Publications by authors named "John Burkhardt"

Article Synopsis
  • Regulatory changes have impacted the workload needed to manage graduate medical education (GME) programs, making it crucial to assess faculty efforts in emergency medicine (EM).
  • A survey study conducted from April 2022 to March 2023 involved 596 faculty members, who reported spending significant weekly hours on various GME activities, with program directors (PDs) dedicating the most time.
  • Significant differences in time spent on tasks were observed based on faculty roles and different quarters of the year, indicating a need for effective faculty support in residency programs.
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  • This study looked at patients with atrial fibrillation (AF) who had a specific heart procedure called pulsed-field ablation (PFA).
  • Researchers wanted to see if having heart rhythm problems right after the procedure could predict problems later.
  • They found that patients who had rhythm issues in the second or third month after PFA were more likely to have problems a year later, suggesting that the "blanking period" should be considered only 1 month instead of 3.
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  • Purkinje fibers are important in causing ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PMVT), and fascicular substrate modification (FSM) is a proposed treatment method for recurrent VF.
  • This study examined 18 patients who underwent catheter-based FSM targeting the Purkinje fibers, finding that the procedure was both safe and effective, with no complications and high success rates.
  • After 24 months, 88.9% of the patients remained free from arrhythmias, highlighting the efficacy of FSM compared to traditional antiarrhythmic medications.
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The United States Naval Academy long-term scintillation measurement campaign was a multi-year effort to characterize optical turbulence in the near-maritime atmospheric boundary layer (ABL). At its core, the field experiment consists of in situ measurements of bulk atmospheric and oceanographic parameters, as well as path-averaged measurements of the refractive index structure parameter, 2, collected using a large-aperture scintillometer. The field experiment ran from January 1st, 2020, through September 26th, 2023, representing the most comprehensive collection of optical turbulence measurements in the near-maritime ABL to date.

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Introduction: Both atrial fibrillation (AF) and amyloidosis increase stroke risk. We evaluated the best anticoagulation strategy in AF patients with coexistent amyloidosis.

Methods: Consecutive AF patients with concomitant amyloidosis were divided into two groups based on the postablation stroke-prophylaxis approach; group 1: left atrial appendage occlusion (LAAO) in eligible patients and group 2: oral anticoagulation (OAC).

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Objectives: Our study aims to better understand and describe the current state of diversity, equity, and inclusion (DEI) leadership in emergency medicine (EM) by identifying the prevalence of department DEI leadership positions, their demographics, and their job duty characteristics.

Methods: We disseminated an electronic survey from April to July 2022 to Society for Academic Emergency Medicine (SAEM) Association of Academic Chairs of Emergency Medicine, Academy for Diversity and Inclusion in Emergency Medicine, and the Equity and Inclusion Committee to identify department DEI leads. From July to August 2022, a 45-question survey was sent to all identified DEI leaders on individual characteristics, DEI experience, and DEI lead job description.

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We present a case of persistent complete atrioventricular block that occurred during the diagnostic portion of a premature ventricular contractions' radiofrequency ablation in a complex heart failure patient. The case was managed by bailout deep left ventricular septal pacing after bipolar radiofrequency elimination of premature ventricular contractions.

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Objectives: The specialty of emergency medicine (EM) is experiencing a significant decrease in student interest. In addition, women are historically underrepresented within the specialty at all levels of training and practice. We sought to understand how clinical experiences and perceptions of EM influence specialty selection by medical students, particularly women.

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Background: High-voltage pulses can cause hemolysis.

Objectives: The authors evaluated the occurrence of hemoglobinuria after pulsed-field ablation (PFA) and its impact on renal function in patients with atrial fibrillation (AF).

Methods: A consecutive series of patients with AF undergoing PFA were included in this analysis.

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Article Synopsis
  • The study analyzed the impact of pulsed-field ablation (PFA) on pulmonary hypertension (PH) in patients with non-paroxysmal atrial fibrillation (AF), comparing it with standard radiofrequency ablation (RFA).
  • It involved 28 patients who had previously undergone multiple RFAs and experienced PH, assessing changes in pulmonary artery pressure before and after the treatment.
  • Results showed that PFA did not worsen mean pulmonary artery pressure compared to RFA, highlighting PFA as a potentially safer option for these patients.
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  • Earlier studies link severe HIV infection with an increased risk of atrial fibrillation (AF), prompting this research on catheter ablation outcomes for HIV+ AF patients.
  • The study included 1438 AF patients, with 31 having HIV, and used propensity matching to compare outcomes between HIV+ and non-HIV patients after their first catheter ablation.
  • Results showed that HIV patients experienced significantly higher recurrence of AF after 5 years (100% vs. 54%) and had more non-pulmonary vein triggers, particularly from the coronary sinus and left atrial appendage, although outcomes after further ablation of these triggers were similar between the two groups.
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Accurate prediction of atmospheric optical turbulence in localized environments is essential for estimating the performance of free-space optical systems. Macro-meteorological models developed to predict turbulent effects in one environment may fail when applied in new environments. However, existing macro-meteorological models are expected to offer some predictive power.

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Meaningful improvements to graduate medical education (GME) have been achieved in recent decades, yet many GME improvement pilots have been small trials without rigorous outcome measures and with limited generalizability. Thus, lack of access to large-scale data is a key barrier to generating empiric evidence to improve GME. In this article, the authors examine the potential of a national GME data infrastructure to improve GME, review the output of 2 national workshops on this topic, and propose a path toward achieving this goal.

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Many of the ethnic and racial workforce inequities in the United States are present in health care systems. Low representation of African American/Black individuals in the health care system workforce can be traced to a history of exclusionary practices that leave such individuals less likely to pursue health careers. Past research found that low representation is driven by inequities in health, education, and employment that are a result of structural racism.

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Background: Acute pericarditis is a known complication of ablation procedures for atrial fibrillation (AF).

Objectives: This study aimed to evaluate the benefits of colchicine monotherapy in terms of reducing the risk of pericarditis and related hospitalization rate in AF patients undergoing catheter ablation.

Methods: Consecutive AF patients undergoing first catheter ablation were classified into 3 groups based on their colchicine use: Group 1: no colchicine; group 2: colchicine from 7 days before to 1 month after ablation; and group 3: colchicine from the day of the procedure to 1 month after.

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Aims: This study aimed to examine the clinical benefits of targeted ablation of all Premature ventricular complex (PVC) morphologies vs. predominant PVC only.

Methods And Results: A total of 171 consecutive patients with reduced left ventricular ejection fraction (LVEF) and ≥2 PVC morphology with high burden (>10%/day) undergoing their first ablation procedure were included in the analysis.

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Article Synopsis
  • The SIMPL mobile app aims to improve feedback and assessment in emergency medicine (EM) residency programs, addressing the inadequacies of traditional end-of-shift evaluations (ESEs).
  • A pilot study at a 4-year EM residency program showed that 62% of faculty and 83% of residents actively engaged with the app, providing a high volume of evaluations that included qualitative feedback, although residents were less interested in numerical ratings.
  • Feedback from both faculty and residents during the pilot highlighted the app's potential for enhancing educational assessments in EM and suggested improvements for future versions.
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Introduction: Medical students often express their plans to care for medically underserved populations, but little is known about how this interest remains during medical school (MS). This study examined how self-reported interest in working with medically underserved communities may change during MS training based on several student characteristics.

Methods: A secondary data analysis of all student records in the Electronic Residency Application Service (ERAS) from 2005 to 2010 is presented.

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Article Synopsis
  • Atrial fibrillation (AF) is common among patients with premature ventricular complexes (PVC), as found in a study of 394 patients undergoing PVC ablation between 2016 and 2019.
  • Out of these, 24% had AF, which was linked to older age, lower left ventricular ejection fraction, and higher CHA DS -VASc scores compared to those without AF.
  • At the 2-year mark, recurrence of PVCs was notably higher in patients with AF (17.7%) than in those without (9.4%), indicating that AF negatively impacts the success of PVC ablation.
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Background: Data on atrial fibrillation (AF) ablation and outcomes are limited in patients with congenital heart disease (CHD). We aimed to investigate the characteristics of patients with CHD presenting for AF ablation and their outcomes.

Methods: A multicenter, retrospective analysis was performed of patients with CHD undergoing AF ablation between 2004 and 2020 at 13 participating centers.

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