Publications by authors named "Chi K Ching"
Article Synopsis
- The study investigates the effectiveness and safety of pulsed field ablation (PFA) for treating atrial fibrillation (AF) in Asia, specifically focusing on its use for pulmonary vein isolation (PVI) and optional posterior wall ablation (PWA).
- A total of 101 AF patients were analyzed, revealing a 1-year atrial arrhythmia recurrence rate of 10% for paroxysmal AF and 21% for persistent AF, with no significant differences in efficacy between PVI-only and PVI + PWA approaches.
- The research concludes that PFA is a safe and effective method for AF ablation, with the additional PWA not leading to increased complications while maintaining procedural efficiency.*
Introduction: Remote monitoring (RM) for cardiac implantable electronic devices is on the rise and has been shown to reduce the burden of in-clinic follow-up visits. We aimed to investigate the long-term clinical outcomes of RM versus no RM.
Methods: This was a prospective, single-centre cohort study of consecutive patients with an implantable cardioverter-defibrillator (ICD) or cardiac resynchronisation therapy-defibrillator (CRT-D) followed up from 2018 to 2023.
Longitudinal reduction in fluoroscopy with continued use of 3-dimensional electroanatomic mapping systems in catheter ablation of supraventricular tachycardia - then and now.
Indian Pacing Electrophysiol J
June 2024
Article Synopsis
- Catheter ablation is an effective treatment for supraventricular tachycardia (SVT), and this study investigates the impact of 3D-electroanatomic mapping (EAM) on fluoroscopy time during the procedure.
- Over 1750 SVT ablation cases were analyzed, finding that EAM leads to longer procedure times but significantly reduces fluoroscopy time (by about 20 minutes) and radiation exposure without increasing complications.
- The study noted that while fluoroscopy time decreased initially, this reduction plateaued after several years, suggesting that more experience with the technique may influence efficiency in complex cases.
Article Synopsis
- The study looked at two ways to monitor patients with heart devices: using smart devices like phones (SM-RM) and traditional bedside monitors (BM-RM).
- It found that patients using smart devices were more likely to follow the monitoring rules and send their health data compared to those using bedside monitors.
- Overall, the smart device method was better in terms of connection, faster data sending, and younger patients were more active in sending updates than older patients.
Article Synopsis
- Subclinical atrial fibrillation (AF) increases risks of developing clinical AF, stroke, and cardiovascular death; researchers aimed to test if closed loop stimulation (CLS) could reduce atrial high-rate episodes (AHREs) in pacemaker patients compared to conventional dual-chamber rate-adaptive pacing (DDDR).
- A study with 1,210 patients showed that those using CLS had a lower incidence of the primary endpoint (first AHRE lasting ≥6 min, stroke, or TIA) compared to DDDR over a 3-year period, particularly effective in patients without atrioventricular block or AF history.
- The findings suggest that dual-chamber CLS significantly reduces AHRE occurrence, highlighting its potential benefits for patients
As the aging population continues to grow, so has the incidence of cardiovascular diseases, including bradycardia, with much of the burden falling on low- and middle-income countries (LMICs). Pacemaker therapy remains the only guideline-recommended therapy for symptomatic bradycardia, but due to the cost and expertise required for pacemaker implants, patients in LMICs have less access to pacemaker therapies. However, with the concerted effort of organizations (governments, non-governmental organizations, industry, and medical societies) strides can continue to be made in improving access to care.
View Article and Find Full Text PDFOn May 27, 2022, the Asia Pacific Heart Rhythm Society and the Heart Rhythm Society convened a meeting of leaders from different professional societies of healthcare providers committed to arrhythmia care from the Asia Pacific region. The overriding goals of the meeting were to discuss clinical and health policy issues that face each country for providing care for patients with electrophysiologic issues, share experiences and best practices, and discuss potential future solutions. Participants were asked to address a series of questions in preparation for the meeting.
View Article and Find Full Text PDFBackground: Atrial fibrillation (AF) is a cause of serious morbidity such as stroke. Early detection and treatment of AF is important. Current guidelines recommend screening via opportunistic pulse taking or 12‑lead electrocardiogram.
View Article and Find Full Text PDFCatheter ablation as first-line treatment for paroxysmal atrial fibrillation.
Ann Acad Med Singap
January 2023
Article Synopsis
- Palpitations are a frequent side effect after receiving mRNA COVID-19 vaccines, although they can vary in severity.
- Some individuals may experience more intense symptoms that warrant additional medical evaluation.
- A notable case involved a healthy man who had significant palpitations and an increased heart rate following both doses of the Pfizer/BioNTech vaccine, highlighting the need for further investigation.
Left atrial appendage (LAA) is believed to be a common site of thrombus formation in patients with atrial fibrillation (AF). However, the commonly-applied stroke risk stratification model (such as. CHADS-VASc score) does not include any structural or hemodynamic features of LAA.
View Article and Find Full Text PDFBackground: Sudden cardiac arrest with or without sudden cardiac death (SCD) represents a heterogeneous spectrum of underlying etiology but is often a catastrophic event. Despite improvements in pre-hospital response and post-resuscitation care, outcomes remain grim. Thus, we aim to evaluate the predictors of survival in out-of-hospital cardiac arrests (OHCAs) and describe autopsy findings of those with the uncertain cause of death (COD).
View Article and Find Full Text PDFArticle Synopsis
- * A total of 22 patients, primarily elderly males with a mean age of 71.7 years, underwent the LBBP procedure, achieving an 86% success rate in lead implantation without major complications.
- * The findings indicate that the Agilis HisPro™ catheter, paired with the Tendril STS Model 2088TC lead, is a promising and safe method for performing LBBP.
Advanced cardiac life support (ACLS) emphasises the use of advanced airway management and ventilation, circulatory support and the appropriate use of drugs in resuscitation, as well as the identification of reversible causes of cardiac arrest. Extracorporeal cardiopulmonary resuscitation and organ donation, as well as special circumstances including drowning, pulmonary embolism and pregnancy are addressed. Resuscitation does not end with ACLS but must continue in post-resuscitation care.
View Article and Find Full Text PDFBackground: The Singapore Cardiac Databank was designed to monitor the performance and outcomes of catheter ablation. We investigated the outcomes of paroxysmal supraventricular tachycardia (PSVT)-ablation in a prospective, nationwide, cohort study.
Methods: Atrioventricular nodal re-entrant tachycardia (AVNRT), atrioventricular re-entry tachycardia (AVRT), or atrial tachycardia (AT)-ablations in Singapore from 2010 to 2018 were studied.
Background: In primary prevention (PP) patients the utilization of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) remains low in many geographies, despite the proven mortality benefit.
Purpose: The objective of this analysis was to examine the mortality benefit in PP patients by guideline-indicated device type: ICD and CRT-D.
Methods: Improve sudden cardiac arrest was a prospective, nonrandomized, nonblinded multicenter trial that enrolled patients from regions where ICD utilization is low.
The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world's population and an increase in cardiovascular risk factors that predispose to AF.
View Article and Find Full Text PDFArticle Synopsis
- * The research utilized data from a population electronic health record database and found that the APACHE IV standard mortality ratio (SMR) improved significantly, indicating better predictive performance over time as well.
- * Overall, despite limited healthcare resources, Hong Kong's ICU services have become more efficient and of higher quality, with shorter than predicted length of stay for patients.
Clinical safety of the ProMRI implantable cardioverter-defibrillator systems during head and lower lumbar magnetic resonance imaging at 3 T: results of the ProMRI 3T ENHANCED Master study.
Europace
November 2019
Aims: There have been no published studies on the safety of magnetic resonance imaging (MRI) at 3 Tesla (3 T) in patients with MRI-conditional implantable cardioverter-defibrillators (ICDs). The aim of this study was to assess clinical safety of the Biotronik ProMRI ICD system during non-diagnostic head and lower lumbar scans under 3 T MRI conditions.
Methods And Results: The study enrolled 129 patients at 12 sites in Australia, Singapore, and Europe.