2023
PPP1R12C Promotes Atrial Hypocontractility in Atrial Fibrillation
Perike S, Gonzalez-Gonzalez F, Abu-Taha I, Damen F, Hanft L, Lizama K, Aboonabi A, Capote A, Aguilar-Sanchez Y, Levin B, Han Z, Sridhar A, Grand J, Martin J, Akar J, Warren C, Solaro R, Ong S, Darbar D, McDonald K, Goergen C, Wolska B, Dobrev D, Wehrens X, McCauley M. PPP1R12C Promotes Atrial Hypocontractility in Atrial Fibrillation. Circulation Research 2023, 133: 758-771. PMID: 37737016, PMCID: PMC10616980, DOI: 10.1161/circresaha.123.322516.Peer-Reviewed Original ResearchConceptsSinus rhythm controlsAtrial hypocontractilityAF inducibilityAtrial contractilityAtrial fibrillationRhythm controlHuman patientsRight atrial appendage tissuePacing-induced AFThromboembolic stroke riskAtrial ejection fractionAtrial appendage tissueAtrial HL-1 cellsHL-1 cellsAtrial strainStroke riskAtrial sizeEjection fractionContractile functionElectrophysiology studyHypocontractilityWestern blotPatientsAtrial myosin light chainSarcomere functionVariation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes
Chui P, Lan Z, Freeman J, Enriquez A, Khera R, Akar J, Masoudi F, Ong E, Curtis J. Variation in hospital use of cardiac resynchronization therapy-defibrillator among eligible patients and association with clinical outcomes. Heart Rhythm 2023, 20: 1000-1008. PMID: 36963741, DOI: 10.1016/j.hrthm.2023.03.022.Peer-Reviewed Original ResearchConceptsEligible patientsICD RegistryCardiac resynchronizationNational Cardiovascular Data Registry ICD RegistryCRT-D implantationCRT-D useHospital-level outcomesStrong guideline recommendationsHospital-level variationPatient-level outcomesIntraclass correlation coefficientQuality improvement effortsHospital mortalityGuideline indicationsReadmission ratesSelect patientsClinical outcomesGuideline recommendationsHospital variationHospital ratesUse of CRTHospital levelHospital usePatientsCase mixPredicting Malignant Ventricular Arrhythmias Using Real-Time Remote Monitoring
Ginder C, Li J, Halperin J, Akar J, Martin D, Chattopadhyay I, Upadhyay G. Predicting Malignant Ventricular Arrhythmias Using Real-Time Remote Monitoring. Journal Of The American College Of Cardiology 2023, 81: 949-961. PMID: 36889873, DOI: 10.1016/j.jacc.2022.12.024.Peer-Reviewed Original ResearchConceptsAppropriate device therapyMalignant ventricular arrhythmiasDevice therapyVentricular arrhythmiasImplantable cardioverter-defibrillator therapyLogistic regressionSeparate multivariable logistic regressionsLead impedanceAppropriate ICD therapyCardioverter-defibrillator therapyCardiac resynchronization therapyMultivariable logistic regressionRemote monitoring dataShock lead impedanceAtrial lead impedanceICD therapyHeart failureResynchronization therapyAppropriate therapyAtrial tachyarrhythmiasVentricular tachycardiaVentricular fibrillationDefibrillator devicesHeart ratePatients
2022
PO-657-07 SPONTANEOUS RESTORATION OF SINUS RHYTHM AFTER INTER ATRIAL SHUNT PLACEMENT IN A PATIENT WITH LONGSTANDING PERSISTENT ATRIAL FIBRILLATION
Ziki M, Hummel J, Lampert R, Akar J. PO-657-07 SPONTANEOUS RESTORATION OF SINUS RHYTHM AFTER INTER ATRIAL SHUNT PLACEMENT IN A PATIENT WITH LONGSTANDING PERSISTENT ATRIAL FIBRILLATION. Heart Rhythm 2022, 19: s273-s274. DOI: 10.1016/j.hrthm.2022.03.295.Peer-Reviewed Original Research
2020
Risk of COVID-19 infection after cardiac electrophysiology procedures
Workman V, Freeman JV, Obasare ER, Jain S, Ganeshan R, Burr A, Blitzer M, Akar J, Lampert R. Risk of COVID-19 infection after cardiac electrophysiology procedures. Heart Rhythm O2 2020, 1: 239-242. PMID: 32904452, PMCID: PMC7455246, DOI: 10.1016/j.hroo.2020.08.006.Peer-Reviewed Original ResearchCOVID-19 infectionEP proceduresNosocomial spreadCOVID-19Probable COVID-19 infectionMedical record reviewPreventive measuresCOVID-19 patientsRisk of developmentCOVID-19 surgeChest painHospital stayHospital transmissionRecord reviewTransient symptomsEmergent proceduresCardiac electrophysiology proceduresNonemergent proceduresElectrophysiology labElectrophysiology proceduresEP labPatientsHospital censusCoronavirus infectionSymptomsIncidence and determinants of QT interval prolongation in COVID‐19 patients treated with hydroxychloroquine and azithromycin
Maraj I, Hummel JP, Taoutel R, Chamoun R, Workman V, Li C, Tran L, DelVecchio A, Howes C, Akar JG. Incidence and determinants of QT interval prolongation in COVID‐19 patients treated with hydroxychloroquine and azithromycin. Journal Of Cardiovascular Electrophysiology 2020, 31: 1904-1907. PMID: 32485061, PMCID: PMC7300464, DOI: 10.1111/jce.14594.Peer-Reviewed Original ResearchEnhanced electrocardiographic monitoring of patients with Coronavirus Disease 2019
Jain S, Workman V, Ganeshan R, Obasare ER, Burr A, DeBiasi RM, Freeman JV, Akar J, Lampert R, Rosenfeld LE. Enhanced electrocardiographic monitoring of patients with Coronavirus Disease 2019. Heart Rhythm 2020, 17: 1417-1422. PMID: 32387247, PMCID: PMC7200355, DOI: 10.1016/j.hrthm.2020.04.047.Peer-Reviewed Original ResearchConceptsQT prolongationCoronavirus disease 2019Electrocardiographic monitoringDisease 2019Pandemic coronavirus disease 2019QT-prolonging medicationsModifiable risk factorsIntensive care unitQT-prolonging drugsOngoing pandemic coronavirus disease 2019Assessment-Recommendation (SBAR) toolCOVID-19Electrophysiology serviceElectrolyte abnormalitiesCare unitUnique patientsPrimary teamRisk factorsPatientsPatient safetyECG monitoringProlongationRelevant interventionsTorsadesPointesTT2 CARDIAC PERFORATION AMONG PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING ABLATION: WHAT ARE THE UNDERLYING PREDICTORS?
Friedman D, Pokorney S, Ghanem A, Marcello S, Kalsekar I, Yadalam S, Akar J, Freeman J, Goldstein L, Khanna R, Piccini J. TT2 CARDIAC PERFORATION AMONG PATIENTS WITH ATRIAL FIBRILLATION UNDERGOING ABLATION: WHAT ARE THE UNDERLYING PREDICTORS? Value In Health 2020, 23: s385-s386. DOI: 10.1016/j.jval.2020.04.1502.Peer-Reviewed Original Research3-Dimensional Transseptal Puncture Based on Electrographic Characteristics of Fossa Ovalis A Fluoroscopy-Free and Echocardiography-Free Method
Yu R, Liu N, Lu J, Zhao X, Hu Y, Zhang J, Xu F, Tang R, Bai R, Akar JG, Dong J, Ma C. 3-Dimensional Transseptal Puncture Based on Electrographic Characteristics of Fossa Ovalis A Fluoroscopy-Free and Echocardiography-Free Method. JACC Cardiovascular Interventions 2020, 13: 1223-1232. PMID: 32438994, DOI: 10.1016/j.jcin.2020.03.015.Peer-Reviewed Original ResearchConceptsAtrial fibrillation ablationFossa ovalisElectrographic characteristicsFibrillation ablationElectroanatomic mappingTransseptal puncture techniqueMajor complicationsRight atriumAncillary imagingAtrial potentialsCatheter connectionsTransseptal needleTransseptal punctureElectrogram voltageIntracardiac echocardiographyElectroanatomic mapsPuncture techniqueEchocardiographyFos mappingPatientsFluoroscopyAblationComplicationsPrecise localizationAtriumAggregating multiple real-world data sources using a patient-centered health-data-sharing platform
Dhruva SS, Ross JS, Akar JG, Caldwell B, Childers K, Chow W, Ciaccio L, Coplan P, Dong J, Dykhoff HJ, Johnston S, Kellogg T, Long C, Noseworthy PA, Roberts K, Saha A, Yoo A, Shah ND. Aggregating multiple real-world data sources using a patient-centered health-data-sharing platform. Npj Digital Medicine 2020, 3: 60. PMID: 32352038, PMCID: PMC7170944, DOI: 10.1038/s41746-020-0265-z.Peer-Reviewed Original ResearchElectronic health recordsCatheter-based atrial fibrillation ablationPatient-reported outcome measures (PROMs) dataAdditional health systemsPost-procedure recoveryProspective cohort studyTertiary care hospitalU.S. tertiary care hospitalDisease-specific symptomsAtrial fibrillation ablationOutcome measure dataDigital weight scaleBariatric surgeryCohort studyCare hospitalFibrillation ablationPharmacy dataWalgreens pharmaciesReal-world data sourcesActivity monitorHealth systemPatientsHealth recordsEHR dataWeight scale
2018
Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus
Hummel JP, Kadado AJ, Baker M, Gehi AK, Mounsey JP, Sadaf MI, Enriquez AD, Freeman JV, Akar JG. Atrial Fibrillation Thermographic and Endoscopic Monitoring of Patients: Safety Algorithm for the Esophagus. Circulation Arrhythmia And Electrophysiology 2018, 11: e006814. PMID: 30562101, DOI: 10.1161/circep.118.006814.Peer-Reviewed Original Research
2017
Arrhythmias after left ventricular assist device implantation: Incidence and management
Kadado AJ, Akar JG, Hummel JP. Arrhythmias after left ventricular assist device implantation: Incidence and management. Trends In Cardiovascular Medicine 2017, 28: 41-50. PMID: 28734595, DOI: 10.1016/j.tcm.2017.07.002.Peer-Reviewed Original ResearchConceptsLeft ventricular assist deviceMechanical circulatory supportVentricular arrhythmiasCirculatory supportContinuous-flow devicesVentricular assist device implantationAssist device implantationNewer-generation continuous-flow devicesHeart failure patientsVentricular assist deviceImplant ICDsFailure patientsHemodynamic supportLVAD recipientsHeart failureDevice implantationFatal outcomeDestination therapySudden deathLethal arrhythmiasMortality ratePatientsArrhythmiasAssist deviceLVAD deviceApplication of Whole Exome Sequencing in the Clinical Diagnosis and Management of Inherited Cardiovascular Diseases in Adults
Seidelmann SB, Smith E, Subrahmanyan L, Dykas D, Abou Ziki MD, Azari B, Hannah-Shmouni F, Jiang Y, Akar JG, Marieb M, Jacoby D, Bale AE, Lifton RP, Mani A. Application of Whole Exome Sequencing in the Clinical Diagnosis and Management of Inherited Cardiovascular Diseases in Adults. Circulation Genomic And Precision Medicine 2017, 10: e001573. PMID: 28087566, PMCID: PMC5245580, DOI: 10.1161/circgenetics.116.001573.Peer-Reviewed Original ResearchConceptsWhole-exome sequencingSudden cardiac deathCardiovascular diseaseClinical diagnosisExome sequencingCardiac deathInherited cardiovascular diseaseCentre of careNovel candidate genesValuable screening toolAdult patientsRisk stratificationPrimary insultCardiac functionGenetic testingScreening toolDiagnosisCVD genesGenetic causeCardiovascular geneticsGenetic panelSuccess rateExome databasesPotential disease associationsPatients
2015
Use of Remote Monitoring Is Associated With Lower Risk of Adverse Outcomes Among Patients With Implanted Cardiac Defibrillators
Akar JG, Bao H, Jones PW, Wang Y, Varosy PD, Masoudi FA, Stein KM, Saxon LA, Normand SL, Curtis JP. Use of Remote Monitoring Is Associated With Lower Risk of Adverse Outcomes Among Patients With Implanted Cardiac Defibrillators. Circulation Arrhythmia And Electrophysiology 2015, 8: 1173-1180. PMID: 26092577, DOI: 10.1161/circep.114.003030.Peer-Reviewed Original ResearchConceptsImplantable cardioverter defibrillatorInitial implantable cardioverter defibrillatorCause mortalityLower riskAdverse outcomesNational Cardiovascular Data Registry ICD RegistryRemote patient monitoringSocial Security Death Master FileCause rehospitalization rateRisk of rehospitalizationImplanted cardiac defibrillatorsDeath Master FileCardiomyopathy pathogenesisCause rehospitalizationICD RegistryRehospitalization ratesMultivariable analysisStudy cohortVital statusService patientsCardioverter defibrillatorCox modelMedicare populationMedicare feePatientsRandomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices
Martin DT, Bersohn MM, Waldo AL, Wathen MS, Choucair WK, Lip GY, Ip J, Holcomb R, Akar JG, Halperin JL. Randomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices. European Heart Journal 2015, 36: 1660-1668. PMID: 25908774, DOI: 10.1093/eurheartj/ehv115.Peer-Reviewed Original ResearchConceptsAtrial tachyarrhythmiasMajor bleedingImplanted defibrillatorsInterruption of anticoagulationRemote rhythm monitoringStandard clinical criteriaCardiac resynchronization devicesAT burdenSystemic embolismThromboembolism ratesPrimary endpointComposite endpointBiventricular defibrillatorMedian timeAtrial fibrillationClinical criteriaResynchronization devicesEarly initiationAnticoagulationRhythm monitoringBleedingPatientsPrimary analysisControl groupAtrial electrograms
2013
Use of Remote Monitoring of Newly Implanted Cardioverter-Defibrillators
Akar JG, Bao H, Jones P, Wang Y, Chaudhry SI, Varosy P, Masoudi FA, Stein K, Saxon LA, Curtis JP. Use of Remote Monitoring of Newly Implanted Cardioverter-Defibrillators. Circulation 2013, 128: 2372-2383. PMID: 24043302, DOI: 10.1161/circulationaha.113.002481.Peer-Reviewed Original ResearchConceptsMedian odds ratioOdds ratioNational Cardiovascular Data Registry ICD RegistryRemote patient monitoringMultivariable logistic regressionHealth-related factorsImplanted cardioverter defibrillatorEligible patientsICD RegistryLack of enrollmentCurrent guidelinesCardioverter defibrillatorPatientsLogistic regressionLocal practice environmentMajor causeHealth insuranceSubsequent activationEnrollmentPractice environmentPatient monitoringPhysiciansActivationRPM systemSuccessful use
2009
Electroanatomic mapping of postpacing intervals clarifies the complete active circuit and variants in atrial flutter
Santucci PA, Varma N, Cytron J, Akar JG, Wilber DJ, Chekakie M, Brysiewicz N. Electroanatomic mapping of postpacing intervals clarifies the complete active circuit and variants in atrial flutter. Heart Rhythm 2009, 6: 1586-1595. PMID: 19879536, DOI: 10.1016/j.hrthm.2009.08.010.Peer-Reviewed Original ResearchConceptsTricuspid annulusAtrial flutterIsthmus-dependent atrial flutterFlutter cycle lengthPosterior borderTypical atrial flutterRight atrial appendageEntire right atriumFlutter circuitAtrial appendageRight atriumVena cavaElectroanatomic mappingElectroanatomic mapsOblique courseCycle lengthPatientsSimilar activationActivation mappingAnteriorFlutterActivationIntervalCavaAtrium
2008
Newly Diagnosed Arrhythmogenic Right Ventricular Dysplasia in an Octogenarian
AKAR JG, SINGH M, AUSEON AJ, WILBER DJ. Newly Diagnosed Arrhythmogenic Right Ventricular Dysplasia in an Octogenarian. Journal Of Cardiovascular Electrophysiology 2008, 19: 1316-1318. PMID: 18631265, DOI: 10.1111/j.1540-8167.2008.01241.x.Peer-Reviewed Original ResearchConceptsARVD/CArrhythmogenic right ventricular dysplasia/cardiomyopathyRight ventricular dysplasia/cardiomyopathyVentricular dysplasia/cardiomyopathyArrhythmogenic right ventricular dysplasiaARVD/C.Right ventricular dysplasiaYears of ageElderly patientsOlder patientsVentricular dysplasiaCase reportPatientsDiagnosisOctogenariansReportCardiomyopathyDysplasiaYearsDiseaseProspective Study of Atrial Fibrillation Termination During Ablation Guided by Automated Detection of Fractionated Electrograms
PORTER M, SPEAR W, AKAR JG, HELMS R, BRYSIEWICZ N, SANTUCCI P, WILBER DJ. Prospective Study of Atrial Fibrillation Termination During Ablation Guided by Automated Detection of Fractionated Electrograms. Journal Of Cardiovascular Electrophysiology 2008, 19: 613-620. PMID: 18462320, DOI: 10.1111/j.1540-8167.2008.01189.x.Peer-Reviewed Original ResearchConceptsPersistent atrial fibrillationAtrial fibrillationParoxysmal atrial fibrillationInitial AF ablationOne-year freedomRecurrent atrial arrhythmiasSingle-procedure outcomesAntiarrhythmic drug therapySelection of patientsSpontaneous atrial fibrillationSites/patientAF termination rateHigher AF termination rateAtrial fibrillation terminationAF ablationProspective studyAtrial arrhythmiasPulmonary veinsDrug therapyAdditional ablationAtrial septumProcedure outcomesPatientsAtrial electrogramsCFAE sites
2007
Regulation of ion channels and arrhythmias in the ischemic heart
Akar JG, Akar FG. Regulation of ion channels and arrhythmias in the ischemic heart. Journal Of Electrocardiology 2007, 40: s37-s41. PMID: 17993326, DOI: 10.1016/j.jelectrocard.2007.05.020.Peer-Reviewed Original ResearchConceptsIschemic injuryElectrophysiological changesIschemic heart diseaseBest treatment strategyCoronary eventsReperfusion phaseVentricular arrhythmiasIschemic episodesHeart diseaseLeading causeElectrical dysfunctionTreatment strategiesIschemic heartMetabolic substratesPatientsArrhythmiasKey cellularTime courseInjuryIon channelsHeartDysfunctionMortalityDisease