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52. A novel tool for arrhythmic risk stratification in desmoplakin gene variant carriers

Author

Electrofysiologie, Genetica Sectie Genoomdiagnostiek, Circulatory Health, Genetica Groep Van Tintelen, Child Health, Team Medisch, Carrick, Richard T, Gasperetti, Alessio, Protonotarios, Alexandros, Murray, Brittney, Laredo, Mikael, van der Schaaf, Iris, Dooijes, Dennis, Syrris, Petros, Cannie, Douglas, Tichnell, Crystal, Gilotra, Nisha A, Cappelletto, Chiara, Medo, Kristen, Saguner, Ardan M, Duru, Firat, Hylind, Robyn J, Abrams, Dominic J, Lakdawala, Neal K, Cadrin-Tourigny, Julia, Targetti, Mattia, Olivotto, Iacopo, Graziosi, Maddalena, Cox, Moniek, Biagini, Elena, Charron, Philippe, Compagnucci, Paolo, Casella, Michela, Conte, Giulio, Tondo, Claudio, Yazdani, Momina, Ware, James S, Prasad, Sanjay K, Calò, Leonardo, Smith, Eric D, Helms, Adam S, Hespe, Sophie, Ingles, Jodie, Tandri, Harikrishna, Ader, Flavie, Peretto, Giovanni, Peters, Stacey, Horton, Ari, Yao, Jessica, Schulze-Bahr, Eric, Dittman, Sven, Carruth, Eric D, Young, Katelyn, Qureshi, Maria, Haggerty, Chris, Parikh, Victoria N, Taylor, Matthew, Mestroni, Luisa, Wilde, Arthur, Sinagra, Gianfranco, Merlo, Marco, Gandjbakhch, Estelle, van Tintelen, J Peter, Te Riele, Anneline S J M, Elliot, Perry, Calkins, Hugh, Wu, Katherine C, James, Cynthia A, Electrofysiologie, Genetica Sectie Genoomdiagnostiek, Circulatory Health, Genetica Groep Van Tintelen, Child Health, Team Medisch, Carrick, Richard T, Gasperetti, Alessio, Protonotarios, Alexandros, Murray, Brittney, Laredo, Mikael, van der Schaaf, Iris, Dooijes, Dennis, Syrris, Petros, Cannie, Douglas, Tichnell, Crystal, Gilotra, Nisha A, Cappelletto, Chiara, Medo, Kristen, Saguner, Ardan M, Duru, Firat, Hylind, Robyn J, Abrams, Dominic J, Lakdawala, Neal K, Cadrin-Tourigny, Julia, Targetti, Mattia, Olivotto, Iacopo, Graziosi, Maddalena, Cox, Moniek, Biagini, Elena, Charron, Philippe, Compagnucci, Paolo, Casella, Michela, Conte, Giulio, Tondo, Claudio, Yazdani, Momina, Ware, James S, Prasad, Sanjay K, Calò, Leonardo, Smith, Eric D, Helms, Adam S, Hespe, Sophie, Ingles, Jodie, Tandri, Harikrishna, Ader, Flavie, Peretto, Giovanni, Peters, Stacey, Horton, Ari, Yao, Jessica, Schulze-Bahr, Eric, Dittman, Sven, Carruth, Eric D, Young, Katelyn, Qureshi, Maria, Haggerty, Chris, Parikh, Victoria N, Taylor, Matthew, Mestroni, Luisa, Wilde, Arthur, Sinagra, Gianfranco, Merlo, Marco, Gandjbakhch, Estelle, van Tintelen, J Peter, Te Riele, Anneline S J M, Elliot, Perry, Calkins, Hugh, Wu, Katherine C, and James, Cynthia A

Published
2024

53. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Arts Assistenten Cardiologie, Genetica Groep Van Tintelen, Cancer, Child Health, Circulatory Health, Team Onderzoek, Carrick, Richard T, De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P, Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A M, Davies, Brianna, Seifer, Colette, Roberts, Jason D, Healey, Jeff S, MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J, Targetti, Mattia, Calò, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K, Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E, Di Marco, Andrea, Jordà, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Delinière, Antoine, Biernacka, Elżbieta K, van Tintelen, J Peter, Platonov, Pyotr G, Olivotto, Iacopo, Saguner, Ardan M, Haugaa, Kristina H, Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D, Te Riele, Anneline S J M, Wu, Katherine C, Calkins, Hugh, James, Cynthia A, Cadrin-Tourigny, Julia, Arts Assistenten Cardiologie, Genetica Groep Van Tintelen, Cancer, Child Health, Circulatory Health, Team Onderzoek, Carrick, Richard T, De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P, Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A M, Davies, Brianna, Seifer, Colette, Roberts, Jason D, Healey, Jeff S, MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J, Targetti, Mattia, Calò, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K, Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E, Di Marco, Andrea, Jordà, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Delinière, Antoine, Biernacka, Elżbieta K, van Tintelen, J Peter, Platonov, Pyotr G, Olivotto, Iacopo, Saguner, Ardan M, Haugaa, Kristina H, Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D, Te Riele, Anneline S J M, Wu, Katherine C, Calkins, Hugh, James, Cynthia A, and Cadrin-Tourigny, Julia

Published
2024

54. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Carrick, Richard T., De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P., Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A. M., Davies, Brianna, Seifer, Colette, Roberts, Jason D., Healey, Jeff S., MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J., Targetti, Mattia, Calo, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K., Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E., Di Marco, Andrea, Jorda, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Deliniere, Antoine, Biernacka, Elzbieta K., van Tintelen, J. Peter, Platonov, Pyotr G., Olivotto, Iacopo, Saguner, Ardan M., Haugaa, Kristina H., Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D., te Riele, Anneline S. J. M., Wu, Katherine C., Calkins, Hugh, James, Cynthia A., Cadrin-Tourigny, Julia, Carrick, Richard T., De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P., Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A. M., Davies, Brianna, Seifer, Colette, Roberts, Jason D., Healey, Jeff S., MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J., Targetti, Mattia, Calo, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K., Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E., Di Marco, Andrea, Jorda, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Deliniere, Antoine, Biernacka, Elzbieta K., van Tintelen, J. Peter, Platonov, Pyotr G., Olivotto, Iacopo, Saguner, Ardan M., Haugaa, Kristina H., Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D., te Riele, Anneline S. J. M., Wu, Katherine C., Calkins, Hugh, James, Cynthia A., and Cadrin-Tourigny, Julia

Abstract

Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs., Funding Agencies|Leonie-Wild Foundation; Leyla Erkan Family Fund for ARVD Research; Hugh Calkins, Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center; Dr Francis P. Chiaramonte Private Foundation; Dr Satish, Rupal, and Robin Shah ARVD Fund at Johns Hopkins; Bogle Foundation; Campanella Family; Patrick J. Harrison Family; Peter French Memorial Foundation; ALF foundation; Wilmerding Endowments; NIH [T32HL007227]; NIH Loan Repayment Program [L30HL165535]; Philippa and Marvin Carsley Cardiology Research Chair; Montreal Heart Institute Foundation; Norwegian Research Council [309762, 288438, 298736]; ZonMW Off Road personal research grant; Dutch Heart Association; Netherlands Cardiovascular Research Initiative - Dutch Heart Foundation [2018-30 PREDICT2]; Dutch Heart Foundation; Netherlands Heart Institute [06901]; Georg and Bertha Schwyzer-Winiker Foundation; Baugarten Foundation; Swiss National Science Foundation; Swiss Heart Foundation; USZ Foundation; Daniel Bravo Foundation; Spanish Society of Cardiology; Sociedad Espanola de Cardiologia; Swedish Heart Lung Foundation

Published
2024
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55. Long-Term Arrhythmic Follow-Up and Risk Stratification of Patients With Desmoplakin-Associated Arrhythmogenic Right Ventricular Cardiomyopathy

Author

Team Onderzoek, Circulatory Health, Genetica, Genetica Groep Van Tintelen, Cancer, Child Health, Gasperetti, Alessio, Carrick, Richard, Protonotarios, Alexandros, Laredo, Mikael, van der Schaaf, Iris, Syrris, Petros, Murray, Brittney, Tichnell, Crystal, Cappelletto, Chiara, Gigli, Marta, Medo, Kristen, Crabtree, Peter, Saguner, Ardan M., Duru, Firat, Hylind, Robyn, Abrams, Dominic, Lakdawala, Neal K., Massie, Charles, Cadrin-Tourigny, Julia, Targetti, Mattia, Olivotto, Iacopo, Graziosi, Maddalena, Cox, Moniek, Biagini, Elena, Charron, Philippe, Casella, Michela, Tondo, Claudio, Yazdani, Momina, Ware, James S., Prasad, Sanjay, Calò, Leonardo, Smith, Eric, Helms, Adam, Hespe, Sophie, Ingles, Jodie, Tandri, Harikrishna, Ader, Flavie, Mestroni, Luisa, Wilde, Arthur, Merlo, Marco, Gandjbakhch, Estelle, Calkins, Hugh, te Riele, Anneline S.J.M., Peter van Tintelen, J., Elliot, Perry, James, Cynthia A., Team Onderzoek, Circulatory Health, Genetica, Genetica Groep Van Tintelen, Cancer, Child Health, Gasperetti, Alessio, Carrick, Richard, Protonotarios, Alexandros, Laredo, Mikael, van der Schaaf, Iris, Syrris, Petros, Murray, Brittney, Tichnell, Crystal, Cappelletto, Chiara, Gigli, Marta, Medo, Kristen, Crabtree, Peter, Saguner, Ardan M., Duru, Firat, Hylind, Robyn, Abrams, Dominic, Lakdawala, Neal K., Massie, Charles, Cadrin-Tourigny, Julia, Targetti, Mattia, Olivotto, Iacopo, Graziosi, Maddalena, Cox, Moniek, Biagini, Elena, Charron, Philippe, Casella, Michela, Tondo, Claudio, Yazdani, Momina, Ware, James S., Prasad, Sanjay, Calò, Leonardo, Smith, Eric, Helms, Adam, Hespe, Sophie, Ingles, Jodie, Tandri, Harikrishna, Ader, Flavie, Mestroni, Luisa, Wilde, Arthur, Merlo, Marco, Gandjbakhch, Estelle, Calkins, Hugh, te Riele, Anneline S.J.M., Peter van Tintelen, J., Elliot, Perry, and James, Cynthia A.

Published
2024

57. Abstract 10565: Personalized Virtual Heart Approach Representing Fatty Infiltration (inFAT) in Arrhythmogenic Right Ventricular (RV) Cardiomyopathy (ARVC) Predicts Ventricular Arrhythmia (VA) Reentrant Circuits and Ablation Targets: A Pilot Study

Author

Zhang, Yingnan, Prakosa, Adityo, Sung, Eric, Gasperetti, Alessio, Carrick, Richard, James, Cynthia, Zimmerman, Stefan, Tichnell, Crystal, Murray, Brittney, Calkins, Hugh G, Tandri, Harikrishna S, and Trayanova, Natalia

Published
2022
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58. Abstract 10034: Novel Late-Gadolinium Enhanced Cardiac Magnetic Resonance (LGE-CMR)-Based Computational Heart Paradigm Predicts Optimal Ventricular Tachycardia (VT) Ablation Targets in Arrhythmogenic Right Ventricular (RV) Cardiomyopathy (ARVC)

Author

Zhang, Yingnan, Prakosa, Adityo, Sung, Eric, Gasperetti, Alessio, Carrick, Richard, James, Cynthia, Zimmerman, Stefan, Tichnell, Crystal, Murray, Brittney, Calkins, Hugh G, Tandri, Harikrishna S, and Trayanova, Natalia

Published
2022
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68. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Carrick, Richard T, primary, De Marco, Corrado, additional, Gasperetti, Alessio, additional, Bosman, Laurens P, additional, Gourraud, Jean-Baptiste, additional, Trancuccio, Alessandro, additional, Mazzanti, Andrea, additional, Murray, Brittney, additional, Pendleton, Catherine, additional, Tichnell, Crystal, additional, Tandri, Harikrishna, additional, Zeppenfeld, Katja, additional, Wilde, Arthur A M, additional, Davies, Brianna, additional, Seifer, Colette, additional, Roberts, Jason D, additional, Healey, Jeff S, additional, MacIntyre, Ciorsti, additional, Alqarawi, Wael, additional, Tadros, Rafik, additional, Cutler, Michael J, additional, Targetti, Mattia, additional, Calò, Leonardo, additional, Vitali, Francesco, additional, Bertini, Matteo, additional, Compagnucci, Paolo, additional, Casella, Michela, additional, Dello Russo, Antonio, additional, Cappelletto, Chiara, additional, De Luca, Antonio, additional, Stolfo, Davide, additional, Duru, Firat, additional, Jensen, Henrik K, additional, Svensson, Anneli, additional, Dahlberg, Pia, additional, Hasselberg, Nina E, additional, Di Marco, Andrea, additional, Jordà, Paloma, additional, Arbelo, Elena, additional, Moreno Weidmann, Zoraida, additional, Borowiec, Karolina, additional, Delinière, Antoine, additional, Biernacka, Elżbieta K, additional, van Tintelen, J Peter, additional, Platonov, Pyotr G, additional, Olivotto, Iacopo, additional, Saguner, Ardan M, additional, Haugaa, Kristina H, additional, Cox, Moniek, additional, Tondo, Claudio, additional, Merlo, Marco, additional, Krahn, Andrew D, additional, te Riele, Anneline S J M, additional, Wu, Katherine C, additional, Calkins, Hugh, additional, James, Cynthia A, additional, and Cadrin-Tourigny, Julia, additional

Published
2024
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69. Catheter ablation of ventricular tachycardia: Lessons learned from past clinical trials and implications for future clinical trials

Author

Pokorney, Sean D, Friedman, Daniel J, Calkins, Hugh, Callans, David J, Daoud, Emile G, Della-Bella, Paolo, Jackson, Kevin P, Shivkumar, Kalyanam, Saba, Samir, Sapp, John, Stevenson, William G, and Al-Khatib, Sana M

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Clinical Trials and Supportive Activities, Patient Safety, Heart Disease, Cardiovascular, Rare Diseases, Clinical Research, Good Health and Well Being, Catheter Ablation, Clinical Trials as Topic, Humans, Recurrence, Tachycardia, Ventricular, Ventricular tachycardia, Catheter ablation, Implantable cardioverter-defibrillator, Clinical trials, Appropriate shock, Antitachycardia pacing, Mortality, Biomedical Engineering, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

Catheter ablation of ventricular tachycardia (VT) has evolved in recent years, especially in patients with ischemic heart disease. Data from prospective studies show that VT catheter ablation reduces the risk of recurrent VT; however, there is a paucity of data on the effect of VT catheter ablation on mortality and patient-centered outcomes such as quality of life. Performing randomized clinical trials of VT catheter ablation can be fraught with challenges, and, as a result, several prior trials of VT catheter ablation had to be stopped prematurely. The main challenges are inability to blind the patient to therapy to obtain a traditional control group, high crossover rates between the 2 arms of the study, patient refusal to participate in trials in which they have an equal chance of receiving a "pill" vs an invasive procedure, heterogeneity of mapping and ablation techniques as well as catheters and equipment, rapid evolution of technology that may make findings of any long trial less relevant to clinical practice, lack of consensus on what constitutes acute procedural and long-term success, and presentation of patients to electrophysiologists late in the course of their disease. In this article, a panel of experts on VT catheter ablation and/or clinical trials of VT catheter ablation review challenges faced in conducting prior trials of VT catheter ablation and offer potential solutions for those challenges. It is hoped that the proposed solutions will enhance the feasibility of randomized clinical trials of VT catheter ablation.

Published
2016

75. 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy: Executive summary

Author

Towbin, Jeffrey A., McKenna, William J., Abrams, Dominic J., Ackerman, Michael J., Calkins, Hugh, Darrieux, Francisco C.C., Daubert, James P., de Chillou, Christian, DePasquale, Eugene C., Desai, Milind Y., Estes, N.A. Mark, III, Hua, Wei, Indik, Julia H., Ingles, Jodie, James, Cynthia A., John, Roy M., Judge, Daniel P., Keegan, Roberto, Krahn, Andrew D., Link, Mark S., Marcus, Frank I., McLeod, Christopher J., Mestroni, Luisa, Priori, Silvia G., Saffitz, Jeffrey E., Sanatani, Shubhayan, Shimizu, Wataru, van Tintelen, J. Peter, Wilde, Arthur A.M., and Zareba, Wojciech

Published
2019
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78. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society

Author

January, Craig T., Wann, L. Samuel, Calkins, Hugh, Chen, Lin Y., Cigarroa, Joaquin E., Cleveland, Joseph C., Jr., Ellinor, Patrick T., Ezekowitz, Michael D., Field, Michael E., Furie, Karen L., Heidenreich, Paul A., Murray, Katherine T., Shea, Julie B., Tracy, Cynthia M., and Yancy, Clyde W.

Published
2019
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86. Pulmonary Vein Isolation With or Without Left Atrial Appendage Ligation in Atrial Fibrillation: The aMAZE Randomized Clinical Trial.

Author

Lakkireddy, Dhanunjaya R., Wilber, David J., Mittal, Suneet, Tschopp, David, Ellis, Christopher R., Rasekh, Abdi, Hounshell, Troy, Evonich, Rudy, Chandhok, Sheetal, Berger, Ronald D., Horton, Rodney, Hoskins, Michael H., Calkins, Hugh, Yakubov, Steven J., Simons, Pamela, Saville, Benjamin R., and Lee, Randall J.

Subjects
PULMONARY veins, LEFT heart atrium, ATRIAL fibrillation, LEFT atrial appendage closure, CLINICAL trials, P-waves (Electrocardiography)
Abstract

Key Points: Question: Does left atrial appendage ligation improve catheter ablation treatment of nonparoxysmal atrial fibrillation? Findings: In this randomized clinical trial of 610 adults, primary effectiveness was based on freedom from atrial arrhythmias at 12 months and was not statistically different between those receiving percutaneous left atrial appendage ligation adjunctive to pulmonary vein isolation and pulmonary vein isolation alone (64.3% vs 59.9%; difference, 4.3% [bayesian 95% credible interval, −4.2% to 13.2%]). Primary safety was met, with a 30-day serious adverse event rate of 3.4%. At 12 months after pulmonary vein isolation, there was complete closure in 84% of patients who underwent left atrial appendage, and 99% had less than or equal to 5 mm of residual communication with the left atrium. Meaning: Percutaneous left atrial appendage ligation adjunctive to pulmonary vein isolation met prespecified safety criteria, but did not meet prespecified efficacy criteria for freedom from atrial arrhythmias at 12 months compared with pulmonary vein isolation alone. Importance: Left atrial appendage elimination may improve catheter ablation outcomes for atrial fibrillation. Objective: To assess the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to catheter pulmonary vein isolation for nonparoxysmal atrial fibrillation. Design, Setting, and Participants: This multicenter, prospective, open-label, randomized clinical trial evaluated the safety and effectiveness of percutaneous left atrial appendage ligation adjunctive to planned pulmonary vein isolation for nonparoxysmal atrial fibrillation present for less than 3 years. Eligible patients were randomized in a 2:1 ratio to undergo left atrial appendage ligation and pulmonary vein isolation or pulmonary vein isolation alone. Use of a 2:1 randomization ratio was intended to provide more device experience and safety data. Patients were enrolled from October 2015 to December 2019 at 53 US sites, with the final follow-up visit on April 21, 2021. Interventions: Left atrial appendage ligation plus pulmonary vein isolation compared with pulmonary vein isolation alone. Main Outcomes and Measures: A bayesian adaptive analysis was used for primary end points. Primary effectiveness was freedom from documented atrial arrythmias of greater than 30 seconds duration 12 months after undergoing pulmonary vein isolation. Rhythm was assessed by Holter monitoring at 6 and 12 months after pulmonary vein isolation, symptomatic event monitoring, or any electrocardiographic tracing obtained through 12 months after pulmonary vein isolation. Primary safety was a composite of predefined serious adverse events compared with a prespecified 10% performance goal 30 days after the procedure. Left atrial appendage closure was evaluated through 12 months after pulmonary vein isolation. Results: Overall, 404 patients were randomized to undergo left atrial appendage ligation plus pulmonary vein isolation and 206 were randomized to undergo pulmonary vein isolation alone. Primary effectiveness was 64.3% with left atrial appendage ligation and pulmonary vein isolation and 59.9% with pulmonary vein isolation only (difference, 4.3% [bayesian 95% credible interval, −4.2% to 13.2%]; posterior superiority probability, 0.835), which did not meet the statistical criterion to establish superiority (0.977). Primary safety was met, with a 30-day serious adverse event rate of 3.4% (bayesian 95% credible interval, 2.0% to 5.0%; posterior probability, 1.0) which was less than the prespecified threshold of 10%. At 12 months after pulmonary vein isolation, complete left atrial appendage closure (0 mm residual communication) was observed in 84% of patients and less than or equal to 5 mm residual communication was observed in 99% of patients. Conclusions and Relevance: Percutaneous left atrial appendage ligation adjunctive to pulmonary vein isolation did not meet prespecified efficacy criteria for freedom from atrial arrhythmias at 12 months compared with pulmonary vein isolation alone for patients with nonparoxysmal atrial fibrillation, but met prespecified safety criteria and demonstrated high rates of closure at 12 months. Trial Registration: ClinicalTrials.gov Identifier: NCT02513797 This multicenter randomized clinical trial examines the effectiveness and safety of left atrial appendage ligation plus pulmonary vein isolation for nonparoxysmal atrial fibrillation treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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89. Pericarditis After Catheter Ablation for Atrial Fibrillation

Author

Yadav, Ritu, primary, Satti, Danish Iltaf, additional, Malwankar, Jui, additional, Lopez-Silva, Carolina, additional, Xu, Lilian, additional, Liebow-Feeser, Elana, additional, Akhtar, Tauseef, additional, Marine, Joseph E., additional, Berger, Ronald, additional, Calkins, Hugh, additional, and Spragg, David, additional

Published
2023
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91. Predicting ventricular tachycardia circuits in patients with arrhythmogenic right ventricular cardiomyopathy using genotype-specific heart digital twins

Author

Zhang, Yingnan, primary, Zhang, Kelly, additional, Prakosa, Adityo, additional, James, Cynthia, additional, Zimmerman, Stefan L, additional, Carrick, Richard, additional, Sung, Eric, additional, Gasperetti, Alessio, additional, Tichnell, Crystal, additional, Murray, Brittney, additional, Calkins, Hugh, additional, and Trayanova, Natalia A, additional

Published
2023
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92. Author Response: Predicting ventricular tachycardia circuits in patients with arrhythmogenic right ventricular cardiomyopathy using genotype-specific heart digital twins

Author

Zhang, Yingnan, primary, Zhang, Kelly, additional, Prakosa, Adityo, additional, James, Cynthia, additional, Zimmerman, Stefan L, additional, Carrick, Richard, additional, Sung, Eric, additional, Gasperetti, Alessio, additional, Tichnell, Crystal, additional, Murray, Brittney, additional, Calkins, Hugh, additional, and Trayanova, Natalia A, additional

Published
2023
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