Publications
183 results found
Sabashnikov A, Weymann A, Haldar S, et al., 2015, Position of totally thoracoscopic surgical ablation in the treatment of atrial fibrillation: An alternative method of conduction testing, Medical Science Monitor Basic Research, Vol: 21, Pages: 76-80, ISSN: 2325-4394
Recent advances in surgical techniques and understanding of the pathophysiology of atrial fibrillation has led to the development of a less invasive thoracoscopic surgical treatment including video-assisted bilateral pulmonary vein isolation using bipolar radiofrequency ablation clamps. More recently, the same operation became possible via a totally thoracoscopic approach.In this paper we describe technical aspects of the thoracoscopic approach to surgical treatment of AF and discuss its features, benefits and limitations. Furthermore, we present a new alternative technique of conduction testing using endoscopic multi-electrode recording catheters.An alternative electrophysiological mapping strategy involves a multi-electrode recording catheter designed primarily for percutaneous endocardial electrophysiologic mapping procedure. According to our initial experience, the recordings obtained from the multi-electrode catheters positioned around the pulmonary veins are more accurate than the recordings obtained from the multifunctional ablation and pacing pen.The totally thoracoscopic surgical ablation approach is a feasible and efficient treatment strategy for atrial fibrillation. The conduction testing can be easily and rapidly performed using a multifunctional pen or multi-electrode recording catheter.
Jarman JWE, Panikker S, Das M, et al., 2015, Relationship Between Contact Force Sensing Technology and Medium-Term Outcome of Atrial Fibrillation Ablation: A Multicenter Study of 600 Patients, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 26, Pages: 378-384, ISSN: 1045-3873
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- Citations: 48
Bedair R, Babu-Narayan SV, Dimopoulos K, et al., 2015, Acceptance and psychological impact of implantable defibrillators amongst adults with congenital heart disease, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 181, Pages: 218-224, ISSN: 0167-5273
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- Citations: 22
Ismail TF, Panikker S, Markides V, et al., 2015, CT imaging for left atrial appendage closure: A review and pictorial essay, JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, Vol: 9, Pages: 89-102, ISSN: 1934-5925
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- Citations: 29
Panikker S, Virmani R, Sakakura K, et al., 2015, Left atrial appendage electrical isolation and concomitant device occlusion: A safety and feasibility study with histologic characterization, HEART RHYTHM, Vol: 12, Pages: 202-210, ISSN: 1547-5271
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- Citations: 20
Ullah W, Hunter RJ, Haldar S, et al., 2014, Comparison of Robotic and Manual Persistent AF Ablation Using Catheter Contact Force Sensing: An International Multicenter Registry Study, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 37, Pages: 1427-1435, ISSN: 0147-8389
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- Citations: 24
Panikker S, Lord J, Jarman J, et al., 2014, 45Real world experience left atrial appendage closure provides superior cost benefits relative to new and established oral anticoagulants., Europace, Vol: 16 Suppl 3
Recent evidence supports left atrial appendage closure (LAAC) as a cost-effective alternative to warfarin. However these findings, based on clinical trial populations, may not be generalisable to clinical practice. The cost-impact of a real world experience of LAAC compared with warfarin, dabigatran, rivaroxaban, apixaban, aspirin and no therapy in patients with nonvalvular atrial fibrillation (NVAF) is unknown.
Wynn GJ, Das M, Bonnett LJ, et al., 2014, Efficacy of Catheter Ablation for Persistent Atrial Fibrillation A Systematic Review and Meta-Analysis of Evidence From Randomized and Nonrandomized Controlled Trials, CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 7, Pages: 841-U149, ISSN: 1941-3149
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- Citations: 102
Franks R, Boutou A, Mohan D, et al., 2014, Dynamics of QT interval from rest to peak exercise among COPD patients, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936
Shah BN, Babu-Narayan S, Li W, et al., 2014, Severe Mitral Annular Calcification: Insights from Multimodality Imaging, TEXAS HEART INSTITUTE JOURNAL, Vol: 41, Pages: 245-247, ISSN: 0730-2347
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- Citations: 2
Jarman JWE, Wong T, Kojodjojo P, et al., 2014, Organizational Index Mapping to Identify Focal Sources During Persistent Atrial Fibrillation, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 25, Pages: 355-363, ISSN: 1045-3873
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- Citations: 26
Jones DG, Johar S, Wang J, et al., 2014, Atrial Tachycardia after AF Ablation: An Alternate Mechanism?, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 37, Pages: 375-378, ISSN: 0147-8389
Yeo WT, Jarman JWE, Li W, et al., 2014, Adverse impact of chronic subpulmonary left ventricular pacing on systemic right ventricular function in patients with congenitally corrected transposition of the great arteries, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 171, Pages: 184-191, ISSN: 0167-5273
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- Citations: 33
Yao Y, Ding L, Chen W, et al., 2013, The training and learning process of transseptal puncture using a modified technique, EUROPACE, Vol: 15, Pages: 1784-1790, ISSN: 1099-5129
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- Citations: 8
SUMAN-HORDUNA IRINA, HILLIER NATHAN, WONG TOM, 2013, Resynchronization or Proarrhythmia? A Conundrum, Pacing and Clinical Electrophysiology, Pages: n/a-n/a, ISSN: 0147-8389
Jones DG, Jarman JWE, Lyne JC, et al., 2013, The safety and efficacy of trans-baffle puncture to enable catheter ablation of atrial tachycardias following the Mustard procedure: A single centre experience and literature review, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 1115-1120, ISSN: 0167-5273
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- Citations: 15
Haldar S, Jarman JWE, Panikker S, et al., 2013, Contact force sensing technology identifies sites of inadequate contact and reduces acute pulmonary vein reconnection: A prospective case control study, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 168, Pages: 1160-1166, ISSN: 0167-5273
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- Citations: 76
Jones DG, Wong T, 2013, Catheter ablation versus rate control for atrial fibrillation: what have we learnt from the ARC-HF trial?, Future Cardiol, Vol: 9, Pages: 599-602
Jones DG, Haldar SK, Jarman JWE, et al., 2013, Impact of Stepwise Ablation on the Biatrial Substrate in Patients With Persistent Atrial Fibrillation and Heart Failure, CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 6, Pages: 761-768, ISSN: 1941-3149
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- Citations: 13
Mantziari L, Suman-Horduna I, Gujic M, et al., 2013, Use of Asymmetric Bidirectional Catheters with Different Curvature Radius for Catheter Ablation of Cardiac Arrhythmias, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 36, Pages: 757-763, ISSN: 0147-8389
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- Citations: 4
Dhillon PS, Gonna H, Li A, et al., 2013, Skin burns associated with radiofrequency catheter ablation of cardiac arrhythmias., Pacing Clin Electrophysiol, Vol: 36, Pages: 764-767
Skin burns are a rare complication associated with radiofrequency catheter ablation of cardiac arrhythmias. Burns related to the indifferent electrode patch may be severe and result in significant comorbidity. We describe our experience of skin burns and discuss potential predisposing and possible causative factors.
Jones DG, Haldar SK, Hussain W, et al., 2013, A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure., J Am Coll Cardiol., Vol: 18, Pages: 1894-1903
OBJECTIVES:This study sought to compare catheter ablation with rate control for persistent atrial fibrillation (AF) in heart failure (HF).BACKGROUND:The optimal therapy for AF in HF is unclear. Drug-based rhythm control has not proved clinically beneficial. Catheter ablation improves cardiac function in patients with HF, but impact on physiological performance has not been formally evaluated in a randomized trial.METHODS:In a randomized, open-label, blinded-endpoint clinical trial, adults with symptomatic HF, radionuclide left ventricular ejection fraction (EF) ≤35%, and persistent AF were assigned to undergo catheter ablation or rate control. Primary outcome was 12-month change in peak oxygen consumption. Secondary endpoints were quality of life, B-type natriuretic peptide, 6-min walk distance, and EF. Results were analyzed by intention-to-treat.RESULTS:Fifty-two patients (age 63 ± 9 years, EF 24 ± 8%) were randomized, 26 each to ablation and rate control. At 12 months, 88% of ablation patients maintained sinus rhythm (single-procedure success 68%). Under rate control, rate criteria were achieved in 96%. The primary endpoint, peak oxygen consumption, significantly increased in the ablation arm compared with rate control (difference +3.07 ml/kg/min, 95% confidence interval: 0.56 to 5.59, p = 0.018). The change was not evident at 3 months (+0.79 ml/kg/min, 95% confidence interval: -1.01 to 2.60, p = 0.38). Ablation improved Minnesota score (p = 0.019) and B-type natriuretic peptide (p = 0.045) and showed nonsignificant trends toward improved 6-min walk distance (p = 0.095) and EF (p = 0.055).CONCLUSIONS:This first randomized trial of ablation versus rate control to focus on objective exercise performance in AF and HF shows significant benefit from ablation, a strategy that also improves symptoms and neurohormonal status. The effects develop over 12 months, consistent with progressive amelioration of the HF syndrome. (A Randomised Trial to Assess Cath
Suman-Horduna I, Jarman JWE, Wong T, 2013, Epicardially originating ventricular tachycardia: an unusual presentation of bronchiectasis, EUROPACE, Vol: 15, Pages: 741-741, ISSN: 1099-5129
Niespialowska-Steuden M, Markides V, Jones D, et al., 2013, CATHETER ABLATION FOR ATRIAL ARRHYTHMIAS RAPIDLY IMPROVES THROMBOTIC PROFILE OVER AND ABOVE THERAPEUTIC ANTICOAGULATION, 62nd Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: E275-E275, ISSN: 0735-1097
Jones DG, Haldar SK, Hussain W, et al., 2013, A randomized trial to assess catheter ablation versus rate control in the management of persistent atrial fibrillation in heart failure, J Am Coll Cardiol, Vol: 61, Pages: 1894-1903, ISSN: 1558-3597
OBJECTIVES: This study sought to compare catheter ablation with rate control for persistent atrial fibrillation (AF) in heart failure (HF). BACKGROUND: The optimal therapy for AF in HF is unclear. Drug-based rhythm control has not proved clinically beneficial. Catheter ablation improves cardiac function in patients with HF, but impact on physiological performance has not been formally evaluated in a randomized trial. METHODS: In a randomized, open-label, blinded-endpoint clinical trial, adults with symptomatic HF, radionuclide left ventricular ejection fraction (EF) </=35%, and persistent AF were assigned to undergo catheter ablation or rate control. Primary outcome was 12-month change in peak oxygen consumption. Secondary endpoints were quality of life, B-type natriuretic peptide, 6-min walk distance, and EF. Results were analyzed by intention-to-treat. RESULTS: Fifty-two patients (age 63 +/- 9 years, EF 24 +/- 8%) were randomized, 26 each to ablation and rate control. At 12 months, 88% of ablation patients maintained sinus rhythm (single-procedure success 68%). Under rate control, rate criteria were achieved in 96%. The primary endpoint, peak oxygen consumption, significantly increased in the ablation arm compared with rate control (difference +3.07 ml/kg/min, 95% confidence interval: 0.56 to 5.59, p = 0.018). The change was not evident at 3 months (+0.79 ml/kg/min, 95% confidence interval: -1.01 to 2.60, p = 0.38). Ablation improved Minnesota score (p = 0.019) and B-type natriuretic peptide (p = 0.045) and showed nonsignificant trends toward improved 6-min walk distance (p = 0.095) and EF (p = 0.055). CONCLUSIONS: This first randomized trial of ablation versus rate control to focus on objective exercise performance in AF and HF shows significant benefit from ablation, a strategy that also improves symptoms and neurohormonal status. The effects develop over 12 months, consistent with progressive amelioration of the HF syndrome. (A Randomised Trial to Assess Cat
Jones DG, Haldar SK, Sharma R, et al., 2012, A Randomised Trial to Assess Catheter Ablation versus Rate Control in the Management of Persistent Atrial Fibrillation in Chronic Heart Failure, Scientific Sessions of the American-Heart-Association, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: 2788-2788, ISSN: 0009-7322
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- Citations: 2
Haldar S, Jarmin J, Panikker S, et al., 2012, The Use of Contact Force Data during Pulmonary Vein Isolation Translates into Improved Clinical Outcomes for Atrial Fibrillation Ablation Patients, CIRCULATION, Vol: 126, ISSN: 0009-7322
Jarman JW, Wong T, Kojodojojo P, et al., 2012, Spatiotemporal behavior of high dominant frequency during paroxysmal and persistent atrial fibrillation in the human left atrium., Circ Arrhythm Electrophysiol., Vol: 4, Pages: 650-658
BACKGROUNDSites of high dominant frequency (DF(peak)) are thought to indicate the location of drivers of atrial fibrillation (AF), but characterization of their spatiotemporal distribution and stability, critical to their relevance as targets for catheter ablation, requires simultaneous global mapping of the left atrium.METHODS AND RESULTS:Noncontact electrograms recorded simultaneously from 256 left atrial sites during spontaneous AF were analyzed. After subtraction of the ventricular component, fast Fourier transform identified the DF at each site. Focal areas of DF(peak) were defined as those having a DF >20% above all neighboring sites. Twenty-four patients with spontaneous AF (11 paroxysmal and 13 persistent) were studied. In paroxysmal AF, sites of DF(peak) (mean DF, 11.6±2.9 Hz) were observed in 100% of patients (present during 65% of the mapping period). In contrast, DF(peak) was detected in only 31% of patients with persistent AF (P<0.001) and for only 5% of the mapping period (P<0.001). In both groups, locations of DF(peak) varied widely in both consecutive and separated segments of AF (κ coefficient range, -0.07-0.22). Activation sequences around sites of DF(peak) did not demonstrate centrifugal activation that would be expected from focal drivers.CONCLUSIONS:Focal areas of high DF are more frequent in paroxysmal than persistent AF, are spatiotemporally unstable, are not the source of centrifugal activation, and are not, therefore, indicative of fixed drivers of AF. In the absence of spatiotemporal stability, the success of ablation at sites of DF(peak) cannot be explained by elimination of fixed drivers.
Jarman JWE, Lascelles K, Wong T, et al., 2012, Clinical experience of entirely subcutaneous implantable cardioverterdefibrillators in children and adults: cause for caution, EUROPEAN HEART JOURNAL, Vol: 33, Pages: 1351-1359, ISSN: 0195-668X
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- Citations: 104
Giannakoulas G, Dimopoulos K, Yuksel S, et al., 2012, Atrial tachyarrhythmias late after Fontan operation are related to increase in mortality and hospitalization., Publisher: Elsevier, Pages: 221-226
BACKGROUND: Atrial tachyarrhythmias are a known complication late after Fontan operation. Limited information is available on their prognostic value.METHODS:All patients with previous Fontan operation followed at our institution since 1999 were identified from the electronic database and included in this study. Demographic and clinical characteristics including history of atrial tachyarrhythmias were recorded at the earliest full clinical assessment and patients were followed thereafter for all-cause mortality and hospitalization.RESULTS:A total of 98 patients, mean age 31.5 ± 8.9 years, 43.8% male, 31.6% with a total cavopulmonary connection (TCPC) were identified. A history of atrial tachyarrhythmia was present at baseline in 60.2% of patients who were older (33.0 ± 8.3 vs 29.1 ± 9.4 years, p=0.002), less likely to have a TCPC (13.5% vs 58.9%, p<0.001), and more symptomatic in terms of NYHA class (51.9% vs 26.7%, p=0.007) compared to arrhythmia-free patients. During a median follow-up of 6.7 years 18 patients died and 64 patients were hospitalized. Even after adjustment for baseline clinical characteristics, atrial tachyarrhythmia was an independent predictor of death (propensity score adjusted HR 9.35, 95% CI: 1.10-79.18, p=0.04, c-statistic 0.88) and composite of death or hospitalization (propensity score adjusted HR 5.00, 95% CI: 2.47-10.09, p<0.0001).CONCLUSIONS:In adult patients with a Fontan-type operation, the presence of atrial tachyarrhythmias is associated with higher morbidity and mortality at mid-term follow-up. Whether early arrhythmia targeting intervention may improve clinical outcome needs to be studied in a prospective manner.
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