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35 results on '"Steinhaus, Daniel"'

2. Pulsed Field vs Conventional Thermal Ablation for Paroxysmal Atrial Fibrillation: Recurrent Atrial Arrhythmia Burden

Author

Whang, William, Reddy, Vivek, Koruth, Jacob, Dukkipati, Srinivas, DeLurgio, David, Patel, Anshul, Osorio, Jose, Rajendra, Anil, Morales, Gustavo, D'Souza, Benjamin, Bullinga, John, Cuoco, Frank, Sidney, Darren, Daccarett, Marcos, Harding, John, Sangrigoli, Robert, Pickett, Robert, Kaiser, Daniel, Natale, Andrea, Gallinghouse, Joseph, Gupta, Sanjaya, Steinhaus, Daniel, Mansour, Moussa, Heist, Kevin, Van Houzen, Nathan, Winterfield, Jeffrey, Field, Michael, McElderry, Tom, Maddox, William, Chinitz, Larry, Holmes, Douglas, Calkins, Hugh, Spragg, David, Eldadah, Zayd, Lee, Sung, Thomaides, Athanasios, Mangrum, Michael, Gibson, Douglas, Olson, Nicholas, Woods, Christopher, Schricker, Amir, Ellis, Christopher, Michaud, Gregory, Gerstenfeld, Edward, Moss, Joshua David, Dewland, Thomas, Mountantonakis, Stavros, Skipitaris, Nicholas, Bhasin, Kabir, Su, Wilber, Zawaneh, Michael, Weiss, Jonathan P., Santangeli, Pasquale, Lin, David, Kim, Jamie, Haugh, Connor, Latacha, Matthew, Patel, Chinmay, Link, Michael, Ellenbogen, Kenneth, Koneru, Jayanthi, Halperin, Blair, Jones, D. Randolph, D'Avila, Andre, Waks, Jonathan, Kumar, Kapil, Reddy, Vivek Y., d'Avila, Andre, Gupta, Sanjaya K., Eldadah, Zayd A., Pickett, Robert A., Su, Wilber W., Waks, Jonathan W., Schneider, Christopher W., Richards, Elizabeth, Albrecht, Elizabeth M., Sutton, Brad S., and Gerstenfeld, Edward P.

Published
2024
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18. Accuracy of the Apple watch for detection of AF: A multicenter experience.

Author

Wasserlauf, Jeremiah, Vogel, Kelly, Whisler, Cailin, Benjamin, Emelia, Helm, Robert, Steinhaus, Daniel A., Yousuf, Omair, and Passman, Rod S.

Subjects
ATRIAL fibrillation diagnosis, RESEARCH evaluation, PREDICTIVE tests, WEARABLE technology, PATIENT monitoring, DESCRIPTIVE statistics, SENSITIVITY & specificity (Statistics)
Abstract

Introduction: The Apple watch (AW) irregular rhythm notification (IRN) feature uses photoplethysmography to identify prolonged episodes of irregular rhythm suggestive of atrial fibrillation (AF). IRN is FDA cleared for those with no previous history of AF, however, these devices are increasingly being used for AF management. The objective of the present study was to determine the accuracy of the IRN in subjects with a previous diagnosis of nonpermanent AF. Methods: Subjects with a history of nonpermanent AF and either an insertable cardiac monitor (ICM) or cardiac implanted electronic device (CIED) with <5% ventricular pacing were fitted with an AW Series 5 for 6 months. AF episodes were compared between the ICM/CIED and IRN. The primary endpoints were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the IRN by subject for AF ≥1 h. Secondary endpoints were sensitivity and PPV by AF episode ≥1 h. Analysis was limited to a maximum of 10 ICM/CIED episodes per subject and included only those AF episodes occurring during active AW use confirmed by activity data. Results: Thirty participants were enrolled. Mean age was 65.4 ± 12.2 years and 40% were female. There were 10 ICMs and 20 CIEDs. Eleven subjects had AF on ICM/CIED while the AW was worn, of whom 8 were detected by IRN. There were no false positive IRN detections by subject ("by subject" 72% sensitivity, 100% specificity, 100% PPV, and 90% NPV). Five subjects had AF only when the AW was not worn. There were a total of 70 AF episodes on ICM/CIED, 35 of which occurred while the AW was being worn. Of these, 21 were detected by IRN with 1 false positive ("by episode" sensitivity = 60.0%, PPV = 95.5%). Conclusion: In a population with known AF, the AW IRN had a low rate of false positive detections and high specificity. Sensitivity for detection by subject and by AF episode was lower. The current IRN algorithm appears accurate for AF screening as currently cleared, but increased sensitivity and wear times would be necessary for disease management. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Hyperdynamic left ventricular ejection fraction in the intensive care unit

Author

Massachusetts Institute of Technology. Institute for Medical Engineering & Science, Paonessa, Joseph R., Brennan, Thomas, Pimentel, Marco, Steinhaus, Daniel, Feng, Mengling, Celi, Leo A., Massachusetts Institute of Technology. Institute for Medical Engineering & Science, Paonessa, Joseph R., Brennan, Thomas, Pimentel, Marco, Steinhaus, Daniel, Feng, Mengling, and Celi, Leo A.

Abstract

Introduction Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database. Methods We conducted a longitudinal, single-center, retrospective cohort study of adult patients who underwent echocardiography during a medical or surgical ICU admission at the Beth Israel Deaconess Medical Center using the Multiparameter Intelligent Monitoring in Intensive Care II database. The final cohort had 2867 patients, of whom 324 had HDLVEF, defined as an ejection fraction >70 %. Patients with an ejection fraction <55 % were excluded. Results Compared with critically ill patients with normal left ventricular ejection fraction, the finding of HDLVEF in critically ill patients was associated with female sex, increased age, and the diagnoses of hypertension and cancer. Patients with HDLVEF had increased 28-day mortality compared with those with normal ejection fraction in multivariate logistic regression analysis adjusted for age, sex, Sequential Organ Failure Assessment score, Elixhauser score for comorbidities, vasopressor use, and mechanical ventilation use (odds ratio 1.38, 95 % confidence interval 1.039–1.842, p =0.02). Conclusions The presence of HDLVEF portended increased 28-day mortality, and may be helpful as a gravity marker for prognosis in patients admitted to the ICU. Further research is warranted to gain a better understanding of how these patients respond to common interventions in the ICU and to determine if pharmacologic modulation of HDLVEF improves outcomes.

Published
2021

25. Chocolate intake and incidence of heart failure : Findings from the Cohort of Swedish Men.

Author

Steinhaus, Daniel A, Mostofsky, Elizabeth, Levitan, Emily B, Dorans, Kirsten S, Håkansson, Niclas, Wolk, Alicja, Mittleman, Murray A, Steinhaus, Daniel A, Mostofsky, Elizabeth, Levitan, Emily B, Dorans, Kirsten S, Håkansson, Niclas, Wolk, Alicja, and Mittleman, Murray A

Abstract

The objective of this study was to evaluate the association of chocolate consumption and heart failure (HF) in a large population of Swedish men. METHODS: We conducted a prospective cohort study of 31,917 men 45-79 years old with no history of myocardial infarction, diabetes, or HF at baseline who were participants in the population-based Cohort of Swedish Men study. Chocolate consumption was assessed through a self-administrated food frequency questionnaire. Participants were followed for HF hospitalization or mortality from January 1, 1998, to December 31, 2011, using record linkage to the Swedish inpatient and cause-of-death registries. RESULTS: During 14 years of follow-up, 2,157 men were hospitalized (n=1,901) or died from incident HF (n=256). Compared with subjects who reported no chocolate intake, the multivariable-adjusted rate ratio of HF was 0.88 (95% CI 0.78-0.99) for those consuming 1-3 servings per month, 0.83 (95% CI 0.72-0.94) for those consuming 1-2 servings per week, 0.82 (95% CI 0.68-0.99) for those consuming 3-6 servings per week, and 1.10 (95% CI 0.84-1.45) for those consuming ≥1 serving per day (P for quadratic trend=.001). CONCLUSIONS: In this large prospective cohort study, there was a J-shaped relationship between chocolate consumption and HF incidence. Moderate chocolate consumption was associated with a lower rate of HF hospitalization or death, but the protective association was not observed among individuals consuming ≥1 serving per day. Journal Subject Codes: Etiology: Epidemiology, Heart failure: Congestive.

Published
2017
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32. Simulation Curriculum in Internal Medicine: Decision-Making Training for Interns Focusing on Acute Clinical Scenarios in Critical Care

Author

Heath, Janae, primary, Kohn, Rachel, additional, Sargsyan, Zaven, additional, Alba, George, additional, Miloslavsky, Eli, additional, Barbash, Ian, additional, Fraser, Traci, additional, Genuardi, Michael, additional, Hayden, Emily, additional, Mathai, Susan, additional, Steinhaus, Daniel, additional, and Currier, Paul, additional

Published
2015
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35. Abstract 16047: A Comparison of Vascular Access Closure Methods Following Atrial Fibrillation/Flutter Catheter Ablation: Insights From the Vascular Closure for Cardiac Ablation Registry (VACCAR)

Author

Gupta, Sanjaya, Moghniuddin, Mohammed, Ramirez, Rigoberto, Yousuf, Omair, Ramza, Brian M, Giocondo, Michael J, Steinhaus, Daniel, and Wimmer, Alan P

Abstract

Introduction:Venous access site management after atrial fibrillation/flutter catheter ablation (CA) traditionally consisted of manual compression (MC). Figure of 8 stitch (FO8) is an alternative and recently vascular closure device (VCD) (Perclose, Abbott Vascular) also received FDA approval for venous closure. There is a paucity of data on outcomes using these methods.Methods:VACCAR assessed outcomes of 3 vascular closure methods following CA. The use of MC, FO8 or VCD was left to the electrophysiologist. MC patients laid flat until activated clotting time (ACT) < 165 seconds then underwent MC and laid flat for 3 more hours. FO8 and VCD patients were allowed to ambulate as soon as 1-hour post procedure, if recovered from anesthesia. Patients were surveyed on their recovery experience. Analysis was performed using Kruskal-Wallis test and posthoc analysis was done by Dunn test with Bonferroni correction. Continuous data is presented as median (interquartile range). Categorical data was analyzed with Chi square or Fisher?s exact test and presented as percentage.Results:Over 18 months, 157 patients received MC, 205 received F08 and 74 received VCD. The median time from procedure end to first ambulation was 6.5 (4.9-7.7) hours for MC, 2.2 (1.3-3.5) hours for F08 and 2.3 (1.4-3.5) hours for VCD. This was significantly longer for MC (p<0.0005) but there was no significant difference between F08 and VCD. The median length of stay was significantly smaller for VCD at 28 (25-29) hours as compared to 29 (28-30) hours for MC (p = 0.005) and 29 (27-30) hours for FO8 (p = 0.02). There was a higher rate of same day discharge in F08 (11.8 %) and VCD (17.6 %) patients as compared to MC (3.3 %) (p = 0.001). The rate of complications was low with only 1 major complication in MC group. There was no significant difference in 3 groups for minor complications (2.6% in MC, 1.5% in F08, 4% in VCD; p = 0.36). Patient satisfaction and perception of pain did not differ between the 3 groups.Conclusion:This is the first registry to compare 3 different methods of vascular closure following electrophysiology procedures. This registry demonstrates the safety and feasibility of both F08 and VCD as an alternative to MC. This has implications for overall workflow and resource utilization.

Published
2019
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