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3. Worldwide survey on implantation of and outcomes for conduction system pacing with His bundle and left bundle branch area pacing leads

Author

Perino, Alexander C., Wang, Paul J., Lloyd, Michael, Zanon, Francesco, Fujiu, Katsuhito, Osman, Faizel, Briongos-Figuero, Sem, Sato, Toshiaki, Aksu, Tolga, Jastrzebski, Marek, Sideris, Skevos, Rao, Praveen, Boczar, Krzysztof, Yuan-ning, Xu, Wu, Michael, Namboodiri, Narayanan, Garcia, Rodrigue, Kataria, Vikas, De Pooter, Jan, Przibille, Oliver, Gehi, Anil K., Cano, Oscar, Katsouras, Grigorios, Cai, Binni, Astheimer, Klaus, Tanawuttiwat, Tanyanan, Datino, Tomas, Rizkallah, Jacques, Alasti, Mohammad, Feld, Gregory, Barrio-Lopez, Maria Teresa, Gilmore, Mark, Conti, Sergio, Yanagisawa, Satoshi, Indik, Julia H., Zou, Jiangang, Saha, Sandeep A., Rodriguez-Munoz, Daniel, Chang, Kuan-Cheng, Lebedev, Dmitry S., Leal, Miguel A., Haeberlin, Andreas, Forno, Alexander R. J. Dal, Orlov, Michael, Frutos, Manuel, Cabanas-Grandio, Pilar, Lyne, Jonathan, Leyva, Francisco, Tolosana, Jose Maria, Ollitrault, Pierre, Vergara, Pasquale, Balla, Cristina, Devabhaktuni, Subodh R., Forleo, Giovanni, Letsas, Konstantinos P., Verma, Atul, Moak, Jeffrey P., Shelke, Abhijeet B., Curila, Karol, Cronin, Edmond M., Futyma, Piotr, Wan, Elaine Y., Lazzerini, Pietro Enea, Bisbal, Felipe, Casella, Michela, Turitto, Gioia, Rosenthal, Lawrence, Bunch, T. Jared, Baszko, Artur, Clementy, Nicolas, Cha, Yong-Mei, Chen, Huang-Chung, Galand, Vincent, Schaller, Robert, Jarman, Julian W. E., Harada, Masahide, Wei, Yong, Kusano, Kengo, Schmidt, Constanze, Hurtado, Marco Antonio Arguello, Naksuk, Niyada, Hoshiyama, Tadashi, Kancharla, Krishna, Iida, Yoji, Mizobuchi, Mashiro, Morin, Daniel P., Cay, Serkan, Paglino, Gabriele, Dahme, Tillman, Agarwal, Sharad, Vijayaraman, Pugazhendhi, and Sharma, Parikshit S.

Published
2023
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7. Women Trainees in Electrophysiology and the Effect of Role Models

Author

Baykaner, Tina, Greif, Shana, Vajapey, Ramya S., Albert, Christine M., Aziz, Zaid, Badhwar, Nitish, Bunch, T. Jared, Cheung, Jim W., Chrispin, Jonathan, Chung, Mina K., Clopton, Paul, Cooper, Daniel H., Cooper, Joshua M., Costea, Alexandru, Huang, Henry D., Hurwitz, Jodie L., Jankelson, Lior, Kapoor, Ridhima, Kroman, Anne, Latchamsetty, Rakesh, Liang, Jackson J., Mansour, Moussa, Marrouche, Nassir F., Merchant, Faisal M., Miller, John M., Mountantonakis, Stavros, Piccini, Jonathan P., Russo, Andrea M., Steinberg, Benjamin A., Tedrow, Usha, Tzou, Wendy S., Wan, Elaine Y., Wang, Paul J., and Han, Janet K.

Published
2024
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8. Research Priorities in the Secondary Prevention of Atrial Fibrillation: A National Heart, Lung, and Blood Institute Virtual Workshop Report

Author

Benjamin, Emelia J, Al‐Khatib, Sana M, Desvigne‐Nickens, Patrice, Alonso, Alvaro, Djoussé, Luc, Forman, Daniel E, Gillis, Anne M, Hendriks, Jeroen ML, Hills, Mellanie True, Kirchhof, Paulus, Link, Mark S, Marcus, Gregory M, Mehra, Reena, Murray, Katherine T, Parkash, Ratika, Piña, Ileana L, Redline, Susan, Rienstra, Michiel, Sanders, Prashanthan, Somers, Virend K, Van Wagoner, David R, Wang, Paul J, Cooper, Lawton S, and Go, Alan S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Comparative Effectiveness Research, Cardiovascular, Prevention, Clinical Trials and Supportive Activities, Heart Disease, Stroke, Good Health and Well Being, Animals, Anti-Arrhythmia Agents, Atrial Fibrillation, Biomedical Research, Body Composition, Cardiac Rehabilitation, Comorbidity, Disease Progression, Health Priorities, Health Services Needs and Demand, Healthy Lifestyle, Humans, National Heart, Lung, and Blood Institute (U.S.), Needs Assessment, Recurrence, Research Design, Risk Assessment, Risk Factors, Secondary Prevention, Treatment Outcome, United States, Weight Loss, atrial fibrillation, cardiac rehabilitation, prevention, research, risk factors, sleep, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF-related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced-based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF-related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team-based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.

Published
2021

9. Worldwide Survey of COVID-19–Associated Arrhythmias

Author

Coromilas, Ellie J, Kochav, Stephanie, Goldenthal, Isaac, Biviano, Angelo, Garan, Hasan, Goldbarg, Seth, Kim, Joon-Hyuk, Yeo, Ilhwan, Tracy, Cynthia, Ayanian, Shant, Akar, Joseph, Singh, Avinainder, Jain, Shashank, Zimerman, Leandro, Pimentel, Maurício, Osswald, Stefan, Twerenbold, Raphael, Schaerli, Nicolas, Crotti, Lia, Fabbri, Daniele, Parati, Gianfranco, Li, Yi, Atienza, Felipe, Zatarain, Eduardo, Tse, Gary, Leung, Keith Sai Kit, Guevara-Valdivia, Milton E, Rivera-Santiago, Carlos A, Soejima, Kyoko, De Filippo, Paolo, Ferrari, Paola, Malanchini, Giovanni, Kanagaratnam, Prapa, Khawaja, Saud, Mikhail, Ghada W, Scanavacca, Mauricio, Hajjar, Ludhmila Abrahão, Rizerio, Brenno, Sacilotto, Luciana, Mollazadeh, Reza, Eslami, Masoud, far, Vahideh Laleh, Mattioli, Anna Vittoria, Boriani, Giuseppe, Migliore, Federico, Cipriani, Alberto, Donato, Filippo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Coromilas, James, Aboyme, Andrew, O’Brien, Connor Galen, Rodriguez, Fatima, Wang, Paul J, Naniwadekar, Aditi, Moey, Melissa, Kow, Chia Siang, Cheah, Wee Kooi, Auricchio, Angelo, Conte, Giulio, Hwang, Jongmin, Han, Seongwook, Lazzerini, Pietro Enea, Franchi, Federico, Santoro, Amato, Capecchi, Pier Leopoldo, Joglar, Jose A, Rosenblatt, Anna G, Zardini, Marco, Bricoli, Serena, Bonura, Rosario, Echarte-Morales, Julio, Benito-González, Tomás, Minguito-Carazo, Carlos, Fernández-Vázquez, Felipe, and Wan, Elaine Y

Subjects
Biomedical and Clinical Sciences, Medical Physiology, Cardiovascular Medicine and Haematology, Clinical Sciences, Aged, Arrhythmias, Cardiac, COVID-19, Cardiac Electrophysiology, Comorbidity, Electrophysiologic Techniques, Cardiac, Female, Global Health, Health Care Surveys, Healthcare Disparities, Humans, Incidence, Male, Middle Aged, Practice Patterns, Physicians', Prevalence, Prognosis, Retrospective Studies, Risk Assessment, Time Factors, arrhythmia, atrial fibrillation, atrial flutter, bradycardia, tachycardia, torsade de pointes, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Medical physiology
Abstract

[Figure: see text].

Published
2021

10. Electrical Substrate Ablation for Refractory Ventricular Fibrillation: Results of the AVATAR Study.

Author

Krummen, David E, Ho, Gordon, Hoffmayer, Kurt S, Schweis, Franz N, Baykaner, Tina, Rogers, AJ, Han, Frederick T, Hsu, Jonathan C, Viswanathan, Mohan N, Wang, Paul J, Rappel, Wouter-Jan, and Narayan, Sanjiv M

Subjects
Humans, Ventricular Premature Complexes, Ventricular Fibrillation, Anti-Arrhythmia Agents, Electrophysiologic Techniques, Cardiac, Catheter Ablation, Treatment Outcome, Electric Countershock, Case-Control Studies, Prospective Studies, Defibrillators, Implantable, Action Potentials, Heart Rate, Time Factors, Adult, Aged, Middle Aged, California, Female, Male, cardiomyopathies, catheter ablation, follow-up studies, rotation, ventricular fibrillation, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Medical Physiology, Cardiovascular System & Hematology
Abstract

[Figure: see text].

Published
2021

11. Termination of persistent atrial fibrillation by ablating sites that control large atrial areas.

Author

Bhatia, Neal K, Rogers, Albert J, Krummen, David E, Hossainy, Samir, Sauer, William, Miller, John M, Alhusseini, Mahmood I, Peszek, Adam, Armenia, Erin, Baykaner, Tina, Brachmann, Johannes, Turakhia, Mintu P, Clopton, Paul, Wang, Paul J, Rappel, Wouter-Jan, and Narayan, Sanjiv M

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Heart Disease, Aged, Atrial Fibrillation, Catheter Ablation, Electric Countershock, Heart Atria, Humans, Middle Aged, Atrial fibrillation, Mechanisms, Drivers, Rotational, Focal, Ablation, Multiwavelet re-entry, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

AimsPersistent atrial fibrillation (AF) has been explained by multiple mechanisms which, while they conflict, all agree that more disorganized AF is more difficult to treat than organized AF. We hypothesized that persistent AF consists of interacting organized areas which may enlarge, shrink or coalesce, and that patients whose AF areas enlarge by ablation are more likely to respond to therapy.Methods and resultsWe mapped vectorial propagation in persistent AF using wavefront fields (WFF), constructed from raw unipolar electrograms at 64-pole basket catheters, during ablation until termination (Group 1, N = 20 patients) or cardioversion (Group 2, N = 20 patients). Wavefront field mapping of patients (age 61.1 ± 13.2 years, left atrium 47.1 ± 6.9 mm) at baseline showed 4.6 ± 1.0 organized areas, each separated by disorganization. Ablation of sites that led to termination controlled larger organized area than competing sites (44.1 ± 11.1% vs. 22.4 ± 7.0%, P

Published
2020

14. Abstract 14122: Evaluating Gender Diversity in Principal Investigators of Cardiac Electrophysiology Clinical Trials

Author

Sadri, Shirin, Soontornviwath, Grace A, Ku, Alice, Bernardez, Crystal O, Ali, Tawfique, Khosla, Ananya, Adhikari, Khusbu K, Duran, Angelina S, Igwe, Joseph-Kelvin, Clark, Kira, Cruz, Erin Rose R, Idris, Muhammed Y, Poullos, Peter, Periyakoil, VJ, Lin, Bryant, Palaniappan, Latha, Yong, Celina M, Onwuanyi, Anekwe, Echols, Melvin, Wang, Paul J, and Kapoor, Ridhima

Published
2023
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16. Activation of PDGF pathway links LMNA mutation to dilated cardiomyopathy.

Author

Lee, Jaecheol, Termglinchan, Vittavat, Diecke, Sebastian, Itzhaki, Ilanit, Lam, Chi Keung, Garg, Priyanka, Lau, Edward, Greenhaw, Matthew, Seeger, Timon, Wu, Haodi, Zhang, Joe Z, Chen, Xingqi, Gil, Isaac Perea, Ameen, Mohamed, Sallam, Karim, Rhee, June-Wha, Churko, Jared M, Chaudhary, Rinkal, Chour, Tony, Wang, Paul J, Snyder, Michael P, Chang, Howard Y, Karakikes, Ioannis, and Wu, Joseph C

Subjects
Cells, Cultured, Chromatin, Myocytes, Cardiac, Humans, Cardiomyopathy, Dilated, Calcium, Receptor, Platelet-Derived Growth Factor beta, Platelet-Derived Growth Factor, Lamin Type A, RNA, Messenger, Signal Transduction, Chromatin Assembly and Disassembly, Homeostasis, Mutation, Models, Biological, Arrhythmias, Cardiac, Induced Pluripotent Stem Cells, Haploinsufficiency, Single-Cell Analysis, Nonsense Mediated mRNA Decay, In Vitro Techniques, Arrhythmias, Cardiac, Cardiomyopathy, Dilated, Cells, Cultured, Models, Biological, Myocytes, RNA, Messenger, Receptor, Platelet-Derived Growth Factor beta, General Science & Technology
Abstract

Lamin A/C (LMNA) is one of the most frequently mutated genes associated with dilated cardiomyopathy (DCM). DCM related to mutations in LMNA is a common inherited cardiomyopathy that is associated with systolic dysfunction and cardiac arrhythmias. Here we modelled the LMNA-related DCM in vitro using patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). Electrophysiological studies showed that the mutant iPSC-CMs displayed aberrant calcium homeostasis that led to arrhythmias at the single-cell level. Mechanistically, we show that the platelet-derived growth factor (PDGF) signalling pathway is activated in mutant iPSC-CMs compared to isogenic control iPSC-CMs. Conversely, pharmacological and molecular inhibition of the PDGF signalling pathway ameliorated the arrhythmic phenotypes of mutant iPSC-CMs in vitro. Taken together, our findings suggest that the activation of the PDGF pathway contributes to the pathogenesis of LMNA-related DCM and point to PDGF receptor-β (PDGFRB) as a potential therapeutic target.

Published
2019

23. Advances in Cardiac Electrophysiology

Author

Piccini, Jonathan P., Russo, Andrea M., Sharma, Parikshit S., Kron, Jordana, Tzou, Wendy, Sauer, William, Park, David S., Birgersdotter-Green, Ulrika, Frankel, David S., Healey, Jeff S., Hummel, John, Koruth, Jacob, Linz, Dominik, Mittal, Suneet, Nair, Devi G., Nattel, Stanley, Noseworthy, Peter A., Steinberg, Benjamin A., Trayanova, Natalia A., Wan, Elaine Y., Wissner, Erik, Zeitler, Emily P., and Wang, Paul J.

Published
2022
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26. Abstract 12117: Machine Learning to Probe Variability in Patient Outcomes After Atrial Fibrillation Ablation - The Stanford AF Registry (start)

Author

Deb, Brototo, bhatia, neal, Rogers, Albert J, Baykaner, Tina, Chang, Hui Ju, Clopton, Paul L, Ganesan, Prasanth, Feng, Ruibin, Ruiperez-Campillo, Samuel, Turakhia, Mintu, Perino, Alexander C, Perez, Marco V, Zei, Paul, Badhwar, Nitish, Badhwar, Nitish, Brodt, Chad, Narayan, Sanjiv M, Wang, Paul J, and Viswanathan, Mohan N

Published
2022
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28. Guidance for rebooting electrophysiology through the COVID-19 pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology: Endorsed by the American College of Cardiology

Author

Lakkireddy, Dhanunjaya R., Chung, Mina K., Deering, Thomas F., Gopinathannair, Rakesh, Albert, Christine M., Epstein, Laurence M., Harding, Clifford V., Hurwitz, Jodie L., Jeffery, Courtney C., Krahn, Andrew D., Kusumoto, Fred M., Lampert, Rachel, Mansour, Moussa, Natale, Andrea, Patton, Kristen K., Seiler, Amber, Shah, Maully J., Wang, Paul J., and Russo, Andrea M.

Published
2020
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29. Guidance for cardiac electrophysiology during the COVID-19 pandemic from the Heart Rhythm Society COVID-19 Task Force; Electrophysiology Section of the American College of Cardiology; and the Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology, American Heart Association

Author

Lakkireddy, Dhanunjaya R., Chung, Mina K., Gopinathannair, Rakesh, Patton, Kristen K., Gluckman, Ty J., Turagam, Mohit, Cheung, Jim W., Patel, Parin, Sotomonte, Juan, Lampert, Rachel, Han, Janet K., Rajagopalan, Bharath, Eckhardt, Lee, Joglar, Jose, Sandau, Kristin E., Olshansky, Brian, Wan, Elaine, Noseworthy, Peter A., Leal, Miguel, Kaufman, Elizabeth, Gutierrez, Alejandra, Marine, Joseph E., Wang, Paul J., and Russo, Andrea M.

Published
2020
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31. Design and Implementation of an Electronic Health Record‐Integrated Hypertension Management Application

Author

Funes Hernandez, Mario, primary, Babakhanian, Meghedi, additional, Chen, Tania P., additional, Sarraju, Ashish, additional, Seninger, Clark, additional, Ravi, Vishnu, additional, Azizi, Zahra, additional, Tooley, James, additional, Chang, Tara I., additional, Lu, Ying, additional, Downing, N. Lance, additional, Rodriguez, Fatima, additional, Li, Ron C., additional, Sandhu, Alexander T., additional, Turakhia, Mintu, additional, Bhalla, Vivek, additional, and Wang, Paul J., additional

Published
2024
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32. Shared Decision-Making in Cardiac Electrophysiology Procedures and Arrhythmia Management

Author

Chung, Mina K., Fagerlin, Angela, Wang, Paul J., Ajayi, Tinuola B., Allen, Larry A., Baykaner, Tina, Benjamin, Emelia J., Branda, Megan, Cavanaugh, Kerri L., Chen, Lin Y., Crossley, George H., Delaney, Rebecca K., Eckhardt, Lee L., Grady, Kathleen L., Hargraves, Ian G., True Hills, Mellanie, Kalscheur, Matthew M., Kramer, Daniel B., Kunneman, Marleen, Lampert, Rachel, Langford, Aisha T., Lewis, Krystina B., Lu, Ying, Mandrola, John M., Martinez, Kathryn, Matlock, Daniel D., McCarthy, Sarah R., Montori, Victor M., Noseworthy, Peter A., Orland, Kate M., Ozanne, Elissa, Passman, Rod, Pundi, Krishna, Roden, Dan M., Saarel, Elizabeth V., Schmidt, Monika M., Sears, Samuel F., Stacey, Dawn, Stafford, Randall S., Steinberg, Benjamin A., Youn Wass, Sojin, and Wright, Jennifer M.

Published
2021
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36. Arrhythmias including atrial fibrillation and congenital heart disease in Kleefstra syndrome: a possible epigenetic link

Author

Vasireddi, Sunil K, primary, Draksler, Tanja Zdolsek, additional, Bouman, Arianne, additional, Kummeling, Joost, additional, Wheeler, Matthew, additional, Reuter, Chloe, additional, Srivastava, Siddharth, additional, Harris, Jacqueline, additional, Fisher, Paul G, additional, Narayan, Sanjiv M, additional, Wang, Paul J, additional, Badhwar, Nitish, additional, Kleefstra, Tjitske, additional, and Perez, Marco V, additional

Published
2023
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37. Who Are We Missing? Reporting of Transgender and Gender‐Expansive Populations in Clinical Trials

Author

Rice, Eli N., primary, Lan, Roy H., additional, Nunes, Julio C., additional, Shah, Rushil, additional, Clark, Kira, additional, Periyakoil, Vyjeyanthi S., additional, Chen, Jonathan H., additional, Lin, Bryant, additional, Echols, Melvin, additional, Awad, Christopher, additional, Idris, Muhammed Y., additional, Cruz, Erin Rose, additional, Poullos, Peter D., additional, Lewis, Eldrin F., additional, Brown‐Johnson, Cati, additional, Igwe, Joseph, additional, Shen, Sa, additional, Palaniappan, Latha, additional, Stefanick, Marcia L., additional, Ritter, Victor, additional, Pemu, Priscilla, additional, Rodriguez, Fatima, additional, Deb, Brototo, additional, Pundi, Krishna, additional, and Wang, Paul J., additional

Published
2023
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38. Disabilities Reporting in Cardiac Clinical Trials: How Are We Doing?

Author

Lan, Roy H., primary, Rice, Eli N., additional, Nunes, Julio C., additional, Shah, Rushil, additional, Igwe, Joseph‐Kevin, additional, Clark, Kira, additional, Periyakoil, Vyjeyanthi S., additional, Chen, Jonathan H., additional, Lin, Bryant, additional, Awad, Christopher, additional, Idris, Muhammed, additional, Cruz, Erin Rose, additional, Lewis, Eldrin F., additional, Johnson, Cati Brown, additional, and Wang, Paul J., additional

Published
2023
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39. Arrhythmias in Special Populations

Author

Wang, Paul J., Joe, Winston B., Willerson, James T, Series editor, Kowey, Peter, editor, Piccini, Jonathan P., editor, Naccarelli, Gerald, editor, and Reiffel, James A., editor

Published
2017
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40. Risk factors for atrial fibrillation and their population burden in postmenopausal women: the Women's Health Initiative Observational Study

Author

Perez, Marco V, Wang, Paul J, Larson, Joseph C, Soliman, Elsayed Z, Limacher, Marian, Rodriguez, Beatriz, Klein, Liviu, Manson, JoAnn E, Martin, Lisa W, Prineas, Ronald, Connelly, Stephanie, Hlatky, Mark, Wassertheil-Smoller, Sylvia, and Stefanick, Marcia L

Subjects
Reproductive Medicine, Biomedical and Clinical Sciences, Heart Disease, Aging, Clinical Research, Cardiovascular, Prevention, Aetiology, 2.4 Surveillance and distribution, 4.2 Evaluation of markers and technologies, Detection, screening and diagnosis, Black or African American, Age Factors, Aged, Atrial Fibrillation, Chi-Square Distribution, Comorbidity, Female, Hispanic or Latino, Humans, Hypertension, Incidence, Kaplan-Meier Estimate, Middle Aged, Multivariate Analysis, Obesity, Peripheral Arterial Disease, Postmenopause, Proportional Hazards Models, Prospective Studies, Risk Factors, United States, White People, Women's Health, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectiveAtrial fibrillation (AF) is the most common arrhythmia in women. Large studies evaluating key AF risk factors in older women are lacking. We aimed to identify risk factors for AF in postmenopausal women and measure population burden of modifiable risk factors.DesignProspective observational study.SettingThe Women's Health Initiative (WHI) Observational Study.Patients93 676 postmenopausal women were followed for an average of 9.8 years for cardiovascular outcomes. After exclusion of women with prevalent AF or incomplete data, 8252 of the remaining 81 892 women developed incident AF.Main outcome measuresIncident AF was identified by WHI-ascertained hospitalisation records and diagnosis codes from Medicare claims. Multivariate Cox hazard regression analysis identified independent risk factors for incident AF.ResultsAge, hypertension, obesity, diabetes, myocardial infarction and heart failure were independently associated with incident AF. Hypertension and overweight status accounted for 28.3% and 12.1%, respectively, of the population attributable risk. Hispanic and African-American participants had lower rates of incident AF (HR 0.58, 95% CI 0.47 to 0.70 and HR 0.59, 95% CI 0.53 to 0.65, respectively) than Caucasians.ConclusionsCaucasian ethnicity, traditional cardiovascular risk factors and peripheral arterial disease were independently associated with higher rates of incident AF in postmenopausal women. Hypertension and overweight status accounted for a large proportion of population attributable risk. Measuring burden of modifiable AF risk factors in older women may help target interventions.

Published
2013

41. Who are we missing? Language exclusivity of patient‐reported outcomes in atrial fibrillation clinical trials.

Author

Lan, Roy H., Guerrero, Eduardo Perez, Lewis, Eldrin F., and Wang, Paul J.

Subjects
CLINICAL trials, LINGUISTICS, MULTILINGUALISM, ATRIAL fibrillation, QUALITY of life, HEALTH outcome assessment
Abstract

Introduction: Patient‐reported outcomes (PROs) are increasingly used to evaluate quality of life (QoL) in Atrial Fibrillation (AF) patients, providing crucial insights in clinical trials. This study examines the frequency of PRO use in AF trials and the linguistic accessibility of AF‐specific PROs. Background: As the United States becomes more multilingual, ensuring PROs are available in various languages is vital. The number of people speaking a language other than English at home has tripled from 23.1 million in 1980 to 67.8 million in 2019. This diversity necessitates the availability of PROs in multiple languages for inclusive clinical assessments. Methods: We queried ClinicalTrials.gov for all US interventional AF trials up to November 28, 2023, reviewing each for PRO usage as primary or secondary outcomes. We identified the five most common AF‐specific and generic PROs, extracting their available translations and original languages from published sources. Results: Of 233 identified trials, 191 had associated publications, with 180 (94.2%) conducted solely in English. Only one trial (0.4%) used an AF‐specific PRO as a primary outcome, compared to four (1.7%) with a generic PRO. Ten trials (4.3%) used AF‐specific PROs as secondary endpoints, versus 22 (9.4%) using generic PROs. AF‐specific PROs had significantly fewer translations than generic PROs (11.2 vs. 148.8; p <.001). The AF Effect on Quality‐of‐Life (AFEQT) was available in 24 languages, with limited translations in commonly spoken US languages like Arabic and Asian languages. Conclusion: The limited availability of AF‐specific PRO translations highlights a barrier to inclusive AF clinical trials. Expanding translations for AF‐specific PROs is crucial for equitable QoL assessments. [ABSTRACT FROM AUTHOR]

Published
2024
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42. Effects of Postmenopausal Hormone Therapy on Incident Atrial Fibrillation

Author

Perez, Marco V, Wang, Paul J, Larson, Joseph C, Virnig, Beth A, Cochrane, Barbara, Curb, J David, Klein, Liviu, Manson, JoAnn E, Martin, Lisa W, Robinson, Jennifer, Wassertheil-Smoller, Sylvia, and Stefanick, Marcia L

Subjects
Cardiovascular, Heart Disease, Clinical Trials and Supportive Activities, Estrogen, Aging, Contraception/Reproduction, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Atrial Fibrillation, Drug Therapy, Combination, Estrogen Replacement Therapy, Estrogens, Female, Humans, Hysterectomy, Incidence, Kaplan-Meier Estimate, Middle Aged, Progestins, Proportional Hazards Models, Time Factors, atrial fibrillation, hormones, women, incidence, randomized controlled trial, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Medical Physiology, Cardiovascular System & Hematology
Abstract

BackgroundAtrial fibrillation (AF) is less prevalent in women versus men, but associated with higher risks of stroke and death in women. The role hormone therapy plays in AF is not well understood.Methods and resultsThe Women's Health Initiative randomized postmenopausal women to placebo or conjugated equine estrogens (0.625 mg/d) plus medroxyprogesterone acetate (2.5 mg/d) if they had a uterus (N=16 608) or to conjugated equine estrogens only if they had prior hysterectomy (N=10 739). Incident AF was identified by ECG and diagnosis codes from Medicare claims or hospitalization records. Hazard ratios for incident AF were estimated using Cox proportional hazards regression. After excluding participants with baseline AF, there were 611 incident AF cases over a mean of 5.6 years among 16 128 estrogen plus progestin participants, and 683 cases over a mean of 7.1 years among 10 251 conjugated equine estrogens alone participants. Incident AF was more frequent in the active groups of both trials, reaching statistical significance in the trial of conjugated equine estrogens alone in women with prior hysterectomy (hazard ratio, 1.17; CI, 1.00-1.36; P=0.045) and in the pooled analysis (hazard ratio, 1.12; CI, 1.00-1.24; P=0.05), but not in the estrogen plus progestin trial (hazard ratio, 1.07; CI, 0.91-1.25; P=0.44). These results were only minimally affected by adjustment for incident stroke, coronary heart disease, and heart failure.ConclusionsIncident AF was modestly elevated in hysterectomized women randomized to postmenopausal E-alone, and in the pooled group randomized to E-alone or estrogen plus progestin. The trend in women with intact uterus receiving estrogen plus progestin, considered separately, was not statistically significant.Clinical trial registration informationClinicalTrials.gov; Identifier: NCT00000611.

Published
2012

48. Recurrent Post-Ablation Paroxysmal Atrial Fibrillation Shares Substrates With Persistent Atrial Fibrillation: An 11-Center Study

Author

Zaman, Junaid A.B., Baykaner, Tina, Clopton, Paul, Swarup, Vijay, Kowal, Robert C., Daubert, James P., Day, John D., Hummel, John, Schricker, Amir A., Krummen, David E., Mansour, Moussa, Tomassoni, Gery F., Wheelan, Kevin R., Vishwanathan, Mohan, Park, Shirley, Wang, Paul J., Narayan, Sanjiv M., and Miller, John M.

Published
2017
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49. Arrhythmias including atrial fibrillation and congenital heart disease in Kleefstra syndrome: a possible epigenetic link.

Author

Vasireddi, Sunil K, Draksler, Tanja Zdolsek, Bouman, Arianne, Kummeling, Joost, Wheeler, Matthew, Reuter, Chloe, Srivastava, Siddharth, Harris, Jacqueline, Fisher, Paul G, Narayan, Sanjiv M, Wang, Paul J, Badhwar, Nitish, Kleefstra, Tjitske, and Perez, Marco V

Abstract

Aims Kleefstra syndrome (KS), often diagnosed in early childhood, is a rare genetic disorder due to haploinsufficiency of EHMT1 and is characterized by neuromuscular and intellectual developmental abnormalities. Although congenital heart disease (CHD) is common, the prevalence of arrhythmias and CHD subtypes in KS is unknown. Methods and results Inspired by a novel case series of KS patients with atrial tachyarrhythmias in the USA, we evaluate the two largest known KS registries for arrhythmias and CHD: Radboudumc (50 patients) based on health record review at Radboud University Medical Center in the Netherlands and GenIDA (163 patients) based on worldwide surveys of patient families. Three KS patients (aged 17–25 years) presented with atrial tachyarrhythmias without manifest CHD. In the international KS registries, the median [interquartile range (IQR)] age was considerably younger: GenIDA/Radboudumc at 10/13.5 (12/13) years, respectively. Both registries had a 40% prevalence of cardiovascular abnormalities, the majority being CHD, including septal defects, vascular malformations, and valvular disease. Interestingly, 4 (8%) patients in the Radboudumc registry reported arrhythmias without CHD, including one atrial fibrillation (AF), two with supraventricular tachycardias, and one with non-sustained ventricular tachycardia. The GenIDA registry reported one patient with AF and another with chronic ectopic atrial tachycardia (AT). In total, atrial tachyarrhythmias were noted in six young KS patients (6/213 or 3%) with at least four (three AF and one AT) without structural heart disease. Conclusion In addition to a high prevalence of CHD, evolving data reveal early-onset atrial tachyarrhythmias in young KS patients, including AF, even in the absence of structural heart disease. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Ablation of Atrial Fibrillation Drivers

Author

Narayan, Sanjiv M., primary, Baykaner, Tina, additional, Brodt, Chad, additional, Zaman, Junaid A.B., additional, Kowalewski, Christopher A.B., additional, Rodrigo, Miguel, additional, Viswanathan, Mohan N., additional, and Wang, Paul J., additional

Published
2019
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