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10. Inter‐atrial septal balloon dilation to facilitate intracardiac echocardiography guided left atrial appendage occlusion.

Author

Goyal, Sandeep K., Bhimani, Ashish A., Kella, Danesh K., Tyagi, Anahita, Polsani, Venkateshwar, and Deering, Thomas F.

Subjects
PREDICTIVE tests, ATRIAL septum, PATIENT safety, SCIENTIFIC observation, COMPUTED tomography, CATHETERIZATION, TREATMENT duration, TREATMENT effectiveness, RETROSPECTIVE studies, LONGITUDINAL method, CASE-control method, LEFT atrial appendage closure, ECHOCARDIOGRAPHY, TIME, FLUOROSCOPY
Abstract

Introduction: Percutaneous left atrial appendage occlusion (LAAO) is traditionally performed under general anesthesia with trans‐esophageal echocardiography guidance. Intracardiac echo (ICE)‐guided LAAO closure is increasing in clinical use. The ICE catheter is crossed into LA via interatrial septum (IAS) after the septum is dilated with LAAO delivery sheath. This step can be time‐consuming and requires significant ICE catheter manipulation, which increases the risk of cardiac perforation. Pre‐emptive septal balloon dilation can potentially help with ICE advancement in the LA. We sought to evaluate the effect of pre‐dilation of the IAS with an 8 mm balloon on the ease of crossing the ICE catheter, fluoroscopy time for crossing, and overall procedure time. Methods: The Piedmont LAAO registry was used to identify consecutive patients who underwent LAAO. The initial 25 patients in whom balloon dilation of the IAS was performed served as the experimental cohort, and the 25 consecutive patients before that in whom balloon dilation was not performed served as controls. In the experimental group, after a trans‐septal puncture, the sheath was retracted to the right atrium with a guidewire still in the LA. An 8 × 40 mm Evercoss™ over the wire balloon was inflated across the IAS. The ICE catheter was then crossed into the LA using the fluoroscopic landmark of the guide wire and the ICE imaging. The sheath was then advanced along the ICE catheter via the transseptal puncture (TSP) and the procedure continued. Follow‐up compputed tomography imaging was obtained at 4–8 weeks. Results: Each group consisted of 25 patients. There were no significant differences in baseline characteristics. All procedures were performed successfully under conscious sedation and ICE guidance. There was a significant reduction in the overall procedure time, fluoroscopy time, and time for transseptal puncture to ICE in LA. There was no difference in the size of the acute residual interatrial shunt, as measured via ICE, or the size and presence of iatrogenic ASD at follow‐up. Conclusion: Balloon dilation of TSP is safe and is associated with increased efficiency in ICE‐guided LAAO procedures. [ABSTRACT FROM AUTHOR]

Published
2024
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11. Rationale, considerations, and goals for atrial fibrillation centers of excellence: A Heart Rhythm Society perspective

Author

Piccini, Jonathan P., Sr, Allred, James, Bunch, T. Jared, Deering, Thomas F., Di Biase, Luigi, Hussein, Ayman A., Lewis, William R., Mittal, Suneet, Natale, Andrea, Osorio, Jose, Packer, Douglas L., Ruff, Christian, Russo, Andrea M., Sanders, Prashanthan, Seiler, Amber, Slotwiner, David, Hills, Mellanie True, Turakhia, Mintu P., Van Gelder, Isabelle C., Varosy, Paul D., Verma, Atul, Volgman, Annabelle S., Wood, Kathryn A., and Deneke, Thomas

Published
2020
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12. Guidance for rebooting electrophysiology through the COVID-19 pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology: Endorsed by the American College of Cardiology

Author

Lakkireddy, Dhanunjaya R., Chung, Mina K., Deering, Thomas F., Gopinathannair, Rakesh, Albert, Christine M., Epstein, Laurence M., Harding, Clifford V., Hurwitz, Jodie L., Jeffery, Courtney C., Krahn, Andrew D., Kusumoto, Fred M., Lampert, Rachel, Mansour, Moussa, Natale, Andrea, Patton, Kristen K., Seiler, Amber, Shah, Maully J., Wang, Paul J., and Russo, Andrea M.

Published
2020
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13. Atrial fibrillation ablation in heart failure patients: Where do we stand in 2023? – State of the art review

Author

Deering, Thomas F., primary, Goyal, Sandeep K., additional, Bhimani, Ashish A., additional, Hoosien, Michael, additional, Karimianpour, Ahmadreza, additional, Krishnasamy, Kavita P., additional, Nilsson, Kent R., additional, Omar, Abdullah, additional, Lakkireddy, Dhanunjaya, additional, Gopinathannair, Rakesh, additional, Katapadi, Aashish, additional, and Sohns, Christian, additional

Published
2023
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24. Atrial fibrillation ablation in heart failure patients: Where do we stand in 2023? – State of the art review.

Author

Deering, Thomas F., Goyal, Sandeep K., Bhimani, Ashish A., Hoosien, Michael, Karimianpour, Ahmadreza, Krishnasamy, Kavita P., Nilsson, Kent R., Omar, Abdullah, Lakkireddy, Dhanunjaya, Gopinathannair, Rakesh, Katapadi, Aashish, and Sohns, Christian

Subjects
*ATRIAL fibrillation, *CATHETER ablation, *INFORMATION storage & retrieval systems, *HEART failure, *DISEASE management
Abstract

Atrial fibrillation (AF) and heart failure are common overlapping cardiovascular disorders. Despite important therapeutic advances over the past several decades, controversy persists about whether a rate control or rhythm control approach constitutes the best option in this population. There is also considerable debate about whether antiarrhythmic drug therapy or ablation is the best approach when rhythm control is pursued. A brief historical examination of the literature addressing this issue will be performed. An analysis of several important clinical outcomes observed in the prospective, randomized studies, which have compared AF ablation to non‐ablation treatment options, will be discussed. This review will conclude with recommendations to guide clinicians on the status of AF ablation as a treatment option when considering management options in heart failure patients with atrial fibrillation. [ABSTRACT FROM AUTHOR]

Published
2024
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25. Heart Rhythm Society Quality Improvement Committee update

Author

Deering, Thomas F., Catanzaro, John N., Sandhu, Roopinder K., Singleton, Matthew, Das, Srikant, Deyell, Marc W., Mulpuru, Siva K., Magnelli-Reyes, Christina L., Koplan, Bruce A., Vergara, Gaston R., Austin, Christopher, Assis, Fabrizio R., Xiang, Kun, Moore, Michelle, and Smith, Anne Marie

Published
2024
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27. Guidance for Rebooting Electrophysiology Through the COVID-19 Pandemic From the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

Author

Lakkireddy, Dhanunjaya R., Chung, Mina K., Deering, Thomas F., Gopinathannair, Rakesh, Albert, Christine M., Epstein, Laurence M., Harding, Clifford V., Hurwitz, Jodie L., Jeffery, Courtney C., Krahn, Andrew D., Kusumoto, Fred M., Lampert, Rachel, Mansour, Moussa, Natale, Andrea, Patton, Kristen K., Seiler, Amber, Shah, Maully J., Wang, Paul J., and Russo, Andrea M.

Published
2020
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30. PO-05-050 BIOLOGIC CARDIOVASCULAR ELECTRONIC DEVICE ENVELOPES ENHANCE POCKET HEALING AND SIMPLIFY REOPERATIVE PROCEDURES

Author

Catanzaro, John, primary, Bilchick, Kenneth C., additional, Christopher, Thomas J., additional, Dsouza, Benjamin, additional, ISSA, ZIAD F., additional, Nekkanti, Rajasekhar, additional, Phan, Huy M., additional, Sangosanya, Afolabi O., additional, Vora, Aaditya M., additional, Yarmohammadi, Hirad, additional, and Deering, Thomas F., additional

Published
2023
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31. Device-detected atrial fibrillation in a large remote-monitored cohort: implications for anticoagulation and need for new pathways of service delivery.

Author

O'Shea, Catherine J., Brooks, Anthony G., Middeldorp, Melissa E., Harper, Curtis, Hendriks, Jeroen M., Russo, Andrea M., Freeman, James V., Gopinathannair, Rakesh, Varma, Niraj, Deering, Thomas F., Campbell, Kevin, and Sanders, Prashanthan

Abstract

Background: Remote monitoring (RM) can facilitate early detection of subclinical and symptomatic atrial fibrillation (AF), providing an opportunity to evaluate the need for stroke prevention therapies. We aimed to characterize the burden of RM AF alerts and its impact on anticoagulation of patients with device-detected AF. Methods: Consecutive patients with a cardiac implantable electronic device, at least one AF episode, undergoing RM were included and assigned an estimated minimum CHA2DS2-VASc score based on age and device type. RM was provided via automated software system, providing rapid alert processing by device specialists and systematic, recurrent prompts for anticoagulation. Results: From 7651 individual, 389,188 AF episodes were identified, 3120 (40.8%) permanent pacemakers, 2260 (29.5%) implantable loop recorders (ILRs), 987 (12.9%) implantable cardioverter defibrillators, 968 (12.7%) cardiac resynchronization therapy (CRT) defibrillators, and 316 (4.1%) CRT pacemakers. ILRs transmitted 48.8% of all AF episodes. At twelve-months, 3404 (44.5%) AF < 6 min, 1367 (17.9%) 6 min–6 h, 1206 (15.8%) 6–24 h, and 1674 (21.9%) ≥ 24 h. A minimum CHA2DS2-VASc score of 2 was assigned to 1704 (63.1%) of the patients with an AF episode of ≥ 6 h, 531 (31.2%) who were not anticoagulated at 12-months, and 1031 (61.6%) patients with an AF episode duration of ≥ 24 h, 290 (28.1%) were not anticoagulated. Conclusions: Despite being intensively managed via RM software system incorporating cues for anticoagulation, a substantial proportion of patients with increased stroke risk remained unanticoagulated after a device-detected AF episode of significant duration. These data highlight the need for improved clinical response pathways and an integrated care approach to RM. Trial registration: Australian New Zealand Clinical Trial Registry: ACTRN12620001232921. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Guidance for Rebooting Electrophysiology Through the COVID-19 Pandemic From the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

Author

Lakkireddy, Dhanunjaya R., primary, Chung, Mina K., additional, Deering, Thomas F., additional, Gopinathannair, Rakesh, additional, Albert, Christine M., additional, Epstein, Laurence M., additional, Harding, Clifford V., additional, Hurwitz, Jodie L., additional, Jeffery, Courtney C., additional, Krahn, Andrew D., additional, Kusumoto, Fred M., additional, Lampert, Rachel, additional, Mansour, Moussa, additional, Natale, Andrea, additional, Patton, Kristen K., additional, Seiler, Amber, additional, Shah, Maully J., additional, Wang, Paul J., additional, and Russo, Andrea M., additional

Published
2020
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