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193 results on '"Melduni, Rowlens M."'

18. Impact of Left Atrial Appendage Closure During Cardiac Surgery on the Occurrence of Early Postoperative Atrial Fibrillation, Stroke, and Mortality: A Propensity Score–Matched Analysis of 10 633 Patients

Author

Melduni, Rowlens M., Schaff, Hartzell V., Lee, Hon-Chi, Gersh, Bernard J., Noseworthy, Peter A., Bailey, Kent R., Ammash, Naser M., Cha, Stephen S., Fatema, Kaniz, Wysokinski, Waldemar E., Seward, James B., Packer, Douglas L., Rihal, Charanjit S., and Asirvatham, Samuel J.

Published
2017
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24. Long‐Term Survival of Patients With Left Ventricular Noncompaction

Author

Vaidya, Vaibhav R., primary, Lyle, Melissa, additional, Miranda, William R., additional, Farwati, Medhat, additional, Isath, Ameesh, additional, Patlolla, Sri Harsha, additional, Hodge, David O., additional, Asirvatham, Samuel J., additional, Kapa, Suraj, additional, Deshmukh, Abhishek J., additional, Foley, Thomas A., additional, Michelena, Hector I., additional, Connolly, Heidi M., additional, and Melduni, Rowlens M., additional

Published
2021
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32. Atrial fibrillation is not an independent predictor of outcome in patients with aortic stenosis

Author

Zhang, Hongju, primary, El-Am, Edward A, additional, Thaden, Jeremy J, additional, Pislaru, Sorin V, additional, Scott, Christopher G, additional, Krittanawong, Chayakrit, additional, Chahal, Anwar A, additional, Breen, Thomas J, additional, Eleid, Mackram F, additional, Melduni, Rowlens M, additional, Greason, Kevin L, additional, McCully, Robert B, additional, Enriquez-Sarano, Maurice, additional, Oh, Jae K, additional, Pellikka, Patricia A, additional, and Nkomo, Vuyisile T, additional

Published
2019
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34. Direct Current Cardioversion of Atrial Arrhythmias in Adults With Cardiac Amyloidosis

Author

El-Am, Edward A., primary, Dispenzieri, Angela, additional, Melduni, Rowlens M., additional, Ammash, Naser M., additional, White, Roger D., additional, Hodge, David O., additional, Noseworthy, Peter A., additional, Lin, Grace, additional, Pislaru, Sorin V., additional, Egbe, Alexander C., additional, Grogan, Martha, additional, and Nkomo, Vuyisile T., additional

Published
2019
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36. Atrial fibrillation is not an independent predictor of outcome in patients with aortic stenosis.

Author

Hongju Zhang, El-Am, Edward A., Thaden, Jeremy J., Pislaru, Sorin V., Scott, Christopher G., Krittanawong, Chayakrit, Chahal, Anwar A., Breen, Thomas J., Eleid, Mackram F., Melduni, Rowlens M., Greason, Kevin L., McCully, Robert B., Enriquez-Sarano, Maurice, Oh, Jae K., Pellikka, Patricia A., Nkomo, Vuyisile T., and Zhang, Hongju

Abstract

Objectives: To examine the prognostic significance of atrial fibrillation (AF) versus sinus rhythm (SR) on the management and outcomes of patients with severe aortic stenosis (AS).Methods: 1847 consecutive patients with severe AS (aortic valve area ≤1.0 cm2 and aortic valve systolic mean Doppler gradient ≥40 mm Hg or peak velocity ≥4 m/s) and left ventricular ejection fraction ≥50% were identified. The independent association of AF and all-cause mortality was assessed.Results: Age was 76±11 years and 46% were female; 293 (16%) patients had AF and 1554 (84%) had SR. In AF, 72% were symptomatic versus 71% in SR. Survival rate at 5 years for AF (41%) was lower than SR (65%) (age- and sex-adjusted HR=1.66 (1.40-1.98), p<0.0001). In multivariable analysis, factors associated with mortality included age (HR per 10 years=1.55 (1.42-1.69), p<0.0001), dyspnoea (HR=1.58 (1.33-1.87), p<0.0001), ≥ moderate mitral regurgitation (HR=1.63 (1.22-2.18), p=0.001), right ventricular systolic dysfunction (HR=1.88 (1.52-2.33), p<0.0001), left atrial volume index (HR per 10 mL/m2=1.13 (1.07-1.19), p<0.0001) and aortic valve replacement (AVR) (HR=0.44 (0.38-0.52), p<0.0001). AF was not a predictor of mortality independent of variables strongly correlated HR=1.02 (0.84-1.25), p=0.81). The 1-year probability of AVR following diagnosis of severe AS was lower in AF (49.8%) than SR (62.5%) (HR=0.73 (0.62-0.86), p<0.001); among patients with AF not referred for AVR, symptoms were frequently attributed to AF instead of AS.Conclusion: AF was associated with poor prognosis in patients with severe AS, but apparent differences in outcomes compared with SR were explained by factors other than AF including concomitant cardiac abnormalities and deferral of AVR due to attribution of cardiac symptoms to AF. [ABSTRACT FROM AUTHOR]

Published
2020
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41. Atrial fibrillation is not an independent predictor of outcome in patients with aortic stenosis

Author

Zhang, Hongju, El-Am, Edward A, Thaden, Jeremy J, Pislaru, Sorin V, Scott, Christopher G, Krittanawong, Chayakrit, Chahal, Anwar A, Breen, Thomas J, Eleid, Mackram F, Melduni, Rowlens M, Greason, Kevin L, McCully, Robert B, Enriquez-Sarano, Maurice, Oh, Jae K, Pellikka, Patricia A, and Nkomo, Vuyisile T

Abstract

ObjectivesTo examine the prognostic significance of atrial fibrillation (AF) versus sinus rhythm (SR) on the management and outcomes of patients with severe aortic stenosis (AS).Methods1847 consecutive patients with severe AS (aortic valve area ≤1.0 cm2and aortic valve systolic mean Doppler gradient ≥40 mm Hg or peak velocity ≥4 m/s) and left ventricular ejection fraction ≥50% were identified. The independent association of AF and all-cause mortality was assessed.ResultsAge was 76±11 years and 46% were female; 293 (16%) patients had AF and 1554 (84%) had SR. In AF, 72% were symptomatic versus 71% in SR. Survival rate at 5 years for AF (41%) was lower than SR (65%) (age- and sex-adjusted HR=1.66 (1.40–1.98), p<0.0001). In multivariable analysis, factors associated with mortality included age (HR per 10 years=1.55 (1.42–1.69), p<0.0001), dyspnoea (HR=1.58 (1.33–1.87), p<0.0001), ≥ moderate mitral regurgitation (HR=1.63 (1.22–2.18), p=0.001), right ventricular systolic dysfunction (HR=1.88 (1.52–2.33), p<0.0001), left atrial volume index (HR per 10 mL/m2=1.13 (1.07–1.19), p<0.0001) and aortic valve replacement (AVR) (HR=0.44 (0.38–0.52), p<0.0001). AF was not a predictor of mortality independent of variables strongly correlated HR=1.02 (0.84–1.25), p=0.81). The 1-year probability of AVR following diagnosis of severe AS was lower in AF (49.8%) than SR (62.5%) (HR=0.73 (0.62–0.86), p<0.001); among patients with AF not referred for AVR, symptoms were frequently attributed to AF instead of AS.ConclusionAF was associated with poor prognosis in patients with severe AS, but apparent differences in outcomes compared with SR were explained by factors other than AF including concomitant cardiac abnormalities and deferral of AVR due to attribution of cardiac symptoms to AF.

Published
2020
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44. Role of Left Ventricular Diastolic Dysfunction in Predicting Atrial Fibrillation Recurrence after Successful Electrical Cardioversion

Author

Melduni, Rowlens M. and Cullen, Michael W.

Subjects
Article, Featured Review
Abstract

The role of left ventricular (LV) diastolic dysfunction in predicting atrial fibrillation (AF) recurrence after successful electrical cardioversion is largely unknown. Studies suggest that there may be a link between abnormal LV compliance and the initial development, and recurrence of AF after electrical cardioversion. Although direct-current cardioversion (DCCV) is a well-established and highly effective method to convert AF to sinus rhythm, it offers little else beyond immediate rate control because it does not address the underlying cause of AF. Preservation of sinus rhythm after successful cardioversion still remains a challenge for clinicians. Despite the use of antiarrhythmic drugs and serial cardioversions, the rate of AF recurrence remains high in the first year. Current evidence suggests that diastolic dysfunction, which is associated with atrial volume and pressure overload, may be a mechanism underlying the perpetuating cycle of AF recurrence following successful electrical cardioversion. Diastolic dysfunction is considered to be a defect in the ability of the myofibrils, which have shortened against a load in systole to eject blood into the high-pressure aorta, to rapidly or completely return to their resting length. Consequently, LV filling is impaired and the non-compliant left ventricle is unable to fill at low pressures. As a result, left atrial and pulmonary vein pressure rises, and electrical and structural remodeling of the atrial myocardium ensues, creating a vulnerable substrate for AF. In this article, we review the current evidence highlighting the association of LV diastolic dysfunction with AF recurrence after successful electrical cardioversion and provide an approach to the management of LV diastolic dysfunction to prevent AF recurrence.

Published
2012

46. Abstract 16730: Prognostic Biomarker for Prediction of Sinus Rhythm Maintenance, Stroke and Long-Term Survival Following Successful Electrical Cardioversion of Non-Valvular Atrial Fibrillation: The Role of Left Atrial Appendage Flow

Author

Melduni, Rowlens M, primary, Roman, Jorge, additional, Lee, Hon-Chi, additional, Friedman, Paul A, additional, Malouf, Joseph F, additional, White, Roger D, additional, Hodge, David O, additional, Jean, Nathalie, additional, Bruce, Charles J, additional, Munger, Thomas M, additional, Gersh, Bernard J, additional, and Ammash, Naser M, additional

Published
2014
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47. Abstract 9908: Transcatheter Aortic Valve Replacement for High-risk Severe Aortic Stenosis: An Analysis of Incidence, Predictors and Prognostic Impact of New-onset Postprocedural Atrial Fibrillation- Mayo Clinic Experience

Author

Melduni, Rowlens M, primary, Greason, Kevin L, additional, Suri, Rakesh M, additional, Nkomo, Vuyisile T, additional, Rihal, Charanjit S, additional, Sarano, Maurice E, additional, Gersh, Bernard J, additional, Holmes, David R, additional, and Mathew, Verghese, additional

Published
2013
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