A5068890461- Cardiac pacing and defibrillation studies
- Cardiac Arrhythmias and Treatments
- Cardiac electrophysiology and arrhythmias
- Neurological disorders and treatments
- Cardiovascular Function and Risk Factors
- Cardiac Imaging and Diagnostics
- Cardiac Structural Anomalies and Repair
- Advanced MRI Techniques and Applications
- ECG Monitoring and Analysis
- Cardiac Valve Diseases and Treatments
- Advanced X-ray and CT Imaging
- Healthcare cost, quality, practices
- Cardiomyopathy and Myosin Studies
- Voice and Speech Disorders
- Radiomics and Machine Learning in Medical Imaging
- Heart Failure Treatment and Management
- Green IT and Sustainability
- Big Data and Business Intelligence
- Quality and Safety in Healthcare
- Heart Rate Variability and Autonomic Control
- Cloud Computing and Resource Management
- Kidney Stones and Urolithiasis Treatments
- Muscle activation and electromyography studies
- Minimally Invasive Surgical Techniques
- Tendon Structure and Treatment
King's College London
2017-2024
St Thomas' Hospital
2017-2024
Guy's and St Thomas' NHS Foundation Trust
2017-2023
Purdue University West Lafayette
2021
Thomas Foundation
2020
National Health Service
2018
Carney Hospital
2014
Maidstone and Tunbridge Wells NHS Trust
2013
University of Otago
1975
Critical Art and Media Practice
1975
Computational models of the heart are increasingly being used in development devices, patient diagnosis and therapy guidance. While software techniques have been developed for simulating single hearts, there remain significant challenges cohorts virtual hearts from multiple patients. To facilitate new simulation model analysis by groups without direct access to medical data, image meshing tools, we created first publicly available cohort twenty-four four-chamber hearts. Our was built failure...
The pericardium affects cardiac motion by limiting epicardial displacement normal to the surface. In computational studies, it is important for model replicate realistic motion, as this physiological fidelity of model. Previous studies showed that accounting effect allows a more simulation. study, we describe mechanism through which causes improved motion. We simulated electrical activation and contraction ventricles on four-chamber heart in presence absence pericardium. mechanical...
His-bundle pacing (HBP) and left bundle (LBP) are emerging as novel delivery methods for cardiac resynchronization therapy (CRT) in heart failure patients with branch block (LBBB). HBP LBP have never been compared to biventricular endocardial (BiV-endo) pacing. Furthermore, there indications of negative effects on right ventricular (RV) activation times (ATs), but these not quantified.The purpose this study was compare changes induced by HBP, LBP, (LV) septal pacing, BiV-endo, epicardial...
Abstract Aims Transvenous lead extraction is associated with a significant risk of complications and identifying patients at highest pre-procedurally will enable interventions to be planned accordingly. We developed the ELECTRa Registry Outcome Score (EROS) applied it registry determine if could appropriately risk-stratify patients. Methods results EROS was devised into low (EROS 1), intermediate 2), high 3). This ESC EORP European Lead Extraction ConTRolled registry; 57.5% 1, 31.8% 2, 10.7%...
We present a novel multimodal deep learning framework for cardiac resynchronisation therapy (CRT) response prediction from 2D echocardiography and magnetic resonance (CMR) data. The proposed method first uses the 'nnU-Net' segmentation model to extract segmentations of heart over full cycle two modalities. Next, classifier is used CRT prediction, which combines latent spaces models At test time, this can be with data only, whilst taking advantage implicit relationship between CMR features...
Fifteen patients (17 feet) with symptoms suggestive of plantar interdigital neuroma underwent magnetic resonance (MR) imaging at 1.5 T a solenoid forefoot coil an 8-cm field view. Surgery was subsequently performed on six feet. masses were identified MR imaging. Five these, in feet that surgery, pathologically confirmed neuromas. In the remaining foot flexor tendon injury probable inflammatory reaction demonstrated but interpreted as indeterminate for neuroma. No neuronal which otherwise...
Cardiac resynchronization therapy (CRT) increases the risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when left (LV) epicardial lead is implanted proximity to scar.
BackgroundOptimal lead positioning is an important determinant of cardiac resynchronization therapy (CRT) response.ObjectiveThe purpose this study was to evaluate computed tomography (CT) selection the optimal epicardial vein for left ventricular (LV) placement by targeting regions late mechanical activation and avoiding myocardial scar.MethodsEighteen patients undergoing CRT upgrade with existing pacing systems underwent preimplant electrocardiogram-gated CT assess wall thickness,...
Cardiac Resynchronization Therapy (CRT) is one of the few effective treatments for heart failure patients with ventricular dyssynchrony. The pacing location left ventricle indicated as a determinant CRT outcome. Patient specific computational models allow activation pattern following implant to be predicted and this may used optimize lead placement. In study, effects heterogeneous cardiac substrate (scar, fast endocardial conduction, slow septal functional block) on accurately predicting...
Abstract Aims Transvenous lead extraction (TLE) should ideally be undertaken by experienced operators in a setting that allows urgent surgical intervention. In this analysis of the ELECTRa registry, we sought to determine whether there was significant difference procedure complications and mortality depending on centre volume location. Methods results Analysis ESC EORP European Lead Extraction ConTRolled registry conducted. Low-volume (LoV) centres were defined as <30 procedures/year,...
Long-term outcomes are poorly understood, and data in patients undergoing transvenous lead extraction (TLE) lacking.The purpose of this study was to evaluate factors influencing survival TLE depending on indication.Clinical from consecutive the reference center between 2000 2019 were prospectively collected. The total cohort divided into groups whether there an infective or noninfective indication for TLE. We evaluated association demographic, clinical, device-related procedure-related...
Implantable cardiac defibrillator (ICD) implantation can protect against sudden death after myocardial infarction. However, improved risk stratification for device requirement is still needed.
A 63-year-old patient with ischemic cardiomyopathy, severe left ventricular systolic dysfunction, atrial fibrillation underlying complete heart block, and a conventional cardiac resynchronization therapy-defibrillator (CRT-D), was diagnosed device-related infection. This device
Abstract Aims Cardiac resynchronization therapy (CRT) upgrades may be less likely to improve following intervention. Leadless left ventricular (LV) endocardial pacing has been used for patients with previously failed CRT or high-risk upgrades. We compared procedural and long-term outcomes in undergoing coronary sinus (CS) LV Method results Prospective consecutive CS between 2015 2019 were those WiSE-CRT implantation. response at 6 months was defined as improvement clinical composite score...
Background: Exaggerated beat-to-beat variability of ventricular action potential duration (APD) is linked to arrhythmogenesis. Sympathetic stimulation has been shown increase QT interval variability, but its effect on APD in humans not determined. Methods and Results: 11 heart failure patients with implanted bi-ventricular pacing devices had activation–recovery intervals (ARI, surrogate for APD) recorded from LV epicardial electrodes under constant RV pacing. activity was increased using a...
Abstract Background Transvenous lead extraction (TLE) may be necessary due to infective and noninfective indications. We aim identify predictors of 30‐day mortality risk factors between versus groups systemic local infection subgroups. Methods A total 925 TLEs October 2000 December 2016 were prospectively collected dichotomized (infective group n = 505 vs 420 164 341). Results All‐cause major complication including deaths was significantly higher (5.1%, 26 1.2%, 5, P 0.001) as well (4.0%, 20...
This study hypothesized that guided implants, in which the optimal left ventricular endocardial (LVENDO) pacing location was identified and targeted, would improve acute markers of contractility chronic cardiac resynchronization (CRT) response.Biventricular (BiVENDO) may offer a potential benefit over standard CRT; however, LVENDO site is highly variable. Indiscriminately delivered BiVENDO associated with reverse remodeling response rate between 40% 60%.Registry centers implanting wireless,...
BackgroundEpicardial pacing increases risk of ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) when proximity to scar. Endocardial may be less arrhythmogenic as it preserves the physiological sequences activation and repolarization.ObjectiveThe purpose this study was determine relative endocardial compared epicardial pacing, role transmural gradient action potential duration (APD) location scar on during pacing.MethodsComputational models ICM (n = 24) were used...
Optimal positioning of the left ventricular (LV) lead is an important determinant cardiac resynchronization therapy (CRT) response.
Objectives: The aim of this study is to develop a scar detection method for routine computed tomography angiography (CTA) imaging using deep convolutional neural networks (CNN), which relies solely on anatomical information as input and compatible with existing clinical workflows. Background: Identifying cardiac patients tissue important assisting diagnosis guiding interventions. Late gadolinium enhancement (LGE) magnetic resonance (MRI) the gold standard imaging; however, there are common...