A5063300821- Cardiac Arrhythmias and Treatments
- Atrial Fibrillation Management and Outcomes
- Cardiac electrophysiology and arrhythmias
- Cardiac pacing and defibrillation studies
- Cardiovascular Effects of Exercise
- Cardiac Imaging and Diagnostics
- Rheumatoid Arthritis Research and Therapies
- Glioma Diagnosis and Treatment
- Cardiomyopathy and Myosin Studies
- Cardiac Structural Anomalies and Repair
- Prostate Cancer Treatment and Research
- Cardiovascular Function and Risk Factors
- Gastric Cancer Management and Outcomes
- Prostate Cancer Diagnosis and Treatment
- Hormonal and reproductive studies
- ECG Monitoring and Analysis
- Sarcoidosis and Beryllium Toxicity Research
- Lymphoma Diagnosis and Treatment
- Mechanical Circulatory Support Devices
- Venous Thromboembolism Diagnosis and Management
- Cardiovascular Syncope and Autonomic Disorders
- Chronic Lymphocytic Leukemia Research
- Esophageal Cancer Research and Treatment
- Cardiac Valve Diseases and Treatments
- Advanced Radiotherapy Techniques
Hospital of the University of Pennsylvania
2016-2025
University of Pennsylvania
2016-2025
Scunthorpe General Hospital
2014-2023
Philadelphia University
2023
Raigmore Hospital
2023
Singleton Hospital
2023
Wexham Park Hospital
2023
MRC Clinical Trials Unit at UCL
2023
University College London
2023
Salford Royal Hospital
2023
Early studies suggest that coronavirus disease 2019 (COVID-19) is associated with a high incidence of cardiac arrhythmias. Severe acute respiratory syndrome 2 infection may cause injury to myocytes and increase arrhythmia risk.The purpose this study was evaluate the risk arrest arrhythmias including incident atrial fibrillation (AF), bradyarrhythmias, nonsustained ventricular tachycardia (NSVT) in large urban population hospitalized for COVID-19. We also evaluated correlations between...
Patients with nonischemic left ventricular cardiomyopathy (LVCM) and tachycardia (Vt) have complex 3-dimensional substrate variable involvement of the endocardium (ENDO) epicardium (EPI). The purpose this study was to determine whether ENDO unipolar (UNI) mapping a larger electric field view could identify EPI low bipolar (BIP) voltage regions in patients LVCM undergoing Vt ablation.The reference value for normal determined from 6 without structural heart disease. Consecutive ablation over...
Background— The single-procedure efficacy of pulmonary vein isolation (PVI) is less than optimal in patients with persistent atrial fibrillation (AF). Adjunctive techniques have been developed to enhance these patients. We conducted a study compare 3 ablation strategies AF. Methods and Results— Subjects were randomized as follows: arm 1, PVI + non-PV triggers identified using stimulation protocol (standard approach); 2, standard approach empirical at common AF trigger sites (mitral annulus,...
Catheter ablation (CA) of ventricular tachycardia (VT) in patients with nonischemic dilated cardiomyopathy can be challenging because the complexity underlying substrates. We sought to determine long-term outcomes endocardial and adjuvant epicardial CA cardiomyopathy.We examined 282 consecutive (aged 59±15 years, 80% males) who underwent CA. Ablation was guided by activation/entrainment mapping for tolerated VT pacemapping/targeting abnormal electrograms unmappable VT. Adjuvant performed...
Recent studies have demonstrated spatiotemporal organization in atrial fibrillation (AF), with a left-to-right frequency gradient during AF isolated sheep hearts. We hypothesized that human would also manifest gradient.Thirty-one patients aged 56.7+/-10.5 years history of paroxysmal or persistent (>1 month) were included. Recordings made at each pulmonary vein (PV) ostium and simultaneously from the coronary sinus (CS) posterior right atrium (RA) AF. Sequential fast Fourier transforms (FFTs)...
Background— A proarrhythmic consequence of pulmonary vein (PV) isolation can be a recurrent organized left atrial (LA) tachycardia after ablation. This arrhythmia is frequently referred to as “left flutter,” but the mechanism and best ablation strategy have not been determined. Methods Results— Isolation arrhythmogenic PVs was initially performed by segmental ostial PV guided circular mapping catheter in 341 patients. Patients whose predominant persistent returned for Recurrent LA...
Pulmonary vein (PV) isolation is effective in the treatment of most patients with atrial fibrillation (AF). Some advocate addition linear ablation techniques to improve efficacy; however, previous studies suggest recurrent PV conduction responsible for AF recurrence. The aim this study was determine effectiveness repeat after an initial procedure and if any patient characteristics predict failure procedures.Seventy-four two or more procedures using selective were included. guided...
ECG Patterns of RVOT Tachycardias. Introduction: The superior right ventricular outflow tract (RVOT) septum and free wall are common locations origin for tachycardias (VT). We hypothesized that (1) unique morphologies pace maps from septal free‐wall sites in the could be identified using magnetic electroanatomic mapping accurate anatomical localization; (2) this information help facilitate VT localization. Methods Results: In 14 patients with structurally normal hearts who were undergoing...
Evaluation of ventricular rate control in atrial fibrillation (AF) can be difficult, and the presence an AF-induced cardiomyopathy due to intermittent poor or other causes may underestimated. The outcome with AF ablation patients a decreased left ejection fraction (LVEF) provide insight into this important clinical issue.To determine effect pulmonary vein isolation on LVEF (< = 50%).Ablation consisted proximal arrhythmogenic veins (PVs) elimination non-PV triggers. was determined within 24...
To gain insight into the pathogenesis of right ventricular (RV) cardiomyopathy and tachycardia (VT), we determined clinical electroanatomic characteristics outcome ablative therapy in consecutive patients with (1) RV dilatation, (2) multiple left bundle-branch block (LBBB)-type VTs, (3) an abnormal endocardial substrate defined by contiguous electrogram abnormalities.All 21 had detailed bipolar voltage mapping. Eighteen simultaneous (LV) mapping, including all 4 (RBBB) VT. VT was ablated 19...
Introducton: A 10% incidence of left atrial (LA) thrombus formation has been detected using intracardiac echocardiography (ICE) imaging monitoring during LA ablation for fibrillation (AF). The aim this study was to determine if the intensity anticoagulation reduces pulmonary vein isolation procedure in patients with AF and spontaneous echo contrast (SEC). Methods Results: We studied 511 (age 56 ± 10 years) undergoing ostial isolation/ablation radiofrequency energy. SEC 179 ICE before dual...
Pulmonary vein isolation (PVI) is increasingly used for treatment of atrial fibrillation (AF), but few reports exist regarding long-term success. We determined 5-year outcomes PVI among patients with freedom from AF off antiarrhythmic drugs (AAD) 1 year after PVI.Consecutive paroxysmal or persistent who underwent at the University Pennsylvania 2000 to 2003 and were free ablation included. Proximal PVs non-PV triggers was performed. Long-term success, defined as AAD a single procedure,...
Introduction: The etiology of atrial fibrillation (AF) recurrences after pulmonary vein (PV) isolation is not well described. aim this study was to examine the reason for recurrent AF in patients undergoing a repeat attempt at trigger ablation. Methods and Results: Patients with more than 1 month ablation returned mapping A circular catheter advanced each previously targeted PV ostium determine if still electrically isolated. Ectopy then provoked isoproterenol (up 20 μg/min), burst pacing,...
Catheter ablation of ventricular tachycardia (VT) in arrhythmogenic right cardiomyopathy improves short-term VT-free survival. We sought to determine the long-term outcomes VT control and need for antiarrhythmic drug therapy after endocardial (ENDO) adjuvant epicardial (EPI) substrate modification patients with cardiomyopathy.We examined 62 consecutive Task Force criteria referred a minimum follow-up 1 year. was guided by activation/entrainment mapping tolerated pacemapping/targeting...
The number of elderly patients with atrial fibrillation (AF) is increasing rapidly, and the safety efficacy catheter ablation in this demographic group has not been established.Over a 7-year period we studied 1,165 consecutive undergoing 1,506 AF procedures using consistent protocol that included proximal ostial pulmonary vein (PV) isolation focal non-PV triggers. Outcome was analyzed for three distinct age groups: <65 years (group 1; n = 948 patients), 65-74 2; 185 > or =75 3; 32 patients)...
Background— The occurrence of periprocedural acute hemodynamic decompensation (AHD) in patients undergoing radiofrequency catheter ablation scar-related ventricular tachycardia (VT) has not been previously investigated. Methods and Results— We identified univariate predictors AHD 193 consecutive VT. was defined as persistent hypotension despite vasopressors requiring mechanical support or procedure discontinuation. occurred 22 (11%) patients. Compared with the rest population, were older...
Background— We previously demonstrated that treatment with antiarrhythmic drugs (AADs) during the first 6 weeks after atrial fibrillation (AF) ablation reduces incidence of clinically significant arrhythmias and need for cardioversion or hospitalization arrhythmia management. Whether early rhythm suppression decreases longer-term recurrence is unknown. now report 6-month follow-up data from this study. Methods Results— The Antiarrhythmics After Ablation Atrial Fibrillation study...