Publications by authors named "Kevin Heist"

Background: Papillary muscles are structures integrated into the mitral valve apparatus, having both electrical and mechanical roles. The importance of the papillary muscles (PM) is mainly related to cardiac arrhythmias and mitral regurgitation. The aim of this review is to offer an overview of the anatomy and physiology of the papillary muscles, along with their involvement in cardiovascular pathologies, including arrhythmia development in various conditions and their contribution to secondary mitral regurgitation.

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  • Various catheter designs for Pulsed Field Ablation (PFA) showed differences in safety and efficiency, with reported side effects like hemolysis and kidney injury.
  • A CT-derived computer model compared efficiency (power delivery) and safety (electric current for effective treatment) among multiple designs, finding that efficiency varied significantly across the catheters.
  • High-efficiency catheters minimized atrial blood exposure and demonstrated lower collateral current, suggesting they are safer; however, further in-vivo studies are needed to confirm these findings.
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  • *A study analyzing hospital data from 2016 to 2020 revealed that while the rate of AF/AFL hospitalizations was stable prior to 2020, it dropped sharply in 2020 alongside an increase in severe outcomes like mortality and stroke.
  • *Key factors associated with worse outcomes included older age, ischemic heart disease, chronic kidney disease, and COVID-19 infection itself.
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This systematic review aims to summarize the procedural arrhythmia termination rates in catheter ablation (CA) procedures of atrial or ventricular arrhythmias using the commonly used mapping systems (CARTO, Rhythmia and EnSite/NavX). A systematic search in MEDLINE and Cochrane databases through February 2021 was performed. With regard to atrial fibrillation ablation procedures, acute success rates ranged from 15.

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  • This study focused on patients with acute myocarditis (AM) who experienced ventricular arrhythmia (VA), aiming to identify how common sustained VA recurrence and mortality are, as well as what factors might predict these outcomes.* -
  • A total of 69 AM patients with documented VA were analyzed, revealing that during a median follow-up of 5.5 years, about 39% faced significant health issues including sustained VA or death, with specific predictors like initial monomorphic ventricular tachycardia (MMVT) and impaired heart function being particularly important.* -
  • The research suggests that identifying these predictors can help stratify patients into low, medium, and high-risk groups for complications over a decade, thus informing treatment strategies for those
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Background: Transcatheter left atrial appendage occlusion (LAAO) is an alternative to oral anticoagulants (OACs) for stroke prevention in patients with atrial fibrillation, but the predictors of LAAO use in routine care are unclear. We aimed to assess the utilization trends of LAAO and compare the change in characteristics of LAAO users versus OACs since its marketing.

Methods: Using the US Medicare claims database (March 15, 2015, to December 31, 2020), we identified patients with atrial fibrillation, ≥65 years, and CHADS-VASc score ≥2 (men) or ≥3 (women), with either first implantation of an LAAO device or initiation of OACs, including apixaban, dabigatran, rivaroxaban, edoxaban, or warfarin.

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  • Transvenous implantable cardioverter-defibrillator (ICD) shocks can lead to increased cardiac biomarkers and potential heart damage due to high voltage gradients, but data comparing these effects to subcutaneous ICDs (S-ICD) is limited.
  • A study used magnetic resonance imaging (MRI) to create a model comparing voltage gradients from S-ICDs and various transvenous ICD types, focusing on high gradients greater than 100 V/cm.
  • Results showed that S-ICDs produced smaller and more uniform voltage gradients in the heart, indicating lower risk of damage compared to transvenous ICDs, especially those with dual coils or closer coil positioning.
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A murine model of myelofibrosis in tibia was used in a co-clinical trial to evaluate segmentation methods for application of image-based biomarkers to assess disease status. The dataset (32 mice with 157 3D MRI scans including 49 test-retest pairs scanned on consecutive days) was split into approximately 70% training, 10% validation, and 20% test subsets. Two expert annotators (EA1 and EA2) performed manual segmentations of the mouse tibia (EA1: all data; EA2: test and validation).

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Quantitative MRI biomarkers are sought to replace painful and invasive sequential bone-marrow biopsies routinely used for myelofibrosis (MF) cancer monitoring and treatment assessment. Repeatability of MRI-based quantitative imaging biomarker (QIB) measurements was investigated for apparent diffusion coefficient (ADC), proton density fat fraction (PDFF), and magnetization transfer ratio (MTR) in a JAK2 V617F hematopoietic transplant model of MF. Repeatability coefficients (RCs) were determined for three defined tibia bone-marrow sections (2-9 mm; 10-12 mm; and 12.

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Introduction: Pericardial bleeding is a rare but life-threatening complication of atrial fibrillation (AF) ablation. Patients taking uninterrupted oral anticoagulation (AC) may be at increased risk for refractory bleeding despite pericardiocentesis and administration of protamine. In such cases, andexanet alfa can be given to reverse rivaroxaban or apixaban.

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Histopathology, the standard method to assess BM in hematologic malignancies such as myeloproliferative neoplasms (MPNs), suffers from notable limitations in both research and clinical settings. BM biopsies in patients fail to detect disease heterogeneity, may yield a nondiagnostic sample, and cannot be repeated frequently in clinical oncology. Endpoint histopathology precludes monitoring disease progression and response to therapy in the same mouse over time, missing likely variations among mice.

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  • Cancer treatments often require combination therapies, which can lead to toxic side effects.
  • A new drug, LP-182, effectively targets key cancer pathways without causing noticeable toxicity, thanks to its unique ability to be absorbed through the lymphatic system.
  • Studies show that LP-182 can reduce disease symptoms and improve survival rates in animal models, paving the way for better treatments that utilize lymphatic drug absorption.
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In this study, we investigated the baseline characteristics and "trajectories" of clinical response in men and women after cardiac resynchronization therapy (CRT) implantation. Although women enjoy improved echocardiographic response after CRT compared with men, the kinetics of this response and its relation to functional performance and outcomes are less clear. We identified 592 patients who underwent CRT implantation at our center between 2004 and 2017 and were serially followed in a multidisciplinary clinic.

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Background: Catheter ablation (CA) for atrial fibrillation (AF) is increasingly utilized in recent years, with promising results. We aimed to investigate the nationwide trends in utilization and procedural complications of CA for AF in patients with mechanical prosthetic valves (MPVs).

Methods And Results: We drew data from the US National Inpatient Sample (NIS) database to identify cases of AF ablations in patients with MPVs, between 2003 and 2015.

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Background: The subcutaneous (S-) implantable cardioverter-defibrillator (ICD) is an alternative to the transvenous (TV-) ICD that is increasingly implanted in younger patients; data on the safety and effectiveness of the S-ICD in older patients are lacking.

Objectives: The purpose of this study was to compare outcomes among older patients who received an S- or TV-ICD.

Methods: The authors compared S-ICD and single-chamber TV-ICD implants in Fee-For-Service Medicare beneficiaries using the National Cardiovascular Data Registry ICD Registry.

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Established roles for PI3K and MAPK signaling pathways in tumorigenesis has prompted extensive research towards the discovery of small-molecule inhibitors as cancer therapeutics. However, significant compensatory regulation exists between these two signaling cascades, leading to redundancy among survival pathways. Consequently, initial clinical trials aimed at either PI3K or MEK inhibition alone have proven ineffective and highlight the need for development of targeted and innovative therapeutic combination strategies.

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While obesity has been shown to be associated with elevated risk for Sudden Cardiac Death (SCD), studies examining its effect on outcomes in SCD victims have shown conflicting results. We aimed to describe the body mass index (BMI) distribution in a nationwide cohort of patients admitted for an out of hospital SCD (OHSCD), and the relationship between BMI and in-hospital mortality. We drew data from the U.

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Background: Data regarding the use of high-power short-duration (HPSD) radiofrequency (RF) in combination with half-normal saline irrigation for catheter irrigation are limited.

Objectives: This study investigated the safety and efficacy of using HPSD RF ablation in combination with half-normal saline irrigation for the treatment of AF.

Methods: One hundred consecutive patients with AF underwent RF ablation using HPSD combined with half-normal saline for catheter irrigation.

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Background: Catheter ablation (CA) for ventricular arrhythmias (VAs) is increasingly utilized in recent years. We aimed to investigate the nationwide trends in utilization and procedural complications of CA for VAs in patients with mechanical valve (MV) prosthesis.

Methods: We drew data from the US National Inpatient Sample database to identify cases of VA ablations, including premature ventricular contraction and ventricular tachycardia, in patients with MVs, between 2003 and 2015.

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Background: Heart failure (HF) patients with CRT devices are a vulnerable patient population during the Coronavirus Disease 2019 (COVID-19) Pandemic. It is important to develop innovative virtual care models to deliver multidisciplinary care while minimizing the risk of SARS-CoV2 exposure.

Objective: We aim to provide a description of how HF patients with CRT devices were assessed and managed in our virtual multidisciplinary clinic during the COVID-19 Pandemic.

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