Publications by authors named "Graham Peigh"

Background: Prior research suggests Black individuals have a lower risk of atrial fibrillation (AF) than White individuals, but this may be related to the underdetection of AF. Whether this trend persists using highly sensitive methods of AF diagnosis has not been well-studied.

Objectives: The objective of this study was to use cardiac implantable electronic devices (CIEDs) capable of AF diagnosis to compare AF incidence between Black and White individuals.

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  • The study investigates the rates and reasons for the removal of subcutaneous implantable cardioverter defibrillators (S-ICDs) among patients who've had them implanted.
  • Out of 372 patients studied over a median follow-up of 4.4 years, 5.9% required extraction, mainly due to bradycardia pacing needs, infections, and inappropriate shocks.
  • Factors such as a history of smoking and a higher body mass index were linked to an increased likelihood of S-ICD extraction, indicating the importance of careful patient selection for the device.
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Background: Atrial fibrillation (AF) outcomes are strongly associated with continuous measures of AF burden.

Objectives: This study sought to assess the association between changes in maximum daily AF duration (MDAFD) and stroke or mortality in patients with cardiac implantable electronic devices (CIEDs).

Methods: The Optum deidentified electronic health record data set (2007-2021) was linked with the Medtronic CareLink heart rhythm database.

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  • The study compared high-density (HD) mapping to non-HD mapping in atrial flutter ablation to assess outcomes and healthcare utilization.
  • Results showed that HD mapping led to a higher rate of successful circuit identification and a greater overall procedure success rate.
  • Additionally, patients who had HD mapping experienced fewer emergency department visits and hospitalizations related to atrial flutter within a year post-procedure.
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Background: Current estimates of atrial fibrillation (AF)-associated mortality rely on claims- or clinical-derived diagnoses of AF, limit AF to a binary entity, or are confounded by comorbidities. The objective of the present study is to assess the association between device-recognized AF and mortality among patients with cardiac implantable electronic devices capable of sensitive and continuous atrial arrhythmia detection. Secondary outcomes include relative mortality among cohorts with no AF, paroxysmal AF, persistent AF, and permanent AF.

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  • Catheter ablation for atrial fibrillation (AF) is the most common procedure in electrophysiology, aiming to isolate pulmonary veins, but there is insufficient data on severe complications worldwide.
  • A study involved collecting and analyzing data from 23 centers with 33,879 procedures to determine the incidence and management of severe complications during AF ablation.
  • The study found that while severe complications like tamponade and stroke have a low incidence, factors like age, gender, and procedure duration play a role in their occurrence; most patients with complications were discharged after about 5 days.
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Background: The use of intravenous (IV) sotalol loading following recent U.S. Food and Drug Administration (FDA) approval of a 1-day loading protocol has reduced the obligatory 3-day hospital stay for sotalol initiation when given orally.

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Background: Although VCAM-1 (vascular cell adhesion molecule-1) and ICAM-1 (intercellular adhesion molecule-1) have been associated with incident heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF), the associations of VCAM-1 and ICAM-1 with sensitive measures of cardiac structure/function are unclear. The objective of this study is to evaluate associations between VCAM-1, ICAM-1, and measures of cardiac structure and function as potential pathways through which cellular adhesion molecules promote HFpEF and AF risk.

Methods And Results: In MESA (Multi-Ethnic Study of Atherosclerosis), we evaluated the associations of circulating VCAM-1 and ICAM-1 at examination 2 (2002-2004) with measures of cardiac structure/function on cardiac magnetic resonance imaging at examination 5 (2010-2011) after multivariable adjustment.

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Background: Integrating patient-specific cardiac implantable electronic device (CIED)-detected atrial fibrillation (AF) burden with measures of health care cost and utilization allows for an accurate assessment of the AF-related impact on health care use.

Objectives: The goal of this study was to assess the incremental cost of device-recognized AF vs no AF; compare relative costs of paroxysmal atrial fibrillation (pAF), persistent atrial fibrillation (PeAF), and permanent atrial fibrillation (PermAF) AF; and evaluate rates and sources of health care utilization between cohorts.

Methods: Using the de-identified Optum Clinformatics U.

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This review discusses the contemporary clinical evaluation and management of patients with comorbid aortic regurgitation (AR) and heart failure (HF) (AR-HF). Importantly, as clinical HF exists along the spectrum of AR severity, the present review also details novel strategies to detect early signs of HF before the clinical syndrome ensues. Indeed, there may be a vulnerable cohort of AR patients who benefit from early detection and management of HF.

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  • Uninterrupted anticoagulation for atrial fibrillation (AF) has been a standard practice since early research, aimed at preventing strokes regardless of how long AF lasts.
  • However, this approach carries risks and may not be suitable for everyone with a history of AF.
  • The REACT-AF trial is being introduced to investigate a more targeted method of anticoagulation, known as "pill in the pocket" approach, which could be more beneficial for certain patients.
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Background: To date, few risk models have been validated to predict recurrent atrial fibrillation (AF) >1 year after ablation. The SCALE-CryoAF score was previously derived to predict very late return of AF (VLRAF) >1 year following cryoballoon ablation (CBA), with strong predictive ability. In this study, we aim to validate the SCALE-CryoAF score for VLRAF after CBA in a novel patient cohort.

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Background: Subcutaneous implantable cardioverter-defibrillators (S-ICD) are an alternative to transvenous ICDs for patients without a need for cardiac pacing. Obese patients have been proposed to be at higher risk for conversion failure with S-ICDs due to subcutaneous fat underneath the device. Optimal device positioning may promote equivalent outcomes between obese and non-obese patients by minimizing the effects of excess adipose tissue.

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Background: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, direct-to-patient, self-applied ECG patch use has substantially increased. There are limited data comparing clinic with self-applied electrocardiogram (ECG) patches.

Objective: The purpose of this study was to compare rates of ECG patch return, percentages of time patches yielded analyzable data (analyzable time), and percentages of prescribed time ECG patches were worn between clinic and self-applied ECG patches before and during COVID-19.

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Background: Impaired quality of life due to atrial fibrillation (AF), which often includes decreased activity level, is an indication for ablation. However, the impact of ablation for AF on activity is poorly understood.

Objective: The purpose of this study was to assess the impact of ablation on activity minutes per day using continuous accelerometer data from cardiac implantable electronic devices (CIEDs).

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Septal reduction techniques can reduce morbidity and mortality in patients with hypertrophic cardiomyopathy. In a patient with hypertrophic cardiomyopathy who was a poor candidate for surgical myectomy and alcohol septal ablation, endocardial radiofrequency ablation of septal hypertrophy provided durable reduction in left ventricular outflow tract gradients and symptomatic improvement. ().

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  • - Obesity increases the risk of recurrent atrial fibrillation (AF) after ablation, but the effect of weight changes before the procedure on long-term AF outcomes is unclear.
  • - A study of 601 patients undergoing pulmonary vein isolation found that weight loss during the year prior to ablation was linked to improved freedom from AF after 15 months, particularly in obese individuals and some nonobese patients.
  • - The findings suggest that encouraging patients to lose weight before AF ablation could enhance their recovery outcomes, warranting further research on effective weight loss strategies.
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Purpose Of Review: This review discusses the mechanisms, clinical implications, and treatments of left atrial (LA) myopathy in comorbid atrial fibrillation (AF) and heart failure (HF) across the spectrum of ejection fraction.

Recent Findings: AF and HF are highly comorbid conditions. Left atrial (LA) myopathy, characterized by impairments in LA structure, function, or electrical conduction, plays a fundamental role in the development of both AF and HF with preserved ejection fraction (AF-HFpEF) along with AF and HF with reduced ejection fraction (AF-HFrEF).

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