patients with drug-refractory, recurrent, symptomatic paroxysmal atrial fibrillation (AF).Irrigated radiofrequency (RF) ablation catheters lose tissue temperature acuity, which is vital in assessing lesion formation. DiamondTemp Ablation (DTA) was designed to re-establish accurate tissue temperature measurements during ablation.A total of 482 patients with paroxysmal AF were randomized (239 DTA, 243 control) to undergo pulmonary vein isolation and were followed up at 23 sites. Patients were screened for disease progression, cardiac characteristics, and prior interventions. Primary endpoints were effectiveness (freedom from atrial arrhythmia recurrence) and safety (composite of procedure- and device-related serious adverse events).The primary safety event rate was 3.3% in the DTA group versus 6.6% in the control group (p 0.001 vs. 6.5% noninferiority margin). Primary effectiveness was met in 79.1% of DTA subjects and 75.7% of control subjects (p 0.001 vs. -12.5% noninferiority margin). Secondary endpoint analysis found that off-drug effectiveness favored DTA compared with the control (142 [59.4%] vs. 120 [49.4%], respectively; p = 0.03). Total RF time and individual RF ablation duration were significantly shorter with less saline infused through the DTA catheter (p 0.001). Both arms saw clinically meaningful improvements in quality of life at 12 months.Safety and efficacy of the DTA system proved noninferior to force-sensing RF ablation in a paroxysmal AF population. Efficiencies were observed using DTA with shorter total RF times, individual RF ablation durations, and less saline infusion. (DiamondTemp™ Ablation System for the Treatment of Paroxysmal Atrial Fibrillation; NCT03334630).
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- 2021
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47. Thromboembolic Risk in Atrial Fibrillation Patients With Left Atrial Scar Post-Extensive Ablation
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Carola Gianni, G. Joseph Gallinghouse, John Burkhardt, Andrea Natale, Faiz M. Baqai, Luigi Di Biase, Angel Mayedo, Sanghamitra Mohanty, Rodney Horton, Chintan Trivedi, Amin Al-Ahmad, Bryan MacDonald, Domenico G. Della Rocca, Alisara Anannab, and Mohamed Bassiouny
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Catheter ablation ,Atrial fibrillation ,030204 cardiovascular system & hematology ,medicine.disease ,Ablation ,Single Center ,Thromboembolic risk ,03 medical and health sciences ,0302 clinical medicine ,Left atrial ,Internal medicine ,cardiovascular system ,medicine ,Cardiology ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,business ,Stroke - Abstract
Objectives This study evaluated the association of the post-ablation scar with stroke risk in patients undergoing atrial fibrillation (AF) ablation. Background Late gadolinium enhancement–...
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- 2021
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48. Half‐normal saline versus normal saline for irrigation of open‐irrigated radiofrequency catheters in atrial fibrillation ablation
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Chintan Trivedi, J. David Burkhardt, Rodney Horton, Domenico G. Della Rocca, Andrea Natale, Luigi Di Biase, Amin Al-Ahmad, G. Joseph Gallinghouse, Carola Gianni, Mohamed Bassiouny, Patrick Hranitzky, Shane Bailey, Sanghamitra Mohanty, Bryan MacDonald, Javier Sanchez, and Angel Mayedo
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Catheters ,medicine.medical_treatment ,Population ,Catheter ablation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Physiology (medical) ,Atrial Fibrillation ,medicine ,Humans ,030212 general & internal medicine ,education ,Saline ,education.field_of_study ,business.industry ,Hazard ratio ,Atrial fibrillation ,Equipment Design ,medicine.disease ,Ablation ,Catheter ,Treatment Outcome ,Pulmonary Veins ,Anesthesia ,Catheter Ablation ,Saline Solution ,Cardiology and Cardiovascular Medicine ,Hyponatremia ,business - Abstract
Background The creation of effective and permanent lesions is a crucial factor in determining the success rate of atrial fibrillation (AF) ablation. By increasing the efficacy of radiofrequency (RF) energy-mediated lesion formation, half-normal saline (HNS) as an irrigant for open-irrigated ablation catheters has the potential to reduce procedural times and improve acute and long-term outcomes. Methods This is a double-blind randomized clinical trial of 99 patients undergoing first-time RF catheter ablation for AF. Patients enrolled were randomly assigned in a 1:1 fashion to perform ablation using HNS or normal saline (NS) as an irrigant for the ablation catheter. Results The use of HNS is associated with shorter RF times (26 vs. 33 min; p = .02) with comparable procedure times (104 vs. 104 min). The rate of acute pulmonary vein reconnections (16% vs. 18%) was comparable, with a median of 1 vein reconnection in the HNS arm versus 2 in the NS arm. There was no difference in procedure-related complications, including the incidence of postprocedural hyponatremia when using HNS. Over the 1-year follow-up, there is no significant difference between the HNS and NS with respect to the recurrence of any atrial arrhythmia (off antiarrhythmic drugs [AAD]: 47% vs. 52%; hazard ratio [HR]: 1.17, 95% confidence interval [CI]: 0.66-2.06; off/on AAD: 66% vs. 66%, HR: 1.06, 95% CI: 0.53-2.12), with a potential benefit of using HNS when considering the paroxysmal AF cohort (on/off AAD 73% vs. 62%, HR: 0.72, 95% CI: 0.19-2.70). Conclusions In a mixed cohort of patients undergoing first-time AF ablation, irrigation of open-irrigated RF ablation catheters with HNS is associated with shorter RF times, with a comparably low rate of procedure-related complications. In the long term, there is no significant difference with respect to the recurrence of any atrial arrhythmia. Larger studies with a more homogeneous population are necessary to determine whether HNS improves clinical outcomes.
- Published
- 2021
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49. 3-Dimensional Intracardiac Echocardiography-Guided Percutaneous Closure of a Residual Leak via Radiofrequency Applications After LAAO
- Author
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Domenico G. Della Rocca, Carola Gianni, Michele Magnocavallo, Sanghamitra Mohanty, Amin Al-Ahmad, David R. Tschopp, J. David Burkhardt, Luigi Di Biase, Rodney P. Horton, Andrea Natale, and Heartrhythmmanagement
- Subjects
Echocardiography, Transesophageal/methods ,Atrial Fibrillation ,Atrial Appendage/diagnostic imaging ,Humans ,heart - Published
- 2022
50. Transesophageal Echocardiography Following Left Atrial Appendage Electrical Isolation: Diagnostic Pitfalls and Clinical Implications
- Author
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Carola Gianni, Javier E. Sanchez, Qiong Chen, Domenico G. Della Rocca, Sanghamitra Mohanty, Chintan Trivedi, Amin Al-Ahmad, Mohamed A. Bassiouny, J. David Burkhardt, G. Joseph Gallinghouse, Rodney P. Horton, Patrick M. Hranitzky, Jorge E. Romero, Luigi Di Biase, Mario J. Garcia, and Andrea Natale
- Subjects
Physiology (medical) ,Atrial Fibrillation ,Catheter Ablation ,Anticoagulants ,Humans ,Atrial Appendage ,Cardiology and Cardiovascular Medicine ,Echocardiography, Transesophageal - Abstract
Background: Following left atrial appendage (LAA) electrical isolation, the decision on whether to continue oral anticoagulation after successful atrial fibrillation ablation is based on the study of its mechanical function on transesophageal echocardiography (TEE). In this cohort, LAA contraction is absent and the incorrect interpretation of emptying flow velocities can lead to unwanted clinical sequelae. Methods: One hundred and sixty consecutive TEE exams performed to evaluate the LAA mechanical function following its electrical isolation were reviewed by an experienced operator blinded to the original diagnosis of LAA dysfunction. The rate of diagnostic discrepancy in the assessment LAA dysfunction and its clinical implications were evaluated. Results: Diagnostic discrepancy with misclassification of the LAA mechanical function occurred 36% (58/160) of TEE exams. In most cases (57/58), such discrepancy was observed in the setting of an incorrect original diagnosis of a normal LAA mechanical function despite absent/reduced or inconsistent LAA contraction. This main source of this wrong diagnosis was the wrong interpretation of passive LAA flows (34/57; 60%), followed by failure to identify dissociated firing (15/57; 26%). In rare cases (8/57; 14%), velocities of surrounding structures were interpreted as LAA flow due to misplacement of the pulsed-wave Doppler sample volume. Following LAA isolation, the proportion of patients who experienced a cerebrovascular event while off oral anticoagulation due to the misclassification of their LAA mechanical function was 70% (7/10 [95% CI, 40%–89%]). Conclusions: Underdiagnosis of LAA mechanical dysfunction is common in TEEs performed following LAA electrical isolation, and it is associated with an increased risk of cerebrovascular events owing to oral anticoagulation discontinuation despite absent/reduced LAA contraction. Careful review of the TEE exam by an operator with specific expertise in LAA imaging and familiar with the functional implications of LAA isolation is necessary before interrupting oral anticoagulation in this cohort.
- Published
- 2022
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