Publications by authors named "Usha B Tedrow"
Evaluation of pulsed field ablation lesion characteristics using an in vitro vegetable model.
J Interv Card Electrophysiol
August 2024
Article Synopsis
- Researchers developed a potato model to test cardiac pulsed field ablation (PFA), addressing the lack of established in vitro methods for this evaluation.
- Using a specific electrode setup and high-voltage generator, they created lesions in potato slabs, which were stained to visualize damage.
- The study found that lesion size grew consistently with higher voltage and more applications, mirroring results seen in heart cell studies.
Article Synopsis
- High-frequency low-tidal-volume (HFLTV) ventilation is more effective than standard ventilation (SV) during radiofrequency catheter ablation (RFCA) for treating paroxysmal atrial fibrillation (PAF), as it enhances procedural efficiency and patient outcomes.
- A study analyzed 70 patients who underwent pulmonary vein isolation with either HFLTV or SV, revealing that HFLTV led to shorter ablation durations, higher contact force, and better impedance reduction while maintaining the same ablation index.
- Overall, HFLTV ventilation resulted in significant reductions in total procedural time, ablation time, and RF time compared to SV, indicating its advantages in improving ablation parameters.
Introduction: Patients with viral myocarditis can present with challenging life-threatening arrhythmias. Catheter ablation can be a life-saving procedure in some patients with recurrent drug-refractory ventricular arrhythmias.
Methods And Results: A patient with three prior ablations targeting two different monomorphic ventricular tachycardias (MMVTs) presented with recurrent ventricular tachycardia (VT).
Septal late enhancement by cardiac CT is associated with repeat ablation in nonischemic cardiomyopathy patients.
J Cardiovasc Electrophysiol
September 2024
Introduction: Scar substrate in nonischemic cardiomyopathy (NICM) patients is often difficult to identify. Advances in cardiac imaging, especially using late iodine-enhanced computed tomography (LIE-CT), allow better characterization of scars giving rise to ventricular tachycardia (VT). Currently, there are limited data on clinical correlates of CT-derived scar substrates in NICM.
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- * The research included patients with significantly reduced heart function and compared outcomes like heart failure hospitalizations and all-cause mortality between LBBAP and BIVP for both sexes.
- * Results showed men had better outcomes with LBBAP compared to BIVP, while women showed no significant difference in outcomes between the two pacing methods.
Background: Catheter ablation of ventricular tachycardia (VT) typically requires radiation exposure with its potential adverse health effects. A completely fluoroless ablation approach is achievable using a combination of electroanatomical mapping and intracardiac echocardiography. Nonetheless, data in patients undergoing VT ablation are limited.
View Article and Find Full Text PDFBackground: Left bundle branch area pacing (LBBAP) has emerged as a physiological alternative pacing strategy to biventricular pacing (BIVP) in cardiac resynchronization therapy (CRT). We aimed to assess the impact of LBBAP vs. BIVP on all-cause mortality and heart failure (HF)-related hospitalization in patients undergoing CRT.
View Article and Find Full Text PDFIntroduction: When ventricular tachycardia (VT) recurs after standard RF ablation (sRFA) some patients benefit from repeat sRFA, whereas others warrant advanced methods such as intramural needle ablation (INA). Our objectives are to assess the utility of repeat sRFA and to clarify the benefit of INA when repeat sRFA fails in patients with VT due to structural heart disease.
Methods: In consecutive patients who were prospectively enrolled in a study for INA for recurrent sustained monomorphic VT despite sRFA, repeat sRFA was considered first.
Background: Electrical storm (ES) patients who fail standard therapies have a high mortality rate. Previous studies report effective management of ES with bedside, ultrasound-guided percutaneous stellate ganglion block (SGB). We report our experience with sympathetic blockade administered via a novel alternative approach: proximal intercostal block (PICB).
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- This study compared three pacing strategies for cardiac resynchronization therapy: left bundle branch pacing (LBBP), left ventricular septal pacing (LVSP), and biventricular pacing (BIVP).
- The primary outcome measured was freedom from heart failure-related hospitalizations and all-cause mortality, finding that LBBP significantly outperformed LVSP and showed better outcomes than BIVP.
- Results indicated that LBBP patients had a higher rate of freedom from heart failure hospitalizations (83%) compared to LVSP patients (51.6%) and similar outcomes between LVSP and BIVP.
SARS-CoV-2 Infection Precipitating VT Storm in Patients With Cardiac Sarcoidosis.
JACC Clin Electrophysiol
November 2023
The authors describe 3 patients presenting with cardiac sarcoidosis (CS) flare and ventricular tachycardia (VT) storm following infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19. COVID-19-related cardiac manifestations can vary and include arrythmias, myocarditis, and exacerbation of underlying cardiovascular disease. The exact mechanism of myocardial involvement is not clear but may include abnormal host immune response and direct myocardial injury, thereby predisposing to enhanced arrhythmic risk.
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- Epicardial access (EA) is gaining importance for treating ventricular arrhythmias, but it's underused due to high complication risks and challenging procedures.
- * A study assessed the SAFER technique for EA, finding it to be 100% successful with no severe complications like right ventricular perforation or major hemorrhagic issues.
- * The SAFER technique is simple, efficient, and offers lower complication rates compared to older methods, making it a promising option for interventional cardiology.
Article Synopsis
- Cardiac magnetic resonance (CMR) is being evaluated for its ability to diagnose and predict outcomes in patients with ventricular arrhythmias, particularly its relation to sudden cardiac death (SCD).
- In a study of 642 patients, abnormal CMR findings were found in 40% of those with nonsustained ventricular tachycardia (NSVT) and 66% of those with sustained ventricular tachycardia (VT) or aborted SCD, showing higher rates of major adverse cardiac events (MACE) associated with abnormal results.
- The study concluded that incorporating CMR assessments can significantly enhance risk stratification in patients with ventricular arrhythmias, potentially leading to better management strategies.
Background: We previously reported feasibility of irrigated needle ablation (INA) with a retractable 27-G end-hole needle catheter to treat nonendocardial ventricular arrhythmia substrate, an important cause of ablation failure.
Objectives: The purpose of this study was to report outcomes and complications in our entire INA-treated population.
Methods: Patients with recurrent sustained monomorphic ventricular tachycardia (VT) or high-density premature ventricular contractions (PVCs) despite radiofrequency ablation were prospectively enrolled at 4 centers.
Background: Left bundle branch area pacing (LBBAP) for cardiac resynchronization therapy (CRT) is an alternative to biventricular pacing (BiVp).
Objectives: The purpose of this study was to compare the outcomes between LBBAP and BiVp as an initial implant strategy for CRT.
Methods: In this prospective multicenter, observational, nonrandomized study, first-time CRT implant recipients with LBBAP or BiVp were included.
Article Synopsis
- - This expert consensus statement offers detailed guidance to healthcare professionals on managing cardiac arrhythmias in pregnant patients and their fetuses.
- - It discusses both slow (bradyarrhythmias) and fast (tachyarrhythmias) heart rhythms, providing recommendations for diagnosing and treating these conditions.
- - The document highlights specific issues related to pregnant patients, identifies gaps in current knowledge, and suggests future research directions.
Background: Recurrent ventricular tachycardia (VT) due to dilated cardiomyopathy (DCM) is difficult to treat, and long-term outcome data are limited.
Objectives: The aim of this study was to identify predictors of mortality or heart transplantation (HTx) and VT recurrence.
Methods: Consecutive patients with DCM accepted for radiofrequency catheter ablation (RFCA) of VT at 9 centers were prospectively enrolled and followed.