A5087088356- Cardiac pacing and defibrillation studies
- Cardiac Arrhythmias and Treatments
- Cardiac electrophysiology and arrhythmias
- Neurological disorders and treatments
- Cardiac Structural Anomalies and Repair
- Advanced MRI Techniques and Applications
- Cardiovascular Function and Risk Factors
- Cardiac Imaging and Diagnostics
- Heart Failure Treatment and Management
- ECG Monitoring and Analysis
- Cardiac Valve Diseases and Treatments
- Atrial Fibrillation Management and Outcomes
- Infective Endocarditis Diagnosis and Management
- Pleural and Pulmonary Diseases
- Heart Rate Variability and Autonomic Control
- Radiomics and Machine Learning in Medical Imaging
- Pericarditis and Cardiac Tamponade
- Cardiomyopathy and Myosin Studies
- Medical Imaging Techniques and Applications
- Hemodynamic Monitoring and Therapy
- Healthcare cost, quality, practices
- Aortic Disease and Treatment Approaches
- Neuroscience and Neural Engineering
- Medical Device Sterilization and Disinfection
- Clinical practice guidelines implementation
Derriford Hospital
2024
Guy's and St Thomas' NHS Foundation Trust
2017-2023
King's College London
2016-2023
University Hospitals Plymouth NHS Trust
2022-2023
University of Medicine and Pharmacy of Craiova
2023
St Thomas' Hospital
2016-2021
National Health Service
2018
British Heart Foundation
2017
University Hospital Southampton NHS Foundation Trust
2016
Dorset County Hospital
2014
BackgroundBiventricular endocardial pacing (BiV ENDO) is a therapy for heart failure patients who cannot receive transvenous epicardial cardiac resynchronization (CRT) or have not responded adequately to CRT. BiV ENDO CRT can be delivered by new wireless LV system (WiSE-CRT system; EBR Systems, Sunnyvale, CA), without the requirement lifelong anticoagulation.ObjectiveThe purpose of this study was assess safety and efficacy WiSE-CRT during real-world clinical use in an international...
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.
Biventricular endocardial pacing (BiV-endo) has demonstrated superior cardiac resynchronization compared to conventional biventricular epicardial (BiV-epi). Left bundle branch area (LBBAP) may also achieve effective therapy (CRT).The purpose of this study was compare the acute electrical and hemodynamic effects BiV-epi, BiV-endo, LBBAP delivered from LV endocardium assess how myocardial scar affects response.Eleven patients with heart failure indications for CRT underwent a temporary...
Optimal lead positioning is an important determinant of cardiac resynchronization therapy (CRT) response. The 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. Eighteen patients undergoing CRT upgrade with existing pacing systems underwent preimplant electrocardiogram-gated CT assess wall thickness, hypoperfusion, activation, scar...
This study sought to test the feasibility of a purpose-built, integrated software platform process, analyze, and overlay cardiac magnetic resonance (CMR) data in real time within combined catheter laboratory imaging scanner suite (X-MRI) guide left ventricular (LV) lead implantation.Suboptimal LV position is major determinant poor resynchronization therapy (CRT) response, optimal site highly patient specific. Pacing myocardial scar associated with poorer outcomes; conversely, targeting...
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...
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...
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...
The role of implantable cardioverter defibrillators (ICDs) in nonischemic cardiomyopathy is unclear and better risk-stratification required. We sought to determine if T1 mapping predicts appropriate defibrillator therapy patients with cardiomyopathy. studied a mixed cohort ischemic whether different cardiac magnetic resonance (CMR) applications (T1 mapping, late gadolinium enhancement, Grayzone) were selectively predictive therapies for the arrhythmic substrates. undertook prospective...
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,...
Optimal positioning of the left ventricular (LV) lead is an important determinant cardiac resynchronization therapy (CRT) response.
The new category of heart failure (HF), Heart Failure with mid range Ejection Fraction (HFmrEF) has recently been proposed recent publications reporting that HFmrEF represents a transitional phase. aim this study was to determine the prevalence and clinical characteristics patients establish what proportion transitioned other types HF, how affected outcomes.Patients were diagnosed HF according 2016 ESC guidelines. Clinical outcomes variables recorded for all consecutive in-patients referred...
Cardiac resynchronization therapy (CRT) is an important treatment for heart failure. Low female enrollment in clinical trials means that current CRT guidelines may be biased toward males. However, females have higher response rates at lower QRS duration (QRSd) thresholds. Sex differences the left ventricle (LV) size could provide explanation improved QRSd. We aimed to test if sex QRSd thresholds are explained by LV and hence predict sex-specific CRT. investigated effect difference has on...
Introduction: The efficacy of de novo cardiac resynchronisation therapy (CRT) in patients with heart failure (HF), left ventricular systolic dysfunction (LVSD), and a broad QRS morphology is well established. However, the optimal stage for upgrading existing pacemakers (PPMs) or implantable cardioverter-defibrillators (ICDs) HF high-burden right (RV) pacing remains uncertain. Thus, this multicentre retrospective analysis compared pre-existing PPMs ICDs who underwent CRT upgrades to...
Background: The temporal pattern of ventricular repolarization is critical importance in arrhythmogenesis. Enhanced beat-to-beat variability (BBV) action potential duration (APD) pro-arrhythmic and increased during sympathetic provocation. Since nerve activity characteristically exhibits burst patterning the low frequency range, we hypothesised that physiologically enhanced may not only increase BBV left APD but also impose a oscillation which further increases repolarisation instability...
Abstract Background Transvenous lead extraction (TLE) may be performed by superior approach using the original implant vein or via a femoral approach; however, limited comparative data exists. We compare outcomes between versus nonfemoral TLE approaches and determine predictors of bailout transfemoral in patients undergoing initial approach. Methods All consecutive TLEs October 2000 March 2018 were prospectively collected ( n = 1052). Patients dichotomized into 118) 934) groups. Results...