Publications by authors named "Syamkumar Menon"

8 Publications

  • Page 1 of 1

Pulmonary Vein Stenosis After Atrial Fibrillation Ablation: Insights From the ADVICE Trial.

Can J Cardiol 2020 12 3;36(12):1965-1974. Epub 2020 Nov 3.

Montreal Health Innovations Coordinating Center (MHICC), Montreal, Quebec, Canada.

Background: Pulmonary vein (PV) stenosis is a complication of atrial fibrillation (AF) ablation. The incidence of PV stenosis after routine post-ablation imaging remains unclear and is limited to single-centre studies. Our objective was to determine the incidence and predictors of PV stenosis following circumferential radiofrequency ablation in the multicentre Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination (ADVICE) trial.

Methods: Patients with symptomatic AF underwent circumferential radiofrequency ablation in one of 13 trial centres. Computed tomographic (CTA) or magnetic resonance (MRA) angiography was performed before ablation and 90 days after ablation. Two blinded reviewers measured PV diameters and areas. PVs with stenosis were classified as severe (> 70%), moderate (50%-70%), or mild (< 50%). Predictors of PV stenosis were identified by means of multivariable logistic regression.

Results: A total of 197 patients (median age 59.5 years, 29.4% women) were included in this substudy. PV stenosis was identified in 41 patients (20.8%) and 47 (8.2%) of 573 ablated PVs. PV stenosis was classified as mild in 42 PVs (7.3%) and moderate in 5 PVs (0.9%). No PVs had severe stenosis. Both cross-sectional area and diameter yielded similar classifications for severity of PV stenosis. Diabetes was associated with a statistically significant increased risk of PV stenosis (OR 4.91, 95% CI 1.45-16.66).

Conclusions: In the first systematic multicentre evaluation of post-ablation PV stenosis, no patient acquired severe PV stenosis. Although the results are encouraging for the safety of AF ablation, 20.8% of patients had mild or moderate PV stenosis, in which the long-term effects are unknown.
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http://dx.doi.org/10.1016/j.cjca.2020.10.013DOI Listing
December 2020

How to measure blood pressure accurately.

Med J Aust 2020 08 21;213(4):163-165.e1. Epub 2020 Jul 21.

Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

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http://dx.doi.org/10.5694/mja2.50701DOI Listing
August 2020

How much do we need to provoke? Challenges and opportunities in refining the pharmacological tests to unmask Brugada syndrome.

Indian Pacing Electrophysiol J 2017 Jul - Aug;17(4):100-101. Epub 2017 Jul 11.

McMaster University, Hamilton, ON, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.ipej.2017.07.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527822PMC
July 2017

Consistent Inconsistency? Is There Pacemaker Malfunction?

J Cardiovasc Electrophysiol 2016 Jan 29;27(1):131-3. Epub 2015 Aug 29.

Arrhythmia Services, Division of Cardiology, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada.

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http://dx.doi.org/10.1111/jce.12757DOI Listing
January 2016

Device therapy in a patient with a biventricular implantable cardioverter-defibrillator: what is the tachycardia?

Pacing Clin Electrophysiol 2013 Mar 16;36(3):383-5. Epub 2012 Aug 16.

Department of Pacing and Electrophysiology, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.

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http://dx.doi.org/10.1111/j.1540-8159.2012.03493.xDOI Listing
March 2013

Entrainment of supraventricular tachycardia: what is the mechanism?

Heart Rhythm 2011 Nov 9;8(11):1809-11. Epub 2010 Nov 9.

Arrhythmia and Pacing Services, Division of Cardiology, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.

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http://dx.doi.org/10.1016/j.hrthm.2010.11.011DOI Listing
November 2011

Epsilon waves during ventricular tachycardia in a case of arrhythmogenic right ventricular dysplasia.

Circulation 2010 Oct;122(17):1752-5

Arrhythmia Services, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.

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http://dx.doi.org/10.1161/CIRCULATIONAHA.110.959080DOI Listing
October 2010

Device-related infection among patients with pacemakers and implantable defibrillators: incidence, risk factors, and consequences.

J Cardiovasc Electrophysiol 2010 Jul 22;21(7):786-90. Epub 2010 Jan 22.

University of Ottawa Heart Institute, Canada.

Background: Device-related infection is a major limitation of device therapy for cardiac arrhythmia.

Methods: The authors analyzed the incidence and risk factors for cardiac device infection (CDI) among consecutive patients implanted with pacemaker (PM) or implantable cardioverter defibrillator (ICD) (including cardiac resynchronization therapy devices) at a tertiary health center in Hamilton, Ontario, Canada. Most patients with device-related infections were identified by an internal infection control system that reports any positive wound and blood cultures following surgery, between 2005 and the present. A retrospective review of patient records was also performed for all patients who received an ICD or PM between July 1, 2003 and March 20, 2007.

Results: A total of 24 infections were identified among 2,417 patients having device surgery (1%). Fifteen of these infections (60%) were diagnosed within 90 days of the last surgical procedure. Univariate analysis showed that patients presenting with CDI were more likely to have had a device replacement, rather than a new implant, had more complex devices (dual/triple chamber vs single), and were more likely to have had a prior lead dislodgement. Multivariate analysis found device replacement (P = 0.02) and cardiac resynchronization therapy (CRT)/dual-chamber devices (P = 0.048) to be independent predictors of infection. One patient developed septic pulmonary emboli after having laser-assisted lead extraction. No patient died and 22 patients received a new device.

Conclusion: CDI occurs in about 1% of cases in high volume facilities. Pulse generator replacement surgery and dual- or triple-chamber device implantation were associated with a significantly increased risk of infection.
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http://dx.doi.org/10.1111/j.1540-8167.2009.01690.xDOI Listing
July 2010
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