Cardiology Commons^™

Atrioventricular Nodal Reentrant Tachycardia Ablation With A Power-Controlled, Contact-Force Catheter., Chase J Contino, Max Weiss, Michael P Riley, Daniel R Frisch

Division of Cardiology Faculty Papers

Radiofrequency catheter ablation is a safe and effective treatment option for atrioventricular nodal reentrant tachycardia (AVNRT). A nonirrigated ablation catheter used in a temperature-controlled mode is traditionally used for AVNRT ablation due to the shallow lesion depth required for successful slow-pathway ablation. In this case, a nonirrigated ablation catheter established inadequate lesions to ablate the slow pathway successfully. The adoption of an irrigated contact-force ablation catheter used in a power-controlled mode was necessary to provide higher power and possibly create a deeper lesion to ablate the slow pathway successfully, thus eliminating AVNRT inducibility in this patient.

Paclitaxel Exposure: Long-Term Safety And Effectiveness Of A Drug-Coated Balloon For Claudication In Pooled Randomized Trials., Peter A Schneider, Marianne Brodmann, Laura Mauri, John Laird, Yoshimitsu Soga, Antonio Micari, Gary Ansel, Mehdi H Shishehbor, Prakash Krishnan, Qi Gao, Kenneth Ouriel, Thomas Zeller

Heart and Vascular Articles

BACKGROUND: Paclitaxel drug-coated balloons (DCB) prevent recurrent claudication after angioplasty, yet data from randomized trials with incomplete follow-up have raised uncertainty regarding long-term mortality.

OBJECTIVES: To evaluate the effect of paclitaxel exposure on the long-term safety and efficacy of angioplasty of femoropopliteal artery lesions in the combined IN.PACT randomized trials.

METHODS: The IN.PACT randomized trials (SFA, N = 331 and Japan, N = 100) each compared the DCB with standard percutaneous transluminal angioplasty (PTA) for claudication, and consented patients for 5 and 3 years, respectively. To address long-term safety, sites were requested to obtain vital status follow-up. In the pooled, …

The Impact Of Chronic Kidney Disease On Outcomes Following Peripheral Vascular Intervention., Dennis I Narcisse, Elizabeth Hope Weissler, Jennifer A Rymer, Ehrin J Armstrong, Eric A Secemsky, William A Gray, Jihad A Mustapha, George L Adams, Gary M Ansel, Manesh R Patel, William Schuyler Jones

Heart and Vascular Articles

BACKGROUND: Patients with chronic kidney disease (CKD) have worsened clinical outcomes following percutaneous coronary intervention; however, limited evidence exists in patients undergoing peripheral vascular intervention (PVI).

PURPOSE: We aimed to assess the effect of CKD on outcomes following PVI for symptomatic peripheral artery disease.

METHODS: Using patients from the LIBERTY 360 study, we compared the rates of 30 day and 1 year major adverse vascular events (MAVE), a composite of all-cause mortality, major amputation, and target vessel/lesion revascularization, between patients with and without CKD (estimated glomular filtration rate less than 60) following PVI. Multivariable adjustment was performed to assess for …

Air Pollution And Non Communicable Diseases, Zafar Fatmi, Shafaq Mahmood, Zainab Samad, Mohammad Wasay

Community Health Sciences

No abstract provided.

Pr Depression With Multilead St Elevation And St Depression In Avr By Left Circumflex Artery Occlusion: How To Differentiate From Acute Pericarditis, Zhong-Qun Zhan, Kjell Nikus, Yochai Birnbaum

Faculty, Staff and Students Publications

PR-segment depression with multilead ST-segment elevation and ST-segment depression in lead aVR are classic ECG manifestation of acute pericarditis. We present a patient, where the etiology of these ECG features was acute ST-elevation myocardial infarction due to left circumflex artery occlusion. To avoid misdiagnosis, unnecessary examinations, and inappropriate therapeutic decisions, the possibility of ST-segment elevation myocardial infarction should be kept in mind even when ECG changes typical for pericarditis are encountered in chest pain patients. Findings of QRS widening and QT interval shortening in leads with ST-segment elevation could help to differentiate acute ST-segment elevation myocardial infarction from acute pericarditis.

Comparison Of The Performance Of The Ncdr Cathpci Score And Mehran Score To Predict Acute Kidney Injury Post-Percutaneous Coronary Intervention, Michelle Nguyen, S. Mustajab Hasan, Steven Quach, Sai Guduru, Faisal Rahim, Aiham Albaeni, Khalid Abusaada

HCA Healthcare Journal of Medicine

Background: A comparison of acute kindney injury (AKI) post-percutaneous coronary intervention (PCI) prediction models is lacking. In this study, we aim to compare the National Cardiovascular Data Registry (NCDR) CathPCI score to the Mehran score in acute coronary syndrome (ACS) vs non-ACS patients.

Methods: We included patients who received PCI at our facility between July 2015 and December 2017. We excluded patients without a pre- and/or post-PCI serum creatinine, patients on dialysis at the time of PCI and patients with missing variables required to calculate the predictive scoring model. The primary outcome of this study was AKI post-PCI. Performance of …

Safety And Efficacy Of Soluble Guanylate Cyclase Stimulators In Patients With Heart Failure: A Systematic Review And Meta-Analysis., Waqas Ullah, Maryam Mukhtar, Aws Al-Mukhtar, Rehan Saeed, Margot Boigon, Donald Haas, Eduardo. Rame

Abington Jefferson Health Papers

BACKGROUND: The utility of novel oral soluble guanylate cyclase (sGC) stimulators (vericiguat and riociguat), in patients with reduced or preserved ejection fraction heart failure (HFrEF/HFpEF) is currently unclear.

AIM: To determine the efficacy and safety of sGC stimulators in HF patients.

METHODS: Multiple databases were searched to identify relevant randomized controlled trials (RCTs). Data on the safety and efficacy of sGC stimulators were compared using relative risk ratio (RR) on a random effect model.

RESULTS: Six RCTs, comprising 5604 patients (2801 in sGC stimulator group and 2803 placebo group) were included. The primary endpoint (a composite of cardiovascular mortality and …

Impact Of A Social Support Program Supervised By A Multidisciplinary Team On Psychosocial Distress And Knowledge About Heart Failure Among Heart Failure Patients, Muhammad Adil Soofi, Zainab Jafery, Faisal Alsamadi

Journal of the Saudi Heart Association

ABSTRACT:

Background: Heart failure drains significant financial resources with morbidity and mortality higher than cancer. Social support is defined as the care provided by the family members, friends and health care workers to the patients. Absence of social support and poor perceived social support will create stress, anxiety, depression and anger which further deteriorate the underlying disease and worsen quality of life. Discussion in group creates better understanding of the disease which helps the patients improving their skills in managing their condition.

Objective: To evaluate the impact of multidisciplinary team supervised social support program on components of psychosocial distress and …

The Difficult Clinical Decision Of Thrombolytic Therapy For Submassive Pulmonary Embolism In A Community Hospital., Qian Zhang, Jonathan Vayalumkal, John Ricely, Daniel L. Gray, Ahmad Raza

Abington Jefferson Health Papers

Submassive or intermediate-risk pulmonary embolism (PE) occurs when an acute PE episode is associated with radiographic evidence of right heart strain without hemodynamic instability. Further risk stratification is important in determining whether systemic thrombolytic therapy should be administered when weighing the risks and benefits. It includes the risk of death from acute PE versus the risk of bleeding. This decision could be further complicated in institutions where there is a lack of complete therapeutic options, which increases the importance of the expertise of a pulmonologist or an intensivist to decide whether rescue reperfusion is needed. We describe the case of …

Comparing Trimetazidine With Allopurinol In Prevention Of Contrast Induced Nephropathy After Coronary Angiography, Haitham Galal, Mahmoud Shehta, Sameh Attia, Islam Bastawy

Journal of the Saudi Heart Association

Objectives: Contrast-induced nephropathy is considered a serious complication following coronary angiography increasing morbidity and mortality. Various drugs have been assessed to reduce the incidence of contrast-induced nephropathy. In this study, we compared trimetazidine and allopurinol as a pharmacological measure to reduce the incidence of contrast-induced nephropathy.

Methods: One hundred and twenty patients undergoing coronary angiography with baseline creatinine clearance more than 30 ml/minute were divided into three groups, 40 patients each. Group 1 received standard parenteral intravenous hydration in the form of isotonic saline at a rate of 1 ml/kg body weight per hour started 12 hours before angiography and …

Conference Proceedings: Aurora Scientific Day 2020

Journal of Patient-Centered Research and Reviews

Abstracts published in this supplement were among those presented at the 46th annual Aurora Scientific Day research symposium, held virtually on May 20, 2020. The symposium provides a forum for describing research studies conducted by faculty, fellows, residents, and allied health professionals affiliated with Wisconsin-based Aurora Health Care, a part of the Advocate Aurora Health health system, which publishes the Journal of Patient-Centered Research and Reviews.

Identifying Genetic Factors That Contribute To The Increased Risk Of Congenital Heart Defects In Infants With Down Syndrome., Cristina E. Trevino, Aaron M. Holleman, Holly Corbitt, Cheryl L. Maslen, Tracie C. Rosser, David J. Cutler, H Richard Johnston, Benjamin L. Rambo-Martin, Jai Oberoi, Kenneth J. Dooley, George T. Capone, Roger H. Reeves, Heather J. Cordell, Bernard D. Keavney, A J Agopian, Elizabeth Goldmuntz, Peter J. Gruber, James O'Brien, Douglas C. Bittel, Lalita Wadhwa, Clifford L. Cua, Jennifer G. Mulle, Michael P. Epstein, Stephanie L. Sherman, Michael E. Zwick

Manuscripts, Articles, Book Chapters and Other Papers

Atrioventricular septal defects (AVSD) are a severe congenital heart defect present in individuals with Down syndrome (DS) at a > 2000-fold increased prevalence compared to the general population. This study aimed to identify risk-associated genes and pathways and to examine a potential polygenic contribution to AVSD in DS. We analyzed a total cohort of 702 individuals with DS with or without AVSD, with genomic data from whole exome sequencing, whole genome sequencing, and/or array-based imputation. We utilized sequence kernel association testing and polygenic risk score (PRS) methods to examine rare and common variants. Our findings suggest that the Notch pathway, particularly …

Ischemic And Bleeding Events Associated With Thrombocytopenia And Thrombocytosis After Percutaneous Coronary Intervention In Patients With Acute Myocardial Infarction, Ji Woong Roh, Sungmin Lim, Youngdeok Hwang, Kwan Yong Lee, Eun Ho Choo, Ik Jun Choi, Byung-Lee Hwang, Chan Joon Kim, Mahn-Won Park, Dong-Bin Kim, Jong-Min Lee, Chul Soo Park, Hee-Yeol Kim, Ki-Dong Yoo, Doo Soo Jeon, Ho Joong Youn, Wook Sung Chung, Min Chul Kim, Myung Ho Jeong, Youngkeun Ahn, Kiyuk Chang

Publications and Research

The early and late ischemic and bleeding clinical outcomes according to baseline platelet count after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) remain unclear. Overall, 10,667 patients from the Cardiovascular Risk and identification of potential high-risk population in AMI (COREA-AMI) I and II registries were classified according to the following universal criteria on baseline platelet counts: (1) moderate to severe thrombocytopenia (platelet < 100 K/µL, n = 101), (2) mild thrombocytopenia (platelet = 100~149 K/µL, n = 631), (3) normal reference (platelet = 150~450 K/µL, n = 9832), and (4) thrombocytosis (platelet > 450 K/µL, n = 103). The primary endpoint was the occurrence of major adverse cardiovascular events (MACE). The secondary outcome was Bleeding Academic Research Consortium (BARC) 2, 3, and 5 bleeding. After adjusting for …

Nondietary Cardiovascular Health Metrics With Patient Experience And Loss Of Productivity Among Us Adults Without Cardiovascular Disease: The Medical Expenditure Panel Survey 2006 To 2015, Martin Tibuakuu, Victor Okunrintemi, Nazir Savji, Neil J. Stone, Salim S. Virani, Ron Blankstein, Ritu Thamman, Roger S. Blumenthal, Erin D. Michos

Office of the Provost

Background: The American Heart Association 2020 Impact Goals aimed to promote population health through emphasis on cardiovascular health (CVH). We examined the association between nondietary CVH metrics and patient-reported outcomes among a nationally representative sample of US adults without cardiovascular disease.
Methods and Results: We included adults aged ≥18 years who participated in the Medical Expenditure Panel Survey between 2006 and 2015. CVH metrics were scored 1 point for each of the following: not smoking, being physically active, normal body mass index, no hypertension, no diabetes mellitus, and no dyslipidemia, or 0 points if otherwise. Diet was not assessed in …

Concurrent Primary Cardiac Tumors In A High Risk Patient Presenting With Tamponade, Joseph B. Zackary Md, Lauren Crowley Ba, Shawn M. Quinn Do, Timothy S. Misselbeck

Department of Emergency Medicine

No abstract provided.

Transcatheter Aortic Valve Implantation: Bahrain Experience, Nooraldaem Yousif, Suddharsan Subbramaniyam, Babu Thevan, Mohammad Amin, Leena Sulaibikh, Nazar Bukamal, Habib Tareif, Sadananda Shivappa, Haitham Amin, Husam A. Noor

Journal of the Saudi Heart Association

STRUCTURED ABSTRACT

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure that is considered a good alternative to surgical aortic valve replacement (sAVR) in selected patients. Our aim is to determine the baseline, procedural characteristics and one-year clinical outcomes of our TAVI registry.

METHODS: This study is a retrospective observational analysis of a prospectively designed cohort comprising 81 consecutive patients treated at Mohammed bin Khalifa Cardiac Centre (MKCC) who were enrolled in Bahrain TAVI registry from February 2014 to February 2019. The clinical endpoints were defined according to the updated Valve Academic Research Consortium-2 (VARC-2) consensus document.

RESULTS: …

Analysis Of Covid-19 Burden, Epidemiology And Mitigation Strategies In Muslim Majority Countries, Rachel Jardine, James Wright, Zainab Samad, Zulfiqar Ahmed Bhutta

Section of Cardiology

Background: Muslim majority countries have experienced a considerable burden of COVID-19 infection. However, there has been a relative lack of research comparing COVID-19 outbreaks and responses between Muslim-majority countries.
Aims: This study aimed to analyse COVID-19 burden, epidemiology and mitigation strategies in Muslim-majority countries.
Methods: We use a mixed-methods approach to describe the course of the COVID-19 pandemic throughout the Islamic world, highlight the range of non-pharmaceutical interventions used and the speed with which they were implemented, and investigate reasons behind the differing responses between Muslim-majority countries. The number of cases and deaths per million population, and the mean time …

Survival Analysis Based On The Duration Of Cpr After In-Hospital Cardiac Arrest, Ahmad Raza, Nayab Nadeem, Ahmad Arslan, Zain Ali, Qian Zhang, Usama Sadiq, Rajesh Patel

Abington Jefferson Health Papers

No abstract provided.

Transcutaneous Energy Transmission: Can We Do It Now?, Yuriy Pya

The VAD Journal

The percutaneous driveline used in contemporary LVADs presents a continuous risk of infection for the duration of support. Minimizing infection in durable mechanical circulatory support systems requires total implantation of all components and energy transfer by means other than percutaneous drivelines. A novel coplanar energy transfer (CET) system, similar to the original transcutaneous energy transfer (TET) design, is unique by incorporating two large rings with coil-within-the-coil topology to ensure strong resonance power. The CET system consists of an internal integrated controller, a battery coupled with an internal thoracic coil ring, and the LVAD pump. External equipment includes a power transmission …

Liposomal Delivery Of Azithromycin Enhances Its Immunotherapeutic Efficacy And Reduces Toxicity In Myocardial Infarction, Ahmed Al-Darraji, Renée R. Donahue, Himi Tripathi, Hsuan Peng, Bryana M. Levitan, Lakshman Chelvarajan, Dalia Haydar, Erhe Gao, David Henson, John C. Gensel, David J. Feola, Vincent J. Venditto, Ahmed K. Abdel-Latif

Gill Heart & Vascular Institute Faculty Publications

A growing body of evidence shows that altering the inflammatory response by alternative macrophage polarization is protective against complications related to acute myocardial infarction (MI). We have previously shown that oral azithromycin (AZM), initiated prior to MI, reduces inflammation and its negative sequelae on the myocardium. Here, we investigated the immunomodulatory role of a liposomal AZM formulation (L-AZM) in a clinically relevant model to enhance its therapeutic potency and avoid off-target effects. L-AZM (40 or 10 mg/kg, IV) was administered immediately post-MI and compared to free AZM (F-AZM). L-AZM reduced cardiac toxicity and associated mortality by 50% in mice. We …