Publications by authors named "Frank Pelosi"

Article Synopsis
  • - Dofetilide, a class III antiarrhythmic, is used to treat atrial fibrillation and flutter, and has been applied off-label for ventricular arrhythmias like PVCs and VTs.
  • - In a study involving 81 patients, dofetilide initiation showed a significant decrease in PVC burden, but was discontinued in some cases due to QT prolongation and lack of efficacy.
  • - Overall, 72% of patients had to stop dofetilide due to inefficacy or intolerance, and there was no significant difference in event-free survival between those treated with dofetilide and those who weren't.
View Article and Find Full Text PDF
Article Synopsis
  • Transseptal puncture (TSP) is essential for left atrial ablation procedures, and this study compares the safety and efficacy of TSP using a 3D mapping system versus intracardiac echocardiography (ICE).
  • The study involved 65 patients with 3D-guided TSP and 151 matched patients with ICE-guided TSP, finding a 100% success rate for both methods.
  • The results showed that 3D-guided TSP had significantly lower fluoroscopy time compared to ICE-guided TSP, while both techniques had no complications, making 3D mapping a safe and effective option without extra cost.
View Article and Find Full Text PDF
Article Synopsis
  • Monitored anesthesia care (MAC) and general anesthesia (GA) are two methods used during catheter ablation for atrial fibrillation (AF), each with its own pros and cons.
  • A study involving 810 patients found no significant differences in complications or long-term outcomes between MAC and GA, although GA resulted in longer anesthesia times and slightly higher costs.
  • Ultimately, both methods showed similar effectiveness and safety in achieving sinus rhythm post-ablation when proper anesthesiology protocols were followed.
View Article and Find Full Text PDF
Article Synopsis
  • Quinidine is a treatment option for certain types of heart rhythm problems but its effectiveness for scar-related monomorphic ventricular tachycardia (MMVT) is uncertain.
  • In a study of 23 patients with MMVT and heart disease, most had previously failed other treatments, and after starting quinidine, many still experienced arrhythmias.
  • Only 27% of patients remained on quinidine after one year, with various side effects reported, indicating the therapy has limited long-term success and tolerability.
View Article and Find Full Text PDF

Purpose: We aim to describe the long-term safety and efficacy of catheter ablation (CA) in young patients (<30 years) with atrial fibrillation (AF).

Methods: This was a retrospective study of patients aged 18-30 who underwent CA for AF, and clinical characteristics and long-term outcomes are reported. Survival analyses were performed between the study group and a propensity-matched older cohort (>30 years, mean age: 58±10 years).

View Article and Find Full Text PDF

Objectives: The study's goal was to compare the efficacy and safety of dofetilide (DOF) versus amiodarone (AMIO) in patients with atrial fibrillation (AF).

Background: Comparative efficacy of DOF versus AMIO in patients with AF has not been well established. In addition, proarrhythmia has been a concern with DOF therapy.

View Article and Find Full Text PDF

Background: Lead damage is a complication caused by lead manipulation or heating damage from conventional electrocautery (EC) after cardiovascular implantable electronic device (CIED) replacement. Application of electrical plasma (PEAK PlasmaBlade) is a new technology that reportedly reduces this risk.

Objectives: This study was designed to compare the effect of EC versus PEAK PlasmaBlade on lead parameters and complications after generator replacement procedures.

View Article and Find Full Text PDF
Article Synopsis
  • Diabetes mellitus (DM) increases the risk of atrial fibrillation (AF), and the impact of antidiabetic medications like metformin on AF outcomes has not been thoroughly explored.* -
  • A study involving 271 patients with DM and AF found that 55% of those treated with metformin remained in sinus rhythm post-catheter ablation, compared to only 40% of those not on metformin, indicating its potential benefits.* -
  • The results suggest that metformin treatment is linked to a reduced risk of recurrent atrial arrhythmias after catheter ablation, but it's uncertain whether this is due to better blood sugar control or other effects of the drug.*
View Article and Find Full Text PDF

Background: Implanted defibrillators are capable of recording activity data based on company-specific proprietary algorithms. This study aimed to determine the prognostic significance of baseline and decline in device-derived activity level across different device companies in the real world.

Methods: We performed a retrospective cohort study of patients (n = 280) who underwent a defibrillator implantation (Boston, Medtronic, St.

View Article and Find Full Text PDF

With the growing obesity epidemic, the global burden of AF and obstructive sleep apnoea (OSA) is increasing at an alarming rate. Obesity, age, male gender, alcohol consumption, smoking and heart failure are common risk factors for both AF and OSA and they are independently associated with adverse cardiovascular outcomes. Weak evidence from observational studies link OSA to the development of AF.

View Article and Find Full Text PDF

Objective: Atrial fibrillation (AF) weekend hospitalizations were reported to have poor outcomes compared to weekday hospitalizations. The relatively poor outcomes on the weekends are usually referred to as 'weekend effect'. We aim to understand trends and outcomes among weekend AF hospitalizations.

View Article and Find Full Text PDF
Article Synopsis
  • The study explored whether antiarrhythmic drug (AAD) therapy impacts mortality rates after catheter ablation (CA) in patients with atrial fibrillation (AF), involving 3,624 patients over a mean follow-up of 6.7 years.
  • Results showed that fewer deaths occurred in the AAD group (2.2%) compared to the no-AAD group (4.5%), suggesting a potential benefit from AAD use.
  • While no significant difference in mortality was confirmed, there was a trend indicating that AAD therapy might be safe and not increase mortality risk after CA of AF.
View Article and Find Full Text PDF

Background: Heart block requiring a pacemaker is common after self-expandable transcatheter aortic valve replacement (SE-TAVR); however, conduction abnormalities may improve over time. Optimal device management in these patients is unknown.

Objective: To evaluate the long-term, natural history of conduction disturbances in patients undergoing pacemaker implantation following SE-TAVR.

View Article and Find Full Text PDF
Article Synopsis
  • This study explored the use of protamine to reverse the anticoagulation effects of heparin in patients undergoing catheter ablation for atrial fibrillation, filling a gap in existing research as no randomized controlled trials had been conducted previously.
  • Researchers found that patients treated with protamine experienced significantly faster hemostasis (about 137 minutes quicker) and ambulation (around 164 minutes quicker) compared to the control group.
  • Importantly, there were no significant differences in the rates of complications like major or minor vascular issues or thromboembolic events between the protamine and control groups, indicating a safer approach.
View Article and Find Full Text PDF

Background: The role of cryoballoon ablation (CBA) for antral pulmonary vein isolation (APVI) has not been well established in persistent atrial fibrillation (PerAF). Isolation of the left atrial posterior wall (BOX) after APVI has been suggested to improve the efficacy of radiofrequency catheter ablation (RFA) in PerAF.

Objective: The purpose of this study was to compare characteristics and clinical outcomes of APVI by CBA vs APVI + BOX by contact force-guided RFA (CF-RFA) in patients with PerAF.

View Article and Find Full Text PDF

Background: The role of obstructive sleep apnea (OSA) on the response to cardiac resynchronization therapy (CRT) and all-cause mortality in patients with advanced heart failure (HF) is unknown.

Objective: We assessed the association between OSA, response to CRT, and all-cause mortality in patients with HF.

Methods: We analyzed records of 548 consecutive patients (mean age 65 ± 13 years; 216 (39%) women; mean follow-up period 76 ± 17 months) who received a CRT-defibrillator device from January 15, 2007 to March 30, 2016 at our tertiary care referral center.

View Article and Find Full Text PDF
Article Synopsis
  • The study aims to assess how the timing between the P wave and local atrial electrograms can indicate complete conduction block during radiofrequency catheter ablation (RFA) for treating atrial flutter caused by cavo-tricuspid isthmus (CTI).
  • It involved 125 patients, with measurements taken before and after achieving complete block, revealing distinct timing differences that can predict CTI block with high sensitivity and specificity.
  • The findings suggest that monitoring these timing intervals is an effective and straightforward method for confirming complete block during the procedure.
View Article and Find Full Text PDF