Publications by authors named "Ghaith Sharaf-Dabbagh"
Precision medicine, which among other aspects includes an individual's genomic data in diagnosis and management, has become the standard-of-care for Mendelian cardiovascular disease (CVD). However, early identification and management of asymptomatic patients with potentially lethal and manageable Mendelian CVD through screening, which is the promise of precision health, remains an unsolved challenge. The reduced costs of genomic sequencing have enabled the creation of biobanks containing in-depth genetic and health information, which have facilitated the understanding of genetic variation, penetrance, and expressivity, moving us closer to the genotype-first screening of asymptomatic individuals for Mendelian CVD.
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- Sudden death is a major concern for middle-aged individuals with medically refractory epilepsy, who are often overlooked in studies about their mortality risks and cardiovascular health.
- The study analyzed data from 7220 participants with epilepsy and revealed they experience higher rates of various cardiovascular diseases (CVD) and arrhythmias compared to a control group without epilepsy.
- Findings indicated that those with epilepsy have significantly increased risks for all-cause mortality (about four times higher) and sudden death (over six times higher), with a notable earlier age of death, highlighting the need for greater research and potential interventions in this demographic.
Article Synopsis
- Cardiac disease can affect different parts of the heart in various ways, like causing thickening in some areas and scarring in others.
- A special heart imaging technique called cardiovascular magnetic resonance (CMR) helps doctors see details about the heart that normal tests can't show, which can help with early diagnosis and treatment planning.
- To improve the effectiveness of CMR, experts suggest a three-step plan to better understand how to use new measurements of heart conditions, including collecting normal data and doing more studies with lots of patients.
Article Synopsis
- * The disease has a familial link, with genetic factors accounting for an estimated 20%-35% of cases, prompting research into its hereditary nature.
- * Future studies aim to better understand the genetic and structural components of MVP and related heart rhythm disorders to improve patient risk assessment and management strategies.
Background: Inherited cardiomyopathies present with broad variation of phenotype. Data are limited regarding genetic screening strategies and outcomes associated with predicted deleterious variants in cardiomyopathy-associated genes in the general population.
Objectives: The authors aimed to determine the risk of mortality and composite cardiomyopathy-related outcomes associated with predicted deleterious variants in cardiomyopathy-associated genes in the UK Biobank.
Background: There is a paucity of data regarding the phenotype of dilated cardiomyopathy (DCM) gene variants in the general population. We aimed to determine the frequency and penetrance of DCM-associated putative pathogenic gene variants in a general adult population, with a focus on the expression of clinical and subclinical phenotype, including structural, functional, and arrhythmic disease features.
Methods: UK Biobank participants who had undergone whole exome sequencing, ECG, and cardiovascular magnetic resonance imaging were selected for study.
Diagnosis, significance, and management of ventricular thrombi in patients referred for VT ablation.
J Cardiovasc Electrophysiol
September 2021
Introduction: In patients with structural heart disease presenting with ventricular tachycardia (VT), detection of ventricular thrombi and subsequent management can be challenging. This study aimed to assess the value of multimodality imaging with cardiac magnetic resonance imaging (CMR), contrast-enhanced transthoracic echocardiography (TTE), and computed tomography (CT) for thrombus detection as well as a management algorithm geared towards anticoagulation and deferred ablation for patients referred for VT ablation.
Methods And Results: A total of 154 consecutive patients referred for VT ablation underwent preprocedural multimodality imaging with CMR, CT, and TTE.
Background: Patients undergoing ablation of premature ventricular complexes (PVCs) can have cardiac scar. Risk factors for the presence of scar are not well defined.
Objectives: To determine the prevalence of scarring detected by delayed enhancement cardiac magnetic resonance imaging (DE-CMR) in patients undergoing ablation of PVCs, to create a risk score predictive of scar, and to explore correlations between the scoring system and long-term outcomes.
Ischemic ventricular tachycardia: Multimodality imaging in precision ablation guidance.
J Cardiovasc Comput Tomogr
December 2021
Radiofrequency ablation is commonly performed in the management of incessant ventricular tachycardias. Pre-procedural planning using different imaging modalities including cardiac computed tomography and cardiac magnetic resonance plays an integral role in understanding the anatomy and potential origin of the arrhythmias to guide successful targeted ablation.
View Article and Find Full Text PDFIntroduction: Left ventricular noncompaction (LVNC) is associated with ventricular arrhythmias (VA) including premature ventricular complexes, and ventricular tachycardia (VT). The value of imaging with delayed enhancement cardiac magnetic resonance (DE-CMR) and programmed ventricular stimulation (PVS) for risk stratification in patients with VA and LVNC is unknown. The purpose of this study was to determine whether DE-CMR and PVS are beneficial for risk stratification and whether CMR helps to identify VA target sites.
View Article and Find Full Text PDFObjectives: This study sought to determine intramural scar characteristics associated with successful premature ventricular complex (PVC) ablations.
Background: Ablating ventricular arrhythmias (VAs) originating from intramural scarring can be challenging. Imaging of intramural scar location may help to determine whether the scar is within reach of the ablation catheter.
Objectives: This study sought to describe cardiac magnetic resonance (CMR) characteristics of ablation lesions within post-infarction scar.
Background: Chronic ablation lesions created during radiofrequency ablation of ventricular tachycardia (VT) in the setting of prior myocardial infarction have not been described in humans.
Methods: Seventeen patients (15 men, ejection fraction 25 ± 8%, 66 ± 6 years of age) with CMR imaging prior to repeat ablation procedures for VT were studied.
Objectives: This study sought to establish a mapping and ablation strategy to target intramural ventricular arrhythmias (VAs) by identifying the precise arrhythmia site of origin (SOO).
Background: Radiofrequency ablation of intramural VAs is challenging because the arrhythmia origin is difficult to localize.
Methods: In 83 consecutive patients with intramural VAs, a stepwise mapping approach was performed: ablation targeted directly the SOO when possible followed by the closest adjacent anatomical structure when necessary.
Introduction: Intramural scarring is a risk factor for sudden cardiac death. The objective of this study was to determine the value of scar quantification for risk stratification in patients with nonischemic cardiomyopathy (NICM) undergoing ablation procedures for ventricular arrhythmias (VA).
Methods And Results: Cardiac late gadolinium-enhanced magnetic resonance imaging was performed in patients with NICM referred for ablation of premature ventricular complexes or ventricular tachycardia (VT).
Objectives: The goal of this study was to assess the value of a stepwise, image-guided ablation approach in patients with cardiomyopathy and predominantly intramural scar.
Background: Few reports have focused on catheter-based ventricular tachycardia (VT) ablation strategies in patients with predominantly intramural scar.
Methods: The study included patients with predominantly intramural scar undergoing VT ablation.
Article Synopsis
- Patients with nonischemic cardiomyopathy (NICM) often have heart issues that need treatment, but accessing the right area can be tricky.
- This study looked at a method using the coronary venous system (CVS) to help treat these patients instead of going through more complicated areas.
- Results showed that in some patients, treatment within the CVS helped fix the heart issue without needing extra procedures, especially if the damaged area was close to the CVS.
Background: Frequent premature ventricular complexes (PVCs) can be an indicator of structural heart disease.
Objective: The purpose of this study was to determine the prevalence of scarring detected by delayed enhancement cardiac magnetic resonance (DE-CMR) imaging in patients with frequent PVCs without apparent structural heart disease and to determine the value of programmed ventricular stimulation (PVS) for risk stratification in patients with frequent PVCs and myocardial scarring.
Methods: DE-CMR imaging was performed in patients without apparent heart disease who had frequent PVCs and were referred for ablation.
Article Synopsis
- A study looked at a treatment called ablation for patients who had heart issues after a heart attack, specifically focusing on a fast heart rhythm called ventricular tachycardia (VT).
- 66 patients were treated, with some having their non-inducible VTs targeted using special heart monitoring devices, while others had only inducible VTs treated.
- The results showed that those who had the non-inducible VTs treated had a lower chance of having VT come back compared to the other group, showing this method could be helpful.
Background: Postinfarction ventricular tachycardia (VT) generally involves myocardial fibers surrounded by scar. Calcification of scar tissue has been described, but the relationship between calcifications within endocardial scar and VTs is unclear. The purpose of this study was to assess the prevalence of myocardial calcifications as detected by cardiac computed tomography (CT) and the benefit for mapping and ablation focusing on nontolerated VTs.
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- ATP-induced ventricular tachycardias (VTs) were found to be common in patients with implantable cardioverter-defibrillators (ICDs) who had previously experienced myocardial infarctions and were undergoing VT ablation procedures.
- In a study involving 162 patients, ATP-induced VTs were typically faster and less likely to be induced with invasive testing compared to spontaneous VTs, and they had fewer identifiable target sites.
- The study concluded that while ATP-induced VTs are prevalent and correlate with increased recurrence rates of VTs after ablation, they do not appear to directly cause recurrence.
Article Synopsis
- Ablation in the left ventricle carries a risk of blood clots, and this study focused on how to manage thromboembolism risk after ventricular tachycardia (VT) ablation in 217 patients.!
- Patients who had extensive ablation received a carefully managed dose of unfractionated heparin followed by 3 months of blood thinners, while those with less extensive ablation were treated with antiplatelet medications.!
- The study found that the thromboembolic and bleeding complications were low regardless of the treatment approach, suggesting the protocol for anticoagulation is effective and that antiplatelet therapy is a viable option for less extensive ablations.!
Predictors and Therapy of Cardiomyopathy Caused by Frequent Ventricular Ectopy.
Curr Cardiol Rep
September 2017
Purpose Of Review: The aim of this review is to describe predictors and therapeutic principles for PVC-induced cardiomyopathy.
Recent Findings: PVC-induced cardiomyopathy is a treatable condition resulting in a reversible form of cardiomyopathy. PVC-induced cardiomyopathy has only recently been recognized as an entity that causes a reversible form of cardiomyopathy.
Article Synopsis
- Preprocedural late gadolinium enhancement magnetic resonance imaging (LGE-MRI) may enhance the success of ventricular tachycardia (VT) ablation in patients with idiopathic dilated cardiomyopathy (DCM).
- A study comparing 96 patients found that those who had LGE-MRI demonstrated significantly higher procedural success rates (63% vs 24%) and better survival rates without VT recurrence, heart transplant, or death during follow-up.
- The findings suggest that using LGE-MRI prior to ablation can improve short-term outcomes, but the benefits in long-term outcomes need further exploration.