Imperial College London

DrZacharyWhinnett

Faculty of MedicineNational Heart & Lung Institute

Reader in Cardiac Electrophysiology
 
 
 
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z.whinnett

 
 
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South- NHLI Cardiovascular ScienceBlock B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Publication Type
Year
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138 results found

Dehbi H-M, Jones S, Sohaib SMA, Finegold JA, Siggers JH, Stegemann B, Whinnett ZI, Francis DPet al., 2015, A novel curve fitting method for AV optimisation of biventricular pacemakers, PHYSIOLOGICAL MEASUREMENT, Vol: 36, Pages: 1889-1900, ISSN: 0967-3334

Journal article

Raphael CE, Finegold JA, Barron AJ, Whinnett ZI, Mayet J, Linde C, Cleland JGF, Levy WC, Francis DPet al., 2015, The effect of duration of follow-up and presence of competing risk on lifespan-gain from implantable cardioverter defibrillator therapy: who benefits the most?, EUROPEAN HEART JOURNAL, Vol: 36, Pages: 1676-1688, ISSN: 0195-668X

Journal article

Sharp A, Sohaib A, Willson K, Mayet J, Hughes A, Kanagaratnam P, Whinnett Z, Kyriacou A, Francis Det al., 2015, SIGNAL-TO-NOISE RATIO DURING HAEMODYNAMIC OPTIMISATION OF AV DELAY IS IMPROVED MORE BY ATRIAL PACING THAN BY INCREASING HEART RATE, British-Cardiac-Society (BCS) Annual Conference on Hearts and Genes, Publisher: BMJ PUBLISHING GROUP, Pages: A25-A26, ISSN: 1355-6037

Conference paper

Luther V, Jamil-Copley S, Koa-Wing M, Shun-Shin M, Hayat S, Linton NW, Lim PB, Whinnett Z, Wright IJ, Lefroy D, Peters NS, Davies DW, Kanagaratnam Pet al., 2015, Non-randomised comparison of acute and long-term outcomes of robotic versus manual ventricular tachycardia ablation in a single centre ischemic cohort., Journal of Interventional Cardiac Electrophysiology, Vol: 43, Pages: 175-185, ISSN: 1572-8595

INTRODUCTION: Robotically guided radiofrequency (RF) ablation offers greater catheter stability that may improve lesion depth. We performed a non-randomised comparison of patients undergoing ventricular tachycardia (VT) ablation either manually or robotically using the Hansen Sensei system for recurrent implantable defibrillator (ICD) therapy. METHODS: Patients with infarct-related scar underwent VT ablation using the Hansen system to assess feasibility compared with patients undergoing manual VT ablation during a similar time period. Power delivery during robotic ablation was restricted to 30 W at 60 s. VT inducibility was checked at the end of the procedure. Pre-ablation ICD therapy burdens over 6 months were compared with post-ablation therapy averaged to a 6-month period. RESULTS: Twelve consecutive patients who underwent robotic VT ablation were compared to 12 consecutive patients undergoing a manual ablation. Patient demographics and comorbidities were similar in the two groups. A higher proportion of robotic cases were urgent (9/12 (75 %)) vs. manual (4/12 (33 %)) (p = 0.1). Post-ablation VT stimulation did not induce clinical VT in 11/12 (92 %) in each group. There were no peri-procedural complications related to ablation delivery. Patients were followed up for approximately 2 years. Averaged over 6 months, robotic ICD therapy burdens fell from 32 (5-400) events to 2.5 (0-11) (p = 0.015). Therapy burden fell from 14 (10-25) to 1 (0-5) (p = 0.023) in the manual group. There was no difference in long-term outcome (p = 0.60) and mortality (4/12 (33 %), p = 1.0). CONCLUSION: Robotically guided VT ablation is both feasible and safe when compared to manual ablation with good acute and long-term outcomes.

Journal article

Sohaib SM, Kyriacou A, Jones S, Manisty CH, Mayet J, Kanagaratnam P, Peters NS, Hughes AD, Whinnett ZI, Francis DPet al., 2015, Evidence that conflict regarding size of haemodynamic response to interventricular delay optimization of cardiac resynchronization therapy may arise from differences in how atrioventricular delay is kept constant., Europace, Vol: 17, ISSN: 1532-2092

AIMS: Whether adjusting interventricular (VV) delay changes haemodynamic efficacy of cardiac resynchronization therapy (CRT) is controversial, with conflicting results. This study addresses whether the convention for keeping atrioventricular (AV) delay constant during VV optimization might explain these conflicts. METHOD AND RESULTS: Twenty-two patients in sinus rhythm with existing CRT underwent VV optimization using non-invasive systolic blood pressure. Interventricular optimization was performed with four methods for keeping the AV delay constant: (i) atrium and left ventricle delay kept constant, (ii) atrium and right ventricle delay kept constant, (iii) time to the first-activated ventricle kept constant, and (iv) time to the second-activated ventricle kept constant. In 11 patients this was performed with AV delay of 120 ms, and in 11 at AV optimum. At AV 120 ms, time to the first ventricular lead (left or right) was the overwhelming determinant of haemodynamics (13.75 mmHg at ±80 ms, P < 0.001) with no significant effect of time to second lead (0.47 mmHg, P = 0.50), P < 0.001 for difference. At AV optimum, time to first ventricular lead again had a larger effect (5.03 mmHg, P < 0.001) than time to second (2.92 mmHg, P = 0.001), P = 0.02 for difference. CONCLUSION: Time to first ventricular activation is the overwhelming determinant of circulatory function, regardless of whether this is the left or right ventricular lead. If this is kept constant, the effect of changing time to the second ventricle is small or nil, and is not beneficial. In practice, it may be advisable to leave VV delay at zero. Specifying how AV delay is kept fixed might make future VV delay research more enlightening.

Journal article

Ploux S, Eschalier R, Whinnett ZI, Lumens J, Derval N, Sacher F, Hocini M, Jais P, Dubois R, Ritter P, Haissaguerre M, Wilkoff BL, Francis DP, Bordachar Pet al., 2015, Electrical dyssynchrony induced by biventricular pacing: Implications for patient selection and therapy improvement, HEART RHYTHM, Vol: 12, Pages: 782-791, ISSN: 1547-5271

Journal article

Sohaib SMA, Finegold JA, Nijjer SS, Hossain R, Linde C, Levy WC, Sutton R, Kanagaratnam P, Francis DP, Whinnett ZIet al., 2015, Opportunity to Increase Life Span in Narrow QRS Cardiac Resynchronization Therapy Recipients by Deactivating Ventricular Pacing Evidence From Randomized Controlled Trials, JACC-HEART FAILURE, Vol: 3, Pages: 327-336, ISSN: 2213-1779

Journal article

Finegold J, Bordachar P, Kyriacou A, Sohaib SMA, Kanagaratnam P, Ploux S, Lim B, Peters N, Davies W, Ritter P, Francis DP, Whinnett ZIet al., 2015, Atrioventricular delay optimization of cardiac resynchronisation therapy: Comparison of non-invasive blood pressure with invasive haemodynamic measures, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 180, Pages: 221-222, ISSN: 0167-5273

Journal article

Eschalier R, Ploux S, Lumens J, Whinnett Z, Varma N, Meillet V, Ritter P, Jais P, Haissaguerre M, Bordachar Pet al., 2015, Detailed analysis of ventricular activation sequences during right ventricular apical pacing and left bundle branch block and the potential implications for cardiac resynchronization therapy, HEART RHYTHM, Vol: 12, Pages: 137-143, ISSN: 1547-5271

Journal article

Jabbour RJ, Shun-Shin MJ, Finegold JA, Sohaib SMA, Cook C, Nijjer SS, Whinnett ZI, Manisty CH, Brugada J, Francis DPet al., 2015, Effect of Study Design on the Reported Effect of Cardiac Resynchronization Therapy (CRT) on Quantitative Physiological Measures: Stratified Meta-Analysis in Narrow-QRS Heart Failure and Implications for Planning Future Studies, JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol: 4, ISSN: 2047-9980

Journal article

Koa-Wing M, Jamil-Copley S, Ariff B, Kojodjojo P, Lim PB, Whinnett Z, Rajakulendran S, Malhotra P, Lefroy D, Peters NS, Davies DW, Kanagaratnam Pet al., 2014, Haemorrhagic cerebral air embolism from an atrio-oesophageal fistula following atrial fibrillation ablation., Perfusion, Vol: 30, Pages: 484-486, ISSN: 0935-0020

We report the case of a man found unconscious three weeks following atrial fibrillation (AF) ablation. Cranial and thoracic imaging demonstrated multiple areas of pneumo-embolic infarction secondary to an atrio-oesophageal fistula (AEF). AEF is a recognised, but rare, complication of AF ablation.(1-8) Early recognition is critical as the mortality is 100% without surgical intervention. We consider the postulated mechanisms of AEF formation, the spectrum of clinical presentation, investigations and treatment.

Journal article

Jones S, Shun-Shin MJ, Cole GD, Whinnett ZI, Francis DPet al., 2014, Iterative method for atrioventricular optimization of cardiac resynchronization therapy: is beauty only in the eye of the beholder? Reply, EUROPACE, Vol: 16, Pages: 1866-1866, ISSN: 1099-5129

Journal article

Sohaib SM, Jones S, Manoharan K, Francisco N, March K, Francis DP, Whinnett ZIet al., 2014, 55Testing the validity of electrogram based AV optimization schemes using real world patient data., Europace, Vol: 16 Suppl 3

Manufacturers have each implemented manufacturer specific methods for electrogram based optimization of AV delay in CRT devices. Agreement between manufacturer algorithms has never been formally tested. Where the algorithms are fully published and available, we tested agreement between different device based AV optimisation scheme, and compared this to the AV optimum selected using non-invasive haemodynamic optimisation.

Journal article

Luther V, Jamil-Copley S, Shun-Shin M, Koa-Wing M, Wright I, Hayat S, Linton N, Lim PB, Lefroy D, Whinnett Z, Davies DW, Peters NS, Kanagaratnam Pet al., 2014, 24Acute and long-term outcomes for patients undergoing radiofrequency catheter ablation of scar-related ventricular tachycardia by robotic catheter navigation., Europace, Vol: 16 Suppl 3

Robotically-guided ablation offers theoretical advantages with greater catheter stability that can improve lesion depth. We performed a non-randomised comparison of patients undergoing ventricular tachycardia (VT) ablation either manually or using the Hansen robotic system.

Journal article

Jabbour R, Shun-Shin M, Finegold JA, Sohaib SMA, Cook C, Whinnett Z, Manisty C, Francis Det al., 2014, Meta-analysis identifying the source of conflict of differing reports of CRT patients with narrow QRS heart failure, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 167-167, ISSN: 0195-668X

Conference paper

Sohaib SMA, Jones S, Kyriacou A, Manisty C, Mayet J, Kanagaratnam P, Peters N, Hughes A, Whinnett Z, Francis Det al., 2014, EVIDENCE THAT HAEMODYNAMIC RESPONSE TO VV DELAY OPTIMISATION OF CRT DEVICES MAY BE SIMPLY A FUNCTION OF THE METHOD OF PROGRAMMING AV DELAY, HEART, Vol: 100, Pages: A21-A22, ISSN: 1355-6037

Journal article

Jabbour R, Shun-Shin M, Finegold J, Sohaib A, Cook C, Whinnett Z, Manisty C, Francis Det al., 2014, META-ANALYSIS IDENTIFYING THE SOURCE OF CONFLICT BETWEEN DIFFERENT TRIAL REPORTS ON THE EFFECT OF CRT IN HEART FAILURE WITH NARROW QRS COMPLEXES, HEART, Vol: 100, Pages: A23-A23, ISSN: 1355-6037

Journal article

Finegold J, Bordachar P, Kyriacou A, Sohaib SMA, Kanagaratnam P, Ploux S, Lim B, Peters N, Davies DW, Lefroy D, Ritter P, Francis D, Whinnett Zet al., 2014, CORRELATION AND REPRODUCIBILITY OF INVASIVE AND NON-INVASIVE HAEMODYNAMIC PARAMETERS FOR IDENTIFYING OPTIMAL AV DELAY IN CARDIAC RESYNCHRONISATION THERAPY, HEART, Vol: 100, Pages: A22-A23, ISSN: 1355-6037

Journal article

Finegold J, Cazeau S, Sohaib SMA, Kyriacou A, Manisty C, Ritter P, Bordachar P, Whinnett Z, Francis Det al., 2014, THE EFFECT OF ALTERING AV DELAY ON THE PRE-EJECTION PERIOD IN PATIENTS WITH BIVENTRICULAR PACEMAKERS, HEART, Vol: 100, Pages: A22-A22, ISSN: 1355-6037

Journal article

Whinnett ZI, Sohaib SMA, Jones S, Kyriacou A, March K, Coady E, Mayet J, Hughes AD, Frenneaux M, Francis DPet al., 2014, British randomised controlled trial of AV and VV optimization ("BRAVO") study: rationale, design, and endpoints, BMC CARDIOVASCULAR DISORDERS, Vol: 14, ISSN: 1471-2261

Journal article

Jamil-Copley S, Bokan R, Kojodjojo P, Qureshi N, Koa-Wing M, Hayat S, Kyriacou A, Sandler B, Sohaib A, Wright I, Davies DW, Whinnett Z, Peters NS, Kanagaratnam P, Lim PBet al., 2014, Noninvasive electrocardiographic mapping to guide ablation of outflow tract ventricular arrhythmias, HEART RHYTHM, Vol: 11, Pages: 587-594, ISSN: 1547-5271

Journal article

Jones S, Shun-Shin MJ, Cole GD, Sau A, March K, Williams S, Kyriacou A, Hughes AD, Mayet J, Frenneaux M, Manisty CH, Whinnett ZI, Francis DPet al., 2014, Applicability of the iterative technique for cardiac resynchronization therapy optimization: full-disclosure, 50-sequential-patient dataset of transmitral Doppler traces, with implications for future research design and guidelines, EUROPACE, Vol: 16, Pages: 541-550, ISSN: 1099-5129

Journal article

Nijjer SS, Sohaib SMA, Whinnett ZI, Lefroy DCet al., 2014, Management of supraventricular tachycardias, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 75, Pages: C26-C28, ISSN: 1750-8460

Journal article

Kyriacou A, Pabari PA, Mayet J, Peters NS, Davies DW, Lim PB, Lefroy D, Hughes AD, Kanagaratnam P, Francis DP, Whinnett ZIet al., 2014, Cardiac resynchronization therapy and AV optimization increase myocardial oxygen consumption, but increase cardiac function more than proportionally, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 171, Pages: 144-152, ISSN: 0167-5273

Journal article

Nijjer SS, Sohaib SMA, Hinnett ZI, Lefroy DCet al., 2014, Diagnosis of supraventricular tachycardias, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 75, Pages: C22-C25, ISSN: 1750-8460

Journal article

Bouri S, Whinnett ZI, Cole GD, Manisty CH, Cleland JG, Francis DPet al., 2014, Definitions of Outcome, Response and Effect in Imaging Research to Avoid Confusion, JACC-CARDIOVASCULAR IMAGING, Vol: 7, Pages: 104-106, ISSN: 1936-878X

Journal article

Finegold JA, Raphael CE, Levy WC, Whinnett Z, Francis DPet al., 2013, Quantification of survival gain from cardiac resynchronization therapy: nonlinear growth with time, and greater gain in low-risk patients, make raw trial data an underestimate of real-world behavior., J Am Coll Cardiol, Vol: 62, Pages: 2406-2413

OBJECTIVES: The goal of this study was to examine the impact of calculation-window duration on lifespan gain (as observed in trials) and on who gains most. BACKGROUND: The landmark trials of biventricular pacing (cardiac resynchronization therapy [CRT]) typically ran for <1 device battery life, and they may therefore underestimate lifespan benefit over longer durations. METHODS: We conducted a meta-analysis of biventricular pacing trials to calculate lifespan gained: first, within the duration of randomized controlled trial data up to 2 years; second, over a 5-year typical battery life; and third, over >1 battery life. Importantly, we applied the Gompertz method for age-related increase in mortality from non-CRT-preventable causes. RESULTS: Five landmark trials (COMPANION [Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure], CARE-HF (CArdiac REsynchronization-Heart Failure), MADIT-CRT [Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy], REVERSE [Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction], RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure)) provided data for 2 years (6,561 patients), with an average hazard ratio of 0.71. Lifespan gained across all trials increased nonlinearly with time from 0.1 month at 1 year, to 0.5 month at 2 years, and a projected 6.5 months at 5 years (65 times more than at 1 year). After multiple devices, it reached 14 months, involving on average 1.6 devices (i.e., 8.8 months per device implanted). Moreover, while over a short window (e.g., 2 years), lower-mortality patients may gain less than higher-mortality patients (1.4 vs. 2.3 months), their positions reverse by 15 years (16.0 vs. 13.7 months). CONCLUSIONS: Lifespan gain from biventricular pacing rises nonlinearly with time. Early on, higher-risk patients exhibit more gain, but later, lower-risk patients exhibit more gain. Quantifying ga

Journal article

Sohaib SMA, Whinnett ZI, Ellenbogen KA, Stellbrink C, Quinn TA, Bogaard MD, Bordachar P, van Gelder BM, van Geldorp IE, Linde C, Meine M, Prinzen FW, Turcott RG, Spotnitz HM, Wichterle D, Francis DPet al., 2013, Cardiac resynchronisation therapy optimisation strategies: Systematic classification, detailed analysis, minimum standards and a roadmap for development and testing, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 170, Pages: 118-131, ISSN: 0167-5273

Journal article

Sohaib SMA, Chen Z, Whinnett ZI, Bouri S, Dickstein K, Linde C, Hayes DL, Manisty CH, Francis DPet al., 2013, Meta-analysis of symptomatic response attributable to the pacing component of cardiac resynchronization therapy, EUROPEAN JOURNAL OF HEART FAILURE, Vol: 15, Pages: 1419-1428, ISSN: 1388-9842

Journal article

Jamil-Copley S, Linton N, Koa-Wing M, Kojodjojo P, Lim PB, Malcolme-Lawes L, Whinnett Z, Wright I, Davies W, Peters N, Francis DP, Kanagaratnam Pet al., 2013, Application of Ripple Mapping with an Electroanatomic Mapping System for Diagnosis of Atrial Tachycardias, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 24, Pages: 1361-1369, ISSN: 1045-3873

Journal article

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