Publications by authors named "Darden D"
Background: Implantable cardiac monitors (ICMs) provide valuable insights into managing atrial fibrillation (AF). Data suggest that ICMs increase AF detection, but their impact on management is still uncertain.
Objectives: To evaluate and compare the impact of ICMs on the clinical management of AF.
Introduction: Despite continued improvement in post-sepsis survival, long term morbidity and mortality remain high. Chronic critical illness (CCI), defined as persistent inflammation and organ injury requiring prolonged intensive care, is a harbinger of poor long-term outcomes in sepsis survivors. Current dogma states that sepsis survivors are immunosuppressed, particularly in CCI.
View Article and Find Full Text PDFArticle Synopsis
- Chronic kidney disease (CKD) and kidney failure with replacement therapy (KFRT) are common in patients with atrial fibrillation (AF), and this study aimed to investigate outcomes after left atrial appendage occlusion (LAAO) procedures in these patients.
- Data from over 59,000 patients indicated that both CKD and KFRT were linked to higher rates of complications during the procedure and increased risk of death and major adverse events within one year.
- However, the study found no significant difference in the rates of stroke over the same period among patients with CKD or KFRT compared to those without.
Outcomes of leadless pacemaker implantation in the United States based on sex.
J Interv Card Electrophysiol
October 2024
Background: To determine differences in baseline characteristics and outcomes of leadless pacemaker implantation based on sex.
Methods: For the purpose of this study, data were extracted from the National Inpatient Sample database for years 2016-2020. The study group was then stratified based on sex.
Background: The use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) significantly improve the chances of survival after out-of-hospital cardiac arrest. Subsequently, state laws mandate training in CPR and AED use for high school graduation. However, training and its impact vary and must be better understood.
View Article and Find Full Text PDFArticle Synopsis
- Sarcopenia, which is the loss of muscle mass, is worsened by factors like aging and severe trauma, leading to complications in older adults during hospitalization.
- A study involving 47 older adults after severe blunt trauma showed that skeletal muscle mass decreased significantly over a six-month period, with the incidence of sarcopenia increasing from 36% to 60%.
- Although the trauma caused temporary declines in physical performance and quality of life, these effects were reversible, returning to baseline levels within six months, indicating that a deeper understanding of sarcopenia and its long-term impacts is needed.
Article Synopsis
- Management of long-standing persistent atrial fibrillation (LSPAF) is challenging, and hybrid convergent ablation with left atrial appendage (LAA) clipping shows better results compared to traditional endocardial-only procedures.!
- A study of 79 patients demonstrated a 73.8% success rate in maintaining freedom from atrial fibrillation after 12 months, but persistent posterior wall activity was noted in a significant number of cases.!
- The findings suggest that combining hybrid ablation and LAA clipping is effective for long-term AF-free survival in LSPAF patients, though recurrence of AF is associated with persistent activity in the posterior wall of the heart.!
Introduction: Hemostasis following large-bore femoral vein access remains a challenge. Manual compression has been the standard of care but requires bedside staff, prolonged bed rest, and longer length of stay. The LockeT is an external compression device that attempts to address these issues while achieving venous hemostasis.
View Article and Find Full Text PDFArticle Synopsis
- Multiple states have implemented CPR training for high school students and staff to reduce sudden cardiac death (SCD), but the quality and execution of these mandates differ significantly across the country.
- A scoring system was created to objectively assess CPR training mandates in all 50 states and the District of Columbia, revealing a wide range in scores that indicate the robustness of these mandates.
- The study's findings suggest that although there is variability in state mandates, no strong link was found between CPR training requirements and reduced SCD rates, underscoring the need for more consistent and effective policies.
Computed tomography predictors of increased transvenous lead extraction difficulty.
Pacing Clin Electrophysiol
September 2024
Background: The ability of computed tomography (CT) characteristics to predict the difficulty of transvenous lead extraction (TLE) is an evolving subject.
Objective: To identify CT characteristics associated with increased TLE difficulty.
Methods: All consecutive patients undergoing TLE at the University of California San Diego from January 2018 to February 2022 were analyzed, utilizing the UC San Diego Lead Extraction Registry.
Article Synopsis
- - Atrial fibrillation (AF) is a common heart rhythm disorder, and the way it's treated in emergency rooms varies widely, affecting patient care and access to effective treatments.
- - The study, which involved 500 patients, compared outcomes between those treated through an organized pathway for AF and those receiving routine care, finding significant advantages for the organized approach.
- - Results showed that patients on the organized pathway had faster access to treatments like ablation and anticoagulation, leading to shorter hospital stays and better overall outcomes compared to the control group.
Background: Cardiac implantable electronic devices (CIEDs) infection remains a serious complication, causing increased morbidity and mortality. Early recognition and escalation to definitive therapy including extraction of the infected device often pose challenges.
Objectives: The purpose of this study was to assess U.
Article Synopsis
- The document outlines guidelines for diagnosing and managing cardiac arrhythmias in athletes, given the rise in sports participation among youth and adults.
- It highlights the importance of expert risk assessments based on athlete symptoms to ensure safe return to sports while minimizing restrictions.
- Key topics covered include treatment strategies, shared decision-making, emergency planning, and recommendations for future research in managing these conditions.
Article Synopsis
- Sepsis leads to specific immune system changes, particularly the increase of myeloid-derived suppressor cells (MDSCs), which help control inflammation but can linger in those with ongoing critical illness.
- The study employs advanced techniques like Cellular Indexing of Transcriptomes and Epitopes by Sequencing to analyze MDSC types based on gene expression and biological functions.
- Findings reveal a new lineage and differentiation pathway for MDSCs following sepsis, emphasizing their variable responses related to patient outcomes and demonstrating their ability to change, contradicting the previous belief of a fixed lineage.
Postsepsis early mortality is being replaced by survivors who experience either a rapid recovery and favorable hospital discharge or the development of chronic critical illness with suboptimal outcomes. The underlying immunological response that determines these clinical trajectories remains poorly defined at the transcriptomic level. As classical and nonclassical monocytes are key leukocytes in both the innate and adaptive immune systems, we sought to delineate the transcriptomic response of these cell types.
View Article and Find Full Text PDFContemporary trends of leadless pacemaker implantation in the United States.
J Cardiovasc Electrophysiol
July 2024
Article Synopsis
- Leadless pacemakers (LPM) are important devices used to help patients with a slow heart rate since they were approved in 2016.
- Researchers studied data from 2016 to 2020 to see how often LPMs were used and what happened to patients during and after the surgery.
- The study found that more LPMs were being used over the years, and fewer patients died after getting the device, but the cost of hospital stays increased in recent years.
Background: Pericardial effusion requiring percutaneous or surgical-based intervention remains an important complication of a leadless pacemaker implantation.
Objective: The study sought to determine real-world prevalence, risk factors, and associated outcomes of pericardial effusion requiring intervention in leadless pacemaker implantations.
Methods: The National Inpatient Sample and International Classification of Diseases-Tenth Revision codes were used to identify patients who underwent leadless pacemaker implantations during the years 2016 to 2020.
Article Synopsis
- Leadless pacemakers are newer devices that can help people with heart problems, especially those with kidney issues, but not much research has been done on how well they work for those patients.
- This study looked at patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) who got leadless pacemakers between 2016 and 2020 to see if they had more complications or longer hospital stays.
- Results showed that patients with CKD and ESRD had more serious problems, longer hospital stays, and higher costs, with about one-third of the patients having these kidney issues.
Background: Frailty is associated with significant morbidity and mortality and may have clinical implications in an advanced age population with atrial fibrillation undergoing left atrial appendage occlusion (LAAO). We sought to develop a novel frailty scale to predict worse outcomes in patients undergoing LAAO.
Methods: Patients in the NCDR LAAO Registry between 2016 and 2021 receiving percutaneous LAAO devices were categorized as non-frail (0 points), pre-frail (1-3 points), or frail (4-5 points) based on a 5-point scale representing multiple domains of frailty: hemoglobin <13.
Background: Catheter ablation improves outcomes in symptomatic atrial fibrillation (AF) patients. However, its safety and efficacy in the very elderly (≥80 years old) is not well described.
Hypothesis: Ablation of AF in the very elderly is safe and effective.