A5012148455- Cardiac Arrhythmias and Treatments
- Atrial Fibrillation Management and Outcomes
- Cardiac pacing and defibrillation studies
- Cardiac electrophysiology and arrhythmias
- Venous Thromboembolism Diagnosis and Management
- Cardiac Structural Anomalies and Repair
- Cardiac Imaging and Diagnostics
- Cardiovascular Syncope and Autonomic Disorders
- Health Systems, Economic Evaluations, Quality of Life
- Cardiovascular Function and Risk Factors
- Mechanical Circulatory Support Devices
- Antiplatelet Therapy and Cardiovascular Diseases
- Acute Ischemic Stroke Management
- Amyloidosis: Diagnosis, Treatment, Outcomes
- Pharmaceutical industry and healthcare
- Cardiac Valve Diseases and Treatments
- Blood Pressure and Hypertension Studies
- Heart Failure Treatment and Management
- Parathyroid Disorders and Treatments
- Heart Rate Variability and Autonomic Control
- Cardiomyopathy and Myosin Studies
- Obstructive Sleep Apnea Research
- Sarcoidosis and Beryllium Toxicity Research
- Meta-analysis and systematic reviews
- Advanced MRI Techniques and Applications
Clinical Research Institute
2016-2025
Duke University
2016-2025
Duke University Hospital
2015-2025
Duke Medical Center
2015-2024
ATP Clinical Research (United States)
2024
iRhythm (United States)
2024
Duke University Health System
2015-2023
Janssen (United States)
2019
Janssen Scientific Affairs (United States)
2019
Durham University
2014-2019
Time in therapeutic range (TTR) of international normalized ratio (INR) 2.0 to 3.0 is important for the safety and effectiveness warfarin anticoagulation. There are few data on TTR among patients with atrial fibrillation (AF) community-based clinical practice.Using US Outcomes Registry Better Informed Treatment Atrial Fibrillation (ORBIT-AF), we examined (using a modified Rosendaal method) 5,210 AF treated at 155 sites. Patients were grouped into quartiles based data. Multivariable logistic...
Background Atrial fibrillation is associated with higher mortality. Identification of causes death and contemporary risk factors for all‐cause mortality may guide interventions. Methods Results In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared Vitamin K Antagonism Prevention Stroke Embolism Trial in Fibrillation (ROCKET AF) study, patients nonvalvular atrial were randomized to rivaroxaban or dose‐adjusted warfarin. Cox proportional hazards regression backward...
Background: There are no randomized data evaluating the safety or efficacy of apixaban for stroke prevention in patients with end-stage kidney disease on hemodialysis and atrial fibrillation (AF). Methods: The RENAL-AF trial (Renal Hemodialysis Patients Allocated Apixaban Versus Warfarin Atrial Fibrillation) was a prospective, randomized, open-label, blinded-outcome evaluation (PROBE) versus warfarin receiving AF CHA 2 DS -VASc score ≥2. were randomly assigned 1:1 to 5 mg twice daily (2.5...
There is uncertainty surrounding the use of direct oral anticoagulants (DOACs) in patients with kidney dysfunction.
Compared with the general population, patients advanced chronic kidney disease have a >10-fold higher burden of atrial fibrillation. Limited data are available guiding use nonvitamin K antagonist oral anticoagulants in this population.We compared safety apixaban warfarin 269 fibrillation and (defined as creatinine clearance [CrCl] 25 to 30 mL/min) enrolled ARISTOTLE trial (Apixaban for Reduction Stroke Other Thromboembolic Events Atrial Fibrillation). Cox proportional models were used...
Background The optimal anticoagulation strategy for patients with atrial fibrillation (AF) and bioprosthetic valve (BPV) replacement or native repair remains uncertain. Hypothesis We evaluated the safety efficacy of apixaban vs warfarin in AF a history BPV repair. Methods Using data from Apixaban Reduction Stroke Other Thromboembolic Events Atrial Fibrillation (ARISTOTLE) (n = 18 201), randomized trial comparing AF, we analyzed subgroup 251) prior surgery. contacted sites by telephone to...
Complete hardware removal is a class I recommendation for cardiovascular implantable electronic device (CIED) infection, but practice patterns and outcomes remain unknown.
ABSTRACT Background The majority of data on left bundle branch area pacing (LBBAP) are a lumenless lead. Data the safety and effectiveness stylet driven leads comparatively lacking. Methods We retrospectively analyzed 265 patients who underwent attempted LBBAP with an 7842 (Boston Scientific, Marlborough, MA) lead in Duke University Health System between 1/1/2020 9/1/2023. Outcomes interest included post‐operative helix extension (≥2 rotations beyond tip), complications, parameters. A nested...
We conducted this pilot randomized clinical trial to determine the feasibility of a large aimed at testing whether early use catheter ablation ventricular tachycardia (VT) is superior antiarrhythmic medications reducing mortality.Patients were enrolled 4 sites if they had ischemic heart disease, an implantable cardioverter defibrillator (ICD), and received ≥1 ICD shock or ≥3 antitachycardia pacing therapies for VT. Patients 2 arms: (1) medication (n = 14) (2) 13); patients followed 3 6...
Background: Lead management is an increasingly important aspect of care in patients with cardiac implantable electronic devices; however, relatively little known about long-term outcomes after capping and abandoning leads. Methods: Using the 5% Medicare sample, we identified de novo device implantations between January 1, 2000, December 31, 2013, a subsequent lead addition or extraction ≥12 months implantation. Patients who underwent for infection were excluded. multivariable Cox...
Implantable cardioverter-defibrillators (ICDs) are not recommended within 40 days of myocardial infarction (MI); thus, ICD implantation might be considered during the post-MI care transition.To examine rates and associated mortality among older MI patients with low ejection fraction (EF).Retrospective observational study Medicare beneficiaries an EF 35% or less after MI, treated at 441 US hospitals between 2007 2010, excluding prior implantation. Follow-up data were available through...
This study identified factors associated with risk for cardiac perforation in the setting of atrial fibrillation (AF) ablation contemporary clinical practice.Cardiac is an uncommon but potentially fatal complication AF ablation. An improved understanding could facilitate improvements procedural safety.Logistic regression models were used to assess predictors among Medicare beneficiaries who underwent from July 1, 2013 and December 31, 2017. Cardiac was defined as a diagnosis hemopericardium,...
Etripamil is a fast-acting, intranasally administered calcium-channel blocker in development for on-demand therapy outside health-care setting paroxysmal supraventricular tachycardia. We aimed to evaluate the efficacy and safety of etripamil 70 mg nasal spray using symptom-prompted, repeat-dose regimen acute conversion atrioventricular-nodal-dependent tachycardia sinus rhythm within 30 min. RAPID was multicentre, randomised, placebo-controlled, event-driven trial, conducted at 160 sites North...
Cardiac implanted electronic device (CIED) pocket and systemic infection remain common complications with traditional CIEDs are associated high morbidity mortality. Leadless pacemakers may be an attractive pacing alternative for many patients following complete hardware removal a CIED by eliminating surgical pocket-related as well lower risk of recurrent complications.To describe use outcomes leadless pacemaker implantation extraction system due to infection.Patient characteristics...
The role of infarct size on left ventricular (LV) remodeling in heart failure after an acute ST-segment elevation myocardial infarction (STEMI) is well recognized. Infarct size, as determined by cardiovascular magnetic resonance (CMR), decreases over time. amount, rate, and duration healing are unknown. A total 66 patients were prospectively enrolled reperfusion for STEMI. Patients underwent a CMR evaluation within 1 week, 4 months, 14 months Mean sizes the at baseline (acute necrosis),...
Background Preprocedural multidetector computed tomography (MDCT) may identify patients at risk for mechanical complications during lead extraction. Methods To describe the use and feasibility of scanning preprocedural planning extraction, we conducted a retrospective study high‐risk patients, who underwent electrocardiogram (ECG)‐gated MDCT before planned extraction between January 1, 2012, March 30, 2013. Results Among 30 mean age was 63 ± 15 years, 60% were male, 20% had prior sternotomy....