5 results on '"Keith Golden"'
Search Results
2. Using a smartwatch to identify the morphology of atrial flutter
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Keith Golden, Jason R. Foreman, Benzy J. Padanilam, and Asim Ahmed
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Apple Watch ,Telemedicine ,Medical device ,business.industry ,Patient wearables ,fungi ,Atrial fibrillation ,Atrial flutter ,biochemical phenomena, metabolism, and nutrition ,equipment and supplies ,medicine.disease ,Smartwatch ,Ambulatory monitoring ,Feature (computer vision) ,Human–computer interaction ,Image ,medicine ,bacteria ,cardiovascular diseases ,Cardiology and Cardiovascular Medicine ,business - Abstract
The Apple Watch (Apple Inc, Cupertino, CA) is a class II medical device that features an electrocardiogram (ECG) monitoring feature that is primarily used for the detection of atrial fibrillation.1 With the increasing availability of the Apple Watch and other consumer-grade rhythm monitoring devices, identifying the strengths and limitations of utilizing these devices in the clinical setting, particularly during an era of increasing telemedicine, is of vital importance. Here we present a case demonstrating a specific limitation of the Apple Watch in the identification of atrial tachyarrhythmias and provide a solution to resolve this issue.
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- 2020
3. Atrial Fibrillation Ablation Using a Closed Irrigation Radiofrequency Ablation Catheter
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Michael A. Morse, Keith Golden, John Paul Mounsey, Eugene Chung, Ankit Patel, Anil K. Gehi, and Pahresah Roomiani
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medicine.medical_specialty ,business.industry ,Proportional hazards model ,medicine.medical_treatment ,Hazard ratio ,Catheter ablation ,Atrial fibrillation ,General Medicine ,medicine.disease ,Ablation ,Surgery ,Catheter ,Internal medicine ,Cohort ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,Survival analysis - Abstract
Background:Catheter ablation is an effective therapy for symptomatic, medically refractory atrial fibrillation (AF). Open-irrigated radiofrequency (RF) ablation catheters produce transmural lesions at the cost of increased fluid delivery. In vivo models suggest closed-irrigated RF catheters create equivalent lesions, but clinical outcomes are limited. Methods:A cohort of 195 sequential patients with symptomatic AF underwent stepwise AF ablation (AFA) using a closed-irrigation ablation catheter. Recurrence of AF was monitored and outcomes were evaluated using Kaplan–Meier survival analysis and Cox proportional hazards models. Results:Mean age was 59.0 years, 74.9% were male, 56.4% of patients were paroxysmal and mean duration of AF was 5.4 years. Patients had multiple comorbidities including hypertension (76.4%), tobacco abuse (42.1%), diabetes (17.4%), and obesity (mean body mass index 30.8). The median follow-up was 55.8 weeks. Overall event-free survival was 73.6% with one ablation and 77.4% after reablation (reablation rate was 8.7%). Median time to recurrence was 26.9 weeks. AF was more likely to recur in patients being treated with antiarrhythmic therapy at the time of last follow-up (recurrence rate 30.3% with antiarrhythmic drugs, 13.2% without antiarrhythmic drugs; hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.1–4.4, P = 0.024) and in those with a history of AF greater than 2 years duration (HR 2.7, 95% CI 1.1–6.9, P = 0.038). Conclusions:Our study represents the largest cohort of patients receiving AFA with closed-irrigation ablation catheters. We demonstrate comparable outcomes to those previously reported in studies of open-irrigation ablation catheters. Given the theoretical benefits of a closed-irrigation system, a large head-to-head comparison using this catheter is warranted. (PACE 2012; 35:506–513)
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- 2012
4. Association between left ventricular ejection fraction post-cardiac resynchronization treatment and subsequent implantable cardioverter defibrillator therapy for sustained ventricular tachyarrhythmias
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Lee W. Gemma, Keith Golden, Joseph A. Manfredi, Sana M. Al-Khatib, David P. Rardon, Laine Thomas, Linda K. Shaw, Richard I. Fogel, Rosh Vatthyam, Eric N. Prystowsky, and Benzy J. Padanilam
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Male ,medicine.medical_specialty ,Indiana ,medicine.medical_treatment ,Population ,Cardiac resynchronization therapy ,Ventricular tachycardia ,Sudden cardiac death ,Cardiac Resynchronization Therapy ,Electrocardiography ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,education ,Aged ,Retrospective Studies ,Heart Failure ,education.field_of_study ,Ejection fraction ,medicine.diagnostic_test ,business.industry ,Incidence ,Stroke Volume ,Middle Aged ,medicine.disease ,Implantable cardioverter-defibrillator ,Defibrillators, Implantable ,Treatment Outcome ,Heart failure ,cardiovascular system ,Cardiology ,Tachycardia, Ventricular ,Female ,Cardiology and Cardiovascular Medicine ,business ,circulatory and respiratory physiology ,Follow-Up Studies - Abstract
Background— Although cardiac resynchronization therapy (CRT) can improve left ventricular ejection fraction (LVEF), it is not known whether a specific level of improvement will predict future implantable cardioverter defibrillator (ICD) therapy. Methods and Results— CRT-defibrillator (CRT-D) was implanted in 423 patients at 1 institution between October 2, 2001 and January 19, 2007. A retrospective analysis was performed to evaluate the relationship between post–CRT-D LVEF and ICD therapy for ventricular tachyarrhythmias. A landmark population of 270 patients, with post–CRT-D LVEF measured and no ICD therapy within 1 year of device implantation, was followed for subsequent outcomes. Of these, 22 patients (8.2%) had subsequent appropriate ICD therapy over a median follow-up of 1.5 years. The estimated 2-year risk of appropriate ICD therapy is 3.0% (95% confidence interval [95% CI], 0%–6.3%), 2.1% (95% CI, 0%–5.0%), and 1.5% (95% CI, 0%–3.9%) for post–CRT-D LVEF of 45%, 50%, and 55%, respectively. In patients with a primary prevention indication for CRT-D, the estimated 2-year risk is 3.3% (95% CI, 0%–7.3%), 2.5% (95% CI, 0%–6.1%), and 1.9% (95% CI, 0%–5.1%) for post–CRT-D LVEF of 45%, 50%, and 55%, respectively. Conclusions— When a CRT responder demonstrates near normalization in LVEF to ≥45%, the incidence of ICD therapy for ventricular arrhythmias becomes low. Future studies are needed to determine whether an ICD is still needed in some of these patients at the time of generator replacement.
- Published
- 2013
5. The EBC TWO Study (European Bifurcation Coronary TWO):A Randomized Comparison of Provisional T-Stenting Versus a Systematic 2 Stent Culotte Strategy in Large Caliber True Bifurcations
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Andreas Baumbach, Miroslaw Ferenc, Michael Maeng, Yves Louvard, Philippe Brunel, Jens Flensted Lassen, Nicola Skipper, Mark S. Spence, Lorraine Bennett, Didier Carrié, Manuel Pan, Alaide Chieffo, Thierry Lefèvre, Goran Stankovic, David Hildick-Smith, Miles Behan, Thomas Hovasse, Francesco Burzotta, Keith G. Oldroyd, [Hildick-Smith, David] Brighton & Sussex Univ Hosp, Sussex Cardiac Ctr, Brighton, E Sussex, England, [Bennett, Lorraine] Brighton & Sussex Univ Hosp, Sussex Cardiac Ctr, Brighton, E Sussex, England, [Skipper, Nicola] Brighton & Sussex Univ Hosp, Sussex Cardiac Ctr, Brighton, E Sussex, England, [Behan, Miles W.] Edinburgh Heart Ctr, Edinburgh, Midlothian, Scotland, [Lassen, Jens F.] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark, [Maeng, Michael] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark, [Chieffo, Alaide] Ist Sci San Raffaele, Dept Cardiol, Milan, Italy, [Lefevre, Thierry] Hosp Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Massy, France, [Hovasse, Thomas] Hosp Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Massy, France, [Louvard, Yves] Hosp Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Massy, France, [Stankovic, Goran] Clin Ctr Serbia, Dept Cardiol, Belgrade, Serbia, [Stankovic, Goran] Univ Belgrade, Fac Med, Belgrade 11001, Serbia, [Burzotta, Francesco] Univ Cattolica Sacro Cuore, Inst Cardiol, Rome, Italy, [Pan, Manuel] Univ Cordoba, Reina Sofia Hosp, Dept Cardiol, E-14071 Cordoba, Spain, [Ferenc, Miroslaw] Univ Heart Ctr Freiburg, Bad Krozingen, Germany, [Spence, Mark S.] Royal Victoria Hosp, Dept Cardiol, Belfast, Antrim, North Ireland, [Oldroyd, Keith] Golden Jubilee Natl Hosp, Dept Cardiol, Glasgow, Lanark, Scotland, [Brunel, Philippe] Clin Fontaine Les Djon, Dept Cardiol, Dijon, France, [Carrie, Didier] Hop Rangueil, Dept Cardiol, Toulouse, France, [Baumbach, Andreas] Bristol Heart Inst, Bristol, Avon, England, Terumo Europe, and Pie Medical Imaging
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Male ,Time Factors ,Acute coronary syndrome ,confidence interval ,coronary disease ,myocardial infarction ,stent ,Cardiology and Cardiovascular Medicine ,medicine.medical_treatment ,Myocardial Infarction ,Coronary Artery Disease ,Double kissing crush ,030204 cardiovascular system & hematology ,Trial ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,Clinical endpoint ,Prospective Studies ,Everolimus-eluting stent ,Consensus document ,030212 general & internal medicine ,Myocardial infarction ,Hazard ratio ,Middle Aged ,Implantation ,3. Good health ,Europe ,Treatment Outcome ,Impact ,Platelet aggregation inhibitor ,Female ,Stents ,medicine.medical_specialty ,Prosthesis Design ,acute coronary syndrome ,03 medical and health sciences ,Percutaneous Coronary Intervention ,medicine ,Journal Article ,Humans ,Society ,Aged ,business.industry ,Stent ,Percutaneous coronary intervention ,medicine.disease ,Myocardial-infarction ,Surgery ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Lesions ,Old ,business ,Platelet Aggregation Inhibitors - Abstract
Background— For the treatment of coronary bifurcation lesions, a provisional strategy is superior to systematic 2-stent techniques for the most bifurcation lesions. However, complex anatomies with large side branches (SBs) with significant ostial disease length are considered by expert consensus to warrant a 2-stent technique upfront. This consensus view has not been scientifically assessed. Methods and Results— Symptomatic patients with large caliber true bifurcation lesions (SB diameter ≥2.5 mm) and significant ostial disease length (≥5 mm) were randomized to either a provisional T-stent strategy or a dual stent culotte technique. Two hundred patients aged 64±10 years, 82% male, were randomized in 20 European centers. The clinical presentations were stable coronary disease (69%) and acute coronary syndromes (31%). SB stent diameter (2.67±0.27 mm) and length (20.30±5.89 mm) confirmed the extent of SB disease. Procedural success (provisional 97%, culotte 94%) and kissing balloon inflation (provisional 95%, culotte 98%) were high. Sixteen percent of patients in the provisional group underwent T-stenting. The primary end point (a composite of death, myocardial infarction, and target vessel revascularization at 12 months) occurred in 7.7% of the provisional T-stent group versus 10.3% of the culotte group (hazard ratio, 1.02; 95% confidence interval, 0.78–1.34; P =0.53). Procedure time, x-ray dose, and cost all favored the simpler procedure. Conclusions— When treating complex coronary bifurcation lesions with large stenosed SBs, there is no difference between a provisional T-stent strategy and a systematic 2-stent culotte strategy in a composite end point of death, myocardial infarction, and target vessel revascularization at 12 months. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT 01560455.
- Published
- 2016
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