2023
Variation 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 ResearchMeSH KeywordsAgedCardiac Resynchronization TherapyDefibrillators, ImplantableHeart FailureHospitalsHumansMedicareTreatment OutcomeUnited StatesConceptsEligible 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 ResearchMeSH KeywordsAgedAnticoagulantsAtrial FibrillationDefibrillators, ImplantableFemaleHumansMaleMiddle AgedTachycardia, VentricularTreatment OutcomeVentricular FibrillationConceptsAppropriate 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
2019
Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database
Hummel JP, Leipold RJ, Amorosi SL, Bao H, Deger KA, Jones PW, Kansal AR, Ott LS, Stern S, Stein K, Curtis JP, Akar JG. Outcomes and costs of remote patient monitoring among patients with implanted cardiac defibrillators: An economic model based on the PREDICT RM database. Journal Of Cardiovascular Electrophysiology 2019, 30: 1066-1077. PMID: 30938894, PMCID: PMC6850124, DOI: 10.1111/jce.13934.Peer-Reviewed Original ResearchAgedAged, 80 and overArrhythmias, CardiacCost-Benefit AnalysisDatabases, FactualDeath, Sudden, CardiacDefibrillators, ImplantableElectric CountershockFemaleHealth Care CostsHumansMaleMedicareModels, EconomicPatient ReadmissionPredictive Value of TestsQuality-Adjusted Life YearsRegistriesRemote Sensing TechnologyTelemetryTime FactorsTreatment OutcomeUnited States
2018
Ventricular Fibrillation Conversion Testing After Implantation of a Subcutaneous Implantable Cardioverter Defibrillator
Friedman DJ, Parzynski CS, Heist EK, Russo AM, Akar JG, Freeman JV, Curtis JP, Al-Khatib SM. Ventricular Fibrillation Conversion Testing After Implantation of a Subcutaneous Implantable Cardioverter Defibrillator. Circulation 2018, 137: 2463-2477. PMID: 29463509, PMCID: PMC5988932, DOI: 10.1161/circulationaha.117.032167.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedCardiomyopathy, HypertrophicDefibrillators, ImplantableFemaleHumansMaleMiddle AgedRegistriesStroke VolumeVentricular FibrillationConceptsImplantable cardioverter defibrillatorS-ICD implantationLogistic regression analysisInhospital complicationsPatient characteristicsCT testingS-ICDsCardioverter defibrillatorConversion testingPrior implantable cardioverter defibrillatorHigher body mass indexMultivariable logistic regression analysisLarger body surface areaSubcutaneous implantable cardioverter defibrillatorTransvenous implantable cardioverter defibrillatorInhospital adverse eventsLow ejection fractionAvailable patient characteristicsBody mass indexBody surface areaFirst-time recipientsMaximum device outputRegression analysisPredictors of useInsufficient safety margin
2017
Addition of Blood Pressure and Weight Transmissions to Standard Remote Monitoring of Implantable Defibrillators and its Association with Mortality and Rehospitalization
Al-Chekakie MO, Bao H, Jones PW, Stein KM, Marzec L, Varosy PD, Masoudi FA, Curtis JP, Akar JG. Addition of Blood Pressure and Weight Transmissions to Standard Remote Monitoring of Implantable Defibrillators and its Association with Mortality and Rehospitalization. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003087. PMID: 28506978, DOI: 10.1161/circoutcomes.116.003087.Peer-Reviewed Original ResearchConceptsBlood pressure dataImplantable defibrillatorsRemote patient monitoringTransmission of weightHeart failure hospitalizationImpaired ejection fractionCardiac resynchronization therapyCox regression modelRisk of mortalityLogistic regression modelsRoutine weightCause hospitalizationFailure hospitalizationBlood pressureCardiovascular hospitalizationEjection fractionResynchronization therapyRegression modelsDevice implantationService patientsHospital characteristicsIndependent associationImproved outcomesLandmark analysisSimilar risk
2016
Determinants of Time in Therapeutic Range in Patients Receiving Oral Anticoagulants (A Substudy of IMPACT)
Lip GY, Waldo AL, Ip J, Martin DT, Bersohn MM, Choucair WK, Akar JG, Wathen M, Halperin JL, Investigators I. Determinants of Time in Therapeutic Range in Patients Receiving Oral Anticoagulants (A Substudy of IMPACT). The American Journal Of Cardiology 2016, 118: 1680-1684. PMID: 27665206, DOI: 10.1016/j.amjcard.2016.08.047.Peer-Reviewed Original ResearchConceptsMean therapeutic rangeTherapeutic rangeSAMe-TTAnticoagulation controlDeterminants of timeNew York Heart Association class INew York Heart Association class IVVitamin K antagonist-treated patientsAdditional stroke risk factorsBetter therapeutic rangeGood anticoagulation controlMean TTR valueOverall TTRStroke risk factorsVitamin K antagonistsRisk of strokeNon-US sitesStroke risk assessmentAHRE durationOral anticoagulationK antagonistsOral anticoagulantsRosendaal methodArrhythmia centersAtrial tachyarrhythmias
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 feePatientsHRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices
Slotwiner D, Varma N, Akar JG, Annas G, Beardsall M, Fogel RI, Galizio NO, Glotzer TV, Leahy RA, Love CJ, McLean RC, Mittal S, Morichelli L, Patton KK, Raitt MH, Ricci RP, Rickard J, Schoenfeld MH, Serwer GA, Shea J, Varosy P, Verma A, Yu CM. HRS Expert Consensus Statement on remote interrogation and monitoring for cardiovascular implantable electronic devices. Heart Rhythm 2015, 12: e69-e100. PMID: 25981148, DOI: 10.1016/j.hrthm.2015.05.008.Peer-Reviewed Original ResearchRandomized 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
2011
Caveat Emptor: Implantable Devices in End‐Stage Renal Disease
CLANCY JF, AKAR JG. Caveat Emptor: Implantable Devices in End‐Stage Renal Disease. Journal Of Cardiovascular Electrophysiology 2011, 22: 1105-1106. PMID: 21848637, DOI: 10.1111/j.1540-8167.2011.02094.x.Peer-Reviewed Original ResearchCommunicable DiseasesDefibrillators, ImplantableFemaleHeart FailureHemorrhageHumansKidney Failure, ChronicMalePacemaker, Artificial
2009
Multicenter randomized study of anticoagulation guided by remote rhythm monitoring in patients with implantable cardioverter-defibrillator and CRT-D devices: Rationale, design, and clinical characteristics of the initially enrolled cohort The IMPACT study
Ip J, Waldo AL, Lip GY, Rothwell PM, Martin DT, Bersohn MM, Choucair WK, Akar JG, Wathen MS, Rohani P, Halperin JL, Investigators F. Multicenter randomized study of anticoagulation guided by remote rhythm monitoring in patients with implantable cardioverter-defibrillator and CRT-D devices: Rationale, design, and clinical characteristics of the initially enrolled cohort The IMPACT study. American Heart Journal 2009, 158: 364-370.e1. PMID: 19699858, DOI: 10.1016/j.ahj.2009.07.002.Peer-Reviewed Original ResearchConceptsAtrial high-rate episodesRisk of strokeAnticoagulant therapyAtrial fibrillationAtrial flutterCardiac resynchronization therapy-defibrillator deviceConventional clinical managementRemote rhythm monitoringStudies of anticoagulationRate of strokeOral anticoagulant therapyHigh-rate episodesAdditional risk factorsCRT-D devicesStroke risk stratificationCommon cardiac arrhythmiaAHRE burdenElectrocardiographic documentationMajor bleedingSystemic embolismProphylactic therapyClinical characteristicsStroke riskAnticoagulation decisionsClinical features
2006
Predicting elevated defibrillation energy requirements in heart failure with reasonable probability
Akar JG. Predicting elevated defibrillation energy requirements in heart failure with reasonable probability. Heart Rhythm 2006, 3: 1017-1018. PMID: 16945793, DOI: 10.1016/j.hrthm.2006.06.015.Peer-Reviewed Original ResearchDefibrillators, ImplantableElectrocardiographyHeart FailureHumansPredictive Value of TestsVentricular Fibrillation