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5. Nationwide Trends in Hospitalizations for Atrial Fibrillation and Flutter in the United States before and during the Outbreak of the COVID-19 Pandemic.

Author

Daoudi, Sarah, John, Kevin, Chalhoub, Fadi, Chee, Jennifer, Infeld, Margaret, Elbaz-Greener, Gabby, Homoud, Munther, Ruskin, Jeremy N., Heist, E. Kevin, Madias, Christopher, Udelson, James, and Rozen, Guy

Subjects
COVID-19 pandemic, ACUTE coronary syndrome, CORONARY disease, ATRIAL fibrillation, ATRIAL arrhythmias, ATRIAL flutter
Abstract

Background/Objectives: Atrial fibrillation (AF) and flutter (AFL) are the most common cardiac arrhythmias worldwide. Cardiovascular complications are a common manifestation of acute and post-acute COVID-19 infection. We aimed to analyze the nationwide trends in clinical characteristics and outcomes of patients hospitalized for AF/AFL before and during the COVID-19 outbreak in the U.S. Methods: This study is a retrospective analysis of patients, aged 18 and older, hospitalized for AF/AFL in the U.S. between 2016 and 2020. We drew data from the National Inpatient Sample (NIS) database. Baseline sociodemographic and clinical data, as well as outcomes including stroke, acute coronary syndrome (ACS), and mortality, were analyzed. Multivariable analysis was performed to identify independent associations between the different clinical and demographic characteristics and the composite endpoint of Mortality/ACS/Stroke. Results: An estimated total of 2,163,699 hospitalizations for AF/AFL were identified. The hospitalization volume between 2016 and 2019 was stable, averaging 465,176 a year, followed by a significant drop to 302,995 in 2020. Patients' median age was 72 years (IQR 62–80), 50.9% were male, and 81.5% were white. The composite endpoint steadily increased from 6.5% in 2016 to 11.8% in 2020 (Ptrend < 0.001). In a multivariable regression analysis, age > 75 (OR: 1.35; 95% CI 1.304–1.399, p < 0.001), ischemic heart disease (OR: 1.466; 95% CI: 1.451–1.481; p < 0.001), and chronic kidney disease (OR: 1.635; 95% CI: 1.616–1.653; p < 0.001) were associated with the composite endpoint. COVID-19 was associated with the composite endpoint outcome in the year 2020 (OR: 1.147; 95% CI: 1.037–1.265; p = 0.007). Conclusions: Hospitalization for AF/AFL dropped significantly during the first year of the COVID-19 pandemic outbreak, possibly due to patients' avoidance of hospital visits. The composite endpoint of Mortality/ACS/Stroke uptrended significantly during the study period. COVID-19 was shown to be independently associated with the adverse composite outcome Mortality/ACS/Stroke. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Abstract P2046: The Role Of A Novel Alpha-crystallin B Chain Variant In Hypertrophic Cardiomyopathy

Author

Chou, Chun, primary, Martin, Gregory, additional, Perera, Gayani, additional, Awata, Junya, additional, Blanton, Robert M, additional, Cao, Xuehong, additional, Tripp, Audrey, additional, Phan, Tina, additional, Alissa, Abdullah, additional, Aljuaid, Mossab, additional, Madias, Christopher, additional, Homoud, Munther, additional, Galper, Jonas B, additional, and Chin, Michael T, additional

Published
2023
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10. Single‐ Versus Dual‐Chamber Implantable Cardioverter‐Defibrillator for Primary Prevention of Sudden Cardiac Death in the United States

Author

Margolis, Gilad, primary, Hamuda, Nashed, additional, Kobo, Ofer, additional, Elbaz Greener, Gabby, additional, Amir, Offer, additional, Homoud, Munther, additional, Madias, Christopher, additional, Heist, Edwin Kevin, additional, Ruskin, Jeremy N., additional, Kazatsker, Mark, additional, Roguin, Ariel, additional, Leshem, Eran, additional, and Rozen, Guy, additional

Published
2023
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17. Early-Onset Complete Atrioventricular Block – Prevalence, Etiology and Utilization of Cardiac Implantable Electronic Devices

Author

Margolis, Gilad, primary, Chee, Jennifer, additional, Kazatsker, Mark, additional, Roguin, Ariel, additional, Madias, Christopher, additional, Homoud, Munther, additional, Kobo, Ofer, additional, Hamuda, Nashed, additional, Dimri, Inon, additional, Heist, E.Kevin, additional, Ruskin, Jeremy N., additional, Leshem, Eran, additional, and Rozen, Guy, additional

Published
2023
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33. Abstract 12234: Is Maintenance of a Subcutaneous Implantable Cardioverter-Defibrillator a Feasible Option in Hypertrophic Cardiomyopathy Patients With Left Bundle Branch Block After Septal Myectomy?

Author

Narayanan, Chockalingam, primary, Shrestha, Srijan, additional, Gionfriddo, William, additional, Weinstock, Jonathan, additional, Homoud, Munther, additional, Maron, Barry, additional, Maron, Martin S, additional, Rowin, Ethan J, additional, Garlitski, Ann, additional, and Madias, Christopher, additional

Published
2021
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34. Abstract 12221: Reduction of Inappropriate Shocks Over Time in Hypertrophic Cardiomyopathy Patients With Subcutaneous Implantable Cardioverter-Defibrillators

Author

Narayanan, Chockalingam, primary, Gionfriddo, William, additional, Shrestha, Srijan, additional, Koethe, Benjamin, additional, Katcher, Benjamin, additional, Garlitski, Ann, additional, Weinstock, Jonathan, additional, Homoud, Munther, additional, Maron, Barry, additional, Maron, Martin S, additional, Rowin, Ethan J, additional, and Madias, Christopher, additional

Published
2021
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35. Abstract 9615: Predictors of Impedance During Subcutaneous ICD Defibrillation Testing in Hypertrophic Cardiomyopathy

Author

Narayanan, Chockalingam A, primary, Shrestha, Srijan, additional, Gionfriddo, William, additional, Koethe, Benjamin, additional, Katcher, Benjamin, additional, Garlitski, Ann, additional, Weinstock, Jonathan, additional, Homoud, Munther, additional, Maron, Barry, additional, Maron, Martin S, additional, Rowin, Ethan J, additional, and Madias, Christopher, additional

Published
2021
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36. Impact of comorbidities on atrial fibrillation and sudden cardiac death in hypertrophic cardiomyopathy.

Author

Sridharan, Aadhavi, Maron, Martin S., Carrick, Richard T., Madias, Christopher A., Huang, Dou, Cooper, Craig, Drummond, Jennifer, Maron, Barry J., and Rowin, Ethan J.

Subjects
STATISTICS, CARDIAC hypertrophy, MULTIVARIATE analysis, ATRIAL fibrillation, CARDIAC arrest, DESCRIPTIVE statistics, BODY mass index, COMORBIDITY
Abstract

Background: The impact of comorbid disease states on the development of atrial and ventricular arrhythmias in patients with hypertrophic cardiomyopathy (HCM) remains unresolved. Objective: Evaluate the association of comorbidities linked to arrhythmias in other cardiovascular diseases (e.g., obesity, systemic hypertension, diabetes, obstructive sleep apnea, renal disorders, tobacco, and alcohol use) to atrial fibrillation (AF) and sudden cardiac death (SCD) events in a large cohort of HCM patients. Methods: A total of 2269 patients, 54 ± 15 years of age, 1392 males, were evaluated at the Tufts HCM Institute between 2004 and 2018 and followed for an average of 4 ± 3 years for new‐onset clinical AF and SCD events (appropriate defibrillation for ventricular tachyarrhythmias, resuscitated cardiac arrest, or SCD). Results: One or more comorbidity was present in 75% of HCM patients, including 50% with ≥2 comorbidities, most commonly obesity (body mass index [BMI] ≥ 30 kg/m2) in 43%. New‐onset atrial fibrillation developed in 11% of our cohort (2.6%/year). On univariate analysis, obesity was associated with a 1.7‐fold increased risk for AF (p =.03) with 12% of obese patients developing AF (3.3%/year) as compared to 7% of patients with BMI < 25 kg/m2 (1.6%/year; p =.006). On multivariate analysis, age and LA transverse dimension emerged as the only variables predictive of AF. Comorbidities, including obesity, were not independently associated with AF development (p >.10 for each). SCD events occurred in 3.3% of patients (0.8%/year) and neither obesity nor other comorbidities were associated with increased risk for SCD (p >.10 for each). Conclusions: In adult HCM patients comorbidities do not appear to impact AF or SCD risk. Therefore, for most patients with HCM, adverse disease related events of AF and SCD appear to be primarily driven by underlying left ventricular and atrial myopathy as opposed to comorbidities. [ABSTRACT FROM AUTHOR]

Published
2022
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37. The State of the Art

Author

Morin, Daniel P., Bernard, Michael L., Madias, Christopher, Rogers, Paul A., Thihalolipavan, Sudarone, and Estes, N.A. Mark

Abstract

As the most common sustained arrhythmia in adults, atrial fibrillation (AF) is an established and growing epidemic. To provide optimal patient care, it is important for clinicians to be aware of AF's epidemiological trends, methods of risk reduction, and the various available treatment modalities. Our understanding of AF's pathophysiology has advanced, and with this new understanding has come advancements in prevention strategies as well as pharmacological and nonpharmacological treatment options. Following PubMed and MEDLINE searches for AF risk factors, epidemiology, and therapies, we reviewed relevant articles (and bibliographies of those articles) published from 2000 to 2016. This “state-of-the-art” review provides a comprehensive update on the understanding of AF in the world today, contemporary therapeutic options, and directions of ongoing and future study.

Published
2024
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38. Abstract 12214: Characterization of Iatrogenic Left Bundle Branch Block After Septal Myectomy for Hypertrophic Cardiomyopathy

Author

Gionfriddo, William, Gionfriddo, William, Burrows, Austin, Narayanan, Chockalingam, Shrestha, Srijan, Rastegar, Hassan, Garlitski, Ann, Weinstock, Jonathan, Homoud, Munther, Rowin, Ethan J, Maron, Martin S, Maron, Barry, and Madias, Christopher

Abstract

Introduction:LBBB results in impaired transseptal conduction and delayed posterolateral LV activation. Criteria for left bundle branch block (LBBB) vary across scientific organizations. Septal myectomy for hypertrophic cardiomyopathy (HCM) could serve as an iatrogenic anatomic model to characterize LBBB.Objective:To describe ECG features of LBBB after septal myectomy for HCM.Methods:ECG data were analyzed for 377 HCM patients (204 male) who developed post-operative LBBB after extended septal myectomy between 2004-2018.Results:Average age of the cohort at myectomy was 53 ± 14 years. Baseline QRS duration (QRSd) was 94 ± 10ms. The post myectomy QRSd was 152 ± 15ms, consistent with an average ΔQRSd of 58 ± 13ms. There was positive correlation between pre and post myectomy QRSd (r = 0.485; p < 0.0001). The average LV end-diastolic diameter (LVEDd) pre and 2 months post myectomy was 40 ± 5.6mm and 46.2 ± 6.5mm, respectively. Positive correlation between post myectomy QRSd and post myectomy LVEDd was also observed (r = 0.340; p < 0.0001). Females and males had pre myectomy QRSd of 93 ± 10ms and 95 ± 10ms respectively (p = 0.007) and post myectomy QRSd of 147 ± 13ms (120-184ms) and 157 ± 14ms (126-209ms) respectively (p < 0.0001). ΔQRSd was less in females than males (54 ± 13ms vs. 62 ± 11ms; p<0.0001). Only 13 females and 3 males had post myectomy QRSd < 130ms. Only 23 males had QRSd < 140ms.Conclusions:Surgical myectomy serves as a model to characterize LBBB. Following myectomy, QRSd correlated with LVEDd as well as pre-myectomy QRSd, and was longer in males due to delayed depolarization of larger hearts in men. Notably only 3 males and a minority of females had QRSd < 130ms. These data provide important insights for the validation of electrocardiographic LBBB criteria.

Published
2021
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40. SEX DIFFERENCES IN CARDIAC SARCOIDOSIS TREATMENT AND OUTCOMES: FINDINGS FROM THE CARDIAC SARCOIDOSIS CONSORTIUM.

Author

Manhil, Dhuha, Crawford, Thomas C., Bogun, Frank M., Gu, Xiaokui, Chicos, Alexandru B., Roukoz, Henri, Zimetbaum, Peter J., Murgatroyd, Francis D., Rosenfeld, Lynda E., Soejima, Kyoko, Bhan, Adarsh K., Vedantham, Vasanth, Dickfeld, Timm-Michael L., De Lurgio, David B., Platonov, Pyotr G., Narasimhan, Calambur, Patton, Kristen K., Rosenthal, David, MUKERJI, SIDDHARTH S., and Madias, Christopher

Subjects
*SARCOIDOSIS
Published
2024
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