Publications by authors named "Ross Hunter"

Article Synopsis
  • * The researchers developed a new measurement called the restitution threshold index (RTI), which reflects the burden of short R-R intervals and found it correlates with reduced LVEF and improvement in LVEF after catheter ablation (CA).
  • * In a study with 104 patients, those with reduced LVEF had a significantly higher RTI, indicating it as a strong predictor for recognizing the risk of LVEF decline and predicting recovery after CA.
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Article Synopsis
  • Atrial fibrillation-induced cardiomyopathy (AIC) is characterized by a drop in left ventricular ejection fraction (LVEF) due to AF, but the reasons why some patients develop AIC are still unclear.* -
  • The study hypothesizes that subtle heart muscle issues exist before LVEF decreases; therefore, a detailed examination of heart function following successful catheter ablation is essential to identify these features.* -
  • Results show that out of 41 participants, 82.9% recovered LVEF post-ablation, yet many still had signs of heart dysfunction, with significant portions exhibiting elevated NT-proBNP levels, ongoing heart failure symptoms, and impaired heart performance despite normalization of LVEF.*
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Article Synopsis
  • - In nonagenarians with complete heart block, dual-chamber (DDD) pacing showed better physiological outcomes compared to single-chamber (VVI) pacing, although the effect on overall mortality is debated.
  • - Among 168 patients studied, those with VVI pacing were older, frailer, and had higher rates of dementia compared to DDD recipients, but both groups had similar age and heart function at baseline.
  • - After adjusting for factors like age and frailty, VVI pacing was linked to significantly higher risks of all-cause mortality and death from congestive cardiac failure, suggesting better long-term outcomes for DDD pacing in this population.
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Background: Atrial fibrillation (AF) is more common in patients with hypertrophic cardiomyopathy (HCM) and is often highly symptomatic. The impact of catheter ablation (CA) may be under-reported when evaluated by long-term freedom from any atrial arrhythmia.

Objectives: This study aims to evaluate whether CA of AF in patients with HCM would significantly reduce AF burden and improve symptoms.

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Introduction: The novel Confirm Rx™ implantable cardiac monitor (ICM) with SharpSense™ technology incorporates a new P-wave discriminator designed to improve AF detection. This study aimed to evaluate the diagnostic performance of the Confirm Rx™ ICM in detecting AF episodes of varying durations.

Methods: We conducted a multicenter retrospective analysis of consecutive patients implanted with a Confirm Rx™ ICM (v1.

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Article Synopsis
  • The study investigates the unclear pathophysiology of atrial fibrillation (AF), focusing on how scar tissue and conduction velocity (CV) affect electrical wavefronts in sinus rhythm (SR) and AF.
  • Researchers analyzed data from 60 patients, finding that local activation times and voltage levels correlate, with enhanced CV heterogeneity often found in areas of low voltage.
  • The findings suggest that CV dynamics influenced by scar tissue lead to varying wavefront propagation in SR and increased rotational activity during AF, highlighting potential new targets for ablation treatment.
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Article Synopsis
  • The heart condition atrial fibrillation (AF) is linked to problems like atrial fibrosis and changes in nerve signals, which can affect how fast electrical signals move through the heart's atrium.* -
  • Doctors studied data from 54 patients to see how different factors including heart voltage and nerve stimulation affected the speed of these signals and where they changed direction, known as pivot points.* -
  • The findings showed that the type of heart tissue and nerve activity can slow down these signals and create more areas where the signals change direction, helping us understand how AF works better.*
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Background And Aims: Catheter ablation is superior to pharmacological therapy in controlling atrial fibrillation (AF). There are few data on the long-term outcome of AF ablation in octogenarian patients. This analysis aims to evaluate the outcome of AF ablation in octogenarians vs.

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Objectives: To assess patients' opioid prescription usage and pain management satisfaction after fracture surgery.

Design: An IRB-approved prospective prognostic cohort study for postoperative patients with fracture was conducted. Patients were evaluated by an independent observer at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively where they were given Detroit Interventional Pain Assessment questionnaires regarding their postoperative pain and opioid usage.

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Background: When using lesion size index (LSI) to guide catheter ablation, it is unclear what combination of power, contact force and time would be preferable to use and what LSI target value to aim for. This study aimed at identifying desirable ablation settings and LSI targets by using tissue impedance drop as indicator of lesion formation.

Methods: Consecutive patients, undergoing their first left atrial (LA) catheter ablation for atrial fibrillation, with radiofrequency energy (RF) powers of 20, 30 and 40 W were enrolled.

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We describe two cases of secondary prevention subcutaneous implantable cardioverter defibrillator (S-ICD) implantation and subsequent S-ICD electrode displacement which initially went undetected. One presentation was a result of a coincidental chest x-ray for respiratory exacerbation and another with an untreated episode highlighted via remote monitoring, both patients were booked to clinic for further investigation. Our findings highlighted had there been a comparison of the existing subcutaneous electrogram (S-ECG) to captured S-ECGs at time of implant the electrode displacement would have been detected beforehand.

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Cardiac resynchronisation therapy (CRT) improves prognosis in patients with heart failure (HF) however the role of ABO blood groups and Rhesus factor are poorly understood. We hypothesise that blood groups may influence clinical and survival outcomes in HF patients undergoing CRT. A total of 499 patients with HF who fulfilled the criteria for CRT implantation were included.

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Article Synopsis
  • The study looked at two types of heart activations (focal and rotational) in patients with atrial fibrillation (AF) and how they relate to areas of low voltage in the heart.
  • Researchers found that most rotational activations were located in low-voltage zones, while only a few focal activations were.
  • The results suggest that rotational activations often depend on focal activations, helping to understand how AF can keep happening in certain patients.
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Background: Antimicrobial envelopes reduce the incidence of cardiac implantable electronic device infections, but their cost restricts routine use in the United Kingdom. Risk scoring could help to identify which patients would most benefit from this technology.

Methods: A novel risk score (BLISTER [Blood results, Long procedure time, Immunosuppressed, Sixty years old (or younger), Type of procedure, Early re-intervention, Repeat procedure]) was derived from multivariate analysis of factors associated with cardiac implantable electronic device infection.

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Background: To date, there are no randomized, double-blinded clinical trials comparing catheter ablation to DC cardioversion (DCCV) with medical therapy in patients with persistent atrial fibrillation (PersAF). Conducting a large-scale trial to address this question presents considerable challenges, including recruitment, blinding, and implementation. We conducted a pilot study to evaluate the feasibility of conducting a definitive placebo-controlled trial.

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Background: Remote monitoring (RM) of implantable cardiac devices provides substantial and complex information, presenting new challenges such as detection of a patient's death.

Objective: This study aims to describe RM transmissions indicating death and propose a management strategy for services.

Methods: The study included consecutive ambulatory outpatients whose deaths were detected via RM.

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Background: Mechanisms sustaining persistent atrial fibrillation (AF) remain unclear.

Objectives: The study sought to evaluate both the clinical outcomes and response to ablation of potential drivers in patients with recurrent persistent AF recurrence following pulmonary vein isolation (PVI).

Methods: A total of 100 patients with persistent AF of <2 years' duration underwent cryoballoon PVI (ECGI phenotyping of persistent AF based on driver burden and distribution to predict response to pulmonary vein isolation).

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Background: There is a paucity of data comparing vitamin K antagonists (VKAs) to direct oral anticoagulants (DOACs) at the time of cardiac implantable electronic device (CIED) surgery. Furthermore, the best management of DOACs (interruption vs continuation) is yet to be determined.

Objectives: This study aimed to compare the incidence of device-related bleeds and thrombotic events based on anticoagulant type (DOAC vs VKA) and regimen (interrupted vs uninterrupted).

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Aims: Pulmonary vein isolation (PVI) is the cornerstone of catheter ablation for atrial fibrillation (AF). There are limited data on the PolarX Cryoballoon. The study aimed to establish the safety, efficacy, and feasibility of same day discharge for Cryoballoon PVI.

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Background: Atrial fibrillation (AF) is common in patients with hypertrophic cardiomyopathy (HCM) and can be challenging to manage. Atrioventricular nodal (AVN) ablation may be an effective management strategy for AF in these patients.

Objective: The purpose of this study was to assess the efficacy of AVN ablation in HCM patients who have failed medical therapy and/or catheter ablation for AF.

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The purpose of this review is to examine the literature on combined pelvic ring and acetabular fractures. We hope to further define the classifications, severities (ISS & Mortality), healing, radiographic parameters, and functional outcomes of such injuries to report all potential recommendations based on findings. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and a systematic search on PubMed and Google Scholar was performed.

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