A5080684729- Cardiac Arrhythmias and Treatments
- Atrial Fibrillation Management and Outcomes
- Cardiac electrophysiology and arrhythmias
- Cardiac pacing and defibrillation studies
- Nonlinear Dynamics and Pattern Formation
- Neuroscience and Neural Engineering
- Healthcare Technology and Patient Monitoring
- Health Systems, Economic Evaluations, Quality of Life
- Venous Thromboembolism Diagnosis and Management
- Ion channel regulation and function
- Anatomy and Medical Technology
- Trauma Management and Diagnosis
- Hemodynamic Monitoring and Therapy
- Thermal Regulation in Medicine
- Cardiac Arrest and Resuscitation
- Esophageal and GI Pathology
- Ultrasound in Clinical Applications
- Ultrasound and Hyperthermia Applications
- Cardiac Imaging and Diagnostics
- Gastroesophageal reflux and treatments
- Neural dynamics and brain function
- Cardiomyopathy and Myosin Studies
- Cellular Mechanics and Interactions
- Foreign Body Medical Cases
- Cardiovascular Effects of Exercise
Sharp Memorial Hospital
2004-2024
San Diego Cardiac Center
2004-2024
ATP Clinical Research (United States)
2024
The University of Texas Southwestern Medical Center
2022-2023
Sharp Grossmont Hospital
2023
Southwestern Medical Center
2022
Scripps Clinic
2020
University of San Diego
2016
University of California, San Francisco
2004
NeuroMetrix (United States)
2004
Catheter ablation of persistent atrial fibrillation (AF) has limited success. Procedural strategies beyond pulmonary vein isolation have failed to consistently improve results. The Marshall contains innervation and AF triggers that can be ablated by retrograde ethanol infusion.To determine whether infusion could results in when added catheter ablation.The Vein Ethanol for Untreated Persistent (VENUS) trial was an investigator-initiated, National Institutes Health-funded, randomized,...
Active esophageal cooling reduces the incidence of endoscopically identified severe lesions during radiofrequency (RF) catheter ablation left atrium for treatment atrial fibrillation. A formal analysis atrioesophageal fistula (AEF) rate with active has not previously been performed.
BACKGROUND: Evidence from clinical trials of early pulsed field ablation (PFA) systems in treating atrial fibrillation has demonstrated their promising potential to reduce complications associated with conventional thermal modalities while maintaining efficacy. However, the lack a fully integrated mapping system, staple technology most modern electrophysiology procedures, poses limitations lesion creation and workflow options. A novel variable-loop PFA catheter an electroanatomic system been...
We have presented evidence that ventricular fibrillation is deterministic chaos arising from quasiperiodicity. The purpose of this study was to determine whether the transition (ventricular fibrillation, VF) periodicity tachycardia) through quasiperiodicity could be produced by progressive reduction tissue mass. In isolated and perfused swine right free wall, recording single cell transmembrane potentials simultaneous mapping (477 bipolar electrodes, 1.6 mm resolution) were performed. mass...
This study sought to evaluate the safety and effectiveness of catheter ablation persistent atrial fibrillation (PsAF) using a porous tip contact force–sensing catheter. Although paroxysmal are established, there limited data on outcomes in patients with PsAF. As such, no is currently approved by Food Drug Administration for PsAF ablation. The prospective, multicenter, nonrandomized PRECEPT (Prospective Review Safety Effectiveness THERMOCOOL SMARTTOUCH SF Catheter Evaluated Treating...
Abstract —To determine the role of pectinate muscle (PM) bundles in formation intra-atrial reentry, 10 isolated canine right atrial tissues were perfused with Tyrode’s solution containing 1 to 2.5 μmol/L acetylcholine (ACh). The endocardium was mapped using 477 bipolar electrodes 1.6-mm resolution. Reentry induced by a premature stimulus (S 2 ). Computer simulation studies used investigate importance regional myocardial thickness reentry formation. A total 40 episodes induced; 28 stationary,...
THERMOCOOL SMARTTOUCH® SF Catheter is a new contact-force (CF)-sensing catheter with 56-hole porous tip designed for improved cooling and reduced fluid delivery compared standard 6-hole open-irrigated catheter. The SMART study examined the periprocedural safety, acute effectiveness, procedural efficiency of drug-refractory symptomatic paroxysmal atrial fibrillation (PAF) ablation. prospective, open-label, non-randomized SMART-SF was conducted at 17 US sites. Circumferential pulmonary vein...
VISITAG SURPOINT (VS)–guided ablation of paroxysmal atrial fibrillation has demonstrated good short- and long-term success rates with low complications in recent, predominantly European, studies. However, there is a lack multicenter data from the United States. This U.S. study evaluated safety effectiveness VS using contact force–sensing catheter for treatment drug-refractory symptomatic fibrillation. The prospective, nonrandomized postapproval was conducted at 32 sites. Ablation consisted...
Wearable devices may be useful for identification, quantification and characterization, management of atrial fibrillation (AF). To date, consumer wrist-worn AF detection using photoplethysmography-based algorithms perform only periodic checks when the user is stationary are US Food Drug Administration cleared prediagnostic uses without intended use clinical decision-making. There an unmet need medical-grade diagnostic that provide long-term, continuous monitoring.
Background —The characteristics of transmembrane potential (TMP) at the core functional reentry in atrium are not well understood. Methods and Results —In protocol 1 (11 dogs), isolated perfused canine right atria were mapped from endocardial surface while simultaneous TMPs recorded epicardial surface. Episodes (n=64) induced presence to 5 μmol/L acetylcholine. Successful TMP recordings activation maps made 8 episodes. The was “near core” if it within 3.2 mm core; otherwise, considered be...
Abstract Background Increased efficiency in procedure times may improve electrophysiology lab throughput and enhance patient care. The choice of esophageal protection method during pulmonary vein isolation (PVI) can affect procedural efficiency, with recent data suggesting that active cooling is associated shorter when compared luminal temperature (LET) monitoring. Objective To compare PVI before after the adoption a large multicenter analysis. Methods Procedural were obtained from 5...
In support of the spiral wave theory reentry, simulation studies and animal models have been utilized to show various patterns tip motion such as meandering drifting. However, demonstration these or any other in cardiac tissues limited. Whether are commonly observed fibrillating is unknown, whether form basis ventricular tachycardia fibrillation remain debatable. Using a computerized dynamic activation display, 108 episodes atrial isolated intact canine tissues, well vitro swine myopathic...
The critical mass for human ventricular fibrillation (VF) and its electrical determinants are unclear. goal of this study was to evaluate the relationship between repolarization characteristics VF in diseased cardiac tissues.Eight native hearts from transplant recipients were studied. right ventricle immediately excised, then perfused (n = 6) or superfused 2) with Tyrode's solution at 36 degrees C. action potential duration (APD) restitution curve determined by an S1-S2 method. Programmed...
There is limited evidence on the long-term clinical benefits of catheter ablation in patients with persistent atrial fibrillation.PRECEPT was a prospective, multicenter, single-arm Food and Drug Administration-regulated investigational device exemption study. Patients were followed up to 15 months after ablation. Outcomes included use antiarrhythmic drugs, rate cardioversions cardiovascular hospitalization, Atrial Fibrillation Effect Quality-of-Life score, Canadian Cardiovascular Society...
Importance The emergence of novel programming guidelines that reduce premature and inappropriate therapies along with the availability new implantable cardioverter-defibrillator (ICD) technologies lacking traditional endocardial antitachycardia pacing (ATP) capabilities requires reevaluation ATP as a first strategy in terminating fast ventricular tachycardias (VTs) primary prevention ICD recipients. Objective To assess role VTs recipients contemporary programming. Design, Setting,...
Abstract Funding Acknowledgements Type of funding sources: None. Background As the burden atrial fibrillation continues to rise with an aging population, there have been contrasting positions on efficacy left ablation. While ablation techniques continued improve over past decades, arrhythmia recurrence rates must be further reduced given patients. Since continuity lesion sets has associated greater durability, it theorized that use active esophageal cooling may facilitate freedom from...
ABSTRACT Background Active esophageal cooling reduces the incidence of endoscopically identified severe lesions during radiofrequency (RF) catheter ablation left atrium for treatment atrial fibrillation. No atrioesophageal fistula (AEF) has been reported to date with active cooling, and only one pericardio-esophageal reported; however, a formal analysis AEF rate not previously performed. Methods Atrial fibrillation procedure volumes before after adoption using dedicated device (ensoETM,...
Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main source(s): Heart, Lung, And Blood Institute the Institutes Health. Background During left atrial ablation, lesions may be placed on posterior wall atrium. Due to anatomical proximity atrium esophagus, there is significant risk for thermal esophageal injury and potentially atrio-esophageal fistula. Ablation persistent fibrillation (AF) involve even more lesion placement, increased procedure...
The prospective, multicenter SMART SF trial demonstrated the acute safety and effectiveness of 56-hole porous tip irrigated contact force (CF) catheter for drug-refractory paroxysmal atrial fibrillation (PAF) ablation with a low primary adverse event rate (2.5%), leading to FDA approval catheter. Here, we are reporting long-term results that have not yet been reported.Ablations were performed using CF guided by 3D mapping system stability module. endpoint was freedom from tachyarrhythmia...
Transmembrane action potentials (TAPs) were recorded during simultaneous mapping of a reentrant wavefront induced in canine isolated atria. The activation pattern was visualized dynamically using high resolution electrode catheter system. During functional reentry (spiral wave), cells the core spiral wave remained quiescent near their resting membrane potential. Cells away from progressively gained TAP amplitude and duration, at periphery generated TAPs with full height duration. anatomical...