Publications by authors named "Konstantinos Siontis"
Background: Multimorbidity is common in patients with atrial fibrillation (AF), yet comorbidity patterns are not well documented.
Methods: The prevalence of 18 chronic conditions (6 cardiometabolic, 7 other somatic, 5 mental health) was obtained in patients with new-onset AF from 2013-2017 from a 27-county region and controls matched 1:1 on age, sex, and county of residence. For AF patients and controls separately, clustering of conditions and co-occurrence beyond chance was estimated (using the asymmetric Somers' D statistic), overall and for ages <65, 65-74, 75-84, and ≥85 years.
Background: The ability to predict recovery of left ventricular ejection fraction (LVEF) in response to guideline-directed therapy among patients with nonischemic cardiomyopathy is desired. We sought to determine whether left ventricular endocardial unipolar voltage measured during invasive electroanatomic mapping could be used to predict LVEF recovery among those with recent-onset nonischemic cardiomyopathy.
Methods: We analyzed the left ventricular voltage maps of patients included in the eMAP trial (Electrogram-Guided Myocardial Advanced Phenotyping; NCT03293381), a prospective, nonrandomized, interventional trial conducted at 2 institutions between 2017 and 2020.
Article Synopsis
- A study investigated the prevalence of non-sustained ventricular tachycardia (NSVT) in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) and its link to sustained ventricular arrhythmias and mortality.
- Out of 217 patients, 53% exhibited NSVT during Holter monitoring, and 5.1% experienced sustained ventricular arrhythmias during an average follow-up of 27 months.
- The presence of NSVT was associated with a higher risk of sustained ventricular arrhythmias, while all-cause mortality was similar between NSVT and non-NSVT groups, although prominent ventricular ectopy was linked to increased risks of both outcomes.
Article Synopsis
- Sarcoidosis is a disease that causes non-caseating granulomas and can affect various organs, with cardiac involvement potentially leading to serious heart issues like arrhythmias or heart failure.
- A 43-year-old man with a history of heart palpitations and dental issues experienced cardiac arrest and was later diagnosed with cardiac and pulmonary sarcoidosis.
- This case emphasizes the importance of thorough medical history and testing to identify rare presentations of sarcoidosis, such as oral involvement, which can have significant implications for patient care.
Article Synopsis
- - Current research indicates that asymptomatic atrial fibrillation (AF) may lead to similar risks of stroke and mortality as symptomatic AF, despite conflicting previous findings.
- - A review of 36 studies, involving over 217,000 participants, showed no significant differences in all-cause mortality, stroke, or other major health outcomes between symptomatic and asymptomatic AF patients; however, symptomatic patients had a higher risk of developing new heart failure.
- - Symptomatic patients tended to receive more aggressive treatments like antiarrhythmic drugs and ablation therapy, while asymptomatic patients had a higher chance of progressing to permanent AF.
Anatomical Ablation of the Atrioventricular Node.
Arrhythm Electrophysiol Rev
August 2024
Background: Atrioventricular (AV) conduction ablation has been achieved by targeting the area of penetration of the conduction axis as defined by recording a His bundle potential. Ablation of the His bundle may reduce the possibility of a robust junctional escape rhythm. It was hypothesised that specific AV nodal ablation is feasible and safe.
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- Current guidelines for using implantable cardioverter-defibrillators (ICDs) in patients with cardiac sarcoidosis and low left ventricular ejection fraction (LVEF) are inconsistent and vary in recommendations.
- This study aimed to assess the risk of ventricular arrhythmias in these patients and compared outcomes based on differing LVEF levels.
- Results showed that patients with LVEF between 36%-49% and those with LVEF ≤35% had similar arrhythmic risks, but those with secondary prevention ICDs demonstrated a significantly higher risk of sustained ventricular tachycardia and fibrillation.
Article Synopsis
- Abnormalities found in invasive electroanatomic mapping (EAM) are linked to myocardial issues in Arrhythmogenic Cardiomyopathy (ACM), but EAM parameters are not currently included in the diagnostic guidelines for ACM.
- A 41-year-old woman experienced frequent PVCs, and while her heart's structure appeared normal on imaging, EAM indicated problems in certain areas of the heart consistent with RV cardiomyopathy.
- The case highlights that advanced RV electropathy can appear before observable structural heart changes, suggesting that future ACM guidelines might need to incorporate EAM findings for better diagnosis, especially in patients with multiple PVCs.
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.
Aims: Recently, deep learning artificial intelligence (AI) models have been trained to detect cardiovascular conditions, including hypertrophic cardiomyopathy (HCM), from the 12-lead electrocardiogram (ECG). In this external validation study, we sought to assess the performance of an AI-ECG algorithm for detecting HCM in diverse international cohorts.
Methods And Results: A convolutional neural network-based AI-ECG algorithm was developed previously in a single-centre North American HCM cohort (Mayo Clinic).
Background And Aims: Incidence and types of secondary tricuspid regurgitation (TR) are not well defined in atrial fibrillation (AFib) and sinus rhythm (SR). Atrial secondary TR (A-STR) is associated with pre-existing AFib; however, close to 50% of patients with A-STR do not have AFib. The aim of this study was to assess incidence, types, and outcomes of ≥ moderate TR in AFib vs.
View Article and Find Full Text PDFBackground: The study aimed to describe the patterns and trends of initiation, discontinuation, and adherence of oral anticoagulation (OAC) in patients with new-onset postoperative atrial fibrillation (POAF), and compare with patients newly diagnosed with non-POAF.
Methods And Results: This retrospective cohort study identified patients newly diagnosed with atrial fibrillation or flutter between 2012 and 2021 using administrative claims data from OptumLabs Data Warehouse. The POAF cohort included 118 366 patients newly diagnosed with atrial fibrillation or flutter within 30 days after surgery.
Article Synopsis
- - The text discusses Calcium Release Deficiency Syndrome (CRDS), a serious genetic heart condition that can cause sudden cardiac arrest without clear reasons and is not detectable through standard tests.
- - The study aimed to analyze electrocardiogram (ECG) responses after brief periods of fast heart rates followed by pauses in order to develop a diagnostic test for CRDS.
- - Findings showed that patients with CRDS had a significantly greater change in T-wave amplitude on their ECG after a pause compared to control groups, indicating a potential diagnostic marker for this syndrome.
Background: The effects of disease-causing MYBPC3 or MYH7 genetic variants on atrial myopathy, atrial fibrillation (AF) clinical course, and catheter ablation efficacy remain unclear.
Objectives: The aim of this study was to characterize the atrial substrate of patients with MYBPC3- or MYH7-mediated hypertrophic cardiomyopathy (HCM) and its impact on catheter ablation outcomes.
Methods: A retrospective single-center study of patients with HCM who underwent genetic testing and catheter ablation for AF was performed.
Aims: Mobile devices such as smartphones and watches can now record single-lead electrocardiograms (ECGs), making wearables a potential screening tool for cardiac and wellness monitoring outside of healthcare settings. Because friends and family often share their smart phones and devices, confirmation that a sample is from a given patient is important before it is added to the electronic health record.
Methods And Results: We sought to determine whether the application of Siamese neural network would permit the diagnostic ECG sample to serve as both a medical test and biometric identifier.