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1. New Concepts in Pacemaker Syndrome

Author

Farmer, Michael D, Estes, Mark NA III, Link, Mark S, Singh, Balbir, Lokhandwala, Yash, Francis, Johnson, and Gupta, Anup

Subjects
JOURNALS: Indian Pacing and Electrophysiology Journal, Indian Pacing and Electrophysiology Journal
Abstract

After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.

Published
2004

2. 2024 HRS expert consensus statement on arrhythmias in the athlete: Evaluation, treatment, and return to play

Author

Lampert, Rachel, Chung, Eugene H., Ackerman, Michael J., Arroyo, Alonso Rafael, Darden, Douglas, Deo, Rajat, Dolan, Joe, Etheridge, Susan P., Gray, Belinda R., Harmon, Kimberly G., James, Cynthia A., Kim, Jonathan H., Krahn, Andrew D., La Gerche, Andre, Link, Mark S., MacIntyre, Ciorsti, Mont, Lluis, Salerno, Jack C., and Shah, Maully J.

Published
2024
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4. Research Priorities in the Secondary Prevention of Atrial Fibrillation: A National Heart, Lung, and Blood Institute Virtual Workshop Report

Author

Benjamin, Emelia J, Al‐Khatib, Sana M, Desvigne‐Nickens, Patrice, Alonso, Alvaro, Djoussé, Luc, Forman, Daniel E, Gillis, Anne M, Hendriks, Jeroen ML, Hills, Mellanie True, Kirchhof, Paulus, Link, Mark S, Marcus, Gregory M, Mehra, Reena, Murray, Katherine T, Parkash, Ratika, Piña, Ileana L, Redline, Susan, Rienstra, Michiel, Sanders, Prashanthan, Somers, Virend K, Van Wagoner, David R, Wang, Paul J, Cooper, Lawton S, and Go, Alan S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Research, Comparative Effectiveness Research, Cardiovascular, Prevention, Clinical Trials and Supportive Activities, Heart Disease, Stroke, Good Health and Well Being, Animals, Anti-Arrhythmia Agents, Atrial Fibrillation, Biomedical Research, Body Composition, Cardiac Rehabilitation, Comorbidity, Disease Progression, Health Priorities, Health Services Needs and Demand, Healthy Lifestyle, Humans, National Heart, Lung, and Blood Institute (U.S.), Needs Assessment, Recurrence, Research Design, Risk Assessment, Risk Factors, Secondary Prevention, Treatment Outcome, United States, Weight Loss, atrial fibrillation, cardiac rehabilitation, prevention, research, risk factors, sleep, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

There has been sustained focus on the secondary prevention of coronary heart disease and heart failure; yet, apart from stroke prevention, the evidence base for the secondary prevention of atrial fibrillation (AF) recurrence, AF progression, and AF-related complications is modest. Although there are multiple observational studies, there are few large, robust, randomized trials providing definitive effective approaches for the secondary prevention of AF. Given the increasing incidence and prevalence of AF nationally and internationally, the AF field needs transformative research and a commitment to evidenced-based secondary prevention strategies. We report on a National Heart, Lung, and Blood Institute virtual workshop directed at identifying knowledge gaps and research opportunities in the secondary prevention of AF. Once AF has been detected, lifestyle changes and novel models of care delivery may contribute to the prevention of AF recurrence, AF progression, and AF-related complications. Although benefits seen in small subgroups, cohort studies, and selected randomized trials are impressive, the widespread effectiveness of AF secondary prevention strategies remains unknown, calling for development of scalable interventions suitable for diverse populations and for identification of subpopulations who may particularly benefit from intensive management. We identified critical research questions for 6 topics relevant to the secondary prevention of AF: (1) weight loss; (2) alcohol intake, smoking cessation, and diet; (3) cardiac rehabilitation; (4) approaches to sleep disorders; (5) integrated, team-based care; and (6) nonanticoagulant pharmacotherapy. Our goal is to stimulate innovative research that will accelerate the generation of the evidence to effectively pursue the secondary prevention of AF.

Published
2021

5. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Krahn, Andrew D., Andrade, Jason G., Beavers, Craig J., Bischoff, James M., Bunch, T. Jared, Campbell, Kristen Bova, Chen, Lin Yee, Dharia, Robin, Dorsch, Michael P., Gerstenfeld, Edward P., Jones, Aubrey E., Kaluzna, Stephanie Dwyer, Masha, Luke, Nault, Isabelle, Noseworthy, Peter A., Pellegrini, Cara N., Tzeis, Stylianos E., Volgman, Annabelle Santos, Zeitler, Emily P., Joglar, José A., Chung, Mina K., Armbruster, Anastasia L., Benjamin, Emelia J., Chyou, Janice Y., Cronin, Edmond M., Deswal, Anita, Eckhardt, Lee L., Goldberger, Zachary D., Gopinathannair, Rakesh, Gorenek, Bulent, Hess, Paul L., Hlatky, Mark, Hogan, Gail, Ibeh, Chinwe, Indik, Julia H., Kido, Kazuhiko, Kusumoto, Fred, Link, Mark S., Linta, Kathleen T., Marcus, Gregory M., McCarthy, Patrick M., Patel, Nimesh, Patton, Kristen K., Perez, Marco V., Piccini, Jonathan P., Russo, Andrea M., Sanders, Prashanthan, Streur, Megan M., Thomas, Kevin L., Times, Sabrina, Tisdale, James E., Valente, Anne Marie, and Van Wagoner, David R.

Published
2024
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7. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Joglar, José A., Chung, Mina K., Armbruster, Anastasia L., Benjamin, Emelia J., Chyou, Janice Y., Cronin, Edmond M., Deswal, Anita, Eckhardt, Lee L., Goldberger, Zachary D., Gopinathannair, Rakesh, Gorenek, Bulent, Hess, Paul L., Hlatky, Mark, Hogan, Gail, Ibeh, Chinwe, Indik, Julia H., Kido, Kazuhiko, Kusumoto, Fred, Link, Mark S., Linta, Kathleen T., Marcus, Gregory M., McCarthy, Patrick M., Patel, Nimesh, Patton, Kristen K., Perez, Marco V., Piccini, Jonathan P., Russo, Andrea M., Sanders, Prashanthan, Streur, Megan M., Thomas, Kevin L., Times, Sabrina, Tisdale, James E., Valente, Anne Marie, and Van Wagoner, David R.

Published
2024
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8. 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure

Author

Chung, Mina K., Patton, Kristen K., Lau, Chu-Pak, Dal Forno, Alexander R.J., Al-Khatib, Sana M., Arora, Vanita, Birgersdotter-Green, Ulrika Maria, Cha, Yong-Mei, Chung, Eugene H., Cronin, Edmond M., Curtis, Anne B., Cygankiewicz, Iwona, Dandamudi, Gopi, Dubin, Anne M., Ensch, Douglas P., Glotzer, Taya V., Gold, Michael R., Goldberger, Zachary D., Gopinathannair, Rakesh, Gorodeski, Eiran Z., Gutierrez, Alejandra, Guzman, Juan C., Huang, Weijian, Imrey, Peter B., Indik, Julia H., Karim, Saima, Karpawich, Peter P., Khaykin, Yaariv, Kiehl, Erich L., Kron, Jordana, Kutyifa, Valentina, Link, Mark S., Marine, Joseph E., Mullens, Wilfried, Park, Seung-Jung, Parkash, Ratika, Patete, Manuel F., Pathak, Rajeev Kumar, Perona, Carlos A., Rickard, John, Schoenfeld, Mark H., Seow, Swee-Chong, Shen, Win-Kuang, Shoda, Morio, Singh, Jagmeet P., Slotwiner, David J., Sridhar, Arun Raghav M., Srivatsa, Uma N., Stecker, Eric C., Tanawuttiwat, Tanyanan, Tang, W.H. Wilson, Tapias, Carlos Andres, Tracy, Cynthia M., Upadhyay, Gaurav A., Varma, Niraj, Vernooy, Kevin, Vijayaraman, Pugazhendhi, Worsnick, Sarah Ann, Zareba, Wojciech, and Zeitler, Emily P.

Published
2023
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14. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Heidenreich, Paul A., Bozkurt, Biykem, Aguilar, David, Allen, Larry A., Byun, Joni J., Colvin, Monica M., Deswal, Anita, Drazner, Mark H., Dunlay, Shannon M., Evers, Linda R., Fang, James C., Fedson, Savitri E., Fonarow, Gregg C., Hayek, Salim S., Hernandez, Adrian F., Khazanie, Prateeti, Kittleson, Michelle M., Lee, Christopher S., Link, Mark S., Milano, Carmelo A., Nnacheta, Lorraine C., Sandhu, Alexander T., Stevenson, Lynne Warner, Vardeny, Orly, Vest, Amanda R., and Yancy, Clyde W.

Published
2022
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15. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Heidenreich, Paul A., Bozkurt, Biykem, Aguilar, David, Allen, Larry A., Byun, Joni J., Colvin, Monica M., Deswal, Anita, Drazner, Mark H., Dunlay, Shannon M., Evers, Linda R., Fang, James C., Fedson, Savitri E., Fonarow, Gregg C., Hayek, Salim S., Hernandez, Adrian F., Khazanie, Prateeti, Kittleson, Michelle M., Lee, Christopher S., Link, Mark S., Milano, Carmelo A., Nnacheta, Lorraine C., Sandhu, Alexander T., Stevenson, Lynne Warner, Vardeny, Orly, Vest, Amanda R., and Yancy, Clyde W.

Published
2022
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16. 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure: Executive Summary

Author

Heidenreich, PAUL A., BOZKURT, BIYKEM, AGUILAR, DAVID, ALLEN, LARRY A., BYUN, JONI-J., COLVIN, MONICA M., DESWAL, ANITA, DRAZNER, MARK H., DUNLAY, SHANNON M., EVERS, LINDA R., FANG, JAMES C., FEDSON, SAVITRI E., FONAROW, GREGG C., HAYEK, SALIM S., HERNANDEZ, ADRIAN F., KHAZANIE, PRATEETI, KITTLESON, MICHELLE M., LEE, CHRISTOPHER S., LINK, MARK S., MILANO, CARMELO A., NNACHETA, LORRAINE C., SANDHU, ALEXANDER T., STEVENSON, LYNNE WARNER, VARDENY, ORLY, VEST, AMANDA R., and YANCY, CLYDE W.

Published
2022
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18. Omega-3 Fatty Acids and Arrhythmias.

Author

Marcus, Mason D. and Link, Mark S.

Subjects
*OMEGA-3 fatty acids, *UNSATURATED fatty acids, *DOCOSAHEXAENOIC acid, *EICOSAPENTAENOIC acid, *SUDDEN death prevention, *IMPLANTABLE cardioverter-defibrillators
Abstract

The pro- and antiarrhythmic effects of omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been extensively studied in preclinical and human trials. Despite early evidence of an antiarrhythmic role of n-3 PUFA in the prevention of sudden cardiac death and postoperative and persistent atrial fibrillation (AF), subsequent well-designed randomized trials have largely not shown an antiarrhythmic benefit. Two trials that tested moderate and high-dose n-3 PUFA demonstrated a reduction in sudden cardiac death, but these findings have not been widely replicated, and the potential of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) to reduce arrhythmic death in combination, or as monotherapy, remains uncertain. The accumulated clinical evidence does not support supplementation of n-3 PUFA for postoperative AF or secondary prevention of AF. Several large, contemporary, randomized controlled trials of high-dose n-3 PUFA for primary or secondary cardiovascular prevention have demonstrated a small, significant, dose-dependent increased risk of incident AF compared with mineral oil or corn oil comparator. These findings were reproduced with both icosapent ethyl monotherapy and a mixed EPA+DHA formulation. The proarrhythmic mechanism of increased AF in contemporary cohorts exposed to high-dose n-3 PUFA is unknown. EPA and DHA and their metabolites have pleiotropic cardiometabolic and pro- and antiarrhythmic effects, including modification of the lipid raft microenvironment; alteration of cell membrane structure and fluidity; modulation of sodium, potassium, and calcium currents; and regulation of gene transcription, cell proliferation, and inflammation. Further characterization of the complex association between EPA, EPA+DHA, and DHA and AF is needed. Which formulations, dose ranges, and patient subgroups are at highest risk, remain unclear. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Arrhythmias in the Athlete

Author

McEnteggart, Shayna, Bhonsale, Aditya, Link, Mark S., Mark Estes, N. A., III, Toth, Peter P., Series Editor, Yan, Gan-Xin, editor, Kowey, Peter R., editor, and Antzelevitch, Charles, editor

Published
2020
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28. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Ommen, Steve R., Mital, Seema, Burke, Michael A., Day, Sharlene M., Deswal, Anita, Elliott, Perry, Evanovich, Lauren L., Hung, Judy, Joglar, José A., Kantor, Paul, Kimmelstiel, Carey, Kittleson, Michelle, Link, Mark S., Maron, Martin S., Martinez, Matthew W., Miyake, Christina Y., Schaff, Hartzell V., Semsarian, Christopher, and Sorajja, Paul

Published
2020
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29. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Author

Ommen, Steve R., Mital, Seema, Burke, Michael A., Day, Sharlene M., Deswal, Anita, Elliott, Perry, Evanovich, Lauren L., Hung, Judy, Joglar, José A., Kantor, Paul, Kimmelstiel, Carey, Kittleson, Michelle, Link, Mark S., Maron, Martin S., Martinez, Matthew W., Miyake, Christina Y., Schaff, Hartzell V., Semsarian, Christopher, and Sorajja, Paul

Published
2020
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30. Impaired longitudinal systolic–diastolic coupling and cardiac response to exercise in patients with hypertrophic cardiomyopathy.

Author

MacNamara, James P., Turlington, William M., Dias, Katrin A., Hearon, Christopher M., Ivey, Erika, Delgado, Vincent A., Brazile, Tiffany L., Wakeham, Denis J., Turer, Aslan T., Link, Mark S., Levine, Benjamin D., and Sarma, Satyam

Subjects
LEFT heart ventricle, EXERCISE physiology, RESEARCH funding, EXERCISE therapy, HEART physiology, CARDIAC hypertrophy, TREATMENT effectiveness, DESCRIPTIVE statistics, AEROBIC capacity, CARDIOPULMONARY system, STROKE volume (Cardiac output), EXERCISE tests, OXYGEN consumption, DIASTOLE (Cardiac cycle), LEFT ventricular dysfunction, CARDIAC rehabilitation, REGRESSION analysis, DISEASE complications
Abstract

Background: In patients with hypertrophic cardiomyopathy (HCM), impaired augmentation of stroke volume and diastolic dysfunction contribute to exercise intolerance. Systolic–diastolic (S‐D) coupling characterizes how systolic contraction of the left ventricle (LV) primes efficient elastic recoil during early diastole. Impaired S‐D coupling may contribute to the impaired cardiac response to exercise in patients with HCM. Methods: Patients with HCM (n = 25, age = 47 ± 9 years) and healthy adults (n = 115, age = 49 ± 10 years) underwent a cardiopulmonary exercise testing (CPET) and echocardiogram. S‐D coupling was defined as the ratio of LV longitudinal excursion of the mitral annulus during early diastole (EDexc) and systole (Sexc) and compared between groups. Peak oxygen uptake (peak V̇O2) (Douglas bags), cardiac index (C2H2 rebreathe), and stroke volume index (SVi) were assessed during CPET. Linear regression was performed between S‐D coupling and peak V̇O2, peak cardiac index, and peak SVi. Results: S‐D coupling was lower in HCM (Controls: 0.63 ± 0.08, HCM: 0.56 ± 0.10, p < 0.001). Peak V̇O2 and stroke volume reserve were lower in patients with HCM (Peak VO2 Controls: 28.5 ± 5.5, HCM: 23.7 ± 7.2 mL/kg/min, p < 0.001, SV reserve: Controls 39 ± 16, HCM 30 ± 18 mL, p = 0.008). In patients with HCM, S‐D coupling was associated with peak V̇O2 (r = 0.47, p = 0.018), peak cardiac index (r = 0.60, p = 0.002), and peak SVi (r = 0.63, p < 0.001). Conclusion: Systolic–diastolic coupling was impaired in patients with HCM and was associated with fitness and the cardiac response to exercise. Inefficient S‐D coupling may link insufficient stroke volume generation, diastolic dysfunction, and exercise intolerance in HCM. [ABSTRACT FROM AUTHOR]

Published
2024
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38. 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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39. Optimizing Outcomes After Out-of-Hospital Cardiac Arrest With Innovative Approaches to Public-Access Defibrillation: A Scientific Statement From the International Liaison Committee on Resuscitation

Author

Brooks, Steven C., Clegg, Gareth R., Bray, Janet, Deakin, Charles D., Perkins, Gavin D., Ringh, Mattias, Smith, Christopher M., Link, Mark S., Merchant, Raina M., Pezo-Morales, Jaime, Parr, Michael, Morrison, Laurie J., Wang, Tzong-Luen, Koster, Rudolph W., and Ong, Marcus E.H.

Published
2022
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44. Randomized Controlled Trial of Moderate‐ and High‐Intensity Exercise Training in Patients With Hypertrophic Cardiomyopathy: Effects on Fitness and Cardiovascular Response to Exercise

Author

MacNamara, James P., primary, Dias, Katrin A., additional, Hearon, Christopher M., additional, Ivey, Erika, additional, Delgado, Vincent A., additional, Saland, Sophie, additional, Samels, Mitchel, additional, Hieda, Michinari, additional, Turer, Aslan T., additional, Link, Mark S., additional, Sarma, Satyam, additional, and Levine, Benjamin D., additional

Published
2023
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46. Contributors

Author

AbdelWahab, Amir, primary, Aras, Kedar K., additional, Arora, Rishi, additional, Azeem, Latib, additional, Berger, Ronald D., additional, Blankenship, James C., additional, Boink, Gerard J.J., additional, Bolignano, Davide, additional, Boucek, Dana, additional, Brügmann, Tobias, additional, Bushi, Doron, additional, Chen, Sheena W., additional, Christoffels, Vincent M., additional, Corban, Michel, additional, Damiano, Regazzoli, additional, Dash, Debabrata, additional, David, Robert, additional, de Vries, Antoine A.F., additional, Devalla, Harsha D., additional, Donahue, J. Kevin, additional, Efimov, Igor R., additional, El-Sabbagh, Abdallah, additional, Francesco, Giannini, additional, Francesco, Ponticelli, additional, Friedman, Paul, additional, Geerts, Dirk, additional, Ghare, M. Imran, additional, Goel, Kashish, additional, Goumans, Marie José T.H., additional, Gray, Robert, additional, Guglielmo, Gallone, additional, Hajj, Stephanie El, additional, Hoffman, Jacob A, additional, Holmes, Jr, David R., additional, Holy, Erik W., additional, Jones, II, Richard P., additional, Laakkonen, Johanna P., additional, Lansky, Alexandra, additional, Lee, K. Benjamin, additional, Link, Mark S, additional, Luca, Baldetti, additional, Mario, Gramegna, additional, Meier, Bernhard, additional, Mody, Dr Rohit, additional, Mummery, Christine L, additional, Nietlispach, Fabian, additional, Nussinovitch, Udi, additional, Nyns, Emile, additional, Panting, Jeffrey S., additional, Parajuli, Shankar P., additional, Patel, Nimesh, additional, Pijnappels, Daniël A., additional, Prasad, Abhiram, additional, Quinn, T. Alexander, additional, Raphael, Claire E., additional, Reshef, Elon, additional, Sabbag, Avi, additional, Sapp, John, additional, Sasse, Philipp, additional, Schneider, Mark J., additional, Tan, Hanno L., additional, Tirziu, Daniela, additional, Trivedi, Amar, additional, Végh, Anna M.D., additional, Witt, Chance, additional, Yin, Rose T., additional, Ylä-Herttuala, Seppo, additional, and Zhou, Shanshan, additional

Published
2020
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