Publications by authors named "Kairav Vakil"
Purpose: Bifascicular block and prolonged PR interval on the electrocardiogram (ECG) have been associated with complete heart block and sudden cardiac death. We sought to determine if cardiac implantable electronic devices (CIED) improve survival in these patients.
Methods: We assessed survival in relation to CIED status among 636 consecutive patients with bifascicular block and prolonged PR interval on the ECG.
Objectives: This study sought to evaluate the clinical outcomes of patients receiving hemodynamic support (HS) during ventricular tacchycardia (VT) ablation.
Background: There are limited real-world data evaluating its effect of HS in ablation outcomes.
Methods: An analysis of 1,655 patients from the International VT Ablation Center Collaborative group was performed.
Objectives: This study sought to evaluate the efficacy of implantable cardioverter-defibrillator (ICD) therapy with or without cardiac resynchronization therapy (CRT) in patients with nonischemic cardiomyopathy (NICM).
Background: The effect of ICD on mortality of patients with NICM and left ventricular ejection fraction ≤35% has recently been questioned. Prior randomized controlled trials (RCTs) evaluating ICD efficacy in patients with NICM have yielded conflicting results.
Objectives: Quality of care utilization measures for patients admitted to the hospital with an acute myocardial infarction (AMI) include length of stay (LOS) and 30-day readmission rates. Our aim was to test whether efforts resulting in reduced LOS in patients diagnosed as having AMI would result in a higher risk of readmission within 30 days of hospital discharge and whether specific interventions could be targeted to reduce readmissions.
Methods: Using data supplied by the Veterans Affairs Inpatient Evaluation Center, we analyzed both the readmissions within 30 days of an AMI and LOS and determined the timing of readmissions and associated diagnoses.
Background: Successful ventricular tachycardia (VT) ablation is associated with improved survival in patients with heart failure. However, the safety and efficacy of VT ablation in the elderly, a population with higher competing nonsudden death risk and comorbidities, have not been well defined.
Methods And Results: The International Ventricular Tachycardia Center Collaborative Study Group registry of 2061 patients who underwent VT ablation at 12 international centers was analyzed.
Objective: The purpose of this study was to evaluate the characteristics and outcome of patients undergoing ablation after electrical storm (ES).
Methods: Clinical and procedural characteristics, ventricular tachycardia (VT) recurrence, and mortality rates from 1940 patients undergoing VT ablation were compared between patients with and without ES.
Results: The group of 677 patients with ES (34.
Importance: Improvement in left ventricular ejection fraction (EF) to >35% occurs in many patients with reduced EF at baseline. To our knowledge, whether implantable cardioverter defibrillator (ICD) therapy improves survival for these patients is unknown.
Objective: To examine the efficacy of ICD therapy in reducing risk of all-cause mortality and sudden cardiac death among patients with an EF ≤35% at baseline, with or without an improvement in EF to >35% during follow-up.
Background: Data evaluating repeat radiofrequency ablation (>1RFA) of ventricular tachycardia (VT) are limited.
Objective: The purpose of this study was to determine the safety and outcomes of VT >1RFA in patients with structural heart disease.
Methods: Patients with structural heart disease undergoing VT RFA at 12 centers with data on prior RFA history were included.
Background: Changes in left ventricular (LV) systolic function in response to coronary artery bypass grafting (CABG) have not been fully assessed.
Methods: Between January 2001 and December 2014, 2,838 consecutive patients underwent isolated CABG at the Minneapolis Veterans Affairs Health Care System. Of these, 375 had echocardiographic assessment of LV function before (within 6 months) and after (3 to 24 months) CABG and were included in this analysis.
Background: Ventricular tachycardia (VT) radiofrequency ablation has been associated with reduced VT recurrence and mortality, although it is typically not considered among New York Heart Association class IV (NYHA IV) heart failure patients. We compared characteristics and VT radiofrequency ablation outcomes of those with and without NYHA IV in the International VT Ablation Center Collaboration.
Methods And Results: NYHA II-IV patients undergoing VT radiofrequency ablation at 12 international centers were included.
Objectives: This study sought to assess the impact of implantable cardioverter-defibrillators (ICDs) on waitlist mortality in patients listed for heart transplantation (HT).
Background: The impact of ICDs on preventing sudden cardiac death in patients awaiting HT has not been studied in large multicenter cohorts. Furthermore, whether ICDs benefit patients with a left ventricular assist device (LVAD) is unknown.
Objectives: The purpose of this study was to determine the incidence and correlates of QT prolongation or ventricular tachycardia (VT) resulting in discontinuation of dofetilide in a real-world setting.
Background: Dofetilide is a class III antiarrhythmic agent approved for achieving and maintaining sinus rhythm in patients with symptomatic atrial fibrillation. Because of a risk of QT prolongation and VT, patients starting dofetilide need to be hospitalized for 3 days to closely monitor telemetry and electrocardiography.
Importance: Significant differences have been described between women and men regarding presentation, mechanism, and treatment outcome of certain arrhythmias. Previous studies of ventricular tachycardia (VT) ablation have not included sufficient women for meaningful comparison.
Objective: To compare outcomes between women and men with structural heart disease undergoing VT ablation.
Objectives: This study evaluated the impact of implantable cardioverter-defibrillators (ICDs) on mortality in patients with left ventricular assist devices (LVADs) by conducting a systematic review and meta-analysis of published studies.
Background: The burden of ventricular arrhythmias in patients with LVADs is high. Prior studies assessing the impact of ICD on survival of patients with LVADs have yielded conflicting results.
Background: Cardiac arrest after cardiac procedures has a case fatality rate of approximately 60%. However, the long-term risk of death and outcomes among survivors of postoperative cardiac arrest is less clear.
Methods: We examined the mortality and outcomes of 6,979 consecutive patients who underwent cardiac operations from 1991 to 2014 in the Minneapolis Veterans Affairs Health Care System.
Background: Pre-operative statin use has shown to reduce the incidence of post-operative atrial fibrillation (AF), but not mortality in patients undergoing cardiac surgery. This association, however, has not been examined in a heart transplant (HT) cohort.
Methods: Adults (≥18 yr) who underwent HT between 1997 and 2007 at the University of Minnesota were retrospectively identified.
Implantable cardioverter-defibrillator (ICD) therapy for primary prevention of sudden cardiac death is not routinely recommended within 90 days of coronary artery bypass grafting (CABG) because of the possibility of an improvement in left ventricular ejection fraction (EF) to>35% after revascularization. We sought to determine the incidence and predictors of EF improvement to >35% after isolated CABG in patients who had a preoperative EF ≤35%. We studied 375 patients who underwent CABG at a tertiary institution and had an echocardiogram preoperatively and postoperatively.
View Article and Find Full Text PDFBackground: Catheter ablation is frequently used as a palliative option to reduce shock burden in patients with ventricular tachycardia (VT). A risk prediction tool that accurately predicts short-term survival could improve patient selection for VT ablation.
Objective: The objective of the study is to assess utility of the Seattle Heart Failure Model (SHFM) to predict 6-month mortality in patients undergoing VT ablation.
Can Autocapture™ Function of Permanent Pacemakers Initiate Ventricular Tachyarrhythmias?
Pacing Clin Electrophysiol
January 2016
Background: The impact of catheter ablation of ventricular tachycardia (VT) on all-cause mortality remains unknown.
Objective: The purpose of this study was to examine the association between VT recurrence after ablation and survival in patients with scar-related VT.
Methods: Analysis of 2061 patients with structural heart disease referred for catheter ablation of scar-related VT from 12 international centers was performed.
Introduction: Severe pre-transplant pulmonary hypertension (PH) has been associated with adverse short-term clinical outcomes after heart transplantation in relatively small single-center studies. The impact of pre-transplant PH on long-term survival after heart transplantation has not been examined in a large, multi-center cohort.
Methods: Adults (≥18 years) who underwent first time heart transplantation in the United States between 1987 and 2012 were retrospectively identified from the United Network for Organ Sharing registry.