Publications by authors named "Dian Munawar"
Left bundle branch pacing (LBBP) has been subject to increasing interest over the last few years due to its capacity for physiological conduction and its advantages compared to His bundle pacing. His bundle pacing has certain limitations, such as a small pacing area for the His bundle, a high threshold that leads to battery depletion, a low R-wave amplitude that may result in atrial or His oversensing, and ventricular signal undersensing. In this case series, four patients (two female and two male) aged 62.
View Article and Find Full Text PDFIntroduction: Carcinoid heart disease (CHD), a complication of carcinoid syndrome (CS), is a rare condition that can lead to right sided valvular heart disease and has been traditionally associated with a poor prognosis. We conducted a systematic review and meta-analysis to explore the accuracy of biomarkers and echocardiography in diagnosing CHD amongst patients who are already known to have neuroendocrine tumours and to assess whether surgical management of CHD leads to a reduction in mortality.
Methods: A systematic literature search of MEDLINE, EMBASE, EBM Reviews, Google Scholar, ClinicalTrials.
Background: Atrial fibrillation (AF) and heart failure (HF) portends a poor outcome. The HF universal definition has incorporated Heart Failure with mildly reduced Ejection Fraction (HFmrEF). We sought to evaluate the relationship between AF and different HF subtypes, with emphasis on HFmrEF.
View Article and Find Full Text PDFBackground: Cardiac arrhythmias are significantly associated with poor outcomes in coronavirus disease 2019 (COVID-19) patients. Microvolt T-wave alternans (TWA) can be automatically quantified and has been recognized as a representation of repolarization heterogeneity and linked to arrhythmogenesis in various cardiovascular diseases. This study aimed to explore the correlation between microvolt TWA and COVID-19 pathology.
View Article and Find Full Text PDFArticle Synopsis
- 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.
Aims: Although overweight and obesity are associated with increased risk of atrial fibrillation (AF), the underlying mechanisms are not well characterised. Recent data suggest that this link may be partly due to abnormal adipose tissue-derived cytokines or adipokines. However, this relationship is not well clarified.
View Article and Find Full Text PDFAims: To systematic review and meta-analyse the association and mechanistic links between atrial fibrillation (AF) and cognitive impairment.
Methods And Results: PubMed, EMBASE, and Cochrane Library were searched up to 27 March 2021 and yielded 4534 citations. After exclusions, 61 were analysed; 15 and 6 studies reported on the association of AF and cognitive impairment in the general population and post-stroke cohorts, respectively.
Obstructive sleep apnea (OSA) is increasingly recognized to be a risk factor for cardiovascular disease. This pilot study assessed the association of OSA and invasive coronary microvascular function in patients with ischemia with no obstructive coronary artery disease (INOCA). Forty-two patients with angina, were prospectively screened at a single tertiary centre covering the northern metropolitan area of South Australia, from February 2018 to December 2020 (ACTRN12618000149268).
View Article and Find Full Text PDFA 60-year old male with paroxysmal atrial fibrillation underwent a combined procedure of left atrial appendage occlusion and pulmonary vein isolation. However, an acute intraprocedural 24-mm Watchman device dislodgement occurred, and thus a decision for urgent surgery was made. However, it was noted during the surgery that the device had migrated further to the descending aorta, just distal to the left subclavian artery.
View Article and Find Full Text PDFIntroduction: Successful pulmonary vein isolation (PVI) for atrial fibrillation (AF) depends on the formation of durable transmural lesions. Recently, novel indices have emerged to guide lesion delivery. The aim of the systematic review of literature was to determine AF recurrence following ablation guided by indices incorporating force, power and time, and compare acute procedural outcomes and 12-month AF recurrence with ablation guided by contact force (CF) guided only.
View Article and Find Full Text PDFIntroduction: The evidence on the association between obesity and atrial fibrillation (AF) recurrence was equivocal. We aimed to evaluate the dose-response relationship between body mass index (BMI) and AF recurrence and adverse events.
Methods: A systematic literature search was conducted using PubMed, Europe PMC, EBSCO, ProQuest and Cochrane Library.
Aims: There is growing evidence that magnetic resonance imaging (MRI) scanning in patients with non-conditional cardiac implantable electronic devices (CIEDs) can be performed safely. Here, we aim to assess the safety of MRI in patients with non-conditional CIEDs.
Methods And Results: English scientific literature was searched using PubMed/Embase/CINAHL with keywords of 'magnetic resonance imaging', 'pacemaker', 'implantable defibrillator', and 'cardiac resynchronization therapy'.
Objective: The aim of the meta-analysis was to determine the association of obesity and heart failure (HF) and the cardiac impact of intentional weight loss following bariatric surgery on cardiac structure and myocardial function in obese subjects.
Methods: MEDLINE, Embase and Web of Science were searched up to 3 April 2018. Studies reporting association and prognostic impact of obesity in HF and the impact of intentional weight loss following bariatric surgery on cardiac structure and myocardial function in obesity were included in the meta-analysis.
Background: The posterior left atrium is an arrhythmogenic substrate that contributes to the initiation and maintenance of atrial fibrillation (AF); however, the feasibility, safety, and efficacy of posterior wall isolation (PWI) as an AF ablation strategy has not been widely reported.
Methods: We undertook a systematic review and meta-analysis of studies performing PWI to assess (1) acute procedural success including the ability to achieve PWI and the number of procedure-related complications, (2) Long-term, clinical success including rates of arrhythmia recurrence and posterior wall reconnection, and (3) The efficacy of PWI compared with pulmonary vein isolation on preventing arrhythmia recurrence. MEDLINE, EMBASE, and Web of Science databases were searched in May 2018 to retrieve relevant studies.
Implication of ventricular pacing burden and atrial pacing therapies on the progression of atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials.
Heart Rhythm
August 2019
Background: Atrial fibrillation (AF) is common after pacemaker implantation. However, the impact of pacemaker algorithms in AF prevention is not well understood.
Objective: The purpose of this study was to evaluate the role of pacing algorithms in preventing AF progression.
Background: Battery longevity is an important factor that may influence the selection of cardiac implantable electronic devices (CIEDs). However, there remains a lack of industry-wide standardized reporting of predicted CIED longevity to facilitate informed decision-making for implanting physicians and payers.
Objective: The purpose of this study was to compare the predicted longevity of current generation CIEDs using best-matched CIEDs settings to assess differences between brands and models.
Aims: Several techniques have been utilized for the ablation of persistent (P) and long-standing persistent (LsP) atrial fibrillation (AF); however, the best approach of substrate ablation remains poorly defined. This study aims to examine the impact of ablation approach on outcomes associated with P or LsP AF ablation by conducting a meta-analysis and regression on contemporary literature.
Methods And Results: A systematic literature review was conducted up to 29 July 2015 for scientific literature reporting on outcomes associated with P or LsP AF ablation.
Background: Medical technology has made significant advances over the last few decades with smaller and more dynamic pacemakers. However, technical failures leading to premature replacement is a cause of concern. We present a series of Medtronic EnRhythm devices that reached premature elective replacement indicator (ERI).
View Article and Find Full Text PDFBackground: Insertable cardiac monitors (ICMs) are increasingly utilized for diagnosis of unexplained syncope and arrhythmia monitoring. The Reveal LINQ is a novel miniaturized ICM with improved algorithms. The feasibility and safety of insertion outside the traditional electrophysiology laboratory is unknown.
View Article and Find Full Text PDFAims: Ideal positioning of left ventricular (LV) pacing lead in cardiac resynchronization therapy (CRT) is technically demanding. This case aims to place LV lead in anterolateral branch of coronary sinus (CS) using collateral route blindly.
Methods And Results: Externalization via the CS ostium using collaterals retrogrogradely, which was not visible in initial balloon occlusion venography, through one delivery sheath with the support of commonly used micro-guide catheter and subsequent successful LV lead placement in anterolateral branch of CS.