Publications by authors named "Hardwin Mead"

Introduction: Little is known about very early atrial fibrillation (AF) ablation after first AF detection.

Methods: We evaluated patients with AF ablation <4 months from newly diagnosed paroxysmal AF (NEWPaAF) and newly diagnosed persistent AF (NEWPeAF). We compared the two patient populations and compared ablation outcomes to those undergoing later ablation.

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Background: Little is known about the very long term durability of atrial fibrillation (AF) ablation.

Objective: The purpose of this study was to evaluate very long term AF ablation outcomes.

Methods: We followed 5200 patients undergoing 7145 ablation procedures.

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Background: The clinical effectiveness of ablating non-paroxysmal atrial fibrillation (non-PAF) relies on proper patient selection. We developed and validated a scoring system to predict non-PAF ablation outcomes.

Methods: Data on 416 non-PAF ablations were analysed using binary logistic regression at a London centre.

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Objectives: This first-in-human feasibility study was undertaken to translate the novel low-voltage MultiPulse Therapy (MPT) (Cardialen, Inc., Minneapolis, Minnesota), which was previously been shown to be effective in preclinical studies in terminating atrial fibrillation (AF), into clinical use.

Background: Current treatment options for AF, the most common arrhythmia in clinical practice, have limited success.

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Background: Heart failure is a major health concern and often requires echocardiography to confirm the diagnosis. We introduce a new method that uses a wearable heart sound and electrocardiogram (ECG) device that can be used in the outpatient setting.

Objective: The purpose of this study was to determine the value of synchronized analysis of heart sounds and ECG in identifying patients with depressed left ventricular ejection fraction (dLVEF) <50%.

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Background: Little is known about the long-term outcomes and predictors of success of high-power, short-duration (HPSD) contact force (CF) atrial fibrillation (AF) ablations.

Objective: The purpose of this study was to determine long-term freedom from AF and predictors of freedom from AF for 50-W, 5- to 15-second CF ablation.

Methods: We examined 4-year outcomes and predictors of freedom from AF after AF ablation for 1250 consecutive patients undergoing HPSD CF ablations.

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Background: Many centers use radiofrequency (RF) energy at 25-35 W for 30-60 seconds. There is a safety concern about using higher power, especially on the posterior wall.

Objective: The purpose of this study was to examine complication rates for atrial fibrillation (AF) ablations performed with high-power, short-duration RF energy.

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Purpose: To compare findings in patients undergoing atrial fibrillation(AF) and/or atrial flutter(AFl) ablation after failed cut and sew (CS) vs. non-cut and sew (NCS) surgical maze.

Methods: We compared 10 patients with prior CS to 25 with prior NCS maze undergoing catheter ablation after failed maze.

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Purpose: The optimal radiofrequency (RF) power and lesion duration using contact force (CF) sensing catheters for atrial fibrillation (AF) ablation are unknown. We evaluate 50 W RF power for very short durations using CF sensing catheters during AF ablation.

Methods: We evaluated 51 patients with paroxysmal (n = 20) or persistent (n = 31) AF undergoing initial RF ablation.

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Background: There is an association between obesity and atrial fibrillation (AF). The impact of obesity on AF ablation procedures is unclear.

Objective: The purpose of this study was to evaluate the influence of body mass index (BMI) on patient characteristics, long-term ablation outcomes, and procedural complications.

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Background: Leadless cardiac pacemakers have emerged as a safe and effective alternative to conventional transvenous single-chamber ventricular pacemakers. Herein, we report a multicenter experience on the feasibility and safety of acute retrieval (<6 weeks) and chronic retrieval (>6 weeks) of the leadless cardiac pacemaker in humans.

Methods And Results: This study included patients enrolled in 3 multicenter trials, who received a leadless cardiac pacemaker implant and who subsequently underwent a device removal attempt.

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Purpose: The purpose of this study was to evaluate ultra high density-activation sequence mapping (UHD-ASM) for ablating atypical atrial flutters.

Methods: For 23 patients with 31 atypical atrial flutters (AAF), we created UHD-ASM.

Results: Demographics age = 65.

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Background: Patients with a variety of clinical presentations undergo atrial fibrillation (AF) ablation. Long-term ablation success rates can vary considerably.

Objective: The purpose of this study was to develop a clinical scoring system to predict long-term freedom from AF after ablation.

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Aims: Atrial fibrillation ablation requires peri-procedural oral anticoagulation (OAC) to prevent thromboembolic events. There are several options for OAC. We evaluate peri-procedural AF ablation complications using a variety of peri-procedural OACs.

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Background: Atrial fibrillation (AF) ablation procedures generally use intraprocedural activated clotting time (ACT) of >300-350 seconds to prevent thromboembolic events.

Objective: To evaluate bleeding and thromboembolic procedural complications in patients with symptomatic AF undergoing ablation procedures with low intraprocedural ACT.

Methods: We examined a subset of 372 of 2334 (15.

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Purpose: This study was conducted to examine the outcomes in patients with prior stroke/transient ischemic attack (CVA/TIA) after atrial fibrillation (AF) ablation and the feasibility of discontinuing oral anticoagulation (OAC).

Methods: This study examined long-term outcomes following AF ablations in 108 patients with a history of prior thromboembolic CVA/TIA. Because of risks of OAC, we frequently discontinue OAC in these patients after successful ablation.

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Aims: Atrial fibrillation (AF) is associated with a high incidence of strokes/thromboembolism. The CHADS2 score assigns points for several clinical variables to identify stroke risk. The CHA2DS2-VASC score uses the same variables but also incorporates age 65 to 74, female gender, and vascular disease in an effort to provide a more refined risk of stroke/thromboembolism.

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Purpose: Atrial fibrillation (AF) ablation uses expensive technology and equipment. Physicians have considerable latitude over equipment choice. Average Medicare reimbursement is $10,338 for uncomplicated AF ablations.

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Patients appearing free of atrial fibrillation (AF) based on limited electrocardiographic monitoring/clinical history late after ablation may still have a large silent AF burden and thus have failed ablations and may be at risk of thromboembolism. We evaluated long-term monitoring (LTM; 7 days or 1 year) in 203 patients off antiarrhythmic drugs who were clinically free of AF >1 year after ablation. A 7-day monitor was done in 186 and 17 had pacemakers in whom the most recent year was analyzed.

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Purpose: The purpose of this study was to evaluate how atrial fibrillation (AF) ablation has evolved over time with regards to patient characteristics, procedural variables, complications, and outcomes.

Methods: We evaluated trends over time from 2003 to 2010 in clinical characteristics, procedural variables, complications, and Kaplan-Meier AF-free rates after the initial and final AF ablation in 1,125 patients undergoing 1,504 ablations.

Results: Evaluating trends from 2003 to 2010, we found that patients undergoing AF ablation became older (P < 0.

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Aims: Atrial fibrillation (AF) ablation is generally performed after patients fail antiarrhythmic drug (AAD) therapy. Some patients have drug contraindications or choose to avoid a lifetime of drug therapy. Little is known about the impact of previous drug therapy on ablation outcomes.

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Introduction: Atrial fibrillation (AF) ablation requires postprocedural anticoagulation to prevent thromboembolic events because of the ablation procedure itself or due to recurrent AF postprocedure. Dabigatran is a new anticoagulant and may be useful after AF ablation to prevent thromboembolic events.

Methods And Results: We evaluated 123 consecutive patients who were started on dabigatran after AF ablation.

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Background: Ablation is more successful for patients with paroxysmal atrial fibrillation (AF1) than for those with persistent (AF2) or longstanding persistent AF (AF3). Many patients fail initial ablation and undergo repeat ablations. Little is known about repeat ablation procedure times, complications, and outcomes.

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