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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212 results found

Pascale P, Shah AJ, Roten L, Whinnett Z, Wilton SB, Jadidi AS, Scherr D, Miyazaki S, Pedersen M, Derval N, Knecht S, Sacher F, Hocini M, Haïssaguerre M, Jaïs Pet al., 2012, Disparate activation of the coronary sinus and inferior left atrium during atrial tachycardia after persistent atrial fibrillation ablation: prevalence, pitfalls, and impact on mapping., J Cardiovasc Electrophysiol, Vol: 23, Pages: 697-707

INTRODUCTION: Persistent atrial fibrillation (AF) ablation may lead to partial disconnection of the coronary sinus (CS). As a result, disparate activation sequences of the local CS versus contiguous left atrium (LA) may be observed during atrial tachycardia (AT). We aimed to evaluate the prevalence of this phenomenon and its impact on activation mapping. METHODS: AT occurring after persistent AF ablation were investigated in 74 consecutive patients. Partial CS disconnection during AT was suspected when double potentials with disparate activation sequences were observed on the CS catheter. Endocardial mapping facing CS bipoles was performed to differentiate LA far-field from local CS potentials. RESULTS: A total of 149 ATs were observed. Disparate LA-CS activations were apparent in 20 ATs after magnifying the recording scale (13%). The most common pattern (90%) was distal to proximal endocardial LA activation against proximal to distal CS activation, the latter involving the whole CS or its distal part. Perimitral macroreentry was more common when disparate LA-CS activations were observed (67% vs 29%; P = 0.002). Partial CS disconnection also resulted in "pseudo" mitral isthmus (MI) block during LA appendage pacing in 20% of patients as local CS activation was proximal to distal despite distal to proximal activation of the contiguous LA. CONCLUSION: Careful analysis of CS recordings during AT following persistent AF ablation often reveals disparate patterns of activation. Recognizing when endocardial LA activation occurs in the opposite direction to the more obvious local CS signals is critical to avoid misleading interpretations during mapping of AT and evaluation of MI block.

Journal article

PLOUX S, VERDOUX H, WHINNETT Z, RITTER P, SANTOS PD, PICARD F, CLEMENTY J, HAÏSSAGUERRE M, BORDACHAR Pet al., 2012, Depression and Severe Heart Failure: Benefits of Cardiac Resynchronization Therapy, Journal of Cardiovascular Electrophysiology, Vol: 23, Pages: 631-636, ISSN: 1045-3873

<jats:p><jats:bold>Depression and Cardiac Resynchronization Therapy</jats:bold>.</jats:p><jats:p><jats:italic>Background:</jats:italic> The relationship between depression and heart failure is neither coincidental nor trivial, since depression is a powerful predictor of re‐hospitalization and mortality. We prospectively studied the prevalence and impact of depression on the clinical outcomes of patients attending for cardiac resynchronization therapy (CRT). We specifically examined whether patients with depression have a different rate of response to CRT and whether CRT has an effect on depressive symptoms.</jats:p><jats:p><jats:italic>Methods:</jats:italic>  Sixty‐eight recipients of CRT systems were included. The depressive status was evaluated before implant and after 6 months by a structured diagnostic interview measuring Diagnostic and Statistical Manual of Mental Disorders (DSM‐IV) criteria of major depression and by a self‐report questionnaire (Center for Epidemiological Studies Depression Scale, CES‐D). The CRT response was assessed at 6 months by a clinical composite score.</jats:p><jats:p><jats:italic>Results:</jats:italic> At inclusion, DSM‐IV criteria of major depression were identified in 41% of the population, while using the self‐report questionnaire 65% were observed to have mild to major depressive symptoms (CES‐D ≥ 16). Only 4 patients were taking antidepressants. At 6 months, 75% were considered responders to CRT. Response to CRT did not differ between those with and without depression at baseline. The rate of patients with depression at 6 months was significantly lower in responders to CRT compared with nonresponders.</jats:p><jats:p><jats:italic>Conclusions:</jats:italic> We found a high prevalence of depressive symptoms in patients receiving CRT systems. Patients with depression should not be excluded from CRT, because they

Journal article

Kyriacou A, Wa MLK, Pabari P, Kanagaratnam P, Peters NS, Mayet J, Francis DP, Whinnett ZIet al., 2012, SHOULD CURRENT MODALITIES OF VV OPTIMISATION BE TRUSTED? AN ASSESSMENT OF THE INTERNAL VALIDITY OF ECHOCARDIOGRAPHIC, ELECTROCARDIOGRAPHIC AND HAEMODYNAMIC MODALITIES OF OPTIMISATION, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A8-A8, ISSN: 1355-6037

Conference paper

Sohaib SMA, Chen Z, Whinnett Z, Francis DP, Manisty Cet al., 2012, UNBIASED ASSESSMENT OF SYMPTOMATIC "RESPONSE RATE" TO CARDIAC RESYNCHRONISATION THERAPY BY SYSTEMATIC REVIEW OF RANDOMISED CONTROLLED TRIALS (REVERSE, MIRACLE, MIRACLE ICD, MIRACLE ICD II, CARE-HF, COMPANION, CONTAK-CD, AND MUSTIC), Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A4-A4, ISSN: 1355-6037

Conference paper

Pabari PA, Kyriacou A, Wright I, Hughes AD, Mayet J, Whinnett ZI, Francis DP, Manisty CHet al., 2012, SIMULTANEOUS INVASIVE PRESSURE AND FLOW MEASUREMENTS DURING ATRIOVENTRICULAR DELAY IMPROVEMENT REVEAL A COMPENSATORY PERIPHERAL VASODILATOR RESPONSE WHICH ATTENUATES THE INITIAL BLOOD PRESSURE INCREMENT: IMPLICATIONS FOR THE DESIGN OF OPTIMISATION PROTOCOLS, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: BMJ PUBLISHING GROUP, Pages: A5-A6, ISSN: 1355-6037

Conference paper

Kyriacou A, Whinnett ZI, Sen S, Pabari P, Davies DW, Peters NS, Kanagaratnam P, Mayet J, Hughes AD, Francis DP, Davies JEet al., 2012, IMPROVEMENT IN CORONARY BLOOD FLOW WITH ACUTE BIVENTRICULAR PACING IS PREDOMINANTLY DUE TO AN INCREASE IN A DIASTOLIC BACKWARD-TRAVELLING DECOMPRESSION (SUCTION) WAVE, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A7-A8, ISSN: 1355-6037

Conference paper

Ploux S, Whinnett Z, Bordachar P, 2012, Left Ventricular Endocardial Pacing and Multisite Pacing to Improve CRT Response, Journal of Cardiovascular Translational Research, Vol: 5, Pages: 213-218, ISSN: 1937-5387

Journal article

JAN E, CAMOU F, TEXIERMAUGEIN J, WHINNETT Z, CAUBET O, PLOUX S, PELLEGRIN J, RITTER P, METAYER PL, ROUDAUT R, HAISSAGUERRE M, BORDACHAR Pet al., 2012, Microbiologic Characteristics and <i>In Vitro</i> Susceptibility to Antimicrobials in a Large Population of Patients with Cardiovascular Implantable Electronic Device Infection, Journal of Cardiovascular Electrophysiology, Vol: 23, Pages: 375-381, ISSN: 1045-3873

<jats:p>Microbiologic Characteristics and <jats:italic>In Vitro</jats:italic> Susceptibility to Antimicrobials.</jats:p><jats:p><jats:italic>Introduction:</jats:italic> The incidence of cardiovascular implantable electronic device (CIED) infection is steadily increasing. However, no consensus has been reached with respect to the type and duration of antimicrobial therapy in this specific population of patients. The role played by new anti‐<jats:italic>Staphylococcus</jats:italic> agents has not been defined. The aims of this study were to describe the microbiological characteristics of a large population of patients with CIED infections and to test the <jats:italic>in vitro</jats:italic> susceptibility of the various strains to different antimicrobials.</jats:p><jats:p><jats:italic>Methods:</jats:italic> Two hundred eighty‐six patients with CIED infection were included. The minimal inhibitory concentrations of 9 antimicrobials, including linezolid, tigecycline, and daptomycin were measured against all strains of staphylococci isolated.</jats:p><jats:p><jats:italic>Results:</jats:italic> Microbiologic confirmation was obtained in 252 (88%) patients, the vast majority were from <jats:italic>Staphylococcus</jats:italic> species (86%), 90% of these were coagulase negative strains and 10% were <jats:italic>Staphylococcus aureus</jats:italic>; 30.5% were methicillin‐resistant. All strains were susceptible to vancomycin, nearly 15% of coagulase negative strains were nonsusceptible to teicoplanin, and nearly 100% of the strains were susceptible to the 3 new antimicrobials.</jats:p><jats:p><jats:italic>Conclusions:</jats:italic> In this large contemporary study, we show that <jats:italic>Staphylococcus</jats:italic> is by far the most common cause of CIED infections, with the majority due to coagulase ne

Journal article

Manisty CH, Al-Hussaini A, Unsworth B, Baruah R, Pabari PA, Mayet J, Hughes AD, Whinnett ZI, Francis DPet al., 2012, The Acute Effects of Changes to AV Delay on BP and Stroke Volume Potential Implications for Design of Pacemaker Optimization Protocols, CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, Vol: 5, Pages: 122-U209, ISSN: 1941-3149

Journal article

Whinnett Z, Bordachar P, 2012, The risks and benefits of transseptal endocardial pacing, CURRENT OPINION IN CARDIOLOGY, Vol: 27, Pages: 19-23, ISSN: 0268-4705

Journal article

Ploux S, Riviere A, Amraoui S, Whinnett Z, Barandon L, Lafitte S, Ritter P, Papaioannou G, Clementy J, Jais P, Bordenave L, Haissaguerre M, Bordachar Pet al., 2011, Positron emission tomography in patients with suspected pacing system infections may play a critical role in difficult cases, Heart Rhythm, Vol: 8, Pages: 1478-1481, ISSN: 1547-5271

Journal article

Kyriacou A, Pabari P, Wright I, Cornellussen R, Sen S, Mayet J, Peters N, Kanagaratnam P, Whinnett Z, Francis DPet al., 2011, The effect of cardiac resynchronization therapy and of atrioventricular delay optimization on mechanoenergetic efficiency: simply, a better value for money, EUROPEAN HEART JOURNAL, Vol: 32, Pages: 151-151, ISSN: 0195-668X

Journal article

Pabari PA, Kyriacou A, Whinnett ZI, Wright I, Willson K, Mayet J, Hughes AD, Francis DPet al., 2011, Invasive evaluation of whether decline in pressure after initial immediate increment on improving AV delay of CRT is due to vasodilatation or decline in cardiac function, EUROPEAN HEART JOURNAL, Vol: 32, Pages: 782-782, ISSN: 0195-668X

Journal article

Manisty CH, Unsworth B, Baruah R, Pabari P, Whinnett ZI, Mayet J, Francis DPet al., 2011, PRESSURE VS FLOW AS A GUIDE FOR PACEMAKER OPTIMISATION? THE ACUTE HAEMODYNAMIC EFFECTS OF CHANGES TO ATRIOVENTRICULAR DELAY, Annual Conference of the British-Cardiovascular-Society (BCS), Publisher: B M J PUBLISHING GROUP, Pages: A58-A58, ISSN: 1355-6037

Conference paper

Whinnett ZI, Nott G, Davies JER, Willson K, Manisty CH, Kanagaratnam P, Peters NS, Davies DW, Hughes AD, Mayet J, Francis DPet al., 2011, Maximizing Efficiency of Alternation Algorithms for Hemodynamic Optimization of the AV Delay of Cardiac Resynchronization Therapy, PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol: 34, Pages: 217-225, ISSN: 0147-8389

Journal article

Pabari PA, Kyriacou A, Whinnett ZI, Wright I, Willson K, Mayet J, Hughes AD, Francis DPet al., 2011, Invasive evaluation of whether decline in pressure after initial immediate increment on improving AV delay of CRT is due to vasodilatation or decline in cardiac function, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 183, Pages: 782-782, ISSN: 1073-449X

Journal article

Kojodjojo P, O'Neill MD, Lim PB, Malcolm-Lawes L, Whinnett ZI, Salukhe TV, Linton NW, Lefroy D, Mason A, Wright I, Peters NS, Kanagaratnam P, Davies DWet al., 2010, Pulmonary venous isolation by antral ablation with a large cryoballoon for treatment of paroxysmal and persistent atrial fibrillation: medium-term outcomes and non-randomised comparison with pulmonary venous isolation by radiofrequency ablation, Heart, Vol: 96, Pages: 1379-1384, ISSN: 1468-201X

Background To prevent atrial fibrillation (AF) recurrenceafter catheter ablation, pulmonary venous isolation (PVI)at an antral level is more effective than segmental ostialablation. Cryoablation around the pulmonary venous (PV)ostia for AF therapy is potentially safer compared toradiofrequency ablation (RFA). The aim of this study wasto investigate the efficacy of a strategy using a largecryoablation balloon to perform antral cryoablation with‘touch-up’ ostial cryoablation for PVI in patients withparoxysmal and persistent AF.Methods Paroxysmal and persistent AF patientsundergoing their first left atrial ablation were recruited.After cryoballoon therapy, each PV was assessed forisolation and if necessary, treated with focal ostialcryoablation until PVI was achieved. Follow-up withHolter monitoring was performed. Clinical outcomes ofthe cryoablation protocol were compared, withconsecutive patients undergoing PVI by RFA.Results 124 consecutive patients underwentcryoablation. 77% of paroxysmal and 48% of persistentAF subjects were free from AF at 12 months aftera single procedure. Over the same time period, 53consecutive paroxysmal AF subjects underwent PVI withRFA and at 12 months, 72% were free from AF at12 months (p¼NS). There were too few persistent AFsubjects (n¼8) undergoing solely PVI by RFA asa comparison group. Procedural and fluoroscopic timesduring cryoablation were significantly shorter than RFA.Conclusions PV isolation can be achieved in less than2 h by a simple cryoablation protocol with excellentresults after a single intervention, particularly forparoxysmal AF.

Journal article

Kyriacou A, Whinnett ZI, Pabari PA, Willson K, Lefroy D, Davies DW, Peters NS, Mayet J, Kanagaratnam P, Francis DPet al., 2010, Adaptation of non-invasive haemodynamic technologies and development of algorithms for cost effective, automated optimisation of cardiac resynchronisation devices, ESC Congress, Publisher: OXFORD UNIV PRESS, Pages: 418-418, ISSN: 0195-668X

Conference paper

Davies JE, Baksi J, Francis DP, Hadjiloizou N, Whinnett ZI, Manisty CH, Aguado-Sierra J, Foale RA, Malik IS, Tyberg JV, Parker KH, Mayet J, Hughes ADet al., 2010, The arterial reservoir pressure increases with aging and is the major determinant of the aortic augmentation index, AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, Vol: 298, Pages: H580-H586, ISSN: 0363-6135

Journal article

Davies JE, Francis DP, Hadjiloizou N, Whinnett ZI, Manisty CH, Aguado-Sierra J, Malik IS, Parker KH, Hughes AD, Mayet Jet al., 2010, Augmentation of Coronary Blood Flow in Systole by Reflected Waves in the Proximal Aorta, 11th International Congress of the IUPESM/World Congress on Medical Physics and Biomedical Engineering, Publisher: SPRINGER, Pages: 61-64, ISSN: 1680-0737

Conference paper

Koa-Wing M, Kojodjojo P, Malcolme-Lawes LC, Salukhe TV, Linton NWF, Grogan AP, Bergman D, Lim PB, Whinnett ZI, McCarthy K, Ho SY, O'Neill MD, Peters NS, Davies DW, Kanagaratnam Pet al., 2009, Robotically Assisted Ablation Produces More Rapid and Greater Signal Attenuation Than Manual Ablation, JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Vol: 20, Pages: 1398-1404, ISSN: 1045-3873

Journal article

Linton NWF, Koa-Wing M, Francis DP, Kojodjojo P, Lim PB, Salukhe TV, Whinnett Z, Davies DW, Peters NS, O'Neill MD, Kanagaratnam Pet al., 2009, Cardiac ripple mapping: A novel three-dimensional visualization method for use with electroanatomic mapping of cardiac arrhythmias, HEART RHYTHM, Vol: 6, Pages: 1754-1762, ISSN: 1547-5271

Journal article

Lim PB, Stuber T, Koa-Wing M, Salukhe TV, Linton NWF, Kojodjojo P, Whinnett ZI, Francis DP, Davies DW, Peters NS, O'Neill MD, Kanagaratnam Pet al., 2009, ACTIVATION OF THE INTRINSIC CARDIAC AUTONOMIC NERVOUS SYSTEM INDUCES ECTOPY, INITIATING ATRIAL FIBRILLATION AND RESULTS IN A GRADIENT OF SHORTENING IN ATRIAL FIBRILLATION CYCLE LENGTHS IN THE PULMONARY VEINS AND ATRIA, Annual Scientific Conference of the British-Cardiovascular-Society, Publisher: B M J PUBLISHING GROUP, Pages: A1-A3, ISSN: 1355-6037

Conference paper

Raphael CE, Whinnett ZI, Davies JE, Fontana M, Ferenczi EA, Manisty CH, Mayet J, Francis DPet al., 2009, Quantifying the paradoxical effect of higher systolic blood pressure on mortality in chronic heart failure, HEART, Vol: 95, Pages: 56-62, ISSN: 1355-6037

Journal article

Whinnett ZI, Francis DP, 2008, To the editor-response., Heart Rhythm, Vol: 5, Pages: e4-e4, ISSN: 1556-3871

Journal article

Davies JER, Whinnett ZI, Hadjiloizou N, Aguado-Sierra J, Parker KH, Francis DP, Hughes AD, Mayet Jet al., 2008, Evidence of augmentation of systolic coronary blood flow by retrograde wave reflection travelling-back from the proximal aorta, JOURNAL OF HUMAN HYPERTENSION, Vol: 22, Pages: 718-719, ISSN: 0950-9240

Journal article

Whinnett ZI, Davies JER, Nott G, Willson K, Manisty CH, Peters NS, Kanagaratnam P, Davies DW, Hughes AD, Mayet J, Francis DPet al., 2008, Efficiency, reproducibility and agreement of five different hemodynamic measures for optimization of cardiac resynchronization therapy, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 129, Pages: 216-226, ISSN: 0167-5273

Journal article

Manisty CH, Willson K, Davies JER, Whinnett ZI, Baruah R, Mebrate Y, Kanagaratnam P, Peters NS, Hughes AD, Mayet J, Francis DPet al., 2008, Induction of oscillatory ventilation pattern using dynamic modulation of heart rate through a pacemaker, AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, Vol: 295, Pages: R219-R227, ISSN: 0363-6119

Journal article

Davies JE, Whinnett ZI, Hadjiloizou N, Manisty CH, Hughes AD, Parker KH, Francis DP, Mayet Jet al., 2008, Microcirculatory-originating pressure predominantly determines coronary blood flow in humans: Evaluation using wave intensity analysis, Annual Scientific Conference of the British-Cardiovascular-Society/British-Society-for-Cardiovascular-Research, Publisher: B M J PUBLISHING GROUP, Pages: A121-+, ISSN: 1355-6037

Conference paper

Davies JE, Hadjiloizou N, Manisty CH, Whinnett ZI, Francis DP, Parker KH, Mayet J, Hughes ADet al., 2008, Evidence to support the role of the aortic reservoir via a direct mechanism in determination of the pressure waveform with ageing, 57th Annual Scientific Session of the American-College-of-Cardiology, Publisher: ELSEVIER SCIENCE INC, Pages: A339-A339, ISSN: 0735-1097

Conference paper

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