A5017885231- Mechanical Circulatory Support Devices
- Cardiac Structural Anomalies and Repair
- Cardiac Arrest and Resuscitation
- Sarcoidosis and Beryllium Toxicity Research
- Cardiac pacing and defibrillation studies
- Viral Infections and Immunology Research
- Pericarditis and Cardiac Tamponade
- Cardiovascular Function and Risk Factors
- Intensive Care Unit Cognitive Disorders
- Cardiac electrophysiology and arrhythmias
- Cardiac Imaging and Diagnostics
- Heart Failure Treatment and Management
- Takotsubo Cardiomyopathy and Associated Phenomena
- Cardiac Arrhythmias and Treatments
- Cardiovascular Effects of Exercise
- Atrial Fibrillation Management and Outcomes
- Transplantation: Methods and Outcomes
- Ferrocene Chemistry and Applications
- Vasculitis and related conditions
- Cardiomyopathy and Myosin Studies
- Cardiac Ischemia and Reperfusion
- Coronary Interventions and Diagnostics
- Venous Thromboembolism Diagnosis and Management
- RNA regulation and disease
- Trace Elements in Health
MedStar Washington Hospital Center
2020-2024
MedStar Georgetown University Hospital
2021-2024
Georgetown University
2020-2024
MedStar Heart & Vascular Institute
2020-2023
MedStar Health
2023
National Institutes of Health
2022
Centro Cardiologico Monzino
2021
Loyola University Medical Center
2007
As patients live longer with left ventricular assist device (LVAD) support, many will either suffer an acute event or develop a gradual, progressive disease that results in terminal prognosis. At the end-of-life, patients, and more often, their families, be faced decision to deactivate LVAD allow natural death. The process of deactivation carries some distinct features distinguish it from withdrawal other forms life-sustaining medical technology: multidisciplinary collaboration is paramount;...
Abstract Sustained ventricular tachycardia and fibrillation (VF) are life‐threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These may impair the support provided by continuous‐flow left assist devices (CF‐LVADs) lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, need for transplantation. We report a case patient CF‐LVAD an implantable cardioverter defibrillator at end of life presented asymptomatic low‐flow...
Use of continuous intravenous inotropic support (CIIS) strictly as palliative therapy for patients with ACC/AHA Stage D (end-stage) Heart Failure (HF) has increased significantly. The harms CIIS may detract from its benefits. To describe benefits (improvement in NYHA functional class) and (infection, hospitalization, days-spent-in-hospital) therapy. Methods: Retrospective analysis end-stage HF initiated on at an urban, academic center the United States between 2014-2016. Clinical outcomes...
Best practices for left ventricular assist devices (LVADs) deactivation at end-of-life (EOL) have yet to be elucidated. We conducted a single-institution retrospective review of patients who died following LVAD between January 2017 and March 2020. Data were obtained from institutional databases electronic health record analyzed using descriptive statistics. Fifty-eight (70% male, 70% African American, median age 62 years) categorized by implant strategy: bridge therapy (BT, N = 22, 38%) or...
Many patients with advanced heart failure (HF) are administered chronic intravenous inotropic support (CIIS) as bridge to surgical therapy; some ultimately never receive surgery. We aimed describe reasons "crossover" from CIIS therapy palliative therapy, and compare end-of-life outcomes initiated on therapy.Single-institution, retrospective cohort study of or between 2010 2016; data obtained through review health records multi-disciplinary selection meeting minutes, was analyzed using...
Left ventricular assist devices (LVADs) provide circulatory support to patients with severe left systolic dysfunction. Many such have a pre-existing implantable cardioverter defibrillator at the time of their LVAD surgery. implantation can alter ICD lead parameters including R wave sensing, RV capture threshold, and impedance. These changes in turn affect ability successfully treat malignant arrythmias. In most who present ineffective shocks, failed shock is assumed be secondary patient’s...
BACKGROUND: Takotsubo Cardiomyopathy (TTC) is classified into 4 types dependent on anatomical area affected identified gross visual assessment. We have sought to understand if it feasible and advantageous use left ventricular global longitudinal strain (LVGLS), LV segmental right ventricle free wall (RVFWS) classify TTC.METHODS: conducted a retrospective observational study twenty-five patients who meet the Modified Mayo Clinic Criteria for TTC [1]. Two independent reviewers performed...
This retrospective case series study sought to describe the safety and clinical effectiveness of propafenone for control arrhythmias in children with without CHD or cardiomyopathy.We reviewed baseline characteristics subsequent outcomes a group 63 treated at 2 sites over 15-year period Therapy was considered effective if no clinically apparent breakthrough episodes were noted on medication.Sixty-three patients (29 males) initiated median age 2.3 years. cardiomyopathy 21/63 (33%). There...
Infiltrative cardiomyopathies are an increasingly recognized cause of heart failure warranting systematic evaluation. Given overlap clinical and imaging findings among etiologies infiltrative cardiomyopathies, comprehensive evaluation, including a history physical examination, advanced cardiac imaging, sometimes endomyocardial biopsy, is required for diagnosis. We report case cardiomyopathy in which biopsy confirmed diagnosis cobalt-induced cardiomyopathy. The novel teaching points...
Pulmonary vein (PV) isolation (PVI) is the most important component of catheter ablation atrial fibrillation (AF) and can be achieved by radiofrequency or cryoballoon (CBA). The CBA system has shown excellent efficacy safety in a number clinical trials independent PV anatomy. However, pneumonectomy significantly alter anatomy posing challenge to CBA. Few cases PVI accomplished have been described patients with lobectomy, but none population. We describe case successful for paroxysmal AF...
Sustained ventricular tachycardia and fibrillation (VF) are life-threatening arrhythmias which remain highly prevalent in patients with advanced heart failure. These may impair the support provided by CF-LVADs lead to frequent hospitalizations, antiarrhythmic medication use, external defibrillations, need for transplantation. We report a case patient CF-LVAD an ICD at end-of-life (EOL) presented asymptomatic low-flow alarms was found have VF of unknown duration. Unique our presence organized...