Publications by authors named "Jackson Liang"
Background: Arrhythmias originating from papillary muscles (PAPs) can be challenging when targeted with catheter ablation. The prevalence and impact of structural abnormalities on PAPs in patients with focal PAP arrhythmias is unknown.
Objectives: The purpose of this study was to analyze, in a consecutive patient series with focal PAP arrhythmias, the impact of structural abnormalities detected by multimodality imaging.
Catheter Ablation of Parahisian Premature Ventricular Complexes From the Right Sinus of Valsalva.
J Cardiovasc Electrophysiol
December 2024
Article Synopsis
- Cather ablation of parahisian PVCs often involves targeting the right sinuses of Valsalva (SoV), but there's limited data on its safety and effectiveness.
- * The study examined 11 male patients (average age 68) undergoing PVC ablation in the right SoV, finding that all had intramural LGE-CMR scar involvement, which affected the success rate.
- * Results showed that 91% of the patients had a successful reduction in PVC burden after the procedure, even though traditional indicators of success were not always present at the effective ablation sites.
Article Synopsis
- Coronary chronic total occlusion (CTO) increases the risk of ventricular arrhythmias (VAs), which can lead to serious heart issues like ventricular tachycardia and sudden cardiac death.
- A meta-analysis reviewing nine studies with over 3000 participants found that patients with CTOs have a 2.25 times higher risk of VAs compared to those with coronary artery disease (CAD) without CTOs.
- The analysis also suggested that percutaneous coronary intervention (PCI) for CTOs significantly lowers the risk of VAs compared to patients managed with optimal medication alone, indicating the potential benefits of revascularization.
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.
Article Synopsis
- * Most patients had drug-refractory VT, with a significant portion having low-voltage zones in the heart, particularly in the interventricular septum, indicating a specific substrate for VT.
- * After an average follow-up of 32 months, 41% of patients experienced sustained VT/VF recurrence, but those achieving complete procedural success had a reduced risk of recurrence compared to those who did not.
Quinidine, the first antiarrhythmic drug, was widely used during the 20th century. Multiple studies have been conducted to provide insights into the pharmacokinetics and pleiotropic effects of Class Ia antiarrhythmic drugs. However, safety concerns and the emergence of new drugs led to a decline in their use during the 1990s.
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- A study evaluated 48 patients undergoing LGE-CMR imaging and ablation, finding that 69% had intramural LGE-CMR scars, which were linked to having more complex PVCs that often required treating multiple heart chambers.
- Despite the increased complexity in patients with scarring, the short-term success rate was 69% and long-term PVC burden was similar between those with and without the scars. *
Ventricular arrhythmias in patients with bicuspid aortic valves.
J Cardiovasc Electrophysiol
June 2024
Article Synopsis
- Bicuspid aortic valves (BAV) are common heart defects, and this study investigates the presence and types of ventricular arrhythmias (VAs) in patients with BAV, particularly looking at late gadolinium enhancement in cardiac imaging.
- The study involved 19 male patients, showing that frequent premature ventricular contractions (PVCs) and monomorphic ventricular tachycardias (VTs) were common, with the majority of VAs linked to the periaortic valve region.
- Results indicated that patients with more significant arrhythmias had larger areas of damaged heart tissue (LGE), and post-ablation, patients experienced a significant reduction in PVCs and improvement in heart function (ejection fraction).
Background: Patients may develop atrial tachycardia (AT) after left atrial (LA) ablation of persistent atrial fibrillation (AF).
Methods: The population consisted of 101 consecutive patients (age = 64.3 ± 8.
Background: Left atrial appendage exclusion (LAAE) is an effective alternative to long-term anticoagulation in patients with atrial fibrillation. Not all patients considered for LAAE undergo the procedure because of ineligibility, anatomic or medical constraints, and preference of the patient.
Objective: The objective of this study was to report on the management strategies and long-term clinical outcomes of patients referred to a dedicated multidisciplinary LAAE clinic, including all who subsequently did and did not undergo LAAE.
Background: Desmoplakin (DSP) pathogenic variants are rare causes of arrhythmogenic cardiomyopathy and often involve the right and left ventricles. Ventricular tachycardia (VT) ablations may be required in these patients, but procedural characteristics have not been reported.
Objectives: In this study, the authors sought to report a multicenter experience of VT ablation in patients with DSP pathogenic variants.
Introduction: The utility of ablation index (AI) to guide ventricular tachycardia (VT) ablation in patients with structural heart disease is unknown. The aim of this study was to assess procedural characteristics and clinical outcomes achieved using AI-guided strategy (target value 550) or conventional non-AI-guided parameters in patients undergoing scar-related VT ablation.
Methods: Consecutive patients (n = 103) undergoing initial VT ablation at a single center from 2017 to 2022 were evaluated.
Article Synopsis
- The study investigates the effectiveness and safety of two different catheter ablation strategies for treating left posterior fascicular ventricular tachycardia (LPF-VT): a novel fragmented antegrade Purkinje (FAP) ablation and a traditional approach targeting earliest Purkinje potential or applying linear ablation.
- In a comparison involving 189 patients, FAP ablation resulted in shorter procedure times and fewer complications compared to traditional methods, with significant differences in the occurrence of left posterior fascicular block (11.6% in FAP group vs. 79.8% in traditional group).
- Both approaches achieved high success rates in eliminating LPF-VT, with similar long-term outcomes; however, the
Article Synopsis
- Programed ventricular stimulation (PVS) is used to assess patients' risk for dangerous heart arrhythmias, but those with negative PVS results can still be at risk, especially if they have symptoms.* -
- This study followed 78 patients with symptomatic ventricular arrhythmias who had negative PVS and suffered from cardiac scarring, analyzing their long-term outcomes with implantable monitors.* -
- Findings revealed that 18% of patients required treatment for arrhythmias or experienced fainting, indicating that cardiac scarring significantly increases the likelihood of adverse events despite negative PVS results.*
Background: Patients with arrhythmias originating from papillary muscles (PAPs) often have pleomorphic ventricular arrhythmias (PVAs) that can result in failed ablations. The mechanism of PVAs is unknown.
Objective: The purpose of this study was to assess the prevalence and mechanisms of PVAs and the impact on outcomes in patients with focal left ventricular PAP ventricular arrhythmias (VAs).
Modern studies have revealed gender and race-related disparities in the management and outcomes of cardiac arrhythmias, but few studies have focused on outcomes for ventricular arrhythmias (VAs) such as ventricular tachycardia (VT) or ventricular fibrillation (VF). The aim of this article is to review relevant studies and identify outcome differences in the management of VA among Black and female patients. We found that female patients typically present younger for VA, are more likely to have recurrent VA after catheter ablation, are less likely to be prescribed antiarrhythmic medication, and are less likely to receive primary prevention ICD placement as compared to male patients.
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