Publications by authors named "Camille Frazier-Mills"
: Patients with postural orthostatic tachycardia syndrome (POTS) or neurogenic orthostatic hypotension (nOH) experience vertigo, confusion, and syncope. Compression garments help reduce venous pooling in these patients, thereby increasing cardiac output. We aimed to determine end-user opinions of compression products intended to alleviate symptoms for POTS and nOH.
View Article and Find Full Text PDFBackground: Implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D) are lifesaving treatments for patients at risk for sudden cardiac death. Effective physician-patient communication during the shared decision-making process is essential. Electrophysiologist-patient conversations were targeted to obtain objective data on the interaction, understand the conversation framework, and uncover opportunities for improved communication.
View Article and Find Full Text PDFColchicine for the Prevention of Recurrent Arrhythmia After Catheter Ablation of Atrial Fibrillation: Results of a Single-Center, Retrospective Study.
Am J Cardiovasc Drugs
November 2023
Background: There is evidence to suggest that colchicine reduces the risk of recurrent atrial fibrillation (AF) after catheter ablation; however, the tolerability and safety of colchicine in routine practice is unknown.
Methods: Patients undergoing catheter ablation for AF who received colchicine after ablation were matched 1:1 to patients who did not by age, sex, and renal function. Recurrent AF was compared between groups categorically at 12 months and via propensity weighted Cox proportional hazards models with and without a 3-month blanking period.
Association of leadless pacing with ventricular and valvular function.
J Cardiovasc Electrophysiol
November 2023
Article Synopsis
- Traditional transvenous pacemakers can negatively affect tricuspid valve function and cause problems with right ventricular (RV) pacing, but the impact of leadless pacemakers on these functions isn't well understood.
- A study conducted at Duke University analyzed the echocardiographic results of 54 patients receiving leadless pacemakers, finding no significant change in tricuspid regurgitation but a notable decrease in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) after 8.9 months.
- The conclusion indicates that while leadless pacemakers didn't worsen valve function in the short term, they were linked to a decrease in biventricular function, reflecting the
Remote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics.
View Article and Find Full Text PDFRemote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics.
View Article and Find Full Text PDFRemote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics.
View Article and Find Full Text PDFBackground: Alert-driven remote patient monitoring (RPM) or fully virtual care without routine evaluations may reduce clinic workload and promote more efficient resource allocation, principally by diminishing nonactionable patient encounters.
Objective: The purpose of this study was to conduct a cost-consequence analysis to compare 3 postimplant implantable cardioverter-defibrillator (ICD) follow-up strategies: (1) in-person evaluation (IPE) only; (2) RPM-conventional (hybrid of IPE and RPM); and (3) RPM-alert (alert-based ICD follow-up).
Methods: We constructed a decision-analytic Markov model to estimate the costs and benefits of the 3 strategies over a 2-year time horizon from the perspective of the US Medicare payer.
Introduction: Micra atrioventricular (AV) provides leadless atrioventricular synchronous pacing by sensing atrial contraction (A4 signal). Real-world operation and reliability of AV synchrony (AVS) assessment using device data have not been described. The purposes of this study were to (1) assess the correlation between AVS and atrial mechanical sensed-ventricular pacing (AM-VP) percentages in patients with permanent high-degree AV block and (2) report on the real-world effectiveness of Micra AV.
View Article and Find Full Text PDFDespite advances in syncope evaluation strategies and risk stratification, the high cost of syncope is largely driven by extensive and often repetitive testing. This analysis of a large deidentified US claims database compared the use of diagnostic tests, therapeutic procedures, and the recurrence rate of acute syncope events before and after placement of an insertable cardiac monitor (ICM) in syncope patients. The patients had a minimum of 1 year of continuous enrollment before and 2 years after ICM placement.
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- CIED infections are common complications tied to traditional cardiac implanted devices, causing significant health risks, but leadless pacemakers may reduce these issues by avoiding surgical pocket complications.
- A study at Duke University examined patient outcomes from leadless pacemaker implantations after CIED system extractions due to infection, focusing on complications and performance.
- In a group of 39 patients, mostly older adults, only 3 major complications arose during an average follow-up of nearly 25 months, and notably, there were no cases of recurrent infections post-implantation.
Article Synopsis
- - The study assessed the real-world effectiveness of AV-synchronous leadless pacemakers by examining outcomes and programming adjustments in patients who had the device implanted from February 2020 to April 2021.
- - Out of 50 patients, many experienced improvements in tracking and AV synchrony, especially those with complete heart block, indicating that adjustments to device settings were often necessary and beneficial.
- - Overall, the findings suggest that frequent programming changes can enhance device performance and patient outcomes, particularly in enhancing the coordination between the heart's atria and ventricles.
Article Synopsis
- Diabetes mellitus (DM) is linked to increased risk of recurrence in atrial fibrillation (AF) after catheter ablation, as shown in a study comparing outcomes between patients with and without DM.
- The study analyzed 351 patients and found those with DM tended to be older, heavier, and had more persistent AF, but had similar rates of complications during the procedure.
- After a median follow-up of nearly 30 months, patients with DM experienced significantly higher rates of AF recurrence, indicating that managing blood sugar levels may be crucial in these patients.
Importance: The proportion of women and underrepresented racial and ethnic groups (UREGs) matriculating into general cardiology fellowships remains low.
Objective: To assess a systematic recruitment initiative aimed at ensuring adequate matriculation of women and UREGs in a general cardiology fellowship.
Design, Setting, And Participants: This quality improvement study took place at a large, tertiary academic medical center and associated Accreditation Council for Graduate Medical Education Cardiovascular Disease fellowship.
Background: Leadless pacemakers (LPs) provide ventricular pacing without the risks associated with transvenous leads and device pockets. LPs are appealing for patients who need pacing, but do not need defibrillator or cardiac resynchronization therapy. Most implanted LPs provide right ventricular pacing without atrioventricular synchrony (VVIR mode).
View Article and Find Full Text PDFIn the COVID-19 era, the heart failure community has witnessed an unprecedented reduction in heart failure-related patient visits and hospitalizations. Social distancing measures present a dilemma for patients with heart failure who require frequent surveillance of volume status and vital signs to minimize heart failure-related symptoms and hospitalizations. With the rise of telemedicine comes an increased focus on remote monitoring technologies.
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- This study aimed to analyze the reasons, features, and results of cardiovascular implantable electronic device (CIED) surgeries in patients who have undergone left ventricular assist device (LVAD) implantation.
- A total of 159 LVAD recipients underwent CIED surgeries between 2009 and 2019, with a higher likelihood for pocket hematomas and infections after the procedures, as well as a 20% mortality rate within one year.
- The findings highlight the need for further research to evaluate the risks versus benefits of CIED surgeries in patients with LVADs.
Introduction: Lead dysfunction can lead to serious consequences including failure to treat ventricular tachycardia or fibrillation (VT/VF). The incidence and mechanisms of lead dysfunction following left ventricular assist device (LVAD) implantation are not well-described. We sought to determine the incidence, mechanisms, timing, and complications of right ventricular lead dysfunction requiring revision following LVAD implantation.
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- Catheter ablation is an effective treatment for atrial fibrillation (AF) in patients with heart failure (HF), and this study compares its efficacy between those with ischemic and nonischemic heart failure.
- The research involved 242 patients, showing that nonischemic patients were generally younger and had better heart function, but overall outcomes in symptom relief and functional status were similar across both groups after the procedure.
- Both groups experienced significant improvements in their symptoms and functional abilities post-ablation, and there was no notable difference in the recurrence of atrial arrhythmias at 12 months between ischemic (74%) and nonischemic patients (78%).
Article Synopsis
- ! Catheter ablation for atrial fibrillation (AF) improves outcomes in heart failure (HF) patients compared to medication, but existing risk scores for predicting AF recurrence (CAAP-AF and APPLE) have not been validated specifically for this group. * ! In a study of 230 HF patients who underwent pulmonary vein isolation (PVI), 33% experienced recurrent AF within 12 months, yet the risk scores did not significantly differ between those with and without recurrence. * ! Overall, the predictive ability of the existing risk scores for AF recurrence in HF patients is limited, indicating a need for better tools for risk assessment in this population. *
Background: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) with preserved ejection fraction (HFpEF).
Objective: The purpose of this study was to compare outcomes of AF ablation in patients with HFpEF vs HF with reduced ejection fraction (HFrEF).
Methods: We performed a retrospective study of 230 patients with HF who underwent AF ablation, including 97 (42.