Publications by authors named "Dorian P"
Background: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.
View Article and Find Full Text PDFBackground: Disparities in atrial fibrillation ablation rates have been studied previously, with a focus on either patient characteristics or systems factors, rather than geographic factors. The impact of electrophysiology (EP) centre practice patterns on ablation rates has not been well studied.
Methods: This population-based cohort study used linked administrative datasets covering physician billing codes, hospitalizations, prescriptions, and census data.
Article Synopsis
- Accurate quantification of exercise intensity is key for linking exercise with cardiovascular health, but self-reported measures may be unreliable.
- A study involving 40 endurance athletes showed that their perceived exertion (RPE) varied greatly and often underestimated actual heart rate and power output during cycling.
- The findings highlight the need for objective measures, as discrepancies between self-reported and actual exertion levels can lead to misleading conclusions about exercise's effects on health.
Background: Patients resuscitated from out-of-hospital cardiac arrest (OHCA) are at high risk of recurrence, posing a substantial burden on healthcare systems. Despite the established benefit of implantable cardioverter defibrillator (ICD) therapy in many such patients, and recommendations by guidelines, few studies have described the proportion of OHCA patients who receive guideline-concordant care.
Methods: The Canadian Institute for Health Information Discharge Abstract Database dataset was used to identify OHCA patients admitted to hospitals across Canada, excluding Quebec.
Background: Postoperative atrial fibrillation (POAF) is associated with increased morbidity and mortality. Epicardial injection of botulinum toxin may suppress POAF.
Objectives: This study sought to assess the safety and efficacy of AGN-151607 for the prevention of POAF after cardiac surgery.
Background: The DOSE VF randomized controlled trial (RCT) employed a pragmatic definition of refractory ventricular fibrillation (VF after three successive shocks). However, it remains unclear whether the underlying rhythm during the first three shocks was shock-refractory or recurrent VF.
Objective: To explore the relationship between alternate defibrillation strategies employed during the DOSE VF RCT and the type of VF, either shock-refractory VF or recurrent VF, on patient outcomes.
Background: Atrial fibrillation (AF) is a common arrhythmia characterized by uncoordinated atrial electrical activity. Lone AF occurs in the absence of traditional risk factors and is frequently observed in male endurance athletes, who face a 2- to 5-fold higher risk of AF compared with healthy, moderately active males. Our understanding of how endurance exercise contributes to the pathophysiology of lone AF remains limited.
View Article and Find Full Text PDFHigh volume endurance training may increase the risk of paroxysmal atrial fibrillation (AF) in middle-aged athletes. Limited data are available describing the cardiovascular phenotype of middle-aged endurance athletes, or the impact of AF on atrial function and exercise performance performed in sinus rhythm. The purpose of this study was to characterize LA phasic function at rest and during exercise in athletes with paroxysmal AF, and to determine its impact on exercise performance.
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- Existing antiarrhythmic drugs have limitations, and a new drug called AP30663, which targets K2 channels, showed promise in animal studies for treating atrial fibrillation (AF), but its effectiveness in humans was not yet known.
- A phase 2 trial was conducted with patients experiencing AF for 7 days or less, comparing two doses of AP30663 to a placebo, but the trial had to be halted due to slow enrollment during the COVID-19 pandemic.
- Results indicated that both doses of AP30663 led to a significant percentage of patients achieving cardioversion from AF to normal sinus rhythm within 90 minutes, with no serious adverse events linked to the drug, suggesting it could be a potential treatment
Article Synopsis
- Animal studies indicate that the effectiveness of double sequential external defibrillation (DSED) may depend on the timing between the two shocks, known as the "DSED interval," but this has not been tested in humans.
- A retrospective study of adult patients with refractory ventricular fibrillation (VF) explored how different DSED intervals affect outcomes like VF termination, return of spontaneous circulation (ROSC), and survival, revealing that shorter intervals (<75 ms) were linked to better outcomes.
- The study found that while shorter DSED intervals improved chances of VF termination and ROSC, there was no significant link between DSED intervals and survival to discharge or neurological status.
Background: Despite chronic therapies, atrial fibrillation (AF) leads to rapid ventricular rates (RVR) often requiring intravenous treatments. Etripamil is a fast-acting, calcium-channel blocker administered intranasally affecting the atrioventricular node within minutes.
Methods: Reduction of Ventricular Rate in Patients with Atrial Fibrillation evaluated the efficacy and safety of etripamil for the reduction of ventricular rate (VR) in patients presenting urgently with AF-RVR (VR ≥110 beats per minute [bpm]), was randomized, double-blind, placebo-controlled, and conducted in Canada and the Netherlands.
Moderate to vigorous physical activity performed regularly is cardioprotective and reduces all-cause mortality, concomitant with increased resting heart rate variability (HRV). However, there are contradictory reports regarding the effects of chronic and acute exercise on nocturnal HRV in those performing exercise well-beyond physical activity guidelines. Therefore, the purpose of this study was to compare the power spectral analysis components of HRV in middle-aged endurance athletes (EA) and recreationally active individuals (REC) and explore acute exercise effects in EA.
View Article and Find Full Text PDFBackground And Aims: Female sex is associated with higher rates of stroke in atrial fibrillation (AF) after adjustment for other CHA2DS2-VASc factors. This study aimed to describe sex differences in age and cardiovascular care to examine their relationship with stroke hazard in AF.
Methods: Population-based cohort study using administrative datasets of people aged ≥66 years diagnosed with AF in Ontario between 2007 and 2019.
Purpose: To compare the predictive value of different myocardial scar quantification thresholds using cardiac MRI for appropriate implantable cardioverter defibrillator (ICD) shock and mortality.
Materials And Methods: In this retrospective, two-center observational cohort study, patients with ischemic or nonischemic cardiomyopathy underwent cardiac MRI prior to ICD implantation. Late gadolinium enhancement (LGE) was first determined visually and then quantified by blinded cardiac MRI readers using different SDs above the mean signal of normal myocardium, full-width half-maximum, and manual thresholding.
Background: Etripamil is a fast-acting, intranasally administered calcium-channel blocker in development for on-demand therapy outside a health-care setting for paroxysmal supraventricular tachycardia. We aimed to evaluate the efficacy and safety of etripamil 70 mg nasal spray using a symptom-prompted, repeat-dose regimen for acute conversion of atrioventricular-nodal-dependent paroxysmal supraventricular tachycardia to sinus rhythm within 30 min.
Methods: RAPID was a multicentre, randomised, placebo-controlled, event-driven trial, conducted at 160 sites in North America and Europe as part 2 of the NODE-301 study.
Objectives: Examining the association of time to treatment (drug or placebo) with survival to hospital discharge and neurologic outcome.
Design: Post hoc analysis of the Resuscitation Outcomes Consortium Amiodarone, Lidocaine, Placebo randomized controlled trial.
Setting: Emergency medical services enrolled patients with out-of-hospital cardiac arrest (OHCA) at multiple North American sites.
Background Atherosclerotic disease is an important contributor to adverse outcomes in patients with atrial fibrillation (AF). There is limited recognition of the association between statin use and stroke rates in AF. We aimed to quantify the association between statin use and stroke rate in AF.
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