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3. Sex-specific outcomes and left atrial remodeling following catheter ablation of persistent atrial fibrillation: results from the DECAAF II trial

Author

Younes, Hadi, Sohns, Christian, Akoum, Nazem, Feng, Han, Tsakiris, Eli, Hajjar, Abdel Hadi El, Donnellan, Eoin, Pandey, Amitabh C., Lim, Chanho, Bidaoui, Ghassan, Mekhael, Mario, Noujeim, Charbel, Chouman, Nour, Assaf, Ala, Shamaileh, Ghaith, Polo, Francisco Tirado, Bsoul, Mayana, Dagher, Lilas, Kreidieh, Omar, Rao, Swati, Sommer, Philipp, Forkmann, Mathias, Brachmann, Johannes, Marrouche, Nassir, and Mahnkopf, Christian

Published
2024
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4. Direct-to-catheter ablation versus second line catheter ablation for persistent atrial fibrillation: Effect on arrhythmia recurrence, AF burden, early left atrium remodeling and quality of life

Author

Younes, Hadi, Ademi, Besim, Tsakiris, Eli, Feng, Han, Pandey, Amitabh C., Mekhael, Mario, Noujaim, Charbel, Lim, Chanho, Dagher, Lilas, Hajjar, Abdel Hadi El, Bidaoui, Ghassan, Bsoul, Mayana, Assaf, Ala, Rao, Swati, Mahnkopf, Christian, Shamaileh, Ghaith, Kreidieh, Omar, Hassan, Abboud, Liu, Yinshuo, Jia, Yishi, Polo, Francisco T., Marrouche, Nassir F., and Donnellan, Eoin

Published
2024
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5. Living Donation and Pregnancy-Related Complications: State of the Evidence and Call To Action for Improved Risk Assessment

Author

Rossi, Ana P., Katz-Greenberg, Goni, Coscia, Lisa, Brady, Carla W., Doligalski, Christina, Irani, Roxanna A., Matas, Arthur, Shah, Silvi, Lentine, Krista L., Afshar, Yalda, Bonn, Julie, Brady, Carla, Byrns, Jennifer, Casale, Jillian P., Constantinescu, Serban, Coscia, Lisa, DeFilippis, Ersilia, Doligalski, Christina, Feld, Lauren, George, Roshan, Goldberg, Aviva, Iltis, Ana, Irani, Roxanna, Jesudason, Shilpa, Katz-Greenberg, Goni, Kittleson, Michelle M., Lentine, Krista, Levine, Deborah, Licciardi, Fred, Matas, Arthur, Moritz, Michael, OʼNeill, Kathleen E., Rao, Swati, Rossi, Ana, Sarkar, Monika, Shah, Silvi, Shingina, Alexandra, and Uccellini, Kim

Published
2024
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7. Abstract 4146618: Differential Impact of Left Atrial Volume on Post-Ablation Recurrence Rates in Patients with Normal and Reduced Left Atrial Ejection Fraction: A DECAAF II Subanalysis

Author

Bsoul, Mayana, Liu, Yingshuo, Assaf, Alaʼ, bidaoui, ghassan, Jia, Yishi, Younes, Hadi, Feng, Han, Mekhael, Mario, Tirado Polo, Francisco, Lim, Chanho, Hui, Yanpei, Hassan, Abboud, Rao, Swati, Pandey, Amitabh, Kreidieh, Omar, donnellan, eoin, and Marrouche, Nassir

Published
2024
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10. Abstract 4144389: Obstructive Sleep Apnea is Associated with Ablation Failure in Paroxysmal Atrial Fibrillation Patients Only: Insights from a left atrial MRI Database

Author

bidaoui, ghassan, Younes, Hadi, Feng, Han, Bsoul, Mayana, Assaf, Alaʼ, Chouman, Nour, Tirado Polo, Francisco, Liu, Yingshuo, Jia, Yishi, Lim, Chanho, Hassan, Abboud, Hui, Yanpei, Tsakiris, Eli, Abi-Rached, Joe, Ademi, Besim, Noujaim, Charbel, Rao, Swati, Kreidieh, Omar, donnellan, eoin, Pandey, Amitabh, and Marrouche, Nassir

Published
2024
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11. Abstract 4144386: Obstructive Sleep Apnea does not Affect Atrial Remodeling and Ablation Success in Persistent Atrial Fibrillation Patients: Insights from DECAAF II

Author

bidaoui, ghassan, Feng, Han, Bsoul, Mayana, Assaf, Alaʼ, Younes, Hadi, Chouman, Nour, Tirado Polo, Francisco, Liu, Yingshuo, Jia, Yishi, Lim, Chanho, Hassan, Abboud, Tsakiris, Eli, Abi-Rached, Joe, Hui, Yanpei, Ademi, Besim, Mekhael, Mario, Noujaim, Charbel, Rao, Swati, Kreidieh, Omar, donnellan, eoin, Pandey, Amitabh, and Marrouche, Nassir

Published
2024
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12. Abstract 4144382: Covering or Encircling the Fibrotic Substrate in the Left Atrium: Does it Matter? Insights from DECAAF II

Author

bidaoui, ghassan, Feng, Han, Bsoul, Mayana, Assaf, Alaʼ, Younes, Hadi, Chouman, Nour, Tirado Polo, Francisco, Liu, Yingshuo, Jia, Yishi, Lim, Chanho, Hassan, Abboud, Tsakiris, Eli, Abi-Rached, Joe, Hui, Yanpei, Ademi, Besim, Mekhael, Mario, Noujaim, Charbel, Rao, Swati, Kreidieh, Omar, Pandey, Amitabh, donnellan, eoin, and Marrouche, Nassir

Published
2024
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13. Abstract 4144315: Impact of Smartphone-based Atrial Fibrillation Burden (SMURDEN) on Quality-of-Life Improvement; Insights from DECAAF II

Author

bidaoui, ghassan, Lim, Chanho, Tirado Polo, Francisco, Bsoul, Mayana, Assaf, Alaʼ, Younes, Hadi, Chouman, Nour, Feng, Han, Liu, Yingshuo, Jia, Yishi, Hassan, Abboud, Tsakiris, Eli, Abi-Rached, Joe, Hui, Yanpei, Ademi, Besim, Mekhael, Mario, Noujaim, Charbel, Rao, Swati, Kreidieh, Omar, donnellan, eoin, Pandey, Amitabh, and Marrouche, Nassir

Published
2024
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14. Abstract 4143118: Association of Left Atrial Fibrosis with AF Burden Post-Ablation: Insights from the DECAAF II Study

Author

Younes, Hadi, Mahnkopf, Christian, Noujaim, Charbel, bidaoui, ghassan, Bsoul, Mayana, Feng, Han, El Hajjar, Abdel Hadi, Mekhael, Mario, Dagher, Lilas, Lim, Chanho, Rao, Swati, Tirado Polo, Francisco, Liu, Yingshuo, Jia, Yishi, Tsakiris, Eli, Assaf, Alaʼ, Ademi, Besim, Shamaileh, Ghaith, Hui, Yanpei, donnellan, eoin, Pandey, Amitabh, and Marrouche, Nassir

Published
2024
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18. Generating strategies for a national comeback in pancreas transplantation: A Delphi survey and US conference report

Author

Abrams, Peter, Alachkar, Nada, Alhamad, Tarek, Ali, Nicole, Axelrod, David, Basu, Arpita, Bloom, Roy, Burke, George, Concepcion, Beatrice, Cooper, Matthew, Craig-Shapiro, Rebecca, Dadhania, Darshana, Doshi, Mona, Drachenberg, Cinthia, Dunn, Ty, Forbes, Rachel, Fridell, Jonathan, Friedewald, John, Gaber, Osama, Gruessner, Rainer, Gruessner, Angelika, Josephson, Michelle, Kandaswamy, Raja, Kaufman, Dixon, Kudva, Yogish, Kukla, Aleksandra, Kumar, Vineeta, Lentine, Krista L., Lu, Yee, McElroy, Lisa, Neidlinge, Nikole, Niederhaus, Silke, Nishio-Lucar, Angie, Odorico, Jon, Parajuli, Sandesh, Parsons, Ronald, Pastan, Stephen, Pavlakis, Martha, Rao, Swati, Ratner, Lloyd, Romeo, Giulio, Sawinski, Deirdre, Scalea, Joseph, Sellers, Marty, Singh, Neeraj, Slaker, Dirk, Stock, Peter, Stratta, Robert, Turgeon, Nicole, Witkowski, Piotr, Woodside, Kenneth, Yadav, Anju, Parsons, Ronald F., Dunn, Ty B., Fridell, Jonathan A., Jesse, Michelle T., and Axelrod, David A.

Published
2024
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20. Lesion monitoring parameters as predictors of atrial arrhythmia recurrence after catheter ablation in persistent AF: A DECAAF II sub‐analysis.

Author

Mekhael, Mario, Feng, Han, Younes, Hadi, Chouman, Nour, Assaf, Ala, Lim, Chanho, Huang, Chao, Donnellan, Eoin, Rao, Swati, Marrouche, Nassir, and Kreidieh, Omar

Subjects
ATRIAL fibrillation treatment, RISK assessment, HEART atrium, SECONDARY analysis, RADIO frequency therapy, RELATIVE medical risk, TREATMENT effectiveness, ATRIAL arrhythmias, ATRIAL fibrillation, CATHETER ablation, DISEASE relapse, PATIENT monitoring, SURVIVAL analysis (Biometry), DISEASE risk factors
Abstract

Background: The formation of transmural lesions is necessary for the ablation of persistent atrial fibrillation (prAF). Ablation index (AI) and generator impedance drop (ID) predict lesion size but their correlation with long‐term outcomes in prAF is not known. Furthermore, we proposed a new parameter, efficacy ratio (ER) calculated as ID/AI, to gain indirect insight into the role of factors affecting ID but not considered by AI. Methods: We included ablations performed during the DECAAF II trial if they had uploaded lesion‐by‐lesion summary data and were performed with radiofrequency catheters on the CARTO system. Average patient‐level parameters were calculated from all generated Vizitags. Results: A total of 427 ablations met inclusion criteria and 166 utilized AI. Analyzed as continuous variables, ID and ER predicted long‐term arrhythmia‐free survival but not AI. The ideal cut‐off for ID was ID ≥ 10.4 ohms and had a C‐index of 0.55. It predicted reduced risk of arrhythmia: hazard ratio 0.56 [0.36–0.88], p =.013 (arrhythmia‐free survival of 67% vs. 52%). Similarly, an ER of 1.7 ohms/100AI had a C‐index of 0.58 and predicted reduced arrhythmia recurrence: HR 0.39 [0.22–0.69], p =.001. ER < 1.7 ohms/100AI was related to just 32% arrhythmia‐free survival. ER improved prognostication as compared to ID alone and identified a subset of low ID patients with even worse outcomes. Conclusion: Average ID was predictive of improved outcomes following ablation of prAF. The ratio of ID/AI (ER) was postulated as a measure to summarize the overall impact of factors not considered in the AI formula and provided improved prognostication. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Body mass index as a determinant of scar formation post‐AF ablation: Insights from DECAAF II.

Author

Bidaoui, Ghassan, Tsakiris, Eli, Younes, Hadi, Feng, Han, Assaf, Ala, Chouman, Nour, Bsoul, Mayana, Polo, Francisco Tirado, Jia, Yishi, Liu, Yingshou, Lim, Chanho, Chamoun, Nadia, Mekhael, Mario, Noujaim, Charbel, Pandey, Amitabh C., Rao, Swati, Kreidieh, Omar, Marrouche, Nassir F., and Donnellan, Eoin

Subjects
BODY mass index, BODY weight, SCARS, MAGNETIC resonance imaging, TREATMENT effectiveness, DESCRIPTIVE statistics, FIBROSIS, ATRIAL fibrillation, CATHETER ablation, CONTRAST media, COMORBIDITY, OBESITY
Abstract

Introduction: Obesity is implicated in adverse atrial remodeling and worse outcomes in patients with atrial fibrillation. The objective of this study is to assess the effect of body mass index (BMI) on ablation‐induced scar formation on late gadolinium enhancement cardiac magnetic resonance imaging (LGE‐CMR). Methods: We conducted an analysis of DECAAF II participants who underwent LGE‐CMR scans to measure scar formation 3 months after catheter ablation. Ablation parameters and lesion delivery were not dependent on BMI. The effect of BMI on ablation success was explored. Results: Our analyses included 811 patients. Comorbidities were more prevalent in obese patients. Baseline left atrial volume was higher in obese individuals, 118, 126, 135, 140, and 143 mm3 for normal weight, overweight, obese grade 1, 2, and 3, respectively (p <.001). BMI was associated with scar formation (R = −0.135, p <.001), with patients with Class 3 obesity having the lowest percentage of ablation‐induced scar, 11.1%, 10.3%, 9.5%, 8.8%, 6.8% by ascending BMI group. There was an inverse correlation between BMI and the amount of fibrosis covered by ablation scar, 24%, 23%, 21%, and 18% by ascending BMI group (p =.001). For the fibrosis‐guided ablation group, BMI was associated with residual fibrosis (R = 0.056, p =.005). Conclusion: Obese patients have lower ablation scar formation, covered fibrosis, and more residual fibrosis postablation compared to nonobese patients, regardless of ablation parameters including impedance drop. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Generating strategies for a national comeback in pancreas transplantation: A Delphi survey and US conference report

Author

Parsons, Ronald F., primary, Lentine, Krista L., additional, Doshi, Mona, additional, Dunn, Ty B., additional, Forbes, Rachel, additional, Fridell, Jonathan A., additional, Jesse, Michelle T., additional, Pavlakis, Martha, additional, Sawinski, Deirdre, additional, Singh, Neeraj, additional, Axelrod, David A., additional, Cooper, Matthew, additional, Abrams, Peter, additional, Alachkar, Nada, additional, Alhamad, Tarek, additional, Ali, Nicole, additional, Axelrod, David, additional, Basu, Arpita, additional, Bloom, Roy, additional, Burke, George, additional, Concepcion, Beatrice, additional, Craig-Shapiro, Rebecca, additional, Dadhania, Darshana, additional, Drachenberg, Cinthia, additional, Dunn, Ty, additional, Fridell, Jonathan, additional, Friedewald, John, additional, Gaber, Osama, additional, Gruessner, Rainer, additional, Gruessner, Angelika, additional, Josephson, Michelle, additional, Kandaswamy, Raja, additional, Kaufman, Dixon, additional, Kudva, Yogish, additional, Kukla, Aleksandra, additional, Kumar, Vineeta, additional, Lu, Yee, additional, McElroy, Lisa, additional, Neidlinge, Nikole, additional, Niederhaus, Silke, additional, Nishio-Lucar, Angie, additional, Odorico, Jon, additional, Parajuli, Sandesh, additional, Parsons, Ronald, additional, Pastan, Stephen, additional, Rao, Swati, additional, Ratner, Lloyd, additional, Romeo, Giulio, additional, Scalea, Joseph, additional, Sellers, Marty, additional, Slaker, Dirk, additional, Stock, Peter, additional, Stratta, Robert, additional, Turgeon, Nicole, additional, Witkowski, Piotr, additional, Woodside, Kenneth, additional, and Yadav, Anju, additional

Published
2024
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29. Diagnostic Role of The Bethesda System of Reporting Thyroid Cytopathology and Immunohistochemistry as an Adjunct to Fine Needle Aspiration Cytology in Differentiating Benign and Malignant Thyroid Lesions: A Cross-sectional Study.

Author

RAO, SWATI, GUPTA, PRAJWALA, SHARMA, NISHI, and BHARDWAJ, MINAKSHI

Subjects
*NEEDLE biopsy, *THYROID nodules, *PAPILLARY carcinoma, *BONE marrow, *THYROID gland
Abstract

Introduction: Fine Needle Aspiration Cytology (FNAC) plays a crucial role in the preoperative assessment of thyroid nodules. The Bethesda System of Reporting Thyroid Cytopathology (TBSRTC; 2023) is a standardised system for reporting thyroid FNAC. However, diagnostic challenges can occur in each category of TBSRTC. Aim: To categorise thyroid FNAC according to TBSRTC and revisit the challenges of cytological diagnosis in each category. Materials and Methods: A cross-sectional, observational study was conducted from November 2018 to April 2020 (18 months) in the Department of Pathology at ABVIMS and Dr. RML Hospital in New Delhi, India. The study included all 470 thyroid FNA cases received in the department from patients presenting with palpable thyroid nodules or ultrasonographically detected solid thyroid lesions, regardless of their age or sex. The cases were classified according to TBSRTC. Diagnostic tests were used to calculate sensitivity, specificity, Negative Predictive Value (NPV), Positive Predictive Value (PPV), and diagnostic accuracy of TBSRTC. Immunoexpression for Human Bone Marrow Endothelium marker-1 (HBME-1) and p63 was studied in Bethesda III to VI category cases, i.e., atypia of undetermined significance (AUS), Suspicious for Malignancy (SFM) and malignant cases only, and not in categories I and II. Results: The study included 470 thyroid FNA cases with a mean age of 39.72 years. Cytohistological follow-up was available for 50 cases, of which six cases were discordant and the remaining 44 cases were concordant. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of TBSRTC were calculated as 50%, 97.06%, 32%, 80.49%, and 82%, respectively. Three cases with diagnostic challenges were revisited and discussed. Immunohistochemistry was performed on a total of 33 FNAC cases. However, histological follow-up was available for only 18 cases, of which seven cases were diagnosed as Papillary Thyroid Carcinoma (PTC) on histological follow-up. HBME-1 and p63 were positive in 57.14% and 42.86% of these cases, respectively. Conclusion: The TBSRTC, 2023, is an excellent reporting system for thyroid FNA and serves as an initial investigative tool for thyroid lesions. Present study findings reveal that it has high specificity and diagnostic accuracy. The Risk of Malignancy (ROM) was comparable to other studies, except for the Bethesda II category. Immunoexpression of HBME-1 and p63 was useful in isolated cases; however, it is not sufficient for cytological diagnosis. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Therapeutic apheresis in kidney transplantation: Emerging trends.

Author

Okwuonu, Chimezie Godswill, Shah, Monarch, Rafique, Iram, Abdelrazeq, Abdallah Saleh, Kamal, Jeanne, Rao, Swati, and Abiodun Balogun, Rasheed

Subjects
FOCAL segmental glomerulosclerosis, KIDNEY transplantation, ARTERIAL catheterization, GRAFT rejection, BLOOD group incompatibility
Abstract

Introduction: The use of therapeutic apheresis (TA) either as stand‐alone or adjunctive treatment in kidney transplantation has increased over the years to become a leading indication. This study shows recent trends in indications for TA related to kidney transplantation, adverse events, and patient outcome in this cohort. Methods: This is a retrospective cohort review of adults who received TA for kidney transplant‐related indications from January 1, 2017, to December 31, 2022, at the University of Virginia Medical Centre, Charlottesville, VA, USA. Data extracted include basic demographics, indication for apheresis, number of procedures, procedure characteristics, procedure‐related adverse events (complications), and serum ionized calcium and serum creatinine. Data were analyzed using statistical package for social sciences (SPSS 2022 IBM Inc). Results: Data from a total of 131 patients who received 860 TA procedures were analyzed. Indications for TA were antibody‐mediated rejection (65.5%), recurrent focal segmental glomerulosclerosis (15%), thrombotic microangiopathy (5%), desensitization for ABO incompatibility (4.5%) and for HLA‐incompatibility (4.5%), and recurrent IgA nephropathy (1%). Some adverse events were encountered in 16.7% of the procedures and include hypocalcemia (7%), vascular access malfunction (0.7%), hypotension (1.2%), arrhythmia (0.6%), and depletion coagulopathy (0.6%). The overall case mortality rate was 8.4% over the 6‐year period. There was one death recorded on machine during TA resulting in a procedure‐mortality rate of 0.12%. Conclusion: Antibody‐mediated rejection was the most common indication for TA related to kidney transplantation. Adverse events were minor and patient survival over the time was within usual limits. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Management of ectopic intestinal variceal bleeding following pancreatic transplant: Two cases.

Author

Kosyakovsky, Jacob, Robinson, Todd J., Rao, Swati, Taylor, Amy C., Brayman, Kenneth L., and Agarwal, Avinash K.

Subjects
GASTROINTESTINAL hemorrhage, PANCREAS transplantation, THERAPEUTIC embolization, HEMORRHAGE, KIDNEY transplantation, INTESTINES
Abstract

Ectopic variceal bleeding is a potentially under recognized source of gastrointestinal (GI) hemorrhage. While vascular complications following pancreatic transplant are relatively common, the development of symptomatic ectopic venous varices has rarely been reported. We report two patients with a remote history of simultaneous kidney pancreas transplant (SPK) presenting two decades after transplant with an occult GI bleed. In both cases, a lengthy diagnostic course was required. The varices were treated with coil embolization via transhepatic approach. Our findings add to the limited literature on this topic and aid in the recognition, diagnosis, and management of this unusual presentation. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Impact of wideband cardiac magnetic resonance on diagnosis, decision-making and outcomes in patients with implantable cardioverter defibrillators

Author

Patel, Hena N, primary, Wang, Shuo, additional, Rao, Swati, additional, Singh, Amita, additional, Landeras, Luis, additional, Besser, Stephanie A, additional, Carter, Spencer, additional, Mishra, Satish, additional, Nishimura, Takuro, additional, Shatz, Dalise Y, additional, Tung, Roderick, additional, Nayak, Hemal, additional, Kawaji, Keigo, additional, Mor-Avi, Victor, additional, and Patel, Amit R, additional

Published
2022
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48. PO-05-125 BODY MASS INDEX AS A DETERMINANT OF SCAR FORMATION POST-AF ABLATION: INSIGHTS FROM THE DECAAF II STUDY

Author

Bidaoui, Ghassan, Younes, Hadi, Jia, Yishi, Assaf, Ala, Chouman, Nour, Chamoun, Nadia, Bsoul, Mayana, Tirado, Francisco, Huang, Chao, Feng, Han, Liu, Yingshuo, Lim, Chanho, McGarvey, Cecile, Tsakiris, Eli, Dahl, Alexander, Lunn, Emma, Noujaim, Charbel, Mekhael, Mario, Pandey, Amitabh C., Rao, Swati, Kreidieh, Omar, Marrouche, Nassir F., and Donnellan, Eoin

Published
2024
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49. PO-05-126 SUSTAINED ATRIAL FIBRILLATION BURDEN IN THE BLANKING PERIOD IS ASSOCIATED WITH A HIGH RISK OF RECURRENCE AFTER CATHETER ABLATION

Author

Bidaoui, Ghassan, Lim, Chanho, Younes, Hadi, Assaf, Ala, Chouman, Nour, Chamoun, Nadia, Bsoul, Mayana, Tirado, Francisco, Huang, Chao, Feng, Han, Liu, Yingshuo, Jia, Yishi, McGarvey, Cecile, Tsakiris, Eli, Dahl, Alexander, Lunn, Emma, Mekhael, Mario, Noujaim, Charbel, Pandey, Amitabh C., Donnellan, Eoin, Rao, Swati, Kreidieh, Omar, and Marrouche, Nassir F.

Published
2024
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