Search Our Scientific Publications & Authors

Heart Rhythm O2 2021 Feb 22;2(1):53-63. Epub 2020 Nov 22.

Harrington Heart and Vascular Institute/University Hospitals Cleveland Medical Center/Case Western Reserve University, Cleveland, Ohio.

Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF).

Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF.

Methods: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016-17 Nationwide Readmissions Database. Read More

Heart Rhythm O2 2020 Dec 3;1(5):317-323. Epub 2020 Oct 3.

Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada.

Background: High-power short-duration (HPSD) ablation has been explored for pulmonary vein isolation. Early data suggest similar efficacy with shorter procedure times and perhaps greater safety. Data are lacking on the use of this ablation strategy for other arrhythmias. Read More

Heart Rhythm O2 2020 Oct 24;1(4):268-274. Epub 2020 Jun 24.

Department of Cardiovascular Medicine, Kyorin University Hospital, Tokyo, Japan.

Background: The incidence of pericardial effusion (PE) during radiofrequency catheter ablation (CA) for atrial fibrillation is approximately 1%. PE is a major complication during CA, but there has been limited literature about the perforation site responsible.

Objective: This study aimed to retrospectively investigate the characteristics of the procedure and the patients in whom PE developed during CA. Read More

Heart Rhythm O2 2020 Jun 12;1(2):96-102. Epub 2020 May 12.

Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, California.

Background: Obesity is associated with a higher incidence of atrial fibrillation (AF). Weight reduction improves outcomes in patients known to have AF.

Objective: The purpose of this study was to compare the incidence of heart failure (HF) or first-time AF hospitalization in obese patients undergoing bariatric surgery (BAS) vs other abdominal surgeries. Read More

J Am Coll Cardiol 2021 Jun;77(23):2875-2886

Population Health Research Institute, Hamilton, Ontario, Canada; Hamilton Health Sciences Centre, Hamilton, Ontario, Canada; Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address:

Background: The prevalence of left atrial (LA) thrombus in patients with atrial fibrillation (AF) or atrial flutter (AFL) on guideline-directed anticoagulation is not well known, yet this may inform transesophageal echocardiogram (TEE) use before cardioversion or catheter ablation.

Objectives: The purpose of this study was to quantify LA thrombus prevalence among patients with AF/AFL on guideline-directed anticoagulation and to identify high-risk subgroups.

Methods: EMBASE, MEDLINE, and CENTRAL were systematically searched from inception to July 2020 for studies reporting on LA thrombus prevalence among patients with AF/AFL undergoing TEE following at least 3 weeks of continuous therapeutic oral anticoagulation with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs). Read More

Front Neurol 2021 24;12:668180. Epub 2021 May 24.

Department of Neurology, Mayo Clinic, Rochester, MN, United States.

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common muscular dystrophies and predominantly affects facial and shoulder girdle muscles. Previous case reports and cohort studies identified minor cardiac abnormalities in FSHD patients, but their nature and frequency remain incompletely characterized. We reviewed cardiac, neurological and genetic findings of 104 patients with genetically confirmed FSHD. Read More

Clin Res Cardiol 2021 Jun 9. Epub 2021 Jun 9.

Department of Electrophysiology, University Heart Center Lübeck, Medical Clinic II, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany.

Aim: To compare patient characteristics, safety and efficacy of catheter ablation of supraventricular tachycardia (SVT) in patients with and without structural heart disease (SHD) enrolled in the German ablation registry.

Methods And Results: From January 2007 until January 2010, a total of 12,536 patients (37.2% with known SHD) were enrolled and followed for at least one year. Read More

Front Cardiovasc Med 2021 21;8:664647. Epub 2021 May 21.

Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy.

Catheter ablation has become a well-established indication for long-term rhythm control in atrial fibrillation (AF) patients refractory to anti-arrhythmic drugs (AADs). Efficacy and safety of AF catheter ablation (AFCA) before AADs failure are, instead, questioned. The aim of the study was to perform a systematic review and meta-analysis of randomized clinical trials (RCTs) comparing first-line AFCA with AADs in symptomatic patients with paroxysmal AF. Read More

Tex Heart Inst J 2021 06;48(2)

Department of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania.

Flecainide, a widely prescribed class IC agent used to treat atrial arrhythmias, can in rare cases cause 1:1 atrial flutter with rapid conduction. We describe the case of a 59-year-old man who was on a maintenance regimen of flecainide for refractory atrial fibrillation. When 1:1 atrial flutter with rapid conduction developed, emergency medical technicians attempted synchronized cardioversion, which caused ventricular fibrillation necessitating defibrillation. Read More

J Am Soc Echocardiogr 2021 May 31. Epub 2021 May 31.

Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Pacing Clin Electrophysiol 2021 Jun 3. Epub 2021 Jun 3.

Cardiology Institute of Espirito Santo.

Background:  Atrial fibrillation (AF) ablation is alternative treatment to medical therapy. Most feared complication is atrioesophageal fistula METHODS: : Observational, retrospective analysis of consecutive 355 patients undergoing first AF ablation. Low-power long-duration (LPLD) group contained 158 patients, with 121 (76. Read More

Clin Ther 2021 May 30. Epub 2021 May 30.

Department of Pharmacy, Brigham and Women's Hospital, Boston, Massachusetts.

Purpose: Cardiac surgery patients frequently require anticoagulation. Warfarin remains the preferred agent, and a few trials have reported negative outcomes with the use of direct-acting oral anticoagulants (DOACs) in these patients. Therefore, limited literature exists that supports the dosing, safety, and efficacy of DOACs within the cardiac surgery population. Read More

JAMA 2021 06;325(21):2160-2168

Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.

Importance: The relative rates of detection of atrial fibrillation (AF) or atrial flutter from evaluating patients with prolonged electrocardiographic monitoring with an external loop recorder or implantable loop recorder after an ischemic stroke are unknown.

Objective: To determine, in patients with a recent ischemic stroke, whether 12 months of implantable loop recorder monitoring detects more occurrences of AF compared with conventional external loop recorder monitoring for 30 days.

Design, Setting, And Participants: Investigator-initiated, open-label, randomized clinical trial conducted at 2 university hospitals and 1 community hospital in Alberta, Canada, including 300 patients within 6 months of ischemic stroke and without known AF from May 2015 through November 2017; final follow-up was in December 2018. Read More

Indian Pacing Electrophysiol J 2021 May 24. Epub 2021 May 24.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.

Endomyocardial fibrosis (EMF) is characterized by fibrous tissue deposition on the endocardial surface leading to impaired filling of one or both ventricles, resulting in either right or left heart failure or both. Although Sinus node dysfunction and tachyarrhythmia - atrial fibrillation, ventricular tachycardia, have been commonly reported, complete heart block (CHB) necessitating a pacemaker is rare in EMF. Transvenous pacing is technically limited by fibrotic obliteration of the affected ventricle that results in poor lead parameters, and alternative pacing strategy like epicardial pacing may be required in many. Read More

J Cardiovasc Electrophysiol 2021 May 26. Epub 2021 May 26.

Ablacon, Inc., Wheat Ridge, Colorado, USA.

Aims: Electrographic flow (EGF) mapping is a method to detect action potential sources within the atria. In a double-blinded retrospective study we evaluated whether sources detected by EGF are related to procedural outcome.

Methods: EGF maps were retrospectively generated using the Ablamap® software from unipolar data recorded with a 64-pole basket catheter from patients who previously underwent focal impulse and rotor modulation-guided ablation. Read More

J Cardiovasc Electrophysiol 2021 May 26. Epub 2021 May 26.

Division of Cardiology, Jean Monnet University, Saint-Etienne, France.

Background: Only few studies have been performed that explore the electrophysiological differences between clockwise (CW) and counterclockwise (CCW) right atrial (RA) cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) using the high-resolution Rhythmia mapping system.

Objectives: We sought to compare CW and CCW CTI-dependent AFL in pure right AFL patients (pts) using the ultra-high-definition (ultra-HD) Rhythmia mapping system and we mathematically developed a cartography model based on automatic velocity RA measurements to identify electrophysiological AFL specificities.

Methods And Results: Thirty-three pts were recruited. Read More

JACC Case Rep 2021 Feb 13;3(2):206-211. Epub 2021 Jan 13.

Division of Cardiology, Department of Pediatrics, University of California, San Francisco, California, USA.

Unguarded mitral valve orifice is a rare disease with only 7 described cases in the literature. We describe the first known case of unguarded mitral valve orifice with normal segmental cardiac anatomy, severe left ventricular dilatation and dysfunction, aortic atresia, and atrial flutter. (). Read More

CJC Open 2021 May 13;3(5):609-618. Epub 2021 Jan 13.

Department of Medicine, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.

Background: Whether advances in identification and management of atrial fibrillation and atrial flutter (collectively, AF) have led to improved outcomes is unclear. We sought to study trends in clinical outcomes selected as quality indicators for nonvalvular AF in Canada.

Methods: We identified hospitalized patients with a first diagnosis of nonvalvular AF between April 2006 and March 2015, in all of Canada except Quebec. Read More

J Innov Card Rhythm Manag 2021 May 15;12(5):4526-4531. Epub 2021 May 15.

Division of Cardiovascular Medicine, Department of Medicine, University of Toledo, Toledo, OH, USA.

As a known phenomenon, crossover between sinus node dysfunction and common atrial tachyarrhythmias-most notably, atrial fibrillation and atrial flutter-in older individuals has previously been seen. Here, we present one of the first case series demonstrating a similar relationship between sinus node dysfunction and much rarer etiologies of tachyarrhythmia-that is, postural tachycardia syndrome and inappropriate sinus tachycardia. The exact pathological mechanisms behind these arrhythmias as well as the observation of concurrent nodal dysfunction are poorly understood. Read More

Am Heart J 2021 May 22. Epub 2021 May 22.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.

Background: Clinical trials are a fundamental tool to evaluate medical interventions but are time-consuming and resource-intensive.

Objectives: To build infrastructure for digital trials to improve efficiency and generalizability and test it using a study to validate an artificial intelligence (AI) algorithm to detect atrial fibrillation (AF).

Design: We will prospectively enroll 1,000 patients who underwent an ECG for any clinical reason in routine practice, do not have a previous diagnosis of AF or atrial flutter, and would be eligible for anticoagulation if AF is detected. Read More

Heart Rhythm 2021 May 21. Epub 2021 May 21.

The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Background: Mortality in single ventricle cohorts remains high with multiple associated factors. The effect of heart block during stage I palliation remains unclear.

Objectives: To study patient and surgical risks for heart block and its effect on transplant-free 12-month survival in single ventricle patients. Read More

Cardiol Ther 2021 May 24. Epub 2021 May 24.

Department of Cardiology, Herzzentrum Segeberger Kliniken GmbH, Am Kurpark 1, 23795, Bad Segeberg, Schleswig-Holstein, Germany.

Introduction: Available data on management of atrial flutter in the early postoperative setting after cardiac surgery are scarce. We aimed to investigate the safety and efficacy (profile) of flutter ablation in the early postoperative phase (30 days after cardiac surgery) in a cohort of 47 consecutive patients.

Methods: Between 2007 and 2016, 47 patients who underwent ablation for postoperative typical atrial flutter were retrospectively identified and analyzed. Read More

J Cardiovasc Electrophysiol 2021 May 24. Epub 2021 May 24.

Duke University Medical Center, Durham, NC, USA.

Background: Paroxysmal supraventricular tachycardia (PSVT) encompasses a range of heart rhythm disorders leading to rapid heart rates. By virtue of its episodic nature, diagnosing PSVT is difficult, and estimating incidence and prevalence on a population level is challenging. The objective of this study was to estimate the incidence and prevalence of PSVT in the United States (US) in contemporary practice. Read More

Eur Heart J Case Rep 2021 May 17;5(5):ytab152. Epub 2021 May 17.

Department of Thoracic and Cardiovascular Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-0801, Japan.

Background: Isolated coronary sinus atrial septal defect (CSASD) is a rare congenital cardiac anomaly, comprising <1% of atrial septal defects. Elderly patients with this anomaly are even more uncommon and sometimes overlooked.

Case Summary: A 73-year-old man with a history of electrical defibrillation therapy for atrial flutter presented with worsening exertional dyspnoea. Read More

Echocardiography 2021 May 21. Epub 2021 May 21.

Kocaeli University Faculty of Medicine Department of Pediatric Hematology, Kocaeli, Turkey.

We report isolated extramedullary relapse in a 14-year-old boy, sequentially presenting with intestinal and cardiac myeloid sarcoma (MS). Acute myeloblastic leukemia M5 was diagnosed 41 months ago. On the 14th month of the second HSCT, he presented with ileus and underwent surgical treatment. Read More

JACC Clin Electrophysiol 2021 05;7(5):591-593

Division of Cardiology, Department of Medicine, Weill Cornell Medical Center, New York, New York, USA. Electronic address:

J Am Coll Cardiol 2021 May 4. Epub 2021 May 4.

Penn State University Heart and Vascular Institute, Penn State University College of Medicine, Hershey, Pa.

J Am Coll Cardiol 2021 May 4. Epub 2021 May 4.

Department of Cardiology (CVK), and Berlin Institute of Health Center for Regenerative Therapies, German Centre for Cardiovascular Research Partner Site Berlin, Charité Universitätsmedizin, Berlin, Germany.

Background: Patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) are at risk of atrial fibrillation or flutter (AFF) due to cardiac remodeling and kidney complications. Finerenone, a novel, selective, nonsteroidal mineralocorticoid receptor antagonist, inhibited cardiac remodeling in preclinical models.

Objectives: To examine the effect of finerenone on new-onset AFF and cardiorenal effects by history of AFF in FIDELIO-DKD. Read More

Drug Saf 2021 May 20. Epub 2021 May 20.

Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health+ Care Institute, Boston, MA, USA.

Introduction: There have been reports of clinically relevant uterine bleeding events among women of reproductive age exposed to rivaroxaban.

Objective: The aim of this study was to compare the risk of severe abnormal uterine bleeding (SAUB) resulting in transfusion or surgical intervention among women on rivaroxaban versus apixaban, dabigatran and warfarin.

Methods: We conducted a retrospective cohort study in the FDA's Sentinel System (10/2010-09/2015) among females aged 18+ years with venous thromboembolism (VTE), or atrial flutter/fibrillation (AF) who newly initiated a direct oral anticoagulant (DOAC; rivaroxaban, apixaban, dabigatran) or warfarin. Read More

J Interv Card Electrophysiol 2021 May 19. Epub 2021 May 19.

Department of Cardiology and Intensive Care, Peter Osypka Heart Center Munich, Hospital Munich South, Am Isarkanal 36, 81379, Munich, Germany.