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Assawamasbunlue N, Lorlowhakarn K, Kewcharoen J, Laisathit P, Shotelersuk V, Ariyachaipanich A. CHARACTERISTICS AND OUTCOMES OF OCTOGENARIAN WITH ACUTE HEART FAILURE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Chaikijurajai T, Worapongsatitaya P, Kewcharoen J, Ponvilawan B, Charoenngam N, Mutirangura P, Dhole AK, Ergando T, Ungprasert P. HYPOCHLOREMIA ON ADMISSION AND MORTALITY RISK IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00894-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Leelaviwat N, Benjanuwattra J, Vutthikraivit W, Kewcharoen J, Trongtorsak A, Abdelnabi M, Del Rio-Pertuz G, Mekraksakit P, Thangjui S, Sethi P. GENOTYPIC OVERLAP BETWEEN BRUGADA SYNDROME AND HYPERTROPHIC CARDIOMYOPATHY OR BRUGADA PHENOCOPY? J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)04314-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Leelaviwat N, Paz P, Abdelnabi M, Benjanuwattra J, Del Rio-Pertuz G, Trongtorsak A, Vutthikraivit W, Kewcharoen J, Sethi P. ASPIRATION THROMBECTOMY: A POSSIBLE PROMISING THERAPY FOR INFERIOR VENA CAVA AND RIGHT ATRIUM THROMBUS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)04384-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Kewcharoen J, Contractor T, Kotak K, Prasad VS. MANAGEMENT OF INADVERTENTLY PLACED TRANS-ARTERIAL PACEMAKER LEAD IN THE LEFT VENTRICLE: A STEP-BY-STEP APPROACH. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)03246-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Leesutipornchai T, Waitayangkoon P, Techasatian W, Aiumtrakul N, Tanariyakul M, Arayangkool C, Nagamine T, Kewcharoen J. URATE-LOWERING THERAPY IS ASSOCIATED WITH A REDUCED RISK OF ARRHYTHMIAS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00529-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Trongtorsak A, Kewcharoen J, Thangjui S, Leelaviwat N, Li S, Luo S, Navaravong L, Marinescu K, Rao A, Volgman AS, Suboc TM. SEX AND OUTCOME DIFFERENCES AFTER CONTINUOUS-FLOW LEFT VENTRICULAR ASSIST DEVICE IMPLANTATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00995-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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Mekraksakit P, Leelaviwat N, Benjanuwattra J, Duangkham S, Del Rio-Pertuz G, Thongprayoon C, Kewcharoen J, Boonpheng B, Pena C, Cheungpasitporn W. A Systematic Review and Meta-Analysis of Posttransplant Anemia With Overall Mortality and Cardiovascular Outcomes Among Kidney Transplant Recipients. Prog Transplant 2023; 33:78-89. [PMID: 36591924 DOI: 10.1177/15269248221145046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction: Posttransplant anemia is a common finding after kidney transplantation. A previous meta-analysis reported an association between anemia and graft loss. However, data on cardiovascular outcomes have not yet been reported. Objective: We conducted an updated meta-analysis to examine the association between posttransplant anemia and outcomes after transplantation including cardiovascular mortality in adult kidney transplant recipients. Methods: We comprehensively searched the databases of MEDLINE and EMBASE from inception to November 2021. Data from each study were combined using the random-effects model. Generic inverse variance method of DerSimonian and Laird was employed to calculate the risk ratios and 95% CIs. Results: Seventeen studies from August 2006 to April 2019 were included (16 463 kidney transplantation recipients). Posttransplant anemia was associated with overall mortality (pooled risk ratio = 1.72 [1.39, 2.13], I2 = 56%), graft loss (pooled risk ratio = 2.28 [1.77, 2.93], I2 = 94%), cardiovascular death (pooled risk ratio = 2.06 [1.35, 3.16], I2 = 0%), and cardiovascular events (pooled risk ratio = 1.33 [1.10, 1.61], I2 = 0%). Early anemia (≤6 months), compared with late anemia (>6 months), has higher risk of overall mortality and graft loss with a pooled risk ratio of 2.63 (95% CI 1.79-3.86; I2 = 0%) and 2.96 (95% CI 2.29-3.82; I2 = 0%), respectively. Discussion: In addition to increased risk of graft loss, our updated meta-analysis demonstrated that posttransplant anemia was significantly associated with poor outcomes after kidney transplantation including overall mortality, graft loss, cardiovascular death, and cardiovascular events. Future studies are required to assess the effects of treatment strategies for posttransplant anemia on posttransplant outcomes including cardiovascular mortality.
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Leelaviwat N, Mekraksakit P, Trongtorsak A, Vutthikraivit W, Kewcharoen J, Abdelnabi M, Del Rio-Pertuz G, Benjanuwattra J, Thangjui S, Navaravong L. AMULET VERSUS WATCHMAN DEVICE FOR LEFT ATRIAL APPENDAGE CLOSURE: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS AND PROPENSITY-SCORE-MATCHED STUDIES. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Kewcharoen J, Giri P, Amini MR, Tan L, Moretta D, Barrett E, Walters EL, Abramov D. Heart failure alters diagnostic yield for pulmonary embolism in patients undergoing computed tomography pulmonary angiogram. Am J Emerg Med 2023; 64:8-11. [PMID: 36427385 DOI: 10.1016/j.ajem.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION There is limited evidence regarding the effects of a pre-existing heart failure (HF) on the diagnostic yield of pulmonary embolism (PE) evaluation in the Emergency Department (ED). METHODS Electronic medical record of consecutive adults who underwent a computed tomography pulmonary angiogram (CTPA) in the ED at Loma Linda University Medical Center between June 1, 2019 and March 25, 2022 were reviewed. Repeat studies for the same patient and patients with unspecified HF diagnoses or isolated right ventricular HF were excluded. Key demographics, lab values and vital signs, relevant medications were collected. Primary outcome was the incidence of PE on CTPA compared between patients with and without pre-existing HF. RESULTS A total of 2846 patients were included in the study (602 patients with HF and 2244 without). In total cohort, 11.7% (n = 334) of patients had PE found on CTPA. The incidence of PE on CTPA was lower among patients with a history of HF than patients without a history of HF (12.5% vs 9%). A history of pre-existing HF was associated with a lower odds ratio for a positive PE study (OR 0.13, 95%CI: 0.03-0.57) in multivariable analyses. CONCLUSIONS In this study, we observed that the incidence of PE among patients who undergo CTPA was lower among patients with pre-existing HF compared to those without. Further studies should determine if HF is an important mitigating factor when risk stratifying patients for PE.
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Kewcharoen J, Shah K, Bhardwaj R, Contractor T, Turagam MK, Mandapati R, Lakkireddy D, Garg J. Electromagnetic Field-Induced Interactions Among Electric Vehicles, New-Generation Electronic Devices, and Cardiovascular Implantable Electronic Devices. JACC Clin Electrophysiol 2023; 9:257-259. [PMID: 36858694 DOI: 10.1016/j.jacep.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/20/2023]
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Leelaviwat N, Mekraksakit P, Kewcharoen J, Thangjui S, Abdelnabi M, Del Rio Pertuz G, Benjanuwattra J, Trongtorsak A. CRT-300.09 Amulet Versus Watchman Device for Left Atrial Appendage Closure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Rattanawong P, Kewcharoen J, Yinadsawaphan T, Fatunde OA, Kanitsoraphan C, Vutthikraivit W, Prasitlumkum N, Chung EH, Shen W. Type of syncope and outcome in Brugada syndrome: A systematic review and meta‐analysis. J Arrhythm 2023; 39:111-120. [PMID: 37021016 PMCID: PMC10068940 DOI: 10.1002/joa3.12822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/24/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Brugada syndrome is an inherited arrhythmic disease associated with major arrhythmic events (MAE). The importance of primary prevention of sudden cardiac death (SCD) in Brugada syndrome is well recognized; however, ventricular arrhythmia risk stratification remains challenging and controversial. We aimed to assess the association of type of syncope with MAE via systematic review and meta-analysis. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to December 2021. Included studies were cohort (prospective or retrospective) studies that reported the types of syncope (cardiac, unexplained, vasovagal, and undifferentiated) and MAE. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate the odds ratio (OR) and 95% confidence intervals (CIs). Results Seventeen studies from 2005 to 2019 were included in this meta-analysis involving 4355 Brugada syndrome patients. Overall, syncope was significantly associated with an increased risk of MAE in Brugada syndrome (OR = 3.90, 95% CI: 2.22-6.85, p < .001, I 2 = 76.0%). By syncope type, cardiac (OR = 4.48, 95% CI: 2.87-7.01, p < .001, I 2 = 0.0%) and unexplained (OR = 4.71, 95% CI: 1.34-16.57, p = .016, I 2 = 37.3%) syncope was significantly associated with increased risk of MAE in Brugada syndrome. Vasovagal (OR = 2.90, 95% CI: 0.09-98.45, p = .554, I 2 = 70.9%) and undifferentiated syncope (OR = 2.01, 95% CI: 1.00-4.03, p = .050, I 2 = 64.6%, respectively) were not. Conclusion Our study demonstrated that cardiac and unexplained syncope was associated with MAE risk in Brugada syndrome populations but not in vasovagal syncope and undifferentiated syncope. Unexplained syncope is associated with a similar increased risk of MAE compared to cardiac syncope.
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Chang AK, Kewcharoen J, Henkel DM, Parwani P, Abramov D. Myocardial Contraction Fraction is not a Predictor of Clinical Outcomes in Acute Systolic Heart Failure: A Brief Report. J Cardiovasc Echogr 2023; 33:27-29. [PMID: 37426719 PMCID: PMC10328125 DOI: 10.4103/jcecho.jcecho_53_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/26/2022] [Accepted: 11/30/2022] [Indexed: 07/11/2023] Open
Abstract
Introduction The utility of myocardial contraction fraction (MCF), a volumetric measure of myocardial shortening, has not been well evaluated in patients with systolic heart failure (SHF). Materials and Methods A single-center, retrospective cohort study of all adults admitted with acute SHF from 2013 to 2018 at an academic medical center. A chart review was performed to identify key echocardiographic transthoracic echocardiogram (TTE), laboratory, and demographic characteristics. MCF was calculated based on M-mode measurements of estimated stroke volume and myocardial volume based on admission TTE. The primary outcome was 30-day combined all-cause readmission/mortality and 365-day all-cause mortality. Results A total of 1282 patients were analyzed. The 30-day composite outcome occurred in 310 patients (24.2%), and all-cause death at 365 days occurred in 375 patients (29.3%). There was a weak correlation between the visually estimated ejection fraction (EF) and MCF (r = 0.356, P < 0.001). Neither MCF nor EF was associated with either component of the primary outcome. Other parameters on TTE that were associated with higher risk of primary outcome were higher tricuspid regurgitation (TR) velocity, larger left atrial (LA) diameter, and moderate or greater TR and mitral regurgitation (MR). Conclusion Echocardiographic predictors of postdischarge adverse events among patients hospitalized with acute SHF include higher TR velocity, larger LA diameter, and at least moderate MR or TR. MCF does not correlate well with visually assessed EF among patients with acute SHF, and neither MCF nor EF provides prognostic information in this population.
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Garg J, Kewcharoen J, Shah K, Turagam M, Bhardwaj R, Contractor T, Mandapati R, Lakkireddy D. Clinical outcomes of radiofrequency catheter ablation of ventricular tachycardia in patients with hypertrophic cardiomyopathy. J Cardiovasc Electrophysiol 2023; 34:219-224. [PMID: 36335616 PMCID: PMC10100142 DOI: 10.1111/jce.15739] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Monomorphic ventricular tachycardia (VT) is rare in patients with hypertrophic cardiomyopathy (HCM), management of which is challenging. Limited data exists on the utility of catheter ablation for the treatment of VT in this population. OBJECTIVES We aimed to assess clinical outcomes of catheter ablation for VT in HCM patients. METHODS A systematic search, without language restriction, using PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials.gov was performed. The meta-analysis was performed using a meta-package for R version 4.0/RStudio version 1.2 and Freeman Tukey double arcsine method to establish the variance of raw proportions. Outcomes measured included (1) acute procedure success (defined as noninducible for clinical VT), (2) freedom from VT at follow-up, (3) mortality. RESULTS This systematic review of six studies (three from the United States and three from Japan) incorporated a total of 68 drug-refractory HCM patients who underwent VT radiofrequency catheter ablation (mean age 57.6 ± 13.3 years, mean LVEF 45.8 ± 15.4%, 85% men, maximum septal wall thickness 17.4 ± 4.6 mm, and 32.3% with an apical aneurysm). Acute procedural success was achieved in 84.5% patients (95% confidence interval [CI]: 70.6%-95.2%) with 27.9% patients had recurrent VT requiring multiple ablations (median 1, IQR 1-3). During the follow-up period (18.3 ± 11.7 months), the pooled incidence of freedom from recurrent VT after index procedure was 70.2% (95% CI: 51.9%-86.2%), while after the last ablation was 82.8% (95% CI: 57%-99.2%). There were two deaths during follow-up, one from heart failure and one from SCD 0.8% (95% CI: 0%-5.8%). CONCLUSION The results of our pooled analysis demonstrated that catheter ablation for VT in HCM patients was associated with high acute procedural success, and reduced VT recurrence-findings comparable to previously published reports in other disease substrates.
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Bhardwaj R, Kewcharoen J, Contractor T, Nayak S, Ai S, Kim U, Mandapati R, Garg J. Echocardiogram-Guided Leadless Pacemaker Implantation. JACC Clin Electrophysiol 2022; 8:1581-1582. [PMID: 36543510 DOI: 10.1016/j.jacep.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 01/18/2023]
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Lorlowhakarn K, Arayakarnkul S, Trongtorsak A, Leesutipornchai T, Kewcharoen J, Sinphurmsukskul S, Siwamogsatham S, Puwanant S, Ariyachaipanich A. Outcomes and predictors of one-year mortality in patients hospitalized with Acute Heart Failure. IJC HEART & VASCULATURE 2022; 43:101159. [PMID: 36467463 PMCID: PMC9713267 DOI: 10.1016/j.ijcha.2022.101159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Registries of patients hospitalized with acute heart failure (AHF) provided useful description of characteristics and outcomes. However, a contemporary registry which provides sufficient evidence on outcomes after discharge is needed. OBJECTIVE The study aims to identify 1-year clinical outcomes and prognostic predictors of patients hospitalized with AHF. METHOD This is a retrospective registry which enrolled patients who were hospitalized due to a principal diagnosis of AHF in a tertiary care center in Thailand between July 2017 and June 2019. Baseline characteristics and hospital courses between the deceased patients and the survivors at 1 year were compared. Prognostic predictors for 1-year mortality were analyzed using Cox regression model. RESULTS A total of 759 patients were enrolled (mean age of 68.9 ± 15 years, 49.8% men, mean ejection fraction of 47.1 ± 19.2%, 55.7% heart failure reduced ejection fraction (HFrEF)). Among these, 40.7% had no history of heart failure. The in-hospital and 1-year mortality was 5.8% and 21.5%, respectively. Patients with HFrEF had lower 1-year mortality compared to those without (HR = 0.57, p = 0.04). Age ≥ 70 years, the history of heart failure, prior heart failure hospitalization, cerebrovascular accident (CVA), reactive airway disease, cancer, length of stay > 10 days and NT-proBNP ≥ 10,000 pg/mL were associated with higher 1-year mortality (p < 0.05). The multivariate analysis showed age, CVA and NT-proBNP were independent predictors. CONCLUSION Patients with AHF had high mortality after discharge. Patients with poor prognostic predictors, such as elderly, may benefit from continuous care. The study is the most recent registry of patients with AHF in Thailand.
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Garg J, Kewcharoen J, Bhardwaj R, Contractor T, Jain S, Mandapati R. Intracardiac echocardiography from coronary sinus. J Cardiovasc Electrophysiol 2022; 33:2382-2388. [PMID: 36153661 PMCID: PMC9828028 DOI: 10.1111/jce.15687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 01/12/2023]
Abstract
Intracardiac echocardiography (ICE) has become an essential tool and is an integral part of percutaneous interventional and electrophysiology (EP) procedures. Intracardiac echocardiography offers real-time, high-quality, near-field evaluation of cardiac anatomy. Standard ICE imaging includes placing the catheter in the right atrium (RA), right ventricle (RV), or left atrium (LA, via the transeptal approach). Coronary sinus echocardiography (CSE) is another alternative, where the ICE catheter is positioned in the coronary sinus (CS). This approach offers better catheter stability and allows operators to visualize cardiac structure with particularly excellent views of the LA, LAA, left ventricle (LV), and mitral annulus. Additionally, CSE is an attractive alternative in cases with unfavorable interatrial septum or fossa ovalis anatomical features that could lead to difficulty advancing ICE catheter in left atrium. In this article focusing on CSE, we provide illustration-based guidance to help operators identify critical cardiac structures from CSE.
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Rattanawong P, Kanitsoraphan C, Kewcharoen J, Sriramoju A, Shanbhag A, Ko Ko NL, Barry T, Vutthikraivit W, Shen WK. Surgical versus catheter ablation in atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Electrophysiol 2022; 33:2152-2163. [PMID: 35771487 DOI: 10.1111/jce.15617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/15/2022] [Accepted: 06/27/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia with a high stroke and mortality rate. The video-assisted thoracoscopic radiofrequency pulmonary vein ablation is a treatment option for patients who fail catheter ablation. Randomized data comparing surgical versus catheter ablation are limited. We performed a meta-analysis of randomized control trials to explore the outcome efficacy between surgical and catheter radiofrequency pulmonary vein ablation in patients with AF. METHODS We comprehensively searched the databases of MEDLINE and EMBASE from inception to December 2020. Included studies were published randomized control trials that compared video-assisted thoracoscopic and catheter radiofrequency pulmonary vein ablation. Data from each study were combined using the fixed-effects, generic inverse variance method of DerSimonian and Laird to calculate odds ratios and 95% confidence intervals. RESULTS Six studies from November 2013 to 2020 were included in this meta-analysis involving 511 AF patients (79% paroxysmal) with 263 catheter ablation (mean age 56±3 years) and 248 surgical ablations (mean age 52 ±4 years). Catheter ablation was associated with increased atrial arrhythmias recurrence when compared to surgical ablation (pooled relative risk=1.85, 95 % confidence interval: 1.44-2.39, p<0.001, I2 =0.0%) but associated with less total major adverse events (pooled relative risk=0.29, 95 % confidence interval: 0.16-0.53, p<0.001, I2 =0.0%). In subgroup analysis, catheter ablation was associated with increased AF recurrence in refractory paroxysmal AF when compared to surgical ablation (pooled relative risk=2.47, 95 % confidence interval: 1.31-4.65, p=0.005, I2 =0.0%) but not in persistent AF (relative risk=1.09, 95 % confidence interval: 0.60-2.0, p=0.773). CONCLUSION Catheter ablation was associated with higher atrial arrhythmia recurrence when compared with surgical ablation. However, our study suggests that the benefit of surgical ablation in patients with persistent AF is unclear. More studies and alternative ablation strategies investigation in persistent AF are warranted. This article is protected by copyright. All rights reserved.
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Kewcharoen J, Shah K, Bhardwaj R, Contractor T, Turagam M, Mandapati R, Lakkireddy D, Garg J. Left atrial appendage occlusion in patients with blood cell dyscrasia. Pacing Clin Electrophysiol 2022; 45:1316-1319. [PMID: 35696197 DOI: 10.1111/pace.14550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
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Prasitlumkum N, Tokavanich N, Trongtorsak A, Cheungpasitporn W, Kewcharoen J, Chokesuwattanaskul R, Akoum N, Jared Bunch T, Navaravong L. Catheter Ablation for Atrial Fibrillation in the Elderly > 75 Years old: Systematic Review and Meta-Analysis. J Cardiovasc Electrophysiol 2022; 33:1435-1449. [PMID: 35589557 DOI: 10.1111/jce.15549] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/30/2022] [Accepted: 05/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Atrial fibrillation (AF) ablation is increasingly performed worldwide. As comfort with AF ablation increases, the procedure is increasingly used in patients that are older and in those with more comorbidities. However, it is not well established whether AF ablation in the elderly, especially those >75 years old, has comparable safety and efficacy to younger populations. OBJECTIVE To compare the efficacy and safety profiles in patients older than 75years undergoing AF ablation with younger patients. METHODS Databases from EMBASE, Medline, PubMed and Cochrane, were searched from inception through September 2021. Studies that compared the success rates in AF catheter ablation and all complications rates between patients who were older vs under 75 years were included. Effect estimates from the individual studies were extracted and combined using random effect, generic inverse variance method of DerSimonian and Laird. RESULTS Twenty-seven observational studies were included in the analysis consisting of 363,542 patients who underwent AF ablation. Comparing patients older than 75 years old to younger patients, there was no difference in the success of ablation rates between elderly and younger patients (pooled OR 0.85: 95% CI:0.69 - 1.05, p=0.131). On the other hand, AF ablation in the elderly was associated with higher complication rates (pooled OR 1.43: 95% CI:1.21 - 1.68, p<0.001) CONCLUSION: As AF ablation is expanded to elderly populations, our study found that AF ablation success rates were similar in both elderly and younger patients. However, older patients experience higher rates of complications that should be considered when offering the procedure and as a means to improve outcomes with future innovations. This article is protected by copyright. All rights reserved.
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Mongkonsritragoon W, Prueksapraoprong C, Kewcharoen J, Tokavanich N, Prasitlumkum N, Huang J, Poowuttikul P. Prevalence and risk associated with asthma in children hospitalized with SARS-CoV-2: a meta-analysis and systematic review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:1382-1384.e1. [PMID: 35123100 PMCID: PMC8808430 DOI: 10.1016/j.jaip.2021.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/25/2021] [Accepted: 12/28/2021] [Indexed: 01/22/2023]
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Prasitlumkum N, Kewcharoen J, Bhardwaj R, Mandapati R, Lakkireddy DR, Garg J. PO-665-01 THE BLIP SIDES OF ADVISOR HD GRID MAPPING CATHETER - MAUDE DATABASE ANALYSIS. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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49
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Shah KB, Kewcharoen J, Turagam MK, Bhardwaj R, Contractor T, Mandapati R, Lakkireddy DR, Garg J. PO-695-07 ADVERSE EVENTS ASSOCIATED WITH ORION BASKET ARRAY MAPPING CATHETER - MAUDE DATABASE ANALYSIS. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Contractor T, Bhardwaj R, Shah K, Kewcharoen J, Mandapati R, Lakkireddy DR, Garg J. PO-682-01 OUTCOME OF CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA IN POST-MYOCARDITIS PATIENTS. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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