A5083855694- Cardiac Arrhythmias and Treatments
- Cardiac electrophysiology and arrhythmias
- Atrial Fibrillation Management and Outcomes
- Cardiac pacing and defibrillation studies
- Cardiovascular Syncope and Autonomic Disorders
- ECG Monitoring and Analysis
- Heart Rate Variability and Autonomic Control
- Cardiac Imaging and Diagnostics
- Cardiomyopathy and Myosin Studies
- Neurological disorders and treatments
- Blood Pressure and Hypertension Studies
- Psychosomatic Disorders and Their Treatments
- Cardiac Arrest and Resuscitation
- Cardiovascular Function and Risk Factors
- Advanced MRI Techniques and Applications
- EEG and Brain-Computer Interfaces
- Venous Thromboembolism Diagnosis and Management
- Botulinum Toxin and Related Neurological Disorders
- Sympathectomy and Hyperhidrosis Treatments
- Long-Term Effects of COVID-19
- Global Public Health Policies and Epidemiology
- Neurosurgical Procedures and Complications
- Disaster Response and Management
- Electrical and Bioimpedance Tomography
- Pain Management and Treatment
Imperial College London
2016-2025
Imperial College Healthcare NHS Trust
2015-2024
Hammersmith Hospital
2015-2024
Lung Institute
2022
National Health Service
2017-2021
Barts Health NHS Trust
2020
University College London
2020
Medtronic (United Kingdom)
2017
Boston Scientific (United States)
2017
Institut de Mathématiques de Bordeaux
2017
His bundle pacing is a new method for delivering cardiac resynchronization therapy (CRT). The authors performed head-to-head, high-precision, acute crossover comparison between and conventional biventricular CRT, measuring effects on ventricular activation hemodynamic function. Patients with heart failure left branch block referred CRT were recruited. Using noninvasive epicardial electrocardiographic imaging, the identified patients in whom shortened time. In these patients, compared of...
BackgroundFor late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) assessment of atrial scar to guide management and targeting ablation in fibrillation (AF), an objective, reproducible method identifying is required.ObjectiveTo describe automated for operator-independent quantification LGE that correlates with colocated endocardial voltage clinical outcomes.MethodsLGE CMR imaging was performed at 2 centers, before 3 months after pulmonary vein isolation paroxysmal AF (n...
Recent studies have demonstrated conflicting mechanisms underlying atrial fibrillation (AF), with the spatial resolution of data often cited as a potential reason for disagreement. The purpose this study was to investigate whether variation in mapping may lead misinterpretation mechanism persistent AF.Simulations rotors and focal sources were performed estimate minimum number recording points required correctly identify AF mechanism. effects different types (action potentials unipolar or...
Head-up tilt test (TT) has been used for >50 years to study heart rate/blood pressure adaptation positional changes, model responses haemorrhage, assess orthostatic hypotension, and evaluate haemodynamic neuroendocrine in congestive failure, autonomic dysfunction, hypertension. During these studies, some subjects experienced syncope due vasovagal reflex. As a result, testing was incorporated into clinical assessment of when the origin unknown. Subsequently, experience supports diagnostic...
BackgroundLocalizing the origin of outflow tract ventricular tachycardias (OTVT) is hindered by lack accuracy electrocardiographic (ECG) algorithms and infrequent spontaneous premature complexes (PVCs) during electrophysiological studies.ObjectivesTo prospectively assess performance noninvasive mapping (ECM) in pre-/periprocedural localization OTVT to guide ablation compare ECM with that published ECG algorithms.MethodsPatients symptomatic OTVT/PVCs undergoing clinically indicated were...
The activation pattern of localized reentry (LR) in atrial tachycardia remains incompletely understood. We used the ultra-high density Rhythmia mapping system to study patterns LR.LR was suggested by small rotatory activations (carousels) containing full spectrum color-coded map. Twenty-three left-sided tachycardias were mapped 15 patients (age: 64±11 years). 16 253±9192 points displayed per map, collected over 26±14 minutes. A total 50 carousels identified (median 2; quartiles 1-3 map),...
Bipolar electrogram voltage during sinus rhythm (V
BackgroundThe ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system may play a role in atrial fibrillation (AF).ObjectiveWe hypothesized that ablating ectopy-triggering GPs (ET-GPs) prevents AF.MethodsGANGLIA-AF (ClinicalTrials.gov identifier NCT02487654) was prospective, randomized, controlled, 3-center trial. ET-GPs were mapped using high frequency stimulation, delivered within refractory period and ablated until nonfunctional. If triggered AF became incessant,...
Excessive prolongation of PR interval impairs coupling atrio-ventricular (AV) contraction, which reduces left ventricular pre-load and stroke volume, worsens symptoms. His bundle pacing allows AV delay shortening while maintaining normal activation. HOPE-HF evaluated whether optimized is preferable to no-pacing, in a double-blind cross-over fashion, patients with heart failure, ejection fraction (LVEF) ≤40%, ≥200 ms either QRS ≤140 or right branch block.
Autonomic Stimulation Induces PV Ectopy and AF. Introduction: The induction of atrial fibrillation (AF) by pulmonary vein (PV) ectopy is well described. triggers for these are not so understood. intrinsic cardiac autonomic nervous system (ANS) has been suggested as a potential upstream regulator that may cause (AF). We hypothesized activation the ANS high frequency stimulation (HFS) ganglionated plexi (GP) can initiate ectopy. Methods Results: During sinus rhythm in 12 patients undergoing...
Background— Left atrial (LA) ganglionated plexi (GP) are part of the intrinsic cardiac autonomic nervous system and implicated in pathogenesis fibrillation. High frequency stimulation is used to identify GP sites humans. The effect ablation on neural pathways connecting GPs humans unknown. Methods Results— Thirty patients undergoing LA with modification were recruited. In persistent fibrillation, endocardial continuous high identified producing AV block. After right lower (N=5), 2 15...
Background— Post-infarct ventricular tachycardia is associated with channels of surviving myocardium within scar characterized by fractionated and low-amplitude signals usually occurring late during sinus rhythm. Conventional automated algorithms for 3-dimensional electro-anatomic mapping cannot differentiate the delayed local signal conduction from initial far-field generated surrounding healthy tissue. Ripple displays every deflection an electrogram, thereby providing fully informative...
Background— Post ablation atrial tachycardias are characterized by low-voltage signals that challenge current mapping methods. Ripple (RM) displays every electrogram deflection as a bar moving from the cardiac surface, resulting in impression of propagating wavefronts when series bars move consecutively. RM fractionated their entirety thereby helping to identify activation areas nonconducting tissue. We prospectively used study tachycardia previously ablated left atrium. Methods and Results—...
This paper describes the Bárány Society Classification OverSight Committee (COSC) position on Cervical Dizziness, sometimes referred to as Vertigo. involved an initial review by a group of experts across broad range fields, and then subsequent COSC. Based upon so far published literature, COSC takes view that evidence supporting mechanistic link between illusory sensation self-motion (i.e. vertigo – spinning or otherwise) neck pathology and/or symptoms pain - either affecting cervical...
Abstract Aims The randomized, double‐blind, placebo‐controlled HOPE‐HF trial assessed the benefit of atrio‐ventricular (AV) delay optimization delivered using His bundle pacing. It recruited patients with left ventricular ejection fraction ≤40%, PR interval ≥200 ms, and baseline QRS ≤140 ms or right branch block. Overall, there was no significant increase in peak oxygen uptake (VO 2 max) but improvement heart failure specific quality life. In this pre‐specified secondary analysis, we...