A5003321939- Cardiac Arrhythmias and Treatments
- Atrial Fibrillation Management and Outcomes
- Cardiac electrophysiology and arrhythmias
- Cardiac pacing and defibrillation studies
- Cardiovascular Effects of Exercise
- Cardiac Imaging and Diagnostics
- Venous Thromboembolism Diagnosis and Management
- ECG Monitoring and Analysis
- Sports injuries and prevention
- Cardiomyopathy and Myosin Studies
- Cardiac Valve Diseases and Treatments
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac Structural Anomalies and Repair
- Cardiovascular Function and Risk Factors
- Cardiovascular Syncope and Autonomic Disorders
- Sarcoidosis and Beryllium Toxicity Research
- Cardiac tumors and thrombi
- Cardiac Arrest and Resuscitation
- Advanced MRI Techniques and Applications
- Pulmonary Hypertension Research and Treatments
- Mechanical Circulatory Support Devices
- Systemic Sclerosis and Related Diseases
- Healthcare Systems and Public Health
- Nuclear Structure and Function
- Cardiovascular Disease and Adiposity
Hospital of the University of Pennsylvania
2016-2025
University of Pennsylvania
2006-2024
RELX Group (United States)
2024
RELX Group (United Kingdom)
2024
Philadelphia University
2011-2023
California University of Pennsylvania
2023
University of Pennsylvania Health System
1999-2021
Pennsylvania Hospital
2021
John Wiley & Sons (United States)
2019
Hudson Institute
2019
Conventional activation mapping is difficult without inducible, stable ventricular tachycardia (VT).We evaluated 16 patients with drug refractory, unimorphic, unmappable VT. Nine had ischemic and 7 nonischemic cardiomyopathy. All implantable defibrillators experienced 6 to 55 VT episodes during the month before treatment. Patients underwent bipolar catheter baseline rhythm. The amount of endocardium an abnormal electrogram amplitude was estimated using fluoroscopy in 3 a magnetic system...
Efficacy of endocardial ventricular tachycardia (VT) ablation in arrhythmogenic right cardiomyopathy/dysplasia may be limited by epicardial VT, thickening, or both. We sought to characterize the versus substrate, measure free wall thickness, and determine efficacy patients with cardiomyopathy/dysplasia.Thirteen consecutive (3 female; aged 43+/-15 years; range, 17 70 years) undergoing sinus rhythm voltage mapping VT after failed were included. In each patient, low bipolar area (<1.0 mV for...
Background— The single-procedure efficacy of pulmonary vein isolation (PVI) is less than optimal in patients with persistent atrial fibrillation (AF). Adjunctive techniques have been developed to enhance these patients. We conducted a study compare 3 ablation strategies AF. Methods and Results— Subjects were randomized as follows: arm 1, PVI + non-PV triggers identified using stimulation protocol (standard approach); 2, standard approach empirical at common AF trigger sites (mitral annulus,...
Catheter ablation (CA) of ventricular tachycardia (VT) in patients with nonischemic dilated cardiomyopathy can be challenging because the complexity underlying substrates. We sought to determine long-term outcomes endocardial and adjuvant epicardial CA cardiomyopathy.We examined 282 consecutive (aged 59±15 years, 80% males) who underwent CA. Ablation was guided by activation/entrainment mapping for tolerated VT pacemapping/targeting abnormal electrograms unmappable VT. Adjuvant performed...
Pulmonary vein (PV) isolation is effective in the treatment of most patients with atrial fibrillation (AF). Some advocate addition linear ablation techniques to improve efficacy; however, previous studies suggest recurrent PV conduction responsible for AF recurrence. The aim this study was determine effectiveness repeat after an initial procedure and if any patient characteristics predict failure procedures.Seventy-four two or more procedures using selective were included. guided...
To gain insight into the pathogenesis of right ventricular (RV) cardiomyopathy and tachycardia (VT), we determined clinical electroanatomic characteristics outcome ablative therapy in consecutive patients with (1) RV dilatation, (2) multiple left bundle-branch block (LBBB)-type VTs, (3) an abnormal endocardial substrate defined by contiguous electrogram abnormalities.All 21 had detailed bipolar voltage mapping. Eighteen simultaneous (LV) mapping, including all 4 (RBBB) VT. VT was ablated 19...
Pulmonary vein isolation (PVI) is increasingly used for treatment of atrial fibrillation (AF), but few reports exist regarding long-term success. We determined 5-year outcomes PVI among patients with freedom from AF off antiarrhythmic drugs (AAD) 1 year after PVI.Consecutive paroxysmal or persistent who underwent at the University Pennsylvania 2000 to 2003 and were free ablation included. Proximal PVs non-PV triggers was performed. Long-term success, defined as AAD a single procedure,...
Introduction: The etiology of atrial fibrillation (AF) recurrences after pulmonary vein (PV) isolation is not well described. aim this study was to examine the reason for recurrent AF in patients undergoing a repeat attempt at trigger ablation. Methods and Results: Patients with more than 1 month ablation returned mapping A circular catheter advanced each previously targeted PV ostium determine if still electrically isolated. Ectopy then provoked isoproterenol (up 20 μg/min), burst pacing,...
Catheter ablation of ventricular tachycardia (VT) in arrhythmogenic right cardiomyopathy improves short-term VT-free survival. We sought to determine the long-term outcomes VT control and need for antiarrhythmic drug therapy after endocardial (ENDO) adjuvant epicardial (EPI) substrate modification patients with cardiomyopathy.We examined 62 consecutive Task Force criteria referred a minimum follow-up 1 year. was guided by activation/entrainment mapping tolerated pacemapping/targeting...
The number of elderly patients with atrial fibrillation (AF) is increasing rapidly, and the safety efficacy catheter ablation in this demographic group has not been established.Over a 7-year period we studied 1,165 consecutive undergoing 1,506 AF procedures using consistent protocol that included proximal ostial pulmonary vein (PV) isolation focal non-PV triggers. Outcome was analyzed for three distinct age groups: <65 years (group 1; n = 948 patients), 65-74 2; 185 > or =75 3; 32 patients)...
Background— The occurrence of periprocedural acute hemodynamic decompensation (AHD) in patients undergoing radiofrequency catheter ablation scar-related ventricular tachycardia (VT) has not been previously investigated. Methods and Results— We identified univariate predictors AHD 193 consecutive VT. was defined as persistent hypotension despite vasopressors requiring mechanical support or procedure discontinuation. occurred 22 (11%) patients. Compared with the rest population, were older...
Background— We previously demonstrated that treatment with antiarrhythmic drugs (AADs) during the first 6 weeks after atrial fibrillation (AF) ablation reduces incidence of clinically significant arrhythmias and need for cardioversion or hospitalization arrhythmia management. Whether early rhythm suppression decreases longer-term recurrence is unknown. now report 6-month follow-up data from this study. Methods Results— The Antiarrhythmics After Ablation Atrial Fibrillation study...
Background— Percutaneous epicardial ablation of ventricular arrhythmias arising from the left summit is limited by presence major coronary vessels and fat. We report outcomes percutaneous mapping ECG features associated with successful ablation. Methods Results— Between January 2003 December 2012, a total 23 consecutive patients (49±14 years; 39% men) underwent instrumentation for because unsuccessful venous system multiple endocardial LV/right sites. Successful was achieved in 5 (22%)...
Atrial arrhythmias are common early after atrial fibrillation (AF) ablation. We hypothesized that empirical antiarrhythmic drug (AAD) therapy for 6 weeks AF ablation would reduce the occurrence of arrhythmias.We randomized consecutive patients with paroxysmal undergoing to (AAD group) or no (no-AAD first In no-AAD group, only atrioventricular nodal blocking agents were prescribed. All wore a transtelephonic monitor 4 discharge and reevaluated at weeks. The primary end point study was...