Publications by authors named "Bradley M Pitman"
Objective: To examine the associations between specific dietary patterns and incident atrial fibrillation (AF).
Methods: Using data from the UK Biobank, dietary intakes were calculated from 24-hour diet recall questionnaires. Indices representing adherence to dietary patterns (Mediterranean-style, Dietary Approaches to Stop Hypertension (DASH) and plant-based diets) were scored, and ultra-processed food consumption was studied as a percentage of total food mass consumed.
Article Synopsis
- The study aimed to evaluate how factors like vector length, implant angle, and patient characteristics influence the accuracy of electrogram sensing in insertable cardiac monitors (ICMs).
- It involved analyzing 1800 ECG tracings from 150 participants using different distances, angles, and postures, finding that longer vector lengths (75 mm) and oblique angles improved P- and R-wave amplitudes significantly.
- The findings suggest that optimizing vector length and implant angle can enhance electrogram visibility, which is crucial for reducing false alerts in cardiac monitoring.
Unlabelled: Although cardiac resynchronization therapy (CRT) is an established therapy in selected patients with heart failure with reduced ejection fraction (HFrEF), its role in orthotopic heart transplant (OHT) recipients remains understudied. We describe a case of successful CRT implantation in an OHT recipient for HFrEF and high-grade atrioventricular block. This case highlights the deliberations made given the lack of clinical trial and observational evidence for this therapy in OHT recipients.
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- * Out of 3,000 screened individuals, only 0.43% were diagnosed with AF, with a higher prevalence in older age groups, particularly those over 70 years.
- * Overall, the findings suggest that while AF is relatively rare in this younger population, its prevalence increases with age, highlighting the need for better awareness and screening in older demographics.
Article Synopsis
- Most modern cardiac implantable electronic devices (CIEDs) can now undergo MRI scans, which requires both pre- and post-scan checks, leading to increased workload for cardiac services.
- A study covering three years revealed 739 CIED checks related to MRI scans, showing a rise in the demand for these checks over time.
- The projected annual cost for handling CIED checks is expected to reach AUD$161,695 in ten years, highlighting the need for better budgeting and staff management.
Objective: Prior data have shown rising acute myocardial infarction (MI) trends in Australia; whether these increases have continued in recent years is not known. This study thus sought to characterise contemporary nationwide trends in MI hospitalisations and coronary procedures in Australia and their associated economic burden.
Methods: The primary outcome measure was the incidence and time trends of total MI, ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) hospitalisations from 1993 to 2017.
Article Synopsis
- - The study investigates how cardiorespiratory fitness (CRF) and obesity impact the mechanical function of the left atrium (LA) in patients with atrial fibrillation (AF).
- - Results reveal that higher CRF is linked to better LA function and less stiffness, while obesity leads to larger LA volumes but does not significantly affect LA function.
- - The findings suggest that promoting higher CRF could benefit AF patients by improving their LA mechanics, despite the negative implications of obesity on heart structure.
Background: Little data exists on electrogram sensing in current generation of miniaturized insertable cardiac monitors (ICMs).
Objective: To compare the sensing capability of ICM with different vector length: Medtronic Reveal LINQ (~40 mm) vs. Biotronik Biomonitor III (BM-III, ~70 mm).
Atrial fibrillation (AF) is the most common cardiac tachyarrhythmia and has a rising global prevalence. Given the increasing burden of AF-related symptoms and complications, new approaches to management are required. Anemia and iron deficiency are common conditions in patients with AF.
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- A study analyzed cardiac implantable electronic device (CIED) checks requested from the emergency department (ED) over a year to determine how often significant issues arise from these checks.
- It was found that 28% of the checks revealed clinically relevant issues, particularly after-hours checks had a higher rate of issues compared to during regular hours.
- Patient-reported ICD shocks and a history of atrial fibrillation (AF) were identified as strong predictors for finding significant issues, while common complaints like syncope/presyncope were less predictive.
Article Synopsis
- - The study investigated the relationship between alcohol consumption and the risk of bradyarrhythmias, using data from the UK Biobank with a focus on various types of alcohol beverages.
- - Researchers followed nearly 408,000 individuals for over 11 years, finding that higher total alcohol consumption did not correlate with increased bradyarrhythmia risk, while beer and cider consumption showed some associations at lower levels.
- - The findings suggest that different types of alcoholic beverages may affect bradyarrhythmias differently, and further research is needed to better understand these relationships.
Article Synopsis
- A study investigated the link between alcohol consumption and the risk of incident ventricular arrhythmias (VAs) and sudden cardiac death (SCD) using data from the UK Biobank, which included over 400,000 middle-aged individuals.
- The research found no significant overall relationship between total alcohol consumption and VAs, but identified that consuming higher amounts of spirits might increase the risk of VAs.
- For SCD, a U-shaped relationship was observed, where moderate alcohol consumption (less than 26 drinks per week) was associated with the lowest risk, while higher consumption of beer and spirits was linked to an increased risk, and wine consumption seemed to reduce risk.
Risk Thresholds for Total and Beverage-Specific Alcohol Consumption and Incident Atrial Fibrillation.
JACC Clin Electrophysiol
December 2021
Objectives: This study sought to characterize associations of total and beverage-specific alcohol consumption with incident atrial fibrillation (AF).
Background: Although binge drinking and moderate to high consumption of alcohol are both established risk factors for AF, comparatively less is known about the effect of low alcohol consumption and whether associations differ by specific alcoholic beverages.
Methods: Using data from the UK Biobank, total and beverage-specific alcohol consumption was calculated as UK standard drinks (8 g alcohol) per week.
Background: Atrial fibrillation (AF) screening using mobile single-lead electrocardiogram (ECG) devices has demonstrated variable sensitivity and specificity. However, limited data exists on the use of such devices in low-resource countries.
Objective: The goal of the research was to evaluate the utility of the KardiaMobile device's (AliveCor Inc) automated algorithm for AF screening in a semirural Ethiopian population.
Background: Indigenous Australians experience a greater burden of AF. Whether this is in-part due to differences in arrhythmogenic structures that appear to contribute to AF differences amongst other ethnicities is not known.
Methods: We studied forty individuals matched for ethnicity and other AF risk factors.
Background: The epidemiology of atrial fibrillation (AF) amongst Indigenous populations remains poorly characterised. We studied hospitalisations for AF in Central Australia, the most populous Indigenous region in the country.
Methods: Patients with a diagnosis of AF admitted to Alice Springs Hospital, the only secondary health care facility and provider of cardiac care in remote Central Australia, were identified from 2006 to 2016.
Article Synopsis
- - A systematic review and meta-analysis of 28 studies involving over 365,000 patients with atrial fibrillation (AF) found that anemia significantly worsens health outcomes, increasing mortality and bleeding risks.
- - Anemia was linked to a 78% higher risk of all-cause mortality, 60% increase in cardiovascular mortality, and significantly elevated risks for stroke and major bleeding events.
- - The study highlights the need for further research into the causes and treatment of anemia in AF patients to potentially improve their clinical outcomes.
Objective: To characterize contemporary pacemaker procedure trends.
Methods: Nationwide analysis of pacemaker procedures and costs between 2008 and 2017 in Australia. The main outcome measures were total, age- and gender-specific implant, replacement, and complication rates, and costs.
Article Synopsis
- The study investigates the long-term impacts of coronary calcification and coronary artery disease (CAD) as seen on CT coronary angiography (CTCA) in Indigenous and non-Indigenous Australians from 2013 to 2017.
- Out of 347 patients, coronary calcification was found in 50% of cases, with varied CAD diagnoses, and while Indigenous ethnicity was initially linked to higher calcification and CAD, this association faded when considering other health conditions.
- Findings show that those with coronary calcification and obstructive CAD had significantly higher rates of major adverse cardiovascular events (MACE), suggesting that CTCA is useful in assessing heart disease risk in remote populations.
Article Synopsis
- A 22-year-old male with a pacemaker experienced acute shortness of breath due to a severe para-valvular leak following an aortic valve replacement and a motor vehicle accident.
- While checking the pacemaker, an initialization process caused unintended asynchronous pacing, triggering a rapid supraventricular tachycardia that led to clinical deterioration.
- Recommendations for device manufacturers include redesigning programmer wands to eliminate built-in magnets to prevent accidental arrhythmias during device interrogation.
Article Synopsis
- Research shows that anticoagulation for atrial fibrillation (AF) is underutilized, especially among Indigenous Australians who are at higher risk for AF and stroke.
- A study analyzed data over 12 years from nearly 19,700 participants to identify factors influencing anticoagulation use, revealing that conditions like hypertension, diabetes, heart failure, and prior strokes increased usage, while older age, female gender, and vascular disease decreased it.
- The findings indicate that anticoagulation use is inadequate in both groups, with a particular concern that hypertension may not be recognized as a significant stroke risk in Indigenous Australians, suggesting a need for improved awareness and treatment efforts.
• LVOT pseudoaneurysm is a rare but important complication of cardiothoracic surgery. • It can present insidiously and is often detected on surveillance echocardiography. • Anatomy can be difficult to elucidate and is shown best with multi-modality imaging.
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- A study investigated the anticoagulation quality in Indigenous Australians with atrial fibrillation (AF), revealing that they have significantly lower time in therapeutic range (TTR) compared to non-Indigenous Australians.
- Data collected from 512 patients showed that despite being younger, Indigenous Australians faced more health issues, contributing to their poorer TTR rates.
- The findings highlight the need for better monitoring of warfarin therapy in both Indigenous and non-Indigenous patients to reduce the risk of strokes.