Publications by authors named "Lakkireddy D"
Introduction: Coronary artery disease (CAD) and peripheral artery disease (PAD) increase the risks of cardiovascular events and death. Digital health technologies are rapidly expanding to improve healthcare quality and access. The Care4Today Connect (C4T CAD-PAD) mobile application is designed to help patients with CAD and/or PAD improve medication adherence, learn about their disease, make lifestyle modifications, and enhance healthcare provider (HCP) connection via an HCP-facing portal.
View Article and Find Full Text PDFBackground: The Amulet IDE trial (AMPLATZER Amulet Left Atrial Appendage Occluder [LAAO] Investigational Device Exemption [IDE] Trial) evaluated the safety and effectiveness of the Amulet occluder (Abbott) in patients with nonvalvular atrial fibrillation. The Amulet IDE trial is the largest randomized LAAO trial, comparing the Amulet occluder with the Watchman 2.5 device (Boston Scientific).
View Article and Find Full Text PDFArticle Synopsis
- The study examines outcomes of percutaneous left atrial appendage occlusion (LAAO) procedures performed by either electrophysiologists (EPs) or interventional cardiologists (ICs) between 2020 and 2022, focusing on patient safety and complications.
- Key findings indicate that EPs utilized intracardiac echocardiography more frequently and achieved lower radiation exposure; however, rates of major adverse events (MAE) and in-hospital mortality were comparable between the two groups.
- Overall, LAAO was deemed safe with no significant differences in outcomes based on operator certification, highlighting the importance of continued use of these techniques by both specialties for broader patient access.
The rapid growth in consumer-facing mobile and sensor technologies has created tremendous opportunities for patient-driven personalized health management. The diagnosis and management of cardiac arrhythmias are particularly well suited to benefit from these easily accessible consumer health technologies. In particular, smartphone-based and wrist-worn wearable electrocardiogram (ECG) and photoplethysmography (PPG) technology can facilitate relatively inexpensive, long-term rhythm monitoring.
View Article and Find Full Text PDFArticle Synopsis
- Left atrial appendage closure (LAAC) is used as an alternative stroke prevention method for patients who cannot take blood thinners, but pulmonary artery injury (PAI) is a rare and serious complication associated with it.
- A review of previous PAI cases and data from the FDA's MAUDE database identified 36 cases, predominantly involving older patients, and highlighted that PAI often presents soon after the procedure, with a significant percentage requiring surgery.
- The study emphasizes the need for heightened awareness of PAI symptoms post-LAAC, especially concerning rapid fluid accumulation around the heart, even without clear predictive signs from imaging or clinical details.
Background: Atrial fibrillation is associated with an increased risk of cardiovascular hospitalization (CVH), which may be triggered by changes in daily burden. Machine learning of dynamic trends in atrial fibrillation burden, as measured by insertable cardiac monitors (ICMs), may be useful in predicting near-term CVH.
Methods: Using Optum's deidentified Clinformatics Data Mart Database (2007-2019), linked with the Medtronic CareLink ICM database, we identified patients with >1 days of ICM-detected atrial fibrillation.
Performance of Atrial Fibrillation Burden Trends for Stroke Risk Stratification.
Circ Arrhythm Electrophysiol
November 2024
Background: Atrial fibrillation (AF) is associated with an increased risk of stroke, yet the limitations of conventional monitoring have restricted our understanding of AF burden risk thresholds. Predictive algorithms incorporating continuous AF burden measures may be useful for predicting stroke. This study evaluated the performance of temporal AF burden trends as predictors of stroke from a large cohort with insertable cardiac monitors.
View Article and Find Full Text PDFBackground: The use of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs) significantly improve the chances of survival after out-of-hospital cardiac arrest. Subsequently, state laws mandate training in CPR and AED use for high school graduation. However, training and its impact vary and must be better understood.
View Article and Find Full Text PDFExpert opinion on design and endpoints for studies on catheter ablation of atrial fibrillation.
J Cardiovasc Electrophysiol
November 2024
Article Synopsis
- Catheter ablation for atrial fibrillation (AF) is widely researched, and this expert opinion aims to enhance future studies by applying lessons from past research and promoting consistency in methodologies.
- The effectiveness of these studies can improve with clearly defined endpoints and a thorough understanding of emerging technologies, as well as a need to revisit some current research methods.
- A panel of clinical experts has produced recommendations highlighting essential elements such as documenting clinical details, managing medications during trials, and assessing outcomes to aid in the standardization and quality of AF catheter ablation studies.
Catheter ablation for atrial fibrillation in patients with prior left atrial appendage occlusion device.
J Interv Card Electrophysiol
September 2024
Background: The safety and efficacy of CA for AF and left-sided atrial arrhythmias (AA) in patients with left atrial appendage occlusion (LAAO) devices are lacking.
Methods: This is a single-center retrospective registry that included all patients with prior LAAO who underwent catheter ablation for AF or left-sided atrial arrhythmia from January 2020-January 2023. The primary outcomes were procedure-related complications, device-related complications, AA recurrence, and stroke.
Article Synopsis
- Management of long-standing persistent atrial fibrillation (LSPAF) is challenging, and hybrid convergent ablation with left atrial appendage (LAA) clipping shows better results compared to traditional endocardial-only procedures.!
- A study of 79 patients demonstrated a 73.8% success rate in maintaining freedom from atrial fibrillation after 12 months, but persistent posterior wall activity was noted in a significant number of cases.!
- The findings suggest that combining hybrid ablation and LAA clipping is effective for long-term AF-free survival in LSPAF patients, though recurrence of AF is associated with persistent activity in the posterior wall of the heart.!
Article Synopsis
- Pulsed-field ablation (PFA) is a new technique for treating heart arrhythmias that focuses on the heart muscle without using heat. The study aims to determine how repeated applications and the contact force of the catheter affect the creation of lesions in heart tissue.
- Researchers used a circular loop catheter to test these factors on a potato model and a swine heart model, observing that more repetitions and better contact lead to deeper and more effective lesions.
- The results suggest that successful PFA relies on the physics of the procedure rather than just the immediate disappearance of electrical signals, indicating a need for precise application techniques.
Introduction: Hemostasis following large-bore femoral vein access remains a challenge. Manual compression has been the standard of care but requires bedside staff, prolonged bed rest, and longer length of stay. The LockeT is an external compression device that attempts to address these issues while achieving venous hemostasis.
View Article and Find Full Text PDFArticle Synopsis
- Multiple states have implemented CPR training for high school students and staff to reduce sudden cardiac death (SCD), but the quality and execution of these mandates differ significantly across the country.
- A scoring system was created to objectively assess CPR training mandates in all 50 states and the District of Columbia, revealing a wide range in scores that indicate the robustness of these mandates.
- The study's findings suggest that although there is variability in state mandates, no strong link was found between CPR training requirements and reduced SCD rates, underscoring the need for more consistent and effective policies.
Catheter-related and clinical complications associated with QDOT MICRO Ablation Catheter.
J Cardiovasc Electrophysiol
September 2024
Article Synopsis
- * A study examining adverse events (AEs) related to this catheter found 302 reports from its FDA approval in 2022 to April 2024, with roughly half being catheter-related issues, primarily physical damage.
- * Common clinical complications reported included pericardial effusion and char formation, with a total of 11 deaths linked to various complications, highlighting the need for better awareness and further research on safety.
Article Synopsis
- * This manuscript discusses different anesthesia strategies for cardiac implantable electronic devices and electrophysiology procedures, covering management before, during, and after these procedures.
- * Effective coordination between electrophysiologists and anesthesiologists is essential for successful outcomes, and recent advancements highlight the necessity for specialized anesthesia care in this field.
Article Synopsis
- - Atrial fibrillation (AF) is a common heart rhythm disorder, and the way it's treated in emergency rooms varies widely, affecting patient care and access to effective treatments.
- - The study, which involved 500 patients, compared outcomes between those treated through an organized pathway for AF and those receiving routine care, finding significant advantages for the organized approach.
- - Results showed that patients on the organized pathway had faster access to treatments like ablation and anticoagulation, leading to shorter hospital stays and better overall outcomes compared to the control group.
Background: Cardiac implantable electronic devices (CIEDs) infection remains a serious complication, causing increased morbidity and mortality. Early recognition and escalation to definitive therapy including extraction of the infected device often pose challenges.
Objectives: The purpose of this study was to assess U.