Publications by authors named "Farshad Raissi"
Background: Current data on outcomes of an initial strategy of catheter ablation vs advanced therapy in patients with severe heart failure (HF) and electric storm (ES) are limited.
Objective: The purpose of this study was to evaluate the outcomes of ventricular tachycardia (VT) ablation vs left ventricular assist device (LVAD) or heart transplantation (HT) in patients with severe HF and ventricular ES.
Methods: Patients with severe HF and ES who underwent VT ablation, LVAD, or HT between 2012 and 2022 at our medical center were reviewed.
Nonsustained ventricular tachycardia (NSVT) is a common arrhythmia associated with heart failure, cardiomyopathy, coronary artery disease, electrolyte imbalances, and congenital heart disorders (Foth et al., 2023). NSVT is often asymptomatic depending on its burden percentage.
View Article and Find Full Text PDFBackground: Respiratory motion management strategies are used to minimize the effects of breathing on the precision of stereotactic ablative radiotherapy for ventricular tachycardia, but the extent of cardiac contractile motion of the human heart has not been systematically explored.
Objective: We aim to assess the magnitude of cardiac contractile motion between different directions and locations in the heart.
Methods: Patients with intracardiac leads or valves who underwent 4-dimensional cardiac computed tomography (CT) prior to a catheter ablation procedure for atrial or ventricular arrhythmias at 2 medical centers were studied retrospectively.
Introduction: Artificial intelligence (AI) ECG arrhythmia mapping provides arrhythmia source localization using 12-lead ECG data; whether this information impacts procedural efficiency is unknown. We performed a retrospective, case-control study to evaluate the hypothesis that AI ECG mapping may reduce time to ablation, procedural duration, and fluoroscopy.
Materials And Methods: Cases in which system output was used were retrospectively enrolled according to IRB-approved protocols at each site.
Background: The effect of contact force (CF) on lesion formation is not clear during pulsed field ablation (PFA). The aim of this study was to evaluate the impact of CF, PFA, and their interplay through the PFA index (PF index) formula on the ventricular lesion size in swine.
Methods: PFA was delivered through the CF-sensing OMNYPULSE catheter.
Background: Pulsed field ablation (PFA) has emerged as a novel energy source for the ablation of atrial fibrillation (AF) using ultrarapid electrical pulses to induce cell death via electroporation.
Objective: The purpose of this study was to compare the safety and acute efficacy of ablation for AF with PFA vs thermal energy sources.
Methods: We performed an extensive literature search and systematic review of studies that evaluated the safety and efficacy of ablation for AF with PFA and compared them to landmark clinical trials for ablation of AF with thermal energy sources.
Article Synopsis
- Pulsed field ablation (PFA) uses ultrarapid electrical pulses for cell death and was compared to thermal energy ablation for treating atrial fibrillation (AF).
- The systematic review analyzed six studies involving 1012 patients, finding that PFA resulted in shorter procedure times, although it had longer fluoroscopy times.
- No significant differences were observed in complications or recurrence rates of AF between the PFA and thermal energy treatments, indicating the need for further research with larger trials.
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.
Article Synopsis
- Cryoballoon ablation (CBA) is a minimally invasive procedure for treating left atrial fibrillation, but it faces challenges like treatment reoccurrences and thermal complications due to uneven thermal distribution.
- A new computational framework has been developed to simulate CBA effects in patient-specific left atrial geometries, using finite element methods to model blood flow, temperature distribution, and lesion formation.
- The model successfully predicts factors affecting lesion formation during CBA, showing that cryoballoon temperature and contact area are critical, while variations in blood velocity and mitral regurgitation have minimal impact.
Arrhythmogenic cardiomyopathy (AC) is a genetic cardiac disorder associated with sudden cardiac death, specifically in young adults (D. Corrado, C. Basso, & D.
View Article and Find Full Text PDFBackground: High-dose isoproterenol infusion is a useful provocative maneuver to elicit triggers of atrial fibrillation (AF) during ablation. We evaluated whether the use of isoproterenol infusion to elicit triggers of AF after ablation is associated with differential outcomes.
Methods: We performed a retrospective study of all patients who underwent de novo radiofrequency catheter ablation of AF enrolled in the University of California, San Diego AF Ablation Registry.
Forward-Solution Noninvasive Computational Arrhythmia Mapping: The VMAP Study.
Circ Arrhythm Electrophysiol
September 2022
Article Synopsis
- The study evaluated the effectiveness of a noninvasive computational mapping system for locating the origins of atrial and ventricular arrhythmias using 12-lead ECG data, comparing it to traditional invasive methods.
- A total of 255 episodes involving various heart conditions from 225 patients across four centers were analyzed, showing a high regional accuracy of 98.7% for ventricular tachycardia in patients with no significant heart disease and an overall accuracy of 96.9% for all episodes.
- The median time for the mapping process was quick, averaging just 0.8 minutes, suggesting the method could be efficient for clinical use.
Characteristics and outcomes of recurrent atrial fibrillation after prior failed pulmonary vein isolation.
J Interv Card Electrophysiol
September 2022
Background: The mechanisms for atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) catheter ablation are unclear. Non-PV organized atrial arrhythmias (PAC, AT, macro-reentrant AFL) are possible contributors; however the prevalence and effect of their ablation on recurrent AF are unknown. We hypothesize that the identification and ablation of non-PV organized atrial arrhythmias were associated with less AF recurrence.
View Article and Find Full Text PDFCardiac resynchronization therapy (CRT) is an established treatment for left bundle branch block (LBBB) resulting in mechanical dyssynchrony. Approximately 1/3 of patients with CRT, however, are non-responders. To understand factors affecting CRT response, an electromechanics-perfusion computational model based on animal-specific left ventricular (LV) geometry and coronary vascular networks located in the septum and LV free wall is developed.
View Article and Find Full Text PDFArticle Synopsis
- Stereotactic ablative radiotherapy (SAbR) shows promise for treating hard-to-manage ventricular tachycardia (VT), but the current procedure is complex and may lack precision due to patient movement and proximity to the stomach.
- * Researchers tested a new approach combining automated 12-lead ECG mapping and respiratory-gated therapy to enhance SAbR planning and ensure safer radiation delivery for VT patients.
- * Results from six patients indicated that this new method successfully mapped VT sites, reduced planning volumes significantly, and led to a substantial decrease in heart shocks, suggesting it’s a feasible and safer workflow that needs further validation with larger studies.
Article Synopsis
- The study aimed to assess whether different antiarrhythmic drugs (AADs) given after catheter ablation for atrial fibrillation affect the risk of early (ER) and late recurrence (LR) of arrhythmias.
- Out of 478 patients, various AADs were prescribed, with a notable finding that those taking amiodarone or dronedarone had a higher likelihood of experiencing LR compared to those on no AADs.
- However, there were no significant differences in ER or the need for another ablation among the groups, suggesting that the increased risk of LR may be influenced by the underlying health conditions of the patients rather than the medications themselves.
Purpose: Early recurrence of atrial tachyarrhythmia (ER) is predictive of late recurrence of atrial tachyarrhythmia (LR) after first-time atrial fibrillation (AF) ablation, but the association in patients undergoing repeat AF ablation is unknown. We aim to determine the incidence and prognostic significance of ER after repeat ablation.
Methods: A total of 259 consecutive patients (mean age 64 years, 75.
Purpose: Mitral annular flutter (MAF) is a common arrhythmia after atrial fibrillation ablation. We sought to compare the efficacy and safety of catheter ablation utilizing either a left atrial anterior wall (LAAW) line or a lateral mitral isthmus (LMI) line.
Methods: We performed a systematic review for all studies that compared LAAW versus LMI lines.
Catheter ablation improves clinical outcomes in atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the role of catheter ablation in HF with a preserved ejection fraction (HFpEF) is less clear. We performed a literature search and systematic review of studies that compared AF recurrence at one year after catheter ablation of AF in patients with HFpEF versus those with HFrEF.
View Article and Find Full Text PDFCatheter ablation improves outcomes in atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). We sought to evaluate the efficacy and safety of catheter ablation of AF in HF patients with a preserved ejection fraction (HFpEF). We performed a retrospective study of all patients who underwent de novo radiofrequency catheter ablation enrolled in the UC San Diego AF Ablation Registry.
View Article and Find Full Text PDFPurpose: Chronotropic incompetence (CI) in patients with heart failure is common and associated with impaired exercise intolerance and adverse outcomes. This study sought to determine the effects of closed loop stimulation (CLS) rate-adaptive pacing on functional capacity in patients with heart failure with reduced ejection fraction (HFrEF) and CI implanted with cardiac resynchronization therapy (CRT) devices.
Methods: A randomized, blinded, cross-over designed trial enrolled patients with HFrEF and CI implanted with a Biotronik CRT-D to complete a quality of life questionnaire, 6-min walk distance (6MWD), and cardiopulmonary exercise testing after two programmed periods: 1-week period of CLS and 1-week period of standard accelerometer (DDDR).
Clinical factors associated with baseline history of atrial fibrillation and subsequent clinical outcomes following initial implantable cardioverter-defibrillator placement.
Pacing Clin Electrophysiol
June 2020
Background: Atrial fibrillation (AF) is frequently present in patients with heart failure (HF) and an implantable cardioverter-defibrillator (ICD). This study aims to identify clinical factors associated with a baseline history of AF in ICD recipients, and compares subsequent clinical outcomes in those with and without a baseline history of AF.
Methods: We studied 566 consecutive first-time ICD recipients at an academic center between 2011 and 2018.
Objective: This study aimed to compare the safety and efficacy of third-generation P2Y inhibitors versus clopidogrel in combination with oral anticoagulation (OAC) with or without aspirin in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI).
Methods: We performed a systematic review including both prospective and retrospective studies that compared dual and triple antithrombotic regimens for bleeding and major adverse cardiac events (MACE) in patients with AF undergoing PCI. We analysed rates of bleeding and MACE by P2Y inhibitor choice.
Obesity and atrial fibrillation (AF) are growing epidemics with significant overlap in co-morbidities. Multiple smaller studies have evaluated the effects of weight loss and risk factor modification on recurrence of AF, reduction in AF burden and improvement in AF symptom severity. The objective of this study was to determine if a modest weight loss of ≥10% of initial body weight is enough to improve outcomes in overweight or obese patients with established AF.
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