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2. Therapeutic potential of conduction system pacing as a method for improving cardiac output during ventricular tachycardia

Author

Keene, Daniel, Miyazawa, Alejandra A., Arnold, Ahran D., Naraen, Akriti, Kaza, Nandita, Mohal, Jagdeep S., Lefroy, David C., Lim, Phang Boon, Ng, Fu Siong, Koa-Wing, Michael, Qureshi, Norman A., Linton, Nick W. F., Wright, Ian, Peters, Nicholas S., Kanagaratnam, Prapa, Shun-Shin, Matthew J., Francis, Darrel P., and Whinnett, Zachary I.

Published
2024
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6. Cerebellum/liver index on baseline 18F-FDG PET/CT to improve prognostication in post-transplant lymphoproliferative disorders: a multicenter retrospective study

Author

Morland, David, Kanagaratnam, Lukshe, Hubelé, Fabrice, Toussaint, Elise, Choquet, Sylvain, Kas, Aurélie, Caquot, Pierre-Ambroise, Haioun, Corinne, Itti, Emmanuel, Leprêtre, Stéphane, Decazes, Pierre, Bijou, Fontanet, Schwartz, Paul, Jacquet, Caroline, Chauchet, Adrien, Matuszak, Julien, Kamar, Nassim, Payoux, Pierre, and Durot, Eric

Published
2024
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8. An Economic Evaluation of a Streamlined Day-Case Atrial Fibrillation Ablation Protocol and Conventional Cryoballoon Ablation versus Antiarrhythmic Drugs in a UK Paroxysmal Atrial Fibrillation Population

Author

Moss, Joe W. E., Todd, Derick, Grodzicki, Lukasz, Palazzolo, Beatrice, Mattock, Richard, Mealing, Stuart, Souter, Maxim, Brown, Benedict, Bromilow, Tom, Lewis, Damian, McCready, James, Tayebjee, Muzahir, Shepherd, Ewen, Sasikaran, Thiagarajah, Coyle, Clare, Ismyrloglou, Eleni, Johnson, Nicholas A., and Kanagaratnam, Prapa

Published
2024
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9. Applying a Power Analysis to Everything We Do: A Qualitative Inquiry to Decolonize the Global Health and Development Project Cycle.

Author

Tuhebwe, Doreen, Brittingham, Sarah, Kanagaratnam, Amandari, Togo, Elikem, OlaOlorun, Funmilola, Wanyenze, Rhoda, Prata, Ndola, and Maragh-Bass, Allysha

Subjects
Humans, Global Health, Qualitative Research, Program Development, Program Evaluation
Abstract

BACKGROUND: Global health and development (GHD) systems that centralize power in the Global North were conceived during colonialism. As a result, they often replicate unequal power structures, maintaining dogged inequities. Growing and historic calls to decolonize GHD advocate for the transfer of power to actors in the Global South. This article identifies examples of colonial legacies in todays GHD projects and offers actionable strategies to decolonize. METHODS: From August 2021 to March 2022, 20 key informants across 15 organizations participated in interviews about their experiences and perspectives relating to the decolonization of GHD. We used deductive thematic coding to identify examples of challenges and strategies to address them across 3 project life cycle phases: conceptualization and contracting, program planning and implementation, and program evaluation and dissemination. RESULTS: Participants described how power is maintained in the Global North, sharing countless examples across the project life cycle, including agenda-setting with minimal local participation or partnership, onerous requirements that limit grantee eligibility, Global North ownership of data collected by and in the Global South, and dissemination in languages and formats that are not easily accessible to Global South audiences. Proposed strategies to decolonize GHD projects include having built-in participatory processes and accountability mechanisms; aligning solicitations with existing local strategies; adapting the process for awarding, contracting, and evaluating investments to increase the representation and competitiveness of Global South entities; creating trusting, respectful relationships with Global South partners; and systematically applying power analyses to each step of the project life cycle. CONCLUSIONS: GHD practitioners suggested project life cycle-based strategies for shifting power and redistributing resources, which we argue will ultimately enhance the value, impact, and sustainability of GHD programming.

Published
2023

10. Catheter Ablation for Ventricular Tachycardia After MI: A Reconstructed Individual Patient Data Meta-analysis of Randomised Controlled Trials.

Author

Reddy, Rohin, Howard, James, Ahmad, Yousif, Shun-Shin, Matthew, Simader, Florentina, Miyazawa, Alejandra, Saleh, Keenan, Naraen, Akriti, Samways, Jack, Katritsis, George, Mohal, Jagdeep, Kaza, Nandita, Porter, Bradley, Keene, Daniel, Linton, Nicholas, Francis, Darrel, Whinnett, Zachary, Luther, Vishal, Kanagaratnam, Prapa, and Arnold, Ahran

Subjects
MI, Ventricular tachycardia, ablation, meta-analysis
Abstract

BACKGROUND: The prognostic impact of ventricular tachycardia (VT) catheter ablation is an important outstanding research question. We undertook a reconstructed individual patient data meta-analysis of randomised controlled trials comparing ablation to medical therapy in patients developing VT after MI. METHODS: We systematically identified all trials comparing catheter ablation to medical therapy in patients with VT and prior MI. The prespecified primary endpoint was reconstructed individual patient assessment of all-cause mortality. Prespecified secondary endpoints included trial-level assessment of all-cause mortality, VT recurrence or defibrillator shocks and all-cause hospitalisations. Prespecified subgroup analysis was performed for ablation approaches involving only substrate modification without VT activation mapping. Sensitivity analyses were performed depending on the proportion of patients with prior MI included. RESULTS: Eight trials, recruiting a total of 874 patients, were included. Of these 874 patients, 430 were randomised to catheter ablation and 444 were randomised to medical therapy. Catheter ablation reduced all-cause mortality compared with medical therapy when synthesising individual patient data (HR 0.63; 95% CI [0.41-0.96]; p=0.03), but not in trial-level analysis (RR 0.91; 95% CI [0.67-1.23]; p=0.53; I2=0%). Catheter ablation significantly reduced VT recurrence, defibrillator shocks and hospitalisations compared with medical therapy. Sensitivity analyses were consistent with the primary analyses. CONCLUSION: In patients with postinfarct VT, catheter ablation reduces mortality.

Published
2023

11. The Lived Experience of International Educators Working in Mid-Atlantic K-8 Schools: A Hermeneutic Phenomenological Study

Author

Popsy Kanagaratnam

Abstract

There is an acknowledged need for teachers who reflect the diversity of the student body in the United States to serve as role models and to connect with the increasingly diverse student population. Until recently, there were few studies on the experiences of non-White teachers working in the public school system. This hermeneutic phenomenological study explored the lived experiences of international educators working in the Washington, DC area. Data were gathered through 17 semi-structured interviews, including four interviews conducted using LEGO bricks. The eight themes that emerged showed the contrast between the lack of resources yet skills and abilities of students in the participants' home countries versus the abundant resources and low skills of some students here; being made to feel like the "other"; adapting to a new culture without a full awareness of that which is hidden; transactional behavior, not relational behavior; teaching during a pandemic; racism in America; motivation to continue teaching; and a system that fails the students. The international educators were resilient and survived in a system that was not designed for them. The data showed a need to acknowledge the role of racism within the structure of school systems and to fully understand and appreciative what international educators can offer the students and the school, rather than viewing them from a deficit perspective and expecting them to conform. Based on these findings, four recommendations are offered for policy and practice. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Published
2023

15. Worldwide Survey of COVID-19–Associated Arrhythmias

Author

Coromilas, Ellie J, Kochav, Stephanie, Goldenthal, Isaac, Biviano, Angelo, Garan, Hasan, Goldbarg, Seth, Kim, Joon-Hyuk, Yeo, Ilhwan, Tracy, Cynthia, Ayanian, Shant, Akar, Joseph, Singh, Avinainder, Jain, Shashank, Zimerman, Leandro, Pimentel, Maurício, Osswald, Stefan, Twerenbold, Raphael, Schaerli, Nicolas, Crotti, Lia, Fabbri, Daniele, Parati, Gianfranco, Li, Yi, Atienza, Felipe, Zatarain, Eduardo, Tse, Gary, Leung, Keith Sai Kit, Guevara-Valdivia, Milton E, Rivera-Santiago, Carlos A, Soejima, Kyoko, De Filippo, Paolo, Ferrari, Paola, Malanchini, Giovanni, Kanagaratnam, Prapa, Khawaja, Saud, Mikhail, Ghada W, Scanavacca, Mauricio, Hajjar, Ludhmila Abrahão, Rizerio, Brenno, Sacilotto, Luciana, Mollazadeh, Reza, Eslami, Masoud, far, Vahideh Laleh, Mattioli, Anna Vittoria, Boriani, Giuseppe, Migliore, Federico, Cipriani, Alberto, Donato, Filippo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Coromilas, James, Aboyme, Andrew, O’Brien, Connor Galen, Rodriguez, Fatima, Wang, Paul J, Naniwadekar, Aditi, Moey, Melissa, Kow, Chia Siang, Cheah, Wee Kooi, Auricchio, Angelo, Conte, Giulio, Hwang, Jongmin, Han, Seongwook, Lazzerini, Pietro Enea, Franchi, Federico, Santoro, Amato, Capecchi, Pier Leopoldo, Joglar, Jose A, Rosenblatt, Anna G, Zardini, Marco, Bricoli, Serena, Bonura, Rosario, Echarte-Morales, Julio, Benito-González, Tomás, Minguito-Carazo, Carlos, Fernández-Vázquez, Felipe, and Wan, Elaine Y

Subjects
Biomedical and Clinical Sciences, Medical Physiology, Cardiovascular Medicine and Haematology, Clinical Sciences, Aged, Arrhythmias, Cardiac, COVID-19, Cardiac Electrophysiology, Comorbidity, Electrophysiologic Techniques, Cardiac, Female, Global Health, Health Care Surveys, Healthcare Disparities, Humans, Incidence, Male, Middle Aged, Practice Patterns, Physicians', Prevalence, Prognosis, Retrospective Studies, Risk Assessment, Time Factors, arrhythmia, atrial fibrillation, atrial flutter, bradycardia, tachycardia, torsade de pointes, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Medical physiology
Abstract

[Figure: see text].

Published
2021

16. Feasibility of mapping and ablating ectopy-triggering ganglionated plexus reproducibly in persistent atrial fibrillation

Author

Coyle, Clare, Koutsoftidis, Simos, Kim, Min-Young, Porter, Bradley, Keene, Daniel, Luther, Vishal, Handa, Balvinder, Kay, Jamie, Lim, Elaine, Malcolme-Lawes, Louisa, Koa-Wing, Michael, Lim, Phang Boon, Whinnett, Zachary I., Ng, Fu Siong, Qureshi, Norman, Peters, Nicholas S., Linton, Nicholas W. F., Drakakis, Emmanuel, and Kanagaratnam, Prapa

Published
2023
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20. RIPPLE-VT study: Multicenter prospective evaluation of ventricular tachycardia substrate ablation by targeting scar channels to eliminate latest scar potentials without direct ablation.

Author

Katritsis, George, Kailey, Balrik, Jamil-Copley, Shahnaz, Luther, Vishal, Koa-Wing, Michael, Cortez-Dias, Nuno, Carpinteiro, Luis, de Sousa, Joao, Martin, Ruairidh, Murray, Stephen, Das, Moloy, Whinnett, Zachary, Lim, Phang Boon, Peters, Nicholas S., Ng, Fu S., Chow, Anthony W., Linton, Nick W.F., and Kanagaratnam, Prapa

Abstract

Recurrent ventricular tachycardia (VT) can be treated by substrate modification of the myocardial scar by catheter ablation during sinus rhythm without VT induction. Better defining this arrhythmic substrate could help improve outcome and reduce ablation burden. The study aimed to limit ablation within postinfarction scar to conduction channels within the scar to reduce VT recurrence. Patients undergoing catheter ablation for recurrent implantable cardioverter-defibrillator therapy for postinfarction VT were recruited at 5 centers. Left ventricular maps were collected on CARTO using a Pentaray catheter. Ripple mapping was used to categorize infarct scar potentials (SPs) by timing. Earliest SPs were ablated sequentially until there was loss of the terminal SPs without their direct ablation. The primary outcome measure was sustained VT episodes as documented by device interrogations at 1 year, which was compared with VT episodes in the year before ablation. The study recruited 50 patients (mean left ventricular ejection fraction, 33% ± 9%), and 37 patients (74%) met the channel ablation end point with successful loss of latest SPs without direct ablation. There were 16 recurrences during 1-year follow-up. There was a 90% reduction in VT burden from 30.2 ± 53.9 to 3.1 ± 7.5 (P <.01) per patient, with a concomitant 88% reduction in appropriate shocks from 2.1 ± 2.7 to 0.2 ± 0.9 (P <.01). There were 8 deaths during follow-up. Those who met the channel ablation end point had no significant difference in mortality, recurrence, or VT burden but had a significantly lower ablation burden of 25.7 ± 4.2 minutes vs 39.9 ± 6.1 minutes (P =.001). Scar channel ablation is feasible by ripple mapping and can be an alternative to more extensive substrate modification techniques. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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23. Beyond Mentoring: Social Support Structures for Young Australian Carpentry Apprentices. Research Report

Author

National Centre for Vocational Education Research (NCVER) (Australia), Buchanan, John, Raffaele, Catherine, Glozier, Nick, and Kanagaratnam, Aran

Abstract

This research focused on how apprenticeships, at their best, provide extensive social support for young people. It draws on, and contributes to, debates about workforce (and especially vocational) development in contemporary Australia. It also contributes to the growing literature on social support and health, especially the role that work could play in improving the mental health of young people. Specifically, it identifies the forms of social support provided to young carpentry apprentices. Findings have been generated from eight case studies, which included smaller organisations and some of Australia's leading construction firms and group training organisations (GTOs). Key findings include: (1) Formal mentoring arrangements were common; (2) Systemic informal support embedded in trade cultures of vocational and social development was significant; (3) Support arrangements were integral--not incidental--to organisational business models; (4) Apprenticeship models of support can extend to occupations above and below trades level; (5) Quasi-apprenticeship support arrangements for occupations below trades level required additional stakeholders and resources; and (6) External program-based mentoring arrangements can complement (but not replace) effective apprenticeship support arrangements. The following are appended: (1) Report on the quantitative phase of this project; and (2) Evolution of the research question and design for this project. [For the accompanying guide, "A Guide to Providing Social Support for Apprentices: Good Practice Guide," see ED567791.]

Published
2016

24. Percutaneous Neuromodulation for Atrial Fibrillation.

Author

Zuhair, Mohamed, Keene, Daniel, Kanagaratnam, Prapa, and Lim, Phang Boon

Abstract

Percutaneous neuromodulation is emerging as a promising therapeutic approach for atrial fibrillation (AF). This article explores techniques such as ganglionated plexi (GP) ablation, and vagus nerve stimulation, pinpointing their potential in modulating AF triggers and maintenance. Noninvasive methods, such as transcutaneous low-level tragus stimulation, offer innovative treatment pathways, with early trials indicating a significant reduction in AF burden. GP ablation may address autonomic triggers, and the potential for GP ablation in neuromodulation is discussed. The article stresses the necessity for more rigorous clinical trials to validate the safety, reproducibility, and efficacy of these neuromodulation techniques in AF treatment. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Author

Deanfield, John, Verma, Subodh, Scirica, Benjamin M, Kahn, Steven E, Emerson, Scott S, Ryan, Donna, Lingvay, Ildiko, Colhoun, Helen M, Plutzky, Jorge, Kosiborod, Mikhail N, Hovingh, G Kees, Hardt-Lindberg, Søren, Frenkel, Ofir, Weeke, Peter E, Rasmussen, Søren, Goudev, Assen, Lang, Chim C, Urina-Triana, Miguel, Pietilä, Mikko, Lincoff, A Michael, Abe, Mitsunori, Abhaichand, Rajpal K, Abhayaratna, Walter P, Abhyankar, Atul, Abidin, Imran B Zainal, Abou Assi, Hiba, Accini Mendoza, Jose L, Adas, Mine, Agaiby, John M, Agarwal, Devendra K, Agha, Maher, Ahmed, Azazuddin, Ahtiainen, Petteri, Aigner, Elmar, Ajay, Naik, Ali, Norsiah, Al-Karadsheh, Amer, Allison, Roy, Allison, Dale C, Alpenidze, Diana, Altuntas, Yuksel, Al-Zoebi, Ayham, Ambuj, Roy, Amerena, John, Anderson, Robert J, Ando, Toshiaki, Andrews, Robert, Antonova, Elizaveta, Appel, Karl-Friedrich, Arantes, Flávia B, Araz, Mustafa, Arbel, Yaron, Arenas León, José L, Argyrakopoulou, Georgia, Ariani, Mehrdad, Arias Mendoza, Maria A, Arif, Ahmed A, Arneja, Jaspal, Aroda, Vanita R, Aronne, Louis J, Arstall, Margaret, Asamoah, Njaimeh, Asanin, Milika, Audish, Hanid, Avram, Rodica, Badat, Aysha, Badiu, Corin V, Bakdash, Wa'el, Bakiner, Okan S, Bandezi, Vuyokazi N, Bang, Liew H, Bansal, Sandeep, Baranyai, Marietta, Barbarash, Olga, Barber, Mark, Barnum, Otis, Barone Rochette, Gilles, Bashkin, Amir, Baum, Seth, Bays, Harold E, Bazzoni Ruiz, Alberto E, Beckowski, Maciej, Beerachee, Yaswin, Bellary, Srikanth, Belousova, Lidia, Berk, Martin, Bernstein, Marc, Berra, Cesare, Beshay, Isaac, Bhagwat, Ajit, Bhan, Arti, Biggs, William C, Billings, Liana, Bitar, Fahed, Block, Bradley, Bo, Simona, Bogdanski, Pawel, Bolshakova, Olga O, Boshchenko, Alla A, Bosworth, Hayden, Botero Lopez, Rodrigo, Bôttcher, Morten, Bourgeois, Ronald, Brautigam, Donald, Breton, Cristian F, Broadley, Andrew, Brockmyre, Andrew P, Brodie, Steven K, Bucci, Marco, Budincevic, Hrvoje, Budoff, Matthew J, Buffman, Barry, Buljubasic, Nediljka, Buranapin, Supawan, Burgess, Lesley, Burguera, Bartolomé, Buriakovska, Olena, Buscemi, Silvio, Busch, Robert, Buse, John B, Buynak, Robert, Byrne, Maria, Caceaune, Elena, Cadena Bonfanti, Alberto J, Calinescu, Cornell V, Call, Robert S, Canecki Varzic, Silvija, Cannon, Kevin, Capehorn, Matt, Cariou, Bertrand, Carr, Jeffrey, Carrillo-Jimenez, Rodolfo, Casas, Marcelo, Castro, Almudena, Celik, Ahmet, Cercato, Cintia, Cermak, Ondrej, Cha, James Y, Chacon, Carolina, Chaicha-Brom, Tira, Chandra, Sandeep, Chettibi, Mohamed, Chevts, Julia, Christopher, Johann, Chrustowski, Witold, Cif, Adriana, Clark, Rebecca, Clark, Wayne, Clifford, Piers, Coetzee, Kathleen, Cogni, Giulia, Colao, Anna Maria, Colquhoun, David M, Concha, Mauricio, Condit, Jonathan, Constance, Christian, Constantin, Ciprian, Constantinescu, Silviana, Corbett, Clive, Cornett, George M, Correia, Marcelo, Cortinovis, Fiorenzo, Cosma, Dana, Creely, Steven, Cross, David, Curtis, Brian, Czochra, Wojciech, Daboul, Nizar Y, Dagdelen, Selcuk, D'agostino, Ronald, Dang, Cuong, Datta, Sudip, Davuluri, Ashwini K, Dawood, Saleem Y, De Jong, Douwe M, De La Cuesta, Carmen, De Los Rios Ibarra, Manuel O, De Pablo, Carmen, De Pauw, Michel, Dela Llana, Alexander, Delibasic, Maja, Delic-Brkljacic, Diana, Demicheli, Thibaud, Denger, Ralf J, Desai, Devang, Desai, Piyush, Desouza, Cyrus V, Dicker, Dror, Djenic, Nemanja, Dobson, Simon, Doi, Masayuki, Doran, Jesse A, Dorman, Reinhart, Dotta, Francesco, Dukes, Carl E, Duronto, Ernesto, Durst, Ronen, Dvoryashina, Irina V, Ebrahim, Iftikhar O, Eggebrecht, Holger, Egstrup, Kenneth, Ekinci, Elif I, Eliasson, Björn, Eliasson, Ken, Enache, Georgiana, Enculescu, Dan, English, Patrick, Ermakova, Polina, Ershova, Olga, Ezaki, Hirotaka, Ezhov, Marat, Farias, Eduardo, Farias, Javier M, Farsky, Pedro S, Ferreira, Daniel, Filteau, Pierre, Finneran, Matthew P, Folkens, Eric M, Fonseca, Alberto G, Fonseca, Luisa, Fordan, Steven, Fourie, Nyda, França, Sara, Franco, Denise R, Franek, Edward, Friedman, Keith, Frittitta, Lucia, Froer, Michael, Fuckar, Krunoslav, Fujii, Kenshi, Fujita, Ryoko, Fukushima, Yasushi, Fulat, Mohamed, Fulwani, Mahesh, Gajos, Grzegorz, Galyavich, Albert, Gambill, Michael L, Gandotra, Dheeraj, Winston, Gandy, Garcia Hernandez, Pedro A, García Reza, Raymundo, Garg, Naveen, Garg, Sandeep, Garvey, William T, Garza, Juan C, Gatta-Cherifi, Blandine, Gelev, Valeri, Geller, Steven A, Geohas, Jeffrey G, Georgiev, Borislav, Ghazi, Adline, Gilbert, Matthew P, Gilinskaya, Olga, Gislason, Gunnar, Gogas Yavuz, Dilek, González Albarrán, Olga, Gordeev, Ivan G, Gorton, Sidney C, Goudev, Assen, Gretland Valderhaug, Tone, Groenemeijer, Bjorn, Gul, Ibrahim, Gullestad, Lars, Gurieva, Irina, Guseva, Galina N, Hagenow, Andreas, Haluzik, Martin, Halvorsen, Sigrun, Hammoudi, Naima, Hanaoka, Keiichi, Hancu, Nicolae, Hanusch, Ursula, Harris, Kathleen, Harris, Barry, Hartleib, Michael, Hartman, Aaron N, Hata, Yoshiki, Heimer, Brian, Herman, Lee, Herzog, William, Hewitt, Eric, Heymer, Peter, Hiremath, Shirish, Hjelmesaeth, Joeran, Høgalmen, Rasmus Geir, Høivik, Hans Olav, Holmer, Helene, Horoshko, Olha, Houser, Patricia M, Hove, Jens D, Hsieh, I-Chang, Hulot, Jean-Sébastien, Hussein, Zanariah, Ilashchuk, Tetiana, Ilveskoski, Erkki, Ipatko, Irina, Iranmanesh, Ali, Isawa, Tsuyoshi, Issa, Moises, Iteld, Bruce, Iwasawa, Takamasa, Jabbar, Danish, Jackson, Richard A, Jackson-Voyzey, Ewart, Jacob, Stephan, Jaffrani, Naseem A, Jardula, Michael F, Jastreboff, Ania, Jensen, Svend E, Jerkins, Terri, Jimenez-Ramos, Silvia A, Jitendra Pal Singh, Sawhney, Johnson, Wallace, Joyce, John M, Jozefowska, Malgorzata, Jugnundan, Prakash, Jungmair, Wolfgang, Jurowiecki, Jaroslaw, Kadokami, Toshiaki, Kahali, Dhiman, Kahrmann, Gerd, Kaiser, Sergio E, Kalmucki, Piotr, Kanadasi, Mehmet, Kandath, David, Kania, Grzegorz, Kannan, J, Kapp, Cornelia, Karczmarczyk, Agnieszka, Kartalis, Athanasios, Kaser, Susanne, Kasim, Sazzli Shahlan, Kastelic, Richard, Kato, Toshiaki, Katova, Tzvetana, Kaul, Upendra, Kautzky-Willer, Alexandra, Kawanishi, Masahiro, Kayikcioglu, Meral, Kazakova, Elena E, Keeling, Philip, Kempe, Hans-Peter, Kereiakes, Dean J, Kerneis, Mathieu, Keski-Opas, Tiina, Khadra, Suhail, Khaisheva, Larisa, Kharakhulakh, Marina, Khlevchuk, Tatiana, Khoo, Jeffrey, Kiatchoosakun, Songsak, Kinoshita, Noriyuki, Kinoshita, Masaharu, Kitamura, Ryoji, Kiyosue, Arihiro, Klavina, Irina, Klein, Eric J, Klimsa, Zdenek, Klonoff, David, Klug, Eric, Kobalava, Zhanna, Kodera, Satoshi, Koga, Tokushi, Kokkinos, Alexander, Koleckar, Pavel, Könyves, László, Koren, Michael J, Kormann, Adrian P, Kostner, Karam, Kreutzmann, Kristin, Krishinan, Saravanan, Krishnasamy, Sathya S, Krivosheeva, Inga, Kruljac, Ivan, Kubicki, Ted, Kuchar, Ladislav, Kujawiak, Monika, Kunishige, Hideyuki, Kurtinecz, Melinda, Kurtz Lisboa, Hugo R, Kushnir, Mykola, Kyyak, Yulian, Lace, Arija, Lakka, Timo, Lalic, Nebojsa, Lalic, Katarina, Lambadiari, Vaia, Lanaras, Leonidas, Lang, Chim, Langlois, Marie-France, Lash, Joseph, Latkovskis, Gustavs, Lau, David, Lazcano Soto, José Roberto, Le Roux, Carel, Ledesma, Gilbert N, Lee, Li Yuan, Lee, Thung-Lip, Lee, Kelvin, Lehrke, Michael, Leite, Silmara O, Leksycka, Agata, Lenzmeier, Thomas, Leonetti, Frida, Leonidova, Viktoriia, Lepor, Norman, Leung, Melissa, Levchenko, Olena, Levins, Peter, Levy, Louis J, Lewis, Matthew, Liberopoulos, Evangelos, Liberty, Idit, Lindholm, Carl-Johan, Lingvay, Ildiko, Linhart, Ales, Liu, Ming-En, Liu, Jenny, Lofton, Holly, Logemann, Timothy, Lombaard, Johannes J, Lombard, Landman, Lorraine, Richard, Lovell, Charles F, Ludvik, Bernhard, Lukaszewicz, Monika, Lupkovics, Géza, Lupovitch, Steven, Lupu, Sirona, Lynch, Mary, Lysak, Zoreslava, Lysenko, Tatyana A, Maeda, Hajime, Maeda, Itaru, Mæng, Michael, Mahajan, Ajay U, Maher, Vincent, Maia, Lilia N, Makotoko, Ellen M, Malavazos, Alexis, Malecha, Jan, Malicherova, Emilia, Manita, Mamoru, Mannucci, Edoardo, Mareev, Viacheslav, Marin, Liliana, Markova, Tatiana, Marso, Steven P, Martens, F.M.A.C., Martinez, Cuper, Martinez Cano, Carlos A, Martins, Cristina, Masmiquel Comas, Luis, Matsumoto, Takashi, Mcdonald, Kenneth, Mcgowan, Barbara, Mcgrew, Frank, Mclean, Barry K, Mcpherson, David D, Merino Torres, Juan Francisco, Meyers, Peter, Meyhöfer, Sebastian, Mezquita Raya, Pedro, Milanova, Maria, Milicic, Davor, Miller, Gary, Mills, Richard E, Mîndrescu, Nicoleta M, Mingrone, Geltrude, Minkova, Dotska A, Mirani, Marco, Miras, Alexander, Mistodie, Cristina V, Mitomo, Satoru, Mittal, Sanjay, Miyake, Taiji, Miyamoto, Naomasa, Molony, David, Monteiro, Pedro, Mooe, Thomas, Moosa, Naeem, Morales Portillo, Cristobal, Morales Villegas, Enrique C, Morawski, Emily J, Morbey, Claire, Morin, Robert P, Morisaki, Kuniaki, Morosanu, Magdalena, Mosenzon, Ofri, Mostovoy, Yuriy, Munir, Iqbal, Muratori, Fabrizio, Murray, Ryan, Murthy, Avinash, Myint, Min, Myshanych, Galyna, Nafornita, Valerica, Nagano, Takuya, Nair, Sunil, Nakhle, Samer N, Natsuaki, Masahiro, Nayak, Bindu M, Nibouche, Djamel Eddine, Nicholls, Stephen, Nicolau, José C, Nicolescu, Georgiana, Nierop, Peter, Niskanen, Leo, Ntaios, George, Nygård, Ottar Kjell, Oaks, Joshua B, Obrezan, Andrey, O'donnell, Philip, Oguri, Mitsutoshi, Oguzhan, Abdurrahman, Oh, Fumiki, Ohsugi, Mitsuru, Okada, Yoshio, Okayama, Hideki, Onaca, Adriana, Onaka, Haruhiko, Oneil, Patrick, Ong, Tiong Kiam, Ong, Stephen, Ono, Yasuhiro, Opsahl, Paul J, Ostrowska, Lucyna, Oviedo, Alejandra, Ozdogan, Oner, Ozpelit, Ebru, Pagkalos, Emmanouil, Pagotto, Uberto, Páll, Dénes, Pandey, Amritanshu- Shekhar, Parkhomenko, Oleksandr, Parvathareddy, Krishna Malakondareddy, Patel, Minesh B, Patsilinakos, Sotirios, Paul, Neil, Pedersen, Sue, Pereira, Isabel, Pereira, Edward Scott, Perez Terns, Paula, Perez-Vargas, Elba A, Pergaeva, Yulia, Perkelvald, Alexander, Peskov, Andrey B, Peter, Jonathan, Peters, Karina, Petit, Catherine, Petrov, Ivo, Philis-Tsimikas, Athena, Pietilä, Mikko, Pinto, Fausto, Piros, Annamária, Piyayotai, Dilok, Platonov, Dmitriy, Poirier, Paul, Pop, Lavinia, Popa, Bogdan, Pop-Busui, Rodica, Poremba, John, Porto, Alejandro, Postadzhiyan, Arman, Pothineni, Ramesh B, Potu, Ranganatha P, Powell, Talessa, Prafulla, Kerkar G, Prager, Rudolf, Prakova-Teneva, Zhulieta R, Pratley, Richard E, Price, Hermione, Pulka, Grazyna, Pullman, John, Punt, Zelda E, Purighalla, Raman S, Purnell, Peter, Qureshi, Mansoor, Rabasa-Lhoret, Remi, Raikhel, Marina A, Rancane, Gita, Randeva, Harpal, Rasouli, Neda, Reurean Pintilei, Delia V, Reyes, Ciro R, Rezgale, Inga, Rice, Eva, Riley, Thaddeus H, Risser, Joseph A, Ristic, Arsen, Rivas Fernández, Margarita, Robbins, David, Robitaille, Yves, Rodbard, Helena W, Rodriguez Plazas, Jaime A, Römer, T.J., Rosen, Glenn, Rosman, Dr Azhari, Rossi, Paulo, Rudenko, Leonid, Ruffin, Omari, Ruhani, Anwar Irawan, Runev, Nikolay, Ruyatkin, Dmitriy, Ruzic, Alen, Ryabov, Vyacheslav V, Rydén, Lars, Saggar, Suraj, Sakamoto, Tomohiro, Salter, Tim, Samal, Aditya K, Samoilova, Yulia, Sanabria, Hugo D, Sancak, Seda, Sangrigoli, Renee, Sansanayudh, Nakarin, Santini, Ferruccio, Saraiva, José F, Sardinov, Ruslan, Sargeant, William, Sari, Ramazan, Sathananthan, Airani, Sathyapalan, Thozhukat, Sato, Atsushi, Sauter, Joachim, Sbraccia, Paolo, Schaap, J., Schaum, Thomas, Schiele, François, Scott, John, Segal Lieberman, Gabriella, Segner, Alexander, Senior, Roxy, Sergeeva-Kondrachenko, Marina Y, Serota, Harvey, Serusclat, Pierre, Sethi, Rishi, Shah, Manoj K, Shah, Neerav, Shalaev, Sergey, Sharma, Raj, Sharma, Sumeet, Shaydyuk, Oksana, Shea, Heidi C, Shechter, Michael, Shehadeh, Naim, Shirazi, Mitra, Shlesinger, Yshay, Shneker, Ayham, Shutemova, Elena, Siasos, Gerasimos, Siddiqui, Imran A, Sidey, Jennifer, Sigal, Felix, Sime, Iveta, Singh, Narendra, Siraj, Elias, Sivalingam, Kanagaratnam, Skoczylas, Grzegorz, Smith, Stephen K, Smolenskaya, Olga, Snyder, Brian, Sofer, Yael, Sofley, C.W., Solano, Royce, Sonmez, Yusuf A, Sorokin, Maxim, Soto González, Alfonso, Sotolongo, Carlos, Soufer, Joseph, Soyluk Selcukbiricik, Ozlem, Spaic, Tamara, Spriggs, Douglas, Sreenan, Seamus, Stahl, Hans-Detlev, Stamatelopoulos, Kimon, Stanislavchuk, Mykola, Stankovic, Goran, Stasek, Josef, Steg, Gabriel, Steindorf, Joerg, Stephan, Dominique, Stewart, John, Still, Christopher, St-Maurice, Francois, Stogowska-Nikiciuk, Barbara, Stoker, Jeff, Stokic, Edita, Strzelecka, Anna, Sturm, Kerstin, Sueyoshi, Atsushi, Sugiura, Toshiyuki, Sultan, Senan, Suplotova, Lyudmila A, Suwanagool, Arisara, Suwanwalaikorn, Sompongse, Sveklina, Tatiana, Swanson, Neil, Swart, Henk, Swenson, Bradley P, Szyprowska, Ewa, Tait, Graeme, Takács, Róbert, Takeuchi, Yuzo, Tamirisa, Aparna, Tanaka, Hideki, Tatovic, Danijela, Tellier, Guy, Teragawa, Hiroki, Teterovska, Dace, Thomas, Nihal, Thuan, Jean-Francois, Tinahones, Francisco, Tisheva-Gospodinova, Snezhanka, Toarba, Cristina, Todoriuk, Liudmyla, Tokmakova, Mariya, Tonstad, Serena, Toplak, Hermann, Tran, Henry, Tripathy, Devjit, Trusau, Aliaksandr, Tsabedze, Nqoba, Tsougos, Elias, Tsoukas, George M, Tuccinardi, Dario, Tuna, Mazhar M, Turatti, Luiz A, Tziomalos, Konstantinos, Udommongkol, Chesda, Ueda, Osamu, Ukkola, Olavi, Unubol, Mustafa, Urbach, Dorothea, Urina Triana, Miguel A, Usdan, Lisa, Vaidya, Bijay, Vale, Noah, Vallieres, Gerald, Van Beek, Andre P, Van De Borne, Philippe, Van Der Walt, Eugene, Van Der Zwaan, C., Van Nieuwenhuizen, Elane, Van Zyl, Louis, Vanduynhoven, Philippe, Varghese, Kiron, Vasileva, Svetla P, Vassilev, Dobrin, Vathesatogkit, Prin, Velychko, Valentyna, Vercammen, Chris, Verges, Bruno, Verma, Subodh, Verwerft, Jan, Vesela, Alica, Veselovskaya, Nadezhda G, Vettor, Roberto, Veze, Irina, Vijan, Vinod, Vijayaraghavan, Ram, Villarino, Adriana, Vincent, Royce, Vinogradova, Oksana, Vishlitzky, Victor, Vlad, Adrian, Vladu, Ionela Mihaela, Vo, Anthony, Von Engelhardt, Charlotte, Von Münchhausen, Candy, Vorobyeva, Olga, Vossenberg, T., Vrolix, Mathias, Vukicevic, Marjana, Vyshnyvetskyy, Ivan, Wadvalla, Shahid, Wagner, Jan, Wakeling, John, Wallace, James, Wan Mohamed, Wan Mohd Izani, Wander, Gurpreet S, Ward, Kathleen, Warren, Mark L, Watanabe, Atsuyuki, Weber, Bruce, Weintraub, Howard, Weisnagel, John, Welker, James, Wendisch, Ulrich, Wenocur, Howard S, Wierum, Craig, Wilding, John, William, Maged, Wilson, Pete, Wilson, Jonathan P, Wong, Yuk-Ki, Wongcharoen, Wanwarang, Wozniak, Iwona, Wu, Chau-Chung, Wyatt, Nell, Wynne, Alan, Yamaguchi, Hiroshi, Yamasaki, Masahiro, Yazici, Dilek, Yeh, Hung-I, Yotov, Yoto, Yuan, Qingyang, Zacher, Jeffrey, Zagrebelnaya, Olga, Zaidman, Cesar J, Zalevskaya, Alsu, Zarich, Stuart, Zatelli, Maria Chiara, Zeller, Helga, Zhdanova, Elena A, Zornitzki, Taiba, Zrazhevskiy, Konstantin, Zykov, Mikhail, Lincoff, A Michael, Ryan, Donna H, Colhoun, Helen M, Deanfield, John E, Emerson, Scott S, Kahn, Steven E, Kushner, Robert F, Plutzky, Jorge, Brown-Frandsen, Kirstine, Hovingh, G Kees, Hardt-Lindberg, Soren, and Tornøe, Christoffer W

Abstract

Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure.

Published
2024
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27. Incidence of diabetes after SARS-CoV-2 infection in England and the implications of COVID-19 vaccination: a retrospective cohort study of 16 million people

Author

Taylor, Kurt, Eastwood, Sophie, Walker, Venexia, Cezard, Genevieve, Knight, Rochelle, Al Arab, Marwa, Wei, Yinghui, Horne, Elsie M F, Teece, Lucy, Forbes, Harriet, Walker, Alex, Fisher, Louis, Massey, Jon, Hopcroft, Lisa E M, Palmer, Tom, Cuitun Coronado, Jose, Ip, Samantha, Davy, Simon, Dillingham, Iain, Morton, Caroline, Greaves, Felix, Macleod, John, Goldacre, Ben, Wood, Angela, Chaturvedi, Nishi, Sterne, Jonathan A C, Denholm, Rachel, Al Arab, Marwa, Almaghrabi, Fatima, Andrews, Colm, Badrick, Ellena, Baz, Sarah, Beckford, Chelsea, Berman, Samantha, Bolton, Tom, Booth, Charlotte, Bowyer, Ruth, Boyd, Andy, Bridger-Staatz, Charis, Brophy, Sinead, Campbell, Archie, Campbell, Kirsteen C, Carnemolla, Alisia, Carpentieri, Jd, Cezard, Genevieve, Chaturvedi, Nishi, Cheetham, Nathan, Costello, Ruth, Cowling, Thomas, Crane, Matthew, Cuitun Coronado, Jose Ignacio, Curtis, Helen, Denaxas, Spiros, Denholm, Rachel, Di Gessa, Giorgio, Dobson, Richard, Douglas, Ian, Evans, Katharine M, Fang, Chao, Ferreira, Vanessa, Finnigan, Lucy, Fisher, Louis, Flaig, Robin, Folarin, Amos, Forbes, Harriet, Foster, Diane, Fox, Laura, Freydin, Maxim, Garcia, Paz, Gibson, Andy, Glen, Fiona, Goldacre, Ben, Goncalves Soares, Ana, Greaves, Felix, Green, Amelia, Green, Mark, Green, Michael, Griffith, Gareth, Hamill Howes, Lee, Hamilton, Olivia, Herbet, Annie, Herrett, Emily, Hopcroft, Lisa, Horne, Elsie, Hou, Bo, Hughes, Alun, Hulme, William, Huntley, Lizzie, Ip, Samantha, Jacques, Wels, Jezzard, Peter, Jones, Louise, Kanagaratnam, Arun, Karthikeyan Suseeladevi, Arun, Katikireddi, Vittal, Kellas, John, Kennedy, Jonathan I, Kibble, Milla, Knight, Rochelle, Knueppel, Anika, Kopasker, Daniel, Kromydas, Theocharis, Kwong, Alex, Langan, Sinead, Lemanska, Agnieszka, Lukaschuk, Elena, Mackenna, Brain, Macleod, John, Maddock, Jane, Mahalingasivam, Viyaasan, Mansfield, Kathryn, McArdle, Fintan, McCartney, Daniel, McEachan, Rosie, McElroy, Eoin, McLachlan, Stela, Mitchell, Ruth, Moltrecht, Bettina, Morley, Jess, Nab, Linda, Neubauer, Stefan, Nigrelli, Lidia, North, Teri, Northstone, Kate, Oakley, Jacqui, Palmer, Tom, Park, Chloe, Parker, Michael, Parsons, Sam, Patalay, Praveetha, Patel, Kishan, Perez-Reche, Francisco, Piechnik, Stefan, Piehlmaier, Dominik, Ploubidis, George, Rafeti, Elena, Raman, Betty, Ranjan, Yatharth, Rapala, Alicja, Rhead, Rebecca, Roberts, Amy, Sampri, Alexia, Sanders, Zeena-Britt, Santorelli, Gillian, Saunders, Laura C, Shah, Anoop, Shah, Syed Ahmar, Sharp, Steve, Shaw, Richard, Sheard, Laura, Sheikh, Aziz, Silverwood, Richard, Smeeth, Liam, Smith, Stephen, Stafford, Jean, Steptoe, Andrew, Sterne, Jonathan, Steves, Claire, Stewart, Callum, Taylor, Kurt, Tazare, John, Teece, Lucy, Thomas, Richard, Thompson, Ellen, Tilling, Kate, Timpson, Nicholas, Tomlinson, Laurie, Toms, Renin, Tunnicliffe, Elizabeth, Turner, Emma L, Walker, Alex, Walker, Venexia, Walter, Scott, Wang, Kevin, Wei, Yinghui, Whitehorn, Rebecca, Wielgoszewska, Bozena, Wild, James M, Willan, Kathryn, Willans, Robert, Williams, Dylan, Wong, Andrew, Wood, Angela, Woodward, Hannah, Wright, John, Yang, Tiffany, Zaninotto, Paola, Zheng, Bang, and Zhu, Jingmin

Abstract

Some studies have shown that the incidence of type 2 diabetes increases after a diagnosis of COVID-19, although the evidence is not conclusive. However, the effects of the COVID-19 vaccine on this association, or the effect on other diabetes subtypes, are not clear. We aimed to investigate the association between COVID-19 and incidence of type 2, type 1, gestational and non-specific diabetes, and the effect of COVID- 19 vaccination, up to 52 weeks after diagnosis.

Published
2024
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29. Changes in the Velocity Structure of the Greenland Ice Sheet

Author

Rignot, Eric and Kanagaratnam, Pannir

Subjects
Climate Action, General Science & Technology
Abstract

Using satellite radar interferometry observations of Greenland, we detected widespread glacier acceleration below 66 degrees north between 1996 and 2000, which rapidly expanded to 70 degrees north in 2005. Accelerated ice discharge in the west and particularly in the east doubled the ice sheet mass deficit in the last decade from 90 to 220 cubic kilometers per year. As more glaciers accelerate farther north, the contribution of Greenland to sea-level rise will continue to increase.

Published
2006

30. Recent ice loss from the Fleming and other glaciers, Wordie Bay, West Antarctic Peninsula

Author

Rignot, E, Casassa, G, Gogineni, S, Kanagaratnam, P, Krabill, W, Pritchard, H, Rivera, A, Thomas, R, Turner, J, and Vaughan, D

Subjects
Meteorology & Atmospheric Sciences
Abstract

Satellite radar interferometry data from 1995 to 2004, and airborne ice thickness data from 2002, reveal that the glaciers flowing into former Wordie Ice Shelf, West Antarctic Peninsula, discharge 6.8 ± 0.3 km3/yr of ice, which is 84 ± 30 percent larger than a snow accumulation of 3.7 ± 0.8 km3/yr over a 6,300 km2 drainage basin. Airborne and ICESat laser altimetry elevation data reveal glacier thinning at rates up to 2 m/yr. Fifty km from its ice front, Fleming Glacier flows 50 percent faster than it did in 1974 prior to the main collapse of Wordie Ice Shelf. We conclude that the glaciers accelerated following ice shelf removal, and have been thinning and losing mass to the ocean over the last decade. This and other observations suggest that the mass loss from the northern part of the Peninsula is not negligible at present. Copyright 2005 by the American Geophysical Union.

Published
2005

31. Accelerated Sea-Level Rise from West Antarctica

Author

Thomas, R, Rignot, E, Casassa, G, Kanagaratnam, P, Acuña, C, Akins, T, Brecher, H, Frederick, E, Gogineni, P, Krabill, W, Manizade, S, Ramamoorthy, H, Rivera, A, Russell, R, Sonntag, J, Swift, R, Yungel, J, and Zwally, J

Subjects
Climate Action, General Science & Technology
Abstract

Recent aircraft and satellite laser altimeter surveys of the Amundsen Sea sector of West Antarctica show that local glaciers are discharging about 250 cubic kilometers of ice per year to the ocean, almost 60% more than is accumulated within their catchment basins. This discharge is sufficient to raise sea level by more than 0.2 millimeters per year. Glacier thinning rates near the coast during 2002-2003 are much larger than those observed during the 1990s. Most of these glaciers flow into floating ice shelves over bedrock up to hundreds of meters deeper than previous estimates, providing exit routes for ice from further inland if ice-sheet collapse is under way.

Published
2004

32. Impact of left ventricular scar burden on response to two different modalities of conduction system CRT

Author

N A D I N E Ali, A D Arnold, A A A Miyazawa, D Keene, J J Chow, N S Peters, P Kanagaratnam, N Qureshi, F S Ng, D Lefroy, D P Francis, M Shun-Shin, G D Cole, and Z I Whinnett

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Introduction Cardiac resynchronisation therapy (CRT) in the form of His bundle CRT and left bundle area CRT can be more effective than the gold standard, biventricular pacing (BVP). In BVP scar burden is known to predict response whether this is true for these novel modalities is not known. Purpose The purpose of this study was to determine whether left ventricular scar burden assessed using cardiac MRI can be used to predict the electrical and acute haemodynamic response to two novel CRT modalities. Methods Patients with standard CRT indications were recruited. They underwent a pre-procedure cardiac MRI, with late gadolinium enhancement (LGE) to quantify scar. His bundle CRT (His CRT) and left bundle area CRT (LBA CRT) were attempted. The electrical response was measured using high precision non-invasive mapping ECGi (CardioInsight, Medtronic). The haemodynamic response was measured with a high precision protocol. We investigated the impact of scar and baseline electrical characteristic on ECGi and haemodynamic response. Results 26 patients were recruited (85% male, mean age 69 ± 10, with ischaemic cardiomyopathy in 35%). LGE was observed in 96% of cases and the mean (range 1-39%). We found a significant correlation between scar extent and the electrical response with both modalities. There was a significant correlation between a lower scar burden and better electrical response. For His CRT the reduction in left ventricular activation time was better with lower scar burden (R= 0.77, p < 0.01, Picture 1), for LBA CRT for reduction in left ventricular activation was also better with lower scar burden (R = 0.53, p = 0.05, Picture 2). With His CRT there was also a significant correlation between lower scar extent and better acute haemodynamic response ( R = 0.6, p = 0.002) but this was not observed with LBA CRT (R = 0.07, p = 0.77). Conclusion Left ventricular myocardial scar can be used to predict the electrical response to two different conduction system CRT modalities.

Published
2023
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33. The feasibility of utilising a cloud-based storage and analysis software in multicentre clinical electrophysiology research

Author

B S Kailey, P Calvert, M Wood, A Tyler, R Stewart, M Morgan, I Kemp, A Golosovs, A Balasundram, S Ganesananthan, Z Borbas, J Whitaker, P Kanagaratnam, D Gupta, and V Luther

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): BioSense Webster Investigator Initiated Study (IIS) Grant. Introduction The COVID-19 pandemic enforced long-term changes in healthcare towards remote working, implementing digital systems that support the safe online sharing of clinical information. A cloud-based storage and analysis software has been developed that uploads 3D mapping cases within the CARTO-3 system for remote review. In addition, it uses artificial intelligence/ machine learning to analyse large procedural datasets. We tested the feasibility of this technology as a future research tool in analysing the first 8 cases recruited to the Ripple AT PLUS study. Methods The Ripple AT PLUS trial is a planned multicentre randomised trial comparing ablation outcomes in scar based atrial tachycardia (AT) using different CARTO mapping approaches. The study recently commenced recruitment (September 2022). The CARTO files for the first 8 cases recruited into this study from different hospitals were securely transferred from CARTO 3 workstations to the Siemens teamplay gateway. Patient identifiers were removed, and anonymized datasets were successfully uploaded onto CARTONET Microsoft Azure cloud. A secure Web-site (https://eu.cartonet.net/login) was accessed for remote review by the research team. Results Uploaded study cases were readily separated from other clinical cases using a research filter. Figure 1 summarises graphical datasets for these study cases presented by CARTONET, (including total procedural duration, mapping vs ablation times, ablation lesions). Their corresponding numerical values were exportable as a Microsoft Excel spreadsheet for individualised review. More detailed mapping and ablation analytics within each case was feasible – this is exemplified in figure 2A, which presents a histogram of the proportion of acquired electrogram bipolar voltages below a modifiable cut-off (0.20mV in this example). Individual case data was easily extracted and combined from all study cases to test different hypothesis – again exemplified in figure 2B, which ascertains how tissue voltage might affect the amount of ablation delivered. Conclusion CARTONET is a secure, simple to use, and efficient cloud-based AI/machine learning system that offers access to clinically relevant data-sets from the CARTO system remotely from the hospital premises. This allows for a variety of rapid analytics, with the potential to improve the efficiency of multicentre clinical electrophysiology research collaboration.

Published
2023
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38. Ultra-high-frequency ECG assessment of QRS fragmentation predicts sudden cardiac death risk in inherited arrhythmia syndromes

Author

K Saleh, A Varnava, M J Shun-Shin, N Ali, J Mohal, K Chiew, M A Hanif, A J Merzah, J P Howard, P Jurak, P Leinveber, P Kanagaratnam, D P Francis, Z I Whinnett, and A Arnold

Subjects
Cardiology and Cardiovascular Medicine
Abstract

Background Fragmentation of the QRS complex, as a surrogate for scar or functionally disrupted ventricular activation, has been postulated as a risk factor for malignant ventricular arrhythmias across a range of cardiac diagnoses including cardiomyopathies, channelopathies and myocardial infarction. Fragmentation is subtle on the conventionally filtered 12-lead ECG and can easily be missed or over-diagnosed. Isolation of high-frequency (HF) QRS components could overcome this to demonstrate easily identifiable fragmentation but this has previously been limited by technological constraints resulting in a limited range of measured frequencies (150–300Hz). Ultra-high-frequency ECG (UHF-ECG) is a novel technology that utilises amplification and signal-averaging techniques to reliably measure frequencies up to 1000Hz. Purpose We explored the use of UHF-ECG in arrhythmia risk stratification. Methods We recruited 60 participants to undergo UHF-ECG recordings, including 23 healthy volunteers and 37 patients with inherited arrhythmia syndromes: 25 hypertrophic cardiomyopathy (HCM), 5 Brugada syndrome, 4 arrhythmogenic cardiomyopathy, 3 idiopathic ventricular fibrillation, 2 long QT syndrome and 1 non-ischaemic dilated cardiomyopathy. The arrhythmia risk status of patients with inherited disease was classified, by two independent researchers, into high or low risk based on their history of cardiac arrest, sustained ventricular arrhythmia, appropriate therapy, syncope and programmed ventricular stimulation result. A third researcher adjudicated disagreement. Two further researchers, blinded to aforementioned risk status, independently assessed the UHF-ECG recordings of all participants. Results 40 patients were classified as low risk, and 20 as high. Healthy volunteer UHF-ECGs showed uniform ventricular activation with single HF peaks in each lead. High-risk patients' UHF-ECGs showed multiple HF peaks, representing QRS fragmentation. The maximum number of HF peaks in any lead was used to measure severity of fragmentation. Example UHF-ECGs are shown in Figure 1. Fragmentation severity (number of peaks) correlated with arrhythmia risk status (chi-square statistic = 8.95, p-value = 0.03) across all participants (Figure 2) and when comparing high to low risk patients with inherited disease. UHF-ECG fragmentation could be observed even when the 12-lead ECG did not show any observable fragmentation. Among patients with inherited disease, patients with HCM showed the largest difference in UHF-ECG fragmentation between high and low risk. UHF-ECG fragmentation analysis showed excellent reproducibility with no difference in number of peaks identified between two independent assessors. Conclusion We demonstrate proof-of-concept that a novel ultra-high-frequency tool for measuring a broad range of high frequency QRS components can be used for sudden death risk stratification in patients with inherited cardiac conditions. Funding Acknowledgement Type of funding sources: None.

Published
2022
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43. Association between admission biomarkers and clinical outcome in older adults diagnosed with an infection in the emergency department

Author

Flamant, Lucas, Giordano Orsini, Guillaume, Ramont, Laurent, Gornet, Marion, De Ruffi, Sebastien, Leroux, Pierre, Kanagaratnam, Lukshe, and Gennai, Stéphane

Abstract

ABSTRACTIntroductionIn older adults, prognostic performances of admission biomarkers have been poorly investigated. This study aims to compare the prognostic abilities of usual admission biomarkers, especially PCT and CRP, for major clinical outcomes, comparing older to younger adults diagnosed with an infection in the ED, and to investigate the prognostic abilities of PCT and CRP depending on the glomerular filtration rate (GFR).MethodsIt was an observational, single-center, retrospective study, conducted in the Reims University Hospital, France. Endpoints were bacteremia, septic shock, and in-hospital mortality, related to the same ED visit.ResultsOver 1 year, 852 patients were included with 291 (34.2%) ≥75 years, and 127 (15.3%) patients had a GFR <30 mL.min−1.1.73 m2. Overall, 74 bacteremia, 56 septic shock and 82 in-hospital deaths have been observed. Prognostic abilities of admission biomarkers tended to be systematically lower in older compared to younger adults (PCT and CRP AUROC for bacteremia were, respectively, 0.71 and 0.62 in older adults vs0.75 and 0.70 in younger adults; PCT and CRP AUROC for septic shock were, respectively, 0.71 and 0.66 in older adults vs0.82 and 0.68 in younger adults). PCT showed a significant discriminating power for septic shock and in-hospital mortality only for GFR ≥ 30, and CRP showed a significant discriminating power for bacteremia and septic shock only for GFR ≥60.ConclusionCaution must be taken when interpreting admission biomarkers, as their prognostic abilities are lower in older adults or in patients with renal insufficiency diagnosed with an infection.

Published
2023
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