Publications by authors named "Luker J"

Purpose: Breast lymphedema after post-lumpectomy radiation therapy (RT) is poorly defined and difficult to treat. The aim of this study was to define the incidence of breast lymphedema and identify factors associated with the risk of developing breast lymphedema (BL) in women undergoing breast-conserving therapy.

Methods: A retrospective cohort study of patients with early-stage breast cancer who underwent breast-conserving surgery (lumpectomy) followed by RT between January 1, 2014 and July 31, 2019 at a single institution.

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Primary Objective: The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians.

Research Design: A participatory study using a mixed-methods, triangulation design.

Methods: The study involved 1.

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Article Synopsis
  • Advanced bipolar radiofrequency catheter ablation (Bi-RFA) is being studied as a new treatment for patients with ventricular tachycardia (VT) and premature ventricular contractions (PVC) that do not respond to standard unipolar radiofrequency ablation (Uni-RFA).
  • A multicenter registry conducted in Europe showed that out of 91 patients treated with Bi-RFA, 74% achieved elimination of clinical VT/PVC, and 78% experienced a significant reduction in PVC burden during follow-up.
  • The procedure was found to be generally safe and feasible, though there were some major complications reported, indicating that Bi-RFA could be a valid option for managing refractory VT/PVC
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Aims: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) have become established in preventing sudden cardiac death, with some advantages over transvenous defibrillator systems, including a lower incidence of lead failures. Despite technological advancements, S-ICD carriers may suffer from significant complications, such as premature battery depletion (PBD), that led to an advisory for nearly 40 000 patients. This multicentre study evaluated the incidence of PBD in a large set of S-ICD patients.

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Aims: Subcutaneous implantable cardioverter-defibrillators (S-ICDs) offer potentially distinct advantages over transvenous defibrillator systems. Recent randomized trials showed significantly lower lead failure rates than transvenous ICD. Still, S-ICDs remain associated with the risk of inappropriate shocks (IAS).

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During a clinical lecturer role, parallel clinical and academic training is undertaken. The anticipation is that a lectureship represents an exciting and expansive time. However, a national crisis has been declared at the clinical lecturer level with a leaky pipeline of clinical academics resulting in dwindling numbers.

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Background: The cryoballoon (CB) has become a standard tool for pulmonary vein isolation (PVI), but the technology is limited in certain ways. A novel RF-balloon (Heliostar™, Biosense Webster, CA, USA) promises the advantages of a balloon technology in combination with 3D mapping.

Methods: To assess procedural data and outcome, all patients undergoing RF-balloon PVI were included and compared with data from consecutive patients undergoing CB PVI for paroxysmal AF.

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Aims: The optimal ablation strategy for recurrent persistent atrial fibrillation (persAF) after initially successful catheter ablation (CA) remains debatable. Dipole density (DD) guided CA using the AcQMap system has been proven to be feasible and effective in patients with persAF. So far, long-term outcome data for DD-guided CA in patients with recurrence of persAF are sparse.

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Background: The newly introduced nonthermal pulsed field ablation (PFA) is a promising technology to achieve fast pulmonary vein isolation (PVI) with high acute success rates and good safety features. However, previous studies have shown that very high power short duration ablation (VHPSD) is also highly effective and fast to achieve PVI with potentially less arrhythmia recurrence compared to conventional radiofrequency ablation. Data comparing PFA to VHPSD-PVI is lacking.

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Article Synopsis
  • A new standard operating procedure (SOP) was developed to identify patients who could skip preprocedural transoesophageal echocardiography (TEE) screening for left atrial thrombi before atrial fibrillation (AF) ablation, aiming to reduce patient risks and discomfort.
  • A study analyzed data from 1,874 patients treated between 2018 and 2022, comparing a group following the new SOP against a matched group that underwent TEE before every procedure.
  • The implementation of the new SOP resulted in a 67% reduction in the number of TEEs performed, with no significant increase in risks of cerebrovascular events, indicating the approach is safe and effective.
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Introduction: Pulmonary vein isolation (PVI) remains the cornerstone in the treatment of atrial fibrillation (AF). PVI using cryoballoon (CB) technology has emerged as a standard procedure in many centers. Recently, pulsed field ablation (PFA) has been introduced and used to achieve PVI.

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  • * A total of 188 patients from two German centers were followed between 2016 and 2019, with regular checks on the TPS system for performance and issues during a follow-up period averaging around 2 years.
  • * Results showed stable performance of the pacing system with no infections or device failures reported, and while the demand for right ventricular pacing increased over time, the battery life remained consistent with expectations.
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Background: There is a growing body of research evidence to guide acute stroke care. Receiving care in a stroke unit improves access to recommended evidence-based therapies and patient outcomes. However, even in stroke units, evidence-based recommendations are inconsistently delivered by healthcare workers to patients with stroke.

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Background: Omnipolar mapping (OT) is a novel tool to acquire omnipolar signals for electro-anatomical mapping, displaying true voltage and real-time wavefront direction and speed independent of catheter orientation. The aim was to analyze previously performed left atrial (LA) and left ventricular (LV) maps for differences using automated OT vs. standard bipolar settings (SD) and HD wave (HDW) algorithm.

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Article Synopsis
  • - The study aimed to compare the effectiveness and procedural differences between high RF-power short-duration (HPSD) ablation and cryoballoon (CB) ablation for pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (persAF).
  • - A total of 721 patients were analyzed, showing that both HPSD and CB successfully achieved PVI, but HPSD procedures took significantly longer than CB procedures without major complications noted in either group.
  • - Follow-up results indicated that HPSD provided a similar rate of arrhythmia-free survival compared to CB, and while CB procedures were quicker, both methods showed low complication rates, warranting
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  • - The study investigates the occurrence of premature battery depletion in subcutaneous implantable cardioverter-defibrillator (S-ICD) devices, which has raised concerns among users and manufacturers alike.
  • - A retrospective analysis examined data from 1,054 S-ICD devices across various centers in Europe and North America, specifically looking at battery failures within 60 months.
  • - Findings revealed that 3.5% of potentially affected S-ICD devices experienced premature battery depletion within an average follow-up of 49 months, confirming the depletion is limited to devices under advisory.
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Background: Motor neurone disease (MND) is a neurodegenerative disease that leads to significant morbidity and mortality. The Global Burden of Disease (GBD) project estimated the MND all-age global prevalence is 4.5 (95% confidence interval (CI)=4.

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  • Reduced biventricular pacing (BiVP) during cardiac resynchronization therapy (CRT) can negatively impact patient outcomes, especially in those with ventricular arrhythmias needing treatment.
  • In a study of 64 CRT patients with reduced BiVP, catheter ablation of premature ventricular contractions (PVC) and intensified medical therapy were used to enhance BiVP levels.
  • Results indicated that PVC ablation led to a greater improvement in BiVP and patient's quality of life compared to medical therapy alone, highlighting the effectiveness of targeted arrhythmia treatments in optimizing CRT outcomes.
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Background: Catheter ablation of ventricular tachycardias (VTs) is one of the most complex tasks in interventional electrophysiology. It is complicated by the fact that VT can recur during treatment which can affect the hemodynamic stability of the patient. In addition, navigation with the ablation or mapping catheter through the valvular apparatus and the trabecularization of the ventricle can be challenging.

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Purpose: Cryoballoon (CB) ablation and radiofrequency (RF) ablation are the most common techniques for pulmonary vein isolation (PVI) in patients with symptomatic atrial fibrillation (AF). An increasing number of patients undergoing PVI are obese. To address the paucity of data on outcomes of CB- vs.

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Objective: To investigate stroke survivors' perceptions of factors influencing their engagement in activity outside of dedicated therapy sessions during inpatient rehabilitation.

Design: Qualitative study.

Setting: Four metropolitan rehabilitation units in Australia.

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Purpose: This study aimed to investigate rehabilitation staff perceptions of factors influencing stroke survivor activity outside of dedicated therapy time for the purpose of supporting successful translation of activity promoting interventions in a rehabilitation unit.

Materials And Methods: Purposive sampling of multi-disciplinary teams from four rehabilitation units was performed, and semi-structured interviews were conducted by telephone, digitally audio-recorded and then transcribed verbatim. A stepped iterative process of thematic analysis was employed until data saturation was reached.

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To assess the effects of consumer engagement in health care policy, research and services. We updated a review published in 2006 and 2009 and revised the previous search strategies for key databases (The Cochrane Central Register of Controlled Trials; MEDLINE; EMBASE; PsycINFO; CINAHL; Web of Science) up to February 2020. Selection criteria included randomised controlled trials assessing consumer engagement in developing health care policy, research, or health services.

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