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531 results on '"Singh, Sheldon M"'

6. Augmented wide area circumferential catheter ablation for reduction of atrial fibrillation recurrence (AWARE) trial: Design and rationale

Author

Nair, Girish M, Birnie, David H, Wells, George A, Nery, Pablo B, Redpath, Calum J, Sarrazin, Jean-Francois, Roux, Jean-Francois, Parkash, Ratika, Bernier, Martin, Sterns, Laurence D., Novak, Paul, Veenhuyzen, George, Morillo, Carlos A., Singh, Sheldon M., Sturmer, Marcio, Chauhan, Vijay S., Angaran, Paul, and Essebag, Vidal

Published
2022
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11. MRI Accurately Visualizes RF Ablation Delivery Targeted to MRI-Defined Arrhythmia Substrates in the Left Ventricle

Author

Krahn, Philippa R. P., Escartin, Terenz, Singh, Sheldon M., Barry, Jennifer, Larsen, Melissa, Guo, Fumin, Pop, Mihaela, and Wright, Graham A.

Abstract

Objective: Investigate the capacity of MRI to evaluate efficacy of radiofrequency (RF) ablations delivered to MRI-defined arrhythmogenic substrates. Methods: Baseline MRI was performed at 3 T including 3D LGE in a swine model of chronic myocardial infarct (N = 8). MRI-derived maps of scar and heterogeneous tissue channels (HTCs) were generated using ADAS 3D. Animals underwent electroanatomic mapping and ablation of the left ventricle in CARTO3, guided by MRI-derived scar maps. Post-ablation MRI (in vivo at 3 T in 5/8 animals; ex vivo at 1.5 T in 3/8) included 3D native T1-weighted IR-SPGR (TI = 700–800 ms) to visualize RF lesions. T1-derived RF lesions were compared against excised tissue. The locations of T1-derived RF lesions were compared against CARTO ablation tags, and segment-wise sensitivity and specificity of lesion detection were calculated within the AHA 17-segment model. Results: RF lesions were clearly visualized in HTCs, scar, and myocardium. Ablation patterns delivered in CARTO matched T1-derived RF lesion patterns with high sensitivity (88.9%) and specificity (94.7%), and were closely matched in registered MR-EP data sets, with a displacement of 5.4$\pm$3.8 mm (N = 152 ablation tags). Conclusion: Integrating MRI into ablative procedures for RF lesion assessment is feasible. Patterns of RF lesions created using a standard 3D EAM system are accurately reflected by MRI visualization in healthy myocardium, scar, and HTCs comprising the MRI-defined arrhythmia substrate. Significance: MRI visualization of RF lesions can provide near-immediate ($< $24 h) assessment of ablation, potentially indicating whether critical MRI-defined ventricular tachycardia substrates have been adequately ablated.

Published
2024
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14. Stroke risk in women with atrial fibrillation.

Author

Buhari, Hifza, Fang, Jiming, Han, Lu, Austin, Peter C, Dorian, Paul, Jackevicius, Cynthia A, Yu, Amy Y X, Kapral, Moira K, Singh, Sheldon M, Tu, Karen, Ko, Dennis T, Atzema, Clare L, Benjamin, Emelia J, Lee, Douglas S, and Abdel-Qadir, Husam

Subjects
ATRIAL fibrillation, AGE differences, STROKE, HOSPITAL emergency services, LDL cholesterol
Abstract

Background and aims Female sex is associated with higher rates of stroke in atrial fibrillation (AF) after adjustment for other CHA2DS2-VASc factors. This study aimed to describe sex differences in age and cardiovascular care to examine their relationship with stroke hazard in AF. Methods Population-based cohort study using administrative datasets of people aged ≥66 years diagnosed with AF in Ontario between 2007 and 2019. Cause-specific hazard regression was used to estimate the adjusted hazard ratio (HR) for stroke associated with female sex over a 2-year follow-up. Model 1 included CHA2DS2-VASc factors, with age modelled as 66–74 vs. ≥ 75 years. Model 2 treated age as a continuous variable and included an age–sex interaction term. Model 3 further accounted for multimorbidity and markers of cardiovascular care. Results The cohort consisted of 354 254 individuals with AF (median age 78 years, 49.2% female). Females were more likely to be diagnosed in emergency departments and less likely to receive cardiologist assessments, statins, or LDL-C testing, with higher LDL-C levels among females than males. In Model 1, the adjusted HR for stroke associated with female sex was 1.27 (95% confidence interval 1.21–1.32). Model 2 revealed a significant age–sex interaction, such that female sex was only associated with increased stroke hazard at age >70 years. Adjusting for markers of cardiovascular care and multimorbidity further decreased the HR, so that female sex was not associated with increased stroke hazard at age ≤80 years. Conclusion Older age and inequities in cardiovascular care may partly explain higher stroke rates in females with AF. [ABSTRACT FROM AUTHOR]

Published
2024
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15. High‐power short‐duration versus low‐power long‐duration ablation for pulmonary vein isolation: A substudy of the AWARE randomized controlled trial.

Author

Joza, Jacqueline, Nair, Girish M., Birnie, David H., Nery, Pablo B., Redpath, Calum J., Sarrazin, Jean‐Francois, Champagne, Jean, Bernick, Jordan, Wells, George A., Essebag, Vidal, Roux, Jean‐Francois, Dussault, Charles, Parkash, Ratika, Bernier, Martin, Sterns, Laurence D., Sapp, John, Novak, Paul, Veenhuyzen, George, Morillo, Carlos A., and Singh, Sheldon M.

Subjects
CONFIDENCE intervals, ATRIAL fibrillation, CATHETER ablation, TREATMENT duration, REGRESSION analysis, TREATMENT effectiveness, COMPARATIVE studies, DESCRIPTIVE statistics, ELECTROCARDIOGRAPHY, RESEARCH funding, PULMONARY veins, PATIENT safety, EVALUATION
Abstract

Introduction: Pulmonary vein isolations (PVI) are being performed using a high‐power, short‐duration (HPSD) strategy. The purpose of this study was to compare the clinical efficacy and safety outcomes of an HPSD versus low‐power, long‐duration (LPLD) approach to PVI in patients with paroxysmal atrial fibrillation (AF). Methods: Patients were grouped according to a HPSD (≥40 W) or LPLD (≤35 W) strategy. The primary endpoint was the 1‐year recurrence of any atrial arrhythmia lasting ≥30 s, detected using three 14‐day ambulatory continuous ECG monitoring. Procedural and safety endpoints were also evaluated. The primary analysis were regression models incorporating propensity scores yielding adjusted relative risk (RRa) and mean difference (MDa) estimates. Results: Of the 398 patients included in the AWARE Trial, 173 (43%) underwent HPSD and 225 (57%) LPLD ablation. The distribution of power was 50 W in 75%, 45 W in 20%, and 40 W in 5% in the HPSD group, and 35 W with 25 W on the posterior wall in the LPLD group. The primary outcome was not statistically significant at 30.1% versus 22.2% in HPSD and LPLD groups with RRa 0.77 (95% confidence interval [CI]) 0.55–1.10; p =.165). The secondary outcome of repeat catheter ablation was not statistically significant at 6.9% and 9.8% (RRa 1.59 [95% CI 0.77–3.30]; p =.208) respectively, nor was the incidence of any ECG documented AF during the blanking period: 1.7% versus 8.0% (RRa 3.95 [95% CI 1.00–15.61; p =.049) in the HPSD versus LPLD group respectively. The total procedure time was significantly shorter in the HPSD group (MDa 97.5 min [95% CI 84.8–110.4)]; p <.0001) with no difference in adjudicated serious adverse events. Conclusions: An HPSD strategy was associated with significantly shorter procedural times with similar efficacy in terms of clinical arrhythmia recurrence. Importantly, there was no signal for increased harm with a HPSD strategy. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Stroke risk in women with atrial fibrillation

Author

Buhari, Hifza, primary, Fang, Jiming, additional, Han, Lu, additional, Austin, Peter C, additional, Dorian, Paul, additional, Jackevicius, Cynthia A, additional, Yu, Amy Y X, additional, Kapral, Moira K, additional, Singh, Sheldon M, additional, Tu, Karen, additional, Ko, Dennis T, additional, Atzema, Clare L, additional, Benjamin, Emelia J, additional, Lee, Douglas S, additional, and Abdel-Qadir, Husam, additional

Published
2023
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25. Prognostic Value of Different Thresholds for Myocardial Scar Quantification on Cardiac MRI Late Gadolinium Enhancement Images in Patients Receiving Implantable Cardioverter Defibrillators

Author

Shalmon, Tamar, primary, Hamad, Faisal Mhd. Dib, additional, Jimenez-Juan, Laura, additional, Kirpalani, Anish, additional, Urzua Fresno, Camila M., additional, Folador, Luciano, additional, Tan, Nigel S., additional, Singh, Sheldon M., additional, Ge, Yin, additional, Dorian, Paul, additional, Lima, João A. C., additional, Wong, Kathy C. K., additional, Deva, Djeven P., additional, and Yan, Andrew T., additional

Published
2023
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28. Standard vs Augmented Ablation of Paroxysmal Atrial Fibrillation for Reduction of Atrial Fibrillation Recurrence

Author

Nair, Girish M., primary, Birnie, David H., additional, Nery, Pablo B., additional, Redpath, Calum J., additional, Sarrazin, Jean-Francois, additional, Roux, Jean-Francois, additional, Parkash, Ratika, additional, Bernier, Martin, additional, Sterns, Laurence D., additional, Sapp, John, additional, Novak, Paul, additional, Veenhuyzen, George, additional, Morillo, Carlos A., additional, Singh, Sheldon M., additional, Sadek, Mouhannad M., additional, Golian, Mehrdad, additional, Klein, Andres, additional, Sturmer, Marcio, additional, Chauhan, Vijay S., additional, Angaran, Paul, additional, Green, Martin S., additional, Bernick, Jordan, additional, Wells, George A., additional, and Essebag, Vidal, additional

Published
2023
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35. Metabolic cardiomyopathy from propionic acidemia precipitating cardiac arrest in a 25-year-old man

Author

Tan, Nigel S., Bajaj, Ravi R., Morel, Chantal, and Singh, Sheldon M.

Subjects
Cardiac arrest -- Causes of -- Diagnosis -- Care and treatment, Echocardiography -- Usage, Youth -- Health aspects -- Genetic aspects, Propionic acidemia -- Complications and side effects -- Care and treatment, Dietary supplements -- Research, Health
Abstract

A 25-year-old man with a medical history of propionic acidemia was brought to hospital after he collapsed while jogging. He was unresponsive, received immediate bystander cardiopulmonary resuscitation and was defibrillated [...]

Published
2018
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36. Pulmonary vein reconnection following catheter ablation of atrial fibrillation using the second-generation cryoballoon versus open-irrigated radiofrequency: results of a multicenter analysis

Author

Aryana, Arash, Singh, Sheldon M., Mugnai, Giacomo, de Asmundis, Carlo, Kowalski, Marcin, Pujara, Deep K., Cohen, Andrew I., Singh, Steve K., Fuenzalida, Charles E., Prager, Nelson, Bowers, Mark R., O’Neill, Padraig Gearoid, Brugada, Pedro, d’Avila, André, and Chierchia, Gian-Battista

Published
2016
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50. Association of Diabetes Duration and Glycemic Control With Stroke Rate in Patients With Atrial Fibrillation and Diabetes: A Population‐Based Cohort Study

Author

Abdel‐Qadir, Husam, primary, Gunn, Madison, additional, Lega, Iliana C., additional, Pang, Andrea, additional, Austin, Peter C., additional, Singh, Sheldon M., additional, Jackevicius, Cynthia A., additional, Tu, Karen, additional, Dorian, Paul, additional, Lee, Douglas S., additional, and Ko, Dennis T., additional

Published
2022
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