Cardiology Commons^™

A Rare Case Of Cardioversion-Induced Ventricular Fibrillation In A 62 Year Old Male Due To Inappropriate Timing: A Case Report, Joshua Brett Sommerer

Rowan-Virtua Research Day

•Atrial fibrillation (AF) is a common arrythmia of the heart due to the atria beating irregularly. AF has a national burden of over 30 million. AF is commonly managed in the outpatient clinic with pharmaceutical interventions. In a minority of cases, medications are unable to restore normal sinus rhythm of the heart, requiring further interventions such as cardiac ablation or trans-esophageal echocardiogram(TEE)/ cardioversion. This arrythmia can frequently leads to blood clots, stroke, and other cardiac complications. •This patient has recurrent paroxysmal AF for 3 years with resistance to multiple medication trials and presents for an outpatient TEE/cardioversion to restore normal …

Clinical Outcomes For Patients With Obstructive Shock With Pe In Octogenarians, Nonagenarians, And Centenarians: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Wasim Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

One of the most common causes of obstructive shock is massive pulmonary embolism. I these patients with compounded morbidities and limited filling of the heart we sought to sample databases to analyze the inpatient outcomes of the population.

Left Atrial Appendage Occlusion In Heart Failure Patients: A Nationwide Evaluation Of Clinical Outcomes, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Between 2010-2019 the global risk of atrial fibrillation has risen. Our research sought to explore the database of patients with AF who underwent left atrial appendage occlusion.

Clinical Outcomes For Patients Who Have Hyperlipidemia Who Underwent Mechanical Directed Thrombolysis For Pulmonary Embolism: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

Mechanical-directed thrombolysis for PE is a recently established therapy option for patients with sub-massive PE with hemodynamic instability. With limited availability on the impact of superimposed anemia on patients that undergo MDT treatment we sought to look more closely at the inpatient population.

Clinical Outcomes Of Left Atrial Appendage Occlusion In Patients With Hyperlipidemia: A Nationwide Analysis, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

We sought to examine the national inpatient sample database to explore in-hospital outcomes for patients with HDL with AF who underwent LAAO.

Outcomes Of Octogenarians, Nonagenarians, And Centenarians That Underwent Left Atrial Appendage Occlusion: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

An evaluation of that national inpatient sample database to explore the outcomes for patients above the age of seventy who underwent left atrial appendage occlusion.

Cardiovascular Risk Factors In The Autism Spectrum Disorder Population, Christian C. Iannuzzelli, Andrea L. Iannuzzelli

Rowan-Virtua Research Day

The population of patients with Autism Spectrum Disorder (ASD) have multiple risks and barriers that may make access to proper health care more difficult. After extensive research, some of these barriers may have been identified that pose greater risks to generating proper care for those with ASD. Some of these barriers include medical complexity, more sedentary lifestyles, poor food choices, as well as health comorbities. Some of these health comorbidities include hypertension, metabolic dysfunction, sleep apnea, and inflammation. This study aims to understand what barriers and risks for CVD are present in those with ASD.

Exploring Mindfulness Meditation In Managing Elevated Blood Pressure And Heart Rate In Debilitating Cardiovascular Disease: A Systematic Review And Meta-Analysis, Han Jie Liu, Krish Patel, Zachary Coren, Youssef Daoud, Zeshan Fahim, Shikhar Rastogi, Justin Le, Avinash Gupta

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in the US, with elevated blood pressure (BP) significantly contributing to its progression. Mindfulness meditation has emerged as a high-value preventative care strategy for managing BP and heart rate (HR); however, its specific effects on managing BP and HR in individuals with debilitating CVD remain poorly understood. This project aims to evaluate the effectiveness of mindfulness meditation on HR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in this population. Following PRISMA 2020 guidelines, we employed a tailored Boolean string to search PubMed, Embase, Web of Science, Cochrane …

The Impact Of Food Deserts And Food Insecurity On Cardiovascular Outcomes In New Jersey, Amina Baig, Cheyenne Myklebust, Jack Hennen, Leah Perez, Rhoda Ukenna-Izuwa, Tayyiaba Farooq

Rowan-Virtua Research Day

Food deserts - areas with limited access to affordable, healthful food - are increasingly being recognized as risk factors for adverse cardiovascular outcomes. This review discusses the link between food desert density and cardiovascular disease risk with a special emphasis on New Jersey. A systematic PubMed, Cochrane, and Embase literature review of studies from 2014 through 2024 was conducted, with some relevant older research dating back to 2001. Some of the keywords used in the search included "food desert," "food insecurity," "cardiovascular disease," and "New Jersey." The search was restricted to English-language research conducted within the United States. The literature …

From Gut To Heart: Tmao As A Predictive Marker For Cardiovascular Risk, Jasjeet Kaur Dhaliwal, Demi Poulathas

Rowan-Virtua Research Day

Background: Trimethylamine N-oxide (TMAO), a metabolite produced by gut microbiota from dietary nutrients such as choline and carnitine, has emerged as a potential biomarker linking the gut microbiome to cardiovascular disease (CVD). This review synthesizes findings from 31 studies examining the association between circulating TMAO levels and cardiovascular outcomes.

Objective: To evaluate the prognostic value of plasma or serum TMAO concentrations in predicting major adverse cardiovascular events (MACE), including myocardial infarction, stroke, and cardiovascular mortality.

Methods: Studies were identified through a systematic search and screened based on inclusion criteria that required human populations, quantification of blood-based TMAO, and analysis of …

Impact Of Language Barriers On Out-Of-Hospital Cardiac Arrest Recognition And Response, Kinjal Mody, Sophie Cherfane, Curt Cackovic

Rowan-Virtua Research Day

Out-of-hospital cardiac arrest (OHCA) causes nearly 350,000 deaths annually in the U.S., with survival largely depending on the timely recognition of cardiac arrest and the initiation of bystander CPR by emergency dispatchers. However, English-centric dispatch systems create barriers for individuals with limited English proficiency, potentially delaying critical responses. This study aims to synthesize research on how language differences impact OHCA recognition and CPR initiation in emergency dispatch settings. We hypothesize that language barriers cause significant delays.

PubMed, Scopus, and Web of Science databases were used to identify relevant studies, using search terms like "language barriers," "cardiac arrest," and "CPR." Inclusion …

Heart To Heart: Exploring Why Cardiovascular Risk Is Higher In South Asians, Jasjeet Kaur Dhaliwal

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading global cause of mortality, but South Asians experience a disproportionately high burden of disease, often developing CVD at younger ages and with lower body mass indices compared to other populations. This project explores the underlying genetic and lifestyle factors contributing to elevated cardiovascular risk in South Asians, aiming to highlight the need for targeted prevention strategies and policy reforms.

A literature review was conducted using peer-reviewed studies, meta-analyses, and reviews published between 2007 and 2024. After screening 47 initial articles, 18 were selected for analysis based on their relevance to genetic and lifestyle risk …

The Presence Of Cardiac Arrhythmias Impacts Hospitalized Patients With Celiac Disease, Rahul Patel, Tirth Patel, Darshan Patel, Trinava Roy, Sachin Prasad, Paul Gill, Rafail Beshai, Joshua Soliman, Brian Blair, C. Jonathan Foster

Rowan-Virtua Research Day

Background

Celiac disease has links to inflammatory bowel disease (IBD), rheumatoid arthritis (RA), and sarcoidosis. The latter 3 also have cardiovascular manifestations associated with them. However, there are limited studies on the in-hospital outcomes of Celiac disease with cardiac manifestations. Therefore, the aim of this study was to evaluate the hospital outcomes of Celiac disease with concomitant arrhythmias.

Methods

Patients aged 18 years with Celiac disease and arrhythmias (atrial fibrillation, atrial flutter, ventricular tachycardia, and supraventricular tachycardia) versus Celiac Disease alone were identified from the US Nationwide Inpatient Sample (NIS), from the years 2019-2020. ICD 10 codes were utilized. Multivariate …

Cardiovascular Effects Of Glp-1 Receptor Agonists In Non-Diabetic Adults With Obesity: A Systematic Literature Review, Mariam Abdeen

Rowan-Virtua Research Day

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.

Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.

Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …

Anabolic Steroid Induced Cardiomyopathy, Oluwatomi Alade

Rowan-Virtua Research Day

Anabolic steroids including testosterone are commonly used as performance-enhancing agents. Its use is predominantly seen in young and middle-aged males. Endogenous testosterone is necessary for cardiac health; however, synthetic anabolic steroids are more potent and associated with adverse effects. These adverse effects include cardiomyopathy and coronary artery disease. The cardiomyopathy, however, can be reversible with discontinuation of the anabolic steroids. This case describes a middle-aged male who had new onset cardiomyopathy and ultimately went into cardiogenic shock secondary to anabolic steroid use.

Assessing The Safety And Effectiveness Of Endovascular Treatment Vs. Surgical Repair Of Aortic Aneurysms In Patients With Marfan Syndrome: A Literature Review, Noor Baig, Zainab Mubasher, Nassos Tziviskos, Joseph Pernini, Marcus Fariello, Ryan Hickey

Rowan-Virtua Research Day

Background: This review compares the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) versus open surgical repair in patients with Marfan Syndrome (MFS) and thoracic aortic aneurysms. We assessed differences in mortality, length of hospital stay, renal impairment, and stroke incidence between the two techniques. Currently, open surgical repair is the gold standard treatment.

Hypothesis: As the gold standard treatment, we expect open surgical repair to have more favorable outcomes than TEVAR.

Methods: A systematic literature search was performed using studies from 2000-2024 across PubMed, Scopus, Embase, Cochrane, and Web of Science. Studies were included if they involved adult …

Preliminary Assessment For Quality Improvement Of Hypertension Management In Kenya, Shubhangi Singh

Honors Theses

Hypertension is a leading contributor to cardiovascular disease (CVD) morbidity and mortality worldwide, with a disproportionate burden in low- and middle-income countries (LMICs). Despite relatively low rates of common behavioral risk factors, the Kasigau region of Kenya experiences high prevalence of hypertension and hypertension-related complications. This study explores self-efficacy, health beliefs, and management behaviors among adults in Kasigau to provide pilot quality improvement data for providers and future intervention planning. A cross-sectional, randomized survey of 45 adults was conducted at the Bughuta Clinic in southeastern Kenya. Participants completed a five-question hypertension-specific, self-efficacy assessment and a health belief model-based survey, with …

A Case Of A Massive Right Atrial Thrombus Removal Under Transesophageal Echocardiographic Guidance, Justin Phillips, Max Kabolowsky, Alex M. Hendon, Samantha Arzillo

HCA Healthcare Journal of Medicine

Background

With the advent of catheter guided interventions, practitioners have added another tool alongside chemical lysis and surgical removal to reduce the clot burden of patients with large emboli and thrombi. Due to comorbid conditions, many patients are poor candidates for surgical or chemical clot treatment but may present optimally for catheter-based thromboembolectomy. In this case, we highlight the benefits of mechanical thrombectomy with transesophageal echocardiographic guidance to reduce the clot burden of a patient who would otherwise be considered a poor candidate for surgical or chemical treatment.

Case Presentation

This case follows a 78-year-old man with a past medical …

Ensemble Learning With Explainable Ai For Improved Heart Disease Prediction Based On Multiple Datasets, Shahid Mohammad Ganie, Pijush Kanti Dutta Pramanik, Zhongming Zhao

Faculty, Staff and Student Publications

Heart disease is one of the leading causes of death worldwide. Predicting and detecting heart disease early is crucial, as it allows medical professionals to take appropriate and necessary actions at earlier stages. Healthcare professionals can diagnose cardiac conditions more accurately by applying machine learning technology. This study aimed to enhance heart disease prediction using stacking and voting ensemble methods. Fifteen base models were trained on two different heart disease datasets. After evaluating various combinations, six base models were pipelined to develop ensemble models employing a meta-model (stacking) and a majority vote (voting). The performance of the stacking and voting …

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Canary In The Carpal Tunnel: A Pilot Study Of The Value Of The Screening For Amyloidosis In Carpal Tunnel Syndrome, Trevor Ruesch, Nevil Khurana, Logan Hansen Md, Katiya Barkho, Julia Malewicz, Charles Day Md

Medical Student Research Symposium

Introduction/Purpose:

Transthyretin amyloidosis occurs in two forms, hereditary transthyretin amyloidosis (hATTR), and wild-type ATTR (wtATTR)². Amyloidosis can result in restrictive cardiomyopathy presenting as heart failure with preserved ejection fraction (HFpEF)⁴. A growing body of evidence demonstrates that amyloidosis may be underdiagnosed and can be caught earlier in the disease course⁵. The proteins causing amyloidosis can also deposit into various tissues including the carpal tunnel leading to carpal tunnel syndrome ².

In this pilot study, we propose that early detection of amyloid via a biopsy of the transverse carpal ligament or tenosynovium in the …

The Role Of Non-Statin Lipid Lowering Therapies To Reduce Ascvd Events In Primary Prevention, Chukwuemezie Mamanu, Dean Karalis

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (ASCVD) remains a leading global health challenge, with low-density lipoprotein (LDL) cholesterol a pivotal risk factor. While statins are cornerstone therapy for lowering LDL cholesterol, many high-risk primary prevention patients are unable to tolerate statin therapy and do not achieve their guideline directed LDL cholesterol goal. For these patients, non-statin therapies offer complementary and alternative approaches to LDL cholesterol reduction.

RECENT FINDINGS: Recent advancements in non-statin therapies have expanded the options available to clinicians to lower LDL cholesterol in high-risk primary prevention patients. Yet these medications are often under-utilized in clinical practice. Observational studies, …

Using Ehr Reminders To Control Hypertension, Umme Kulsoom Ghous, Logan Mcculley, Danielle C. Hall, Linda Katherine Lambert, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Hypertension is a significant risk factor for cardiovascular and kidney diseases but is often under-diagnosed and poorly managed. Electronic Health Records (EHR) can help by providing automated reminders to recheck elevated blood pressure (BP) readings, ensuring accurate measurements, and guiding clinical interventions. This study aims to determine if EHR-based reminders improve BP control in adult patients aged 21 and older, focusing on hypertension diagnosis accuracy and timely management.

Methods

After a literature review, the study took place in a primary care clinic and only included patients with an existing diagnosis of hypertension. Thirty patients were included in the study. …

The Role Of Electrophysiologic Study In Device Selection For Leadless Atrial Pacing, Joshua R Hirsch, Jordan M Gales, Irakli Giorgberidze, Hamid Afshar

The Texas Heart Institute Journal

The AVEIR DR (Abbott Medical) was the first dual-chamber leadless pacing system approved by the US Food and Drug Administration. Many patients with sinus node dysfunction have physiologically normal atrioventricular conduction, so an atrial-only pacing system may be appropriate for them. Three patients with symptomatic sinus node dysfunction underwent device implantation with electrophysiologic study, including incremental atrial pacing until loss of 1:1 atrioventricular conduction (atrioventricular Wenckebach cycle length) and His-ventricular interval measurement. If the atrioventricular Wenckebach cycle length was no more than 400 milliseconds and the His-ventricular interval measurement was no more than 55 milliseconds, single-chamber atrial implantation was deemed …

Spontaneous Distal Middle Cerebral Artery Aneurysm In A Young Male With Full Mutation Of The Fragile X Syndrome With A High-Functioning Phenotype: Illustrative Case, Eleni Papadopoulos, Anna Abrimian, Hekmat Zarzour, Randi J Hagerman, Richard F Schmidt

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Fragile X syndrome (FXS) is a genetic disorder that typically presents with neurodevelopmental abnormalities. Patients with FXS can present with signs and symptoms of connective tissue disorder (CTD) and occasionally with vascular disease. However, cerebrovascular disease is not well documented in these patients, and it is unknown whether there is a direct link between abnormal levels of fragile X protein (FMRP) and its mRNA.

OBSERVATIONS: Here, the authors present a rare case of an adult male with full mutation FXS of a high-functioning phenotype who presented with syncope, and on further evaluation, a fusiform dissecting aneurysm of the distal …

Meta-Analysis On Sex Differences In Mortality And Neurodevelopment In Congenital Heart Defects, Alyssa K Crain, Zhia N Lim, Chloe J Sarfatis, Magela Arias, Travis Holder, Alvaro G Moreira, Antonio F Corno, Tina O Findley

Faculty, Staff and Student Publications

Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related disparities in CHD, there is a need to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration (#CRD42021225610). Articles published from 2015 to 2021 were searched using MeSH descriptors in three major databases (MEDLINE Ovid, Elsevier Embase, and Cochrane Library). Study selection criteria …

Maternal Health And Congenital Heart Defects: Investigating Ventricular Septal Defects In South Texas Region 11, Miguel A. Lopez, Sophia Moon, Jonathan M. Hebert, Padmanabhan Rengasamy

Research Symposium

Congenital heart defects are a known risk factor for early childhood mortality and can be traced to poor maternal health, a crisis plaguing the South Texas region. This perspective research project utilizes previously computed data on the prevalence of ventricular septal defects (VSD) in South Texas region 11 combined with a comprehensive literature review to investigate the correlation between both maternal obesity and diabetes with VSD. Current literature supports a significant association between maternal diabetes and VSD, with one Russian study reporting an eight to nine fold increased risk in VSD in children born to diabetic mothers. By contrast, the …

Acute Heart Failure Secondary To Coxsackie Dilated Cardiomyopathy In An Immunocompetent Adult: A Case Report From A Social Disparities Perspective, Barbara Malaga-Espinoza, Donnel Dockery-Joseph, Jessica Daza, Oscar Lopez, Andres Suarez Parraga

Research Symposium

Introduction: Cardiomyopathies (CM) are defined as myocardial disorders in the absence of coronary artery disease, hypertension, valvular or congenital heart conditions. Dilated CM is characterized by dilation and impaired contraction of one or both ventricles. The prevalence of this condition is underestimated because of variable disease expression and challenging diagnosis. We present the case of an undocumented and immunocompetent patient who debuted with acute heart failure after being exposed to significant environmental stressors.

Case Presentation: A 44-year-old Hispanic gentleman with a history of untreated hypertension presented to the ED with severely persistent left-sided chest pain at rest associated with frontoparietal …

Clinical Variability In Presentation And Management Of Quadricuspid Aortic Valve: A Case Series, Douglas Corsi, Brooke Kelly, Nikta Nair, Meiqi Luo, Brian Osler, Sung-Hae Cho, Praveen Mehrotra, David H Wiener, Drew Johnson

Division of Cardiology Faculty Papers

• Rare presentation of three QAV cases with varied clinical manifestations is reported. • Multimodal imaging is crucial for accurate QAV diagnosis and classification. • QAV is often associated with aortic regurgitation requiring intervention. • Surgical repair is preferred over replacement in suitable patients with QAV. • Long-term follow-up is essential for patients with QAV, even if asymptomatic.