Publications by authors named "Bogun F"
Background: Arrhythmias originating from papillary muscles (PAPs) can be challenging when targeted with catheter ablation. The prevalence and impact of structural abnormalities on PAPs in patients with focal PAP arrhythmias is unknown.
Objectives: The purpose of this study was to analyze, in a consecutive patient series with focal PAP arrhythmias, the impact of structural abnormalities detected by multimodality imaging.
Catheter Ablation of Parahisian Premature Ventricular Complexes From the Right Sinus of Valsalva.
J Cardiovasc Electrophysiol
December 2024
Article Synopsis
- Cather ablation of parahisian PVCs often involves targeting the right sinuses of Valsalva (SoV), but there's limited data on its safety and effectiveness.
- * The study examined 11 male patients (average age 68) undergoing PVC ablation in the right SoV, finding that all had intramural LGE-CMR scar involvement, which affected the success rate.
- * Results showed that 91% of the patients had a successful reduction in PVC burden after the procedure, even though traditional indicators of success were not always present at the effective ablation sites.
Article Synopsis
- Coronary chronic total occlusion (CTO) increases the risk of ventricular arrhythmias (VAs), which can lead to serious heart issues like ventricular tachycardia and sudden cardiac death.
- A meta-analysis reviewing nine studies with over 3000 participants found that patients with CTOs have a 2.25 times higher risk of VAs compared to those with coronary artery disease (CAD) without CTOs.
- The analysis also suggested that percutaneous coronary intervention (PCI) for CTOs significantly lowers the risk of VAs compared to patients managed with optimal medication alone, indicating the potential benefits of revascularization.
Article Synopsis
- - Dofetilide, a class III antiarrhythmic, is used to treat atrial fibrillation and flutter, and has been applied off-label for ventricular arrhythmias like PVCs and VTs.
- - In a study involving 81 patients, dofetilide initiation showed a significant decrease in PVC burden, but was discontinued in some cases due to QT prolongation and lack of efficacy.
- - Overall, 72% of patients had to stop dofetilide due to inefficacy or intolerance, and there was no significant difference in event-free survival between those treated with dofetilide and those who weren't.
Article Synopsis
- * Most patients had drug-refractory VT, with a significant portion having low-voltage zones in the heart, particularly in the interventricular septum, indicating a specific substrate for VT.
- * After an average follow-up of 32 months, 41% of patients experienced sustained VT/VF recurrence, but those achieving complete procedural success had a reduced risk of recurrence compared to those who did not.
Article Synopsis
- A study evaluated 48 patients undergoing LGE-CMR imaging and ablation, finding that 69% had intramural LGE-CMR scars, which were linked to having more complex PVCs that often required treating multiple heart chambers.
- Despite the increased complexity in patients with scarring, the short-term success rate was 69% and long-term PVC burden was similar between those with and without the scars. *
Ventricular arrhythmias in patients with bicuspid aortic valves.
J Cardiovasc Electrophysiol
June 2024
Article Synopsis
- Bicuspid aortic valves (BAV) are common heart defects, and this study investigates the presence and types of ventricular arrhythmias (VAs) in patients with BAV, particularly looking at late gadolinium enhancement in cardiac imaging.
- The study involved 19 male patients, showing that frequent premature ventricular contractions (PVCs) and monomorphic ventricular tachycardias (VTs) were common, with the majority of VAs linked to the periaortic valve region.
- Results indicated that patients with more significant arrhythmias had larger areas of damaged heart tissue (LGE), and post-ablation, patients experienced a significant reduction in PVCs and improvement in heart function (ejection fraction).
Article Synopsis
- Cardiovascular magnetic resonance (CMR) is an important imaging tool for diagnosing heart issues and helping with treatment decisions, especially for patients with cardiac implantable electronic devices (CIED) who often face arrhythmias and cardiomyopathy.
- Over the past 16 years, advancements in both CIED and CMR technologies, as well as MR safety knowledge, underline the need for updated guidelines to ensure safe use of CMR in patients with these devices.
- The SCMR Expert Consensus Statement aims to bridge existing knowledge gaps by combining expert opinions and current data, ultimately supporting evidence-based practices for using CMR in CIED patients.
Background: Desmoplakin (DSP) pathogenic variants are rare causes of arrhythmogenic cardiomyopathy and often involve the right and left ventricles. Ventricular tachycardia (VT) ablations may be required in these patients, but procedural characteristics have not been reported.
Objectives: In this study, the authors sought to report a multicenter experience of VT ablation in patients with DSP pathogenic variants.
Article Synopsis
- Programed ventricular stimulation (PVS) is used to assess patients' risk for dangerous heart arrhythmias, but those with negative PVS results can still be at risk, especially if they have symptoms.* -
- This study followed 78 patients with symptomatic ventricular arrhythmias who had negative PVS and suffered from cardiac scarring, analyzing their long-term outcomes with implantable monitors.* -
- Findings revealed that 18% of patients required treatment for arrhythmias or experienced fainting, indicating that cardiac scarring significantly increases the likelihood of adverse events despite negative PVS results.*
Background: Patients with arrhythmias originating from papillary muscles (PAPs) often have pleomorphic ventricular arrhythmias (PVAs) that can result in failed ablations. The mechanism of PVAs is unknown.
Objective: The purpose of this study was to assess the prevalence and mechanisms of PVAs and the impact on outcomes in patients with focal left ventricular PAP ventricular arrhythmias (VAs).
Gender and race-related disparities in the management of ventricular arrhythmias.
Trends Cardiovasc Med
August 2024
Modern studies have revealed gender and race-related disparities in the management and outcomes of cardiac arrhythmias, but few studies have focused on outcomes for ventricular arrhythmias (VAs) such as ventricular tachycardia (VT) or ventricular fibrillation (VF). The aim of this article is to review relevant studies and identify outcome differences in the management of VA among Black and female patients. We found that female patients typically present younger for VA, are more likely to have recurrent VA after catheter ablation, are less likely to be prescribed antiarrhythmic medication, and are less likely to receive primary prevention ICD placement as compared to male patients.
View Article and Find Full Text PDFIntroduction: Variants of cardiomyopathy genes in patients with nonischemic cardiomyopathy (NICM) generate various phenotypes of cardiac scar and delayed enhancement cardiac magnetic resonance (DE-CMR) imaging which may impact ventricular tachycardia (VT) management.
Methods: The objective was to compare the findings of cardiomyopathy genetic testing on DE-CMR imaging and long-term outcomes among patients with NICM undergoing VT ablation procedures. Image phenotyping and genotyping were performed in a consecutive series of patients referred for VT ablation and correlated to survival free of VT.
Article Synopsis
- - The study focused on how the anatomy of papillary muscles (PAPs) relates to the mapping and successful ablation of ventricular arrhythmias (VAs) in patients.
- - Among 43 patients with frequent PAP arrhythmias, 40% had VAs originating from connections between PAPs and the surrounding myocardium, showing distinct electrocardiographic patterns.
- - Results indicated that patients with a higher number of PAP-myocardial connections (PAP-MYCs) had higher failure rates during ablation procedures, highlighting the importance of detailed anatomical imaging in treatment success.
Risk of Adverse Outcomes Associated With Cardiac Sarcoidosis Diagnostic Schemes.
JACC Clin Electrophysiol
August 2023
Article Synopsis
- A study evaluated the association of various cardiac sarcoidosis (CS) diagnostic criteria from different years (1993, 2006, 2014, and 2017) with negative health outcomes in patients.
- Research involved analyzing data from a global cardiac sarcoidosis registry and identified adverse events like mortality and surgeries in 587 patients.
- Results showed patients meeting the 1993 and 2006 criteria had significantly higher chances of experiencing adverse outcomes compared to those who didn't, while the 2014 and 2017 criteria did not show a significant correlation with these events.
Background: Frequent premature ventricular complexes (PVCs) can cause PVC-induced cardiomyopathy. The value of PVC ablation in patients with preserved left ventricular function in the low-normal range (ejection fraction: 50-55%) is not established. Strain analysis has been used to estimate changes in left ventricular function beyond assessment of the ejection fraction (EF).
View Article and Find Full Text PDF