Publications by authors named "Kurt Roberts-Thomson"
Article Synopsis
- Inpatient monitoring is traditionally recommended when starting sotalol, but this study aimed to evaluate the safety of initiating it in an outpatient setting.
- The study reviewed 880 patients who started sotalol, mostly for atrial fibrillation, and monitored their QTc intervals over time to assess for significant prolongation and other clinical events.
- Findings indicated that outpatient initiation of sotalol is generally safe, with minimal serious adverse effects and a low rate of QTc prolongation, although ongoing monitoring and follow-up are essential.
Article Synopsis
- The study aimed to evaluate how factors like vector length, implant angle, and patient characteristics influence the accuracy of electrogram sensing in insertable cardiac monitors (ICMs).
- It involved analyzing 1800 ECG tracings from 150 participants using different distances, angles, and postures, finding that longer vector lengths (75 mm) and oblique angles improved P- and R-wave amplitudes significantly.
- The findings suggest that optimizing vector length and implant angle can enhance electrogram visibility, which is crucial for reducing false alerts in cardiac monitoring.
Importance: Randomised trials have shown that catheter ablation (CA) is superior to medical therapy for ventricular tachycardia (VT) largely in patients with ischaemic heart disease. Whether this translates to patients with all forms and stages of structural heart disease (SHD-e.g.
View Article and Find Full Text PDFArticle Synopsis
- Most modern cardiac implantable electronic devices (CIEDs) can now undergo MRI scans, which requires both pre- and post-scan checks, leading to increased workload for cardiac services.
- A study covering three years revealed 739 CIED checks related to MRI scans, showing a rise in the demand for these checks over time.
- The projected annual cost for handling CIED checks is expected to reach AUD$161,695 in ten years, highlighting the need for better budgeting and staff management.
Background: Little data exists on electrogram sensing in current generation of miniaturized insertable cardiac monitors (ICMs).
Objective: To compare the sensing capability of ICM with different vector length: Medtronic Reveal LINQ (~40 mm) vs. Biotronik Biomonitor III (BM-III, ~70 mm).
Should We Check It? Assessing Interrogation of Cardiac Implantable Electronic Devices in the Emergency Department-The CHECK-ED Study: Implications for Service Planning and Care Delivery.
Heart Lung Circ
August 2022
Article Synopsis
- A study analyzed cardiac implantable electronic device (CIED) checks requested from the emergency department (ED) over a year to determine how often significant issues arise from these checks.
- It was found that 28% of the checks revealed clinically relevant issues, particularly after-hours checks had a higher rate of issues compared to during regular hours.
- Patient-reported ICD shocks and a history of atrial fibrillation (AF) were identified as strong predictors for finding significant issues, while common complaints like syncope/presyncope were less predictive.
Objectives: This study sought to evaluate the role of cardiac afferent reflexes in atrial fibrillation (AF).
Background: Efferent autonomic tone is not associated with atrial remodeling and AF persistence. However, the role of cardiac afferents is unknown.
Rationale and design of the IRON-AF study: a double-blind, randomised, placebo-controlled study to assess the effect of intravenous ferric carboxymaltose in patients with atrial fibrillation and iron deficiency.
BMJ Open
August 2021
Introduction: Atrial fibrillation (AF) is associated with significantly impaired quality-of-life. Iron deficiency (ID) is prevalent in patients with AF. Correction of ID in other patient populations with intravenous iron supplementation has been shown to be a safe, convenient and effective way of improving exercise tolerance, fatigue and quality-of-life.
View Article and Find Full Text PDFBackground: Indigenous Australians experience a greater burden of AF. Whether this is in-part due to differences in arrhythmogenic structures that appear to contribute to AF differences amongst other ethnicities is not known.
Methods: We studied forty individuals matched for ethnicity and other AF risk factors.
Background: The epidemiology of atrial fibrillation (AF) amongst Indigenous populations remains poorly characterised. We studied hospitalisations for AF in Central Australia, the most populous Indigenous region in the country.
Methods: Patients with a diagnosis of AF admitted to Alice Springs Hospital, the only secondary health care facility and provider of cardiac care in remote Central Australia, were identified from 2006 to 2016.
Article Synopsis
- Research shows that anticoagulation for atrial fibrillation (AF) is underutilized, especially among Indigenous Australians who are at higher risk for AF and stroke.
- A study analyzed data over 12 years from nearly 19,700 participants to identify factors influencing anticoagulation use, revealing that conditions like hypertension, diabetes, heart failure, and prior strokes increased usage, while older age, female gender, and vascular disease decreased it.
- The findings indicate that anticoagulation use is inadequate in both groups, with a particular concern that hypertension may not be recognized as a significant stroke risk in Indigenous Australians, suggesting a need for improved awareness and treatment efforts.
Aims: There is growing evidence that magnetic resonance imaging (MRI) scanning in patients with non-conditional cardiac implantable electronic devices (CIEDs) can be performed safely. Here, we aim to assess the safety of MRI in patients with non-conditional CIEDs.
Methods And Results: English scientific literature was searched using PubMed/Embase/CINAHL with keywords of 'magnetic resonance imaging', 'pacemaker', 'implantable defibrillator', and 'cardiac resynchronization therapy'.
Article Synopsis
- A study investigated the anticoagulation quality in Indigenous Australians with atrial fibrillation (AF), revealing that they have significantly lower time in therapeutic range (TTR) compared to non-Indigenous Australians.
- Data collected from 512 patients showed that despite being younger, Indigenous Australians faced more health issues, contributing to their poorer TTR rates.
- The findings highlight the need for better monitoring of warfarin therapy in both Indigenous and non-Indigenous patients to reduce the risk of strokes.
Background: Obesity is prevalent in Indigenous populations who exhibit significant differences in body fat composition. While excess regional adiposity can be partially inferred from clinical measurements, noninvasive imaging allows for direct quantification of specific fat depots. Epicardial fat is a visceral adipose tissue that has been strongly associated with cardiometabolic disease in other populations.
View Article and Find Full Text PDFImplication of ventricular pacing burden and atrial pacing therapies on the progression of atrial fibrillation: A systematic review and meta-analysis of randomized controlled trials.
Heart Rhythm
August 2019
Background: Atrial fibrillation (AF) is common after pacemaker implantation. However, the impact of pacemaker algorithms in AF prevention is not well understood.
Objective: The purpose of this study was to evaluate the role of pacing algorithms in preventing AF progression.
Ventricular arrhythmias are one of the leading causes of death in patients with a prior myocardial infarction. Implantable cardioverter-defibrillators (ICDs) are very effective in the prevention of sudden cardiac death but the risk of recurrence remains an issue since defibrillation does not alter the underlying substrate. Recurrent ICD shocks are distressing and are associated with an increase in mortality.
View Article and Find Full Text PDFBackground: It has been suggested that ethnicity can make a significant difference to the likelihood of thromboembolic stroke related to atrial fibrillation. Ethnic differences have been shown to alter inflammatory and haemostatic factors; however, this may all be confounded by differences in cardiovascular risk factors between different ethnicity. The impact of different ethnicities on the thrombogenic profile is not known.
View Article and Find Full Text PDFPurpose: Protected channels of surviving myocytes in late postinfarction ventricular scar predispose to ventricular tachycardia (VT). However, only a few patients develop VT spontaneously. We studied differences in electric remodeling and protected channels in late postinfarction patients with and without spontaneous VT.
View Article and Find Full Text PDFBackground: A number of cardiovascular diseases have been linked with bone health and an increased risk of osteoporotic fracture. Whether atrial fibrillation (AF) is associated with subsequent fracture risk is not known.
Methods: Administrative, clinical and hospitalisation information were linked over a 14-year period.
Heart rate variability (HRV) modulates dynamics of ventricular repolarization. A diminishing value of HRV is associated with increased vulnerability to life-threatening ventricular arrhythmias, however the causal relationship is not well-defined. We evaluated if fixed-rate atrial pacing that abolishes the effect of physiological HRV, will alter ventricular repolarization wavefronts and is relevant to ventricular arrhythmogenesis.
View Article and Find Full Text PDFBackground: In ventricular scar, impulse spread is slow because it traverses split and zigzag channels of surviving muscle. We aimed to evaluate scar electrograms to determine their local delay (activation time) and inequality in voltage splitting (entropy), and their relationship to channels. We reasoned that unlike innocuous channels, which are often short with multiple side branches, ventricular tachycardia (VT) supporting channels have very slow impulse spread and possess low entropy because of their longer protected length and relative lack of side-branching.
View Article and Find Full Text PDFEuropean Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardiaca y Electrofisiologia (SOLAECE).
Europace
March 2017
Objectives: This study sought to determine the differences between the prothrombotic properties and chamber characteristics in patients with lone atrial fibrillation (AF) and those with AF and comorbidities.
Background: Thromboembolic risk is increased in patients with AF; however, whether this is due to AF per se or its comorbidities remains unclear.
Methods: A total of 87 patients undergoing ablation were prospectively recruited for the study, including 30 patients with lone AF, 30 patients with AF and comorbidities in sinus rhythm, and 27 patients with left-sided accessory pathways as controls.