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Costello BT, Voskoboinik A, Qadri AM, Rudman M, Thompson MC, Touma F, La Gerche A, Hare JL, Papapostolou S, Kalman JM, Kistler PM, Taylor AJ. Measuring atrial stasis during sinus rhythm in patients with paroxysmal atrial fibrillation using 4 Dimensional flow imaging: 4D flow imaging of atrial stasis. Int J Cardiol 2020; 315:45-50. [PMID: 32439367 DOI: 10.1016/j.ijcard.2020.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/14/2020] [Accepted: 05/04/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Paroxysmal atrial fibrillation (PAF) is associated with cardioembolic risk, however events may occur during sinus rhythm (SR). 4D-flow cardiac magnetic resonance (CMR) imaging allows visualisation of left atrial blood flow, to determine the residence time distribution (RTD), an assessment of atrial transit time. OBJECTIVE To determine if atrial transit time is prolonged in PAF patients during SR, consistent with underlying atrial stasis. METHOD 91 participants with PAF and 18 healthy volunteers underwent 4D flow analysis in SR. Velocity fields were produced RTDs, calculated by seeding virtual 'particles' at the right upper pulmonary vein and counting them exiting the mitral valve. An exponential decay curve quantified residence time of particles in the left atrium, and atrial stasis was expressed as the derived constant (RTDTC) based on heartbeats. The RTDTC was evaluated within the PAF group, and compared to healthy volunteers. RESULTS Patients with PAF (n = 91) had higher RTDTC compared with gender-matched controls (n = 18) consistent with greater atrial stasis (1.68 ± 0.46 beats vs 1.51 ± 0.20 beats; p = .005). PAF patients with greater thromboembolic risk had greater atrial stasis (median RTDTC of 1.72 beats in CHA₂DS₂-VASc≥2 vs 1.52 beats in CHA₂DS₂-VASc<2; p = .03), only female gender and left ventricular ejection fraction contributed significantly to the atrial RTDTC (p = .006 and p = .023 respectively). CONCLUSIONS Atrial stasis quantified by 4D flow is greater in PAF, correlating with higher CHA₂DS₂-VASc scores. Female gender and systolic dysfunction are associated with atrial stasis. RTD offers an insight into atrial flow that may be developed to provide a personalised assessment of thromboembolic risk.
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Voskoboinik A, Butcher E, Sandhu A, Nguyen DT, Tzou W, Della Rocca DG, Natale A, Zado ES, Marchlinski FE, Aguilar M, Sauer W, Tedrow UB, Gerstenfeld EP. Direct Thrombin Inhibitors as an Alternative to Heparin During Catheter Ablation: A Multicenter Experience. JACC Clin Electrophysiol 2020; 6:484-490. [PMID: 32276868 DOI: 10.1016/j.jacep.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/22/2019] [Accepted: 12/03/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The goal of this study was to report a multicenter series of left-sided catheter ablations performed by using intravenous direct thrombin inhibitors (DTIs) as an alternative to heparin. BACKGROUND Amidst a looming worldwide shortage of heparin, there are insufficient data to guide nonheparin-based peri-procedural anticoagulation in patients undergoing catheter ablation. METHODS This study reviewed all catheter ablations at 6 institutions between 2006 and 2019 to assess the safety and efficacy of DTIs for left-sided radiofrequency catheter ablation of atrial fibrillation and ventricular tachycardia. RESULTS In total, 53 patients (age 63.0 ± 9.3 years, 68% male, CHA₂DS₂-VASc [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category] score 2.8 ± 1.6, left ventricular ejection fraction 46 ± 15%) underwent ablation with DTIs (75% bivalirudin, 25% argatroban) due to heparin contraindication(s) (72% heparin-induced thrombocytopenia, 21% heparin allergy, 4% protamine reaction, and 4% religious reasons). The patient's usual oral anticoagulant was continued without interruption in 69%. Procedures were performed for atrial fibrillation (64%) or ventricular tachycardia/premature ventricular contractions (36%). Transseptal puncture was undertaken in 81%, and a contact force-sensing catheter was used in 70%. Vascular ultrasound was used in 71%, and femoral arterial access was gained in 36%. A bolus followed by infusion was used in all but 4 cases, and activated clotting time was monitored peri-procedurally in 72%, with 32% receiving additional boluses. Procedure duration was 216 ± 116 min, and ablation time was 51 ± 22 min. No major bleeding or embolic complications were observed. Four patients had minor self-limiting bleeding complications, including a small pericardial effusion (<1 cm), a small groin hematoma, and hematuria. CONCLUSIONS In this multicenter series, intravenous DTIs were safely used as an alternative to heparin for left-sided catheter ablation.
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Voskoboinik A, Hsia H, Moss J, Vedantham V, Tanel RE, Patel A, Wojciak J, Downs N, Scheinman MM. The many faces of early repolarization syndrome: A single-center case series. Heart Rhythm 2020; 17:273-281. [DOI: 10.1016/j.hrthm.2019.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Indexed: 01/23/2023]
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Voskoboinik A, Kalman JM, De Silva A, Nicholls T, Costello B, Nanayakkara S, Prabhu S, Stub D, Azzopardi S, Vizi D, Wong G, Nalliah C, Sugumar H, Wong M, Kotschet E, Kaye D, Taylor AJ, Kistler PM. Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med 2020; 382:20-28. [PMID: 31893513 DOI: 10.1056/nejmoa1817591] [Citation(s) in RCA: 236] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Excessive alcohol consumption is associated with incident atrial fibrillation and adverse atrial remodeling; however, the effect of abstinence from alcohol on secondary prevention of atrial fibrillation is unclear. METHODS We conducted a multicenter, prospective, open-label, randomized, controlled trial at six hospitals in Australia. Adults who consumed 10 or more standard drinks (with 1 standard drink containing approximately 12 g of pure alcohol) per week and who had paroxysmal or persistent atrial fibrillation in sinus rhythm at baseline were randomly assigned in a 1:1 ratio to either abstain from alcohol or continue their usual alcohol consumption. The two primary end points were freedom from recurrence of atrial fibrillation (after a 2-week "blanking period") and total atrial fibrillation burden (proportion of time in atrial fibrillation) during 6 months of follow-up. RESULTS Of 140 patients who underwent randomization (85% men; mean [±SD] age, 62±9 years), 70 were assigned to the abstinence group and 70 to the control group. Patients in the abstinence group reduced their alcohol intake from 16.8±7.7 to 2.1±3.7 standard drinks per week (a reduction of 87.5%), and patients in the control group reduced their alcohol intake from 16.4±6.9 to 13.2±6.5 drinks per week (a reduction of 19.5%). After a 2-week blanking period, atrial fibrillation recurred in 37 of 70 patients (53%) in the abstinence group and in 51 of 70 patients (73%) in the control group. The abstinence group had a longer period before recurrence of atrial fibrillation than the control group (hazard ratio, 0.55; 95% confidence interval, 0.36 to 0.84; P = 0.005). The atrial fibrillation burden over 6 months of follow-up was significantly lower in the abstinence group than in the control group (median percentage of time in atrial fibrillation, 0.5% [interquartile range, 0.0 to 3.0] vs. 1.2% [interquartile range, 0.0 to 10.3]; P = 0.01). CONCLUSIONS Abstinence from alcohol reduced arrhythmia recurrences in regular drinkers with atrial fibrillation. (Funded by the Government of Victoria Operational Infrastructure Support Program and others; Australian New Zealand Clinical Trials Registry number, ACTRN12616000256471.).
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Nalliah C, Wong G, Lee G, Voskoboinik A, Kee K, Goldin J, Watts T, Linz D, Parameswaren R, Sugumar H, Prabhu S, McLellan A, Ling H, Joseph S, Morton J, Kistler P, Sanders P, Kalman J. 005 Impact of Continuous Positive Airway Pressure on the Atrial Substrate in Patients With Obstructive Sleep Apnoea and Atrial Fibrillation: The SLEEP-AF Substrate Sub-Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kistler P, Chieng D, Sugumar H, Prabhu S, Voskoboinik A, McLellan A, Ling H, Lee G, Kalman J. 241 P Wave Morphology in Focal Atrial Tachycardia: An Updated 2020 Algorithm to Predict site of Origin. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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107
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Wong G, Nalliah C, Lee G, Voskoboinik A, Prabhu S, Parameswaran R, Sugumar H, Anderson R, Al-Kaisey A, McLellan A, Ling L, Sanders P, Kistler P, Kalman J. 029 Gender Differences in Atrial Remodelling in Atrial Fibrillation: Relationship to Ablation Outcomes. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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108
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Wong G, Nalliah C, Lee G, Voskoboinik A, Prabhu S, Parameswaran R, Sugumar H, Al-Kaisey A, Anderson R, McLellan A, Ling L, Morris G, Sanders P, Kistler P, Kalman J. 255 Sinus Node Remodelling in Atrial Fibrillation: Insights from High Density Mapping. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Voskoboinik A, Lee RJ. Anatomic Considerations for Epicardial and Endocardial Left Atrial Appendage Closure. Card Electrophysiol Clin 2019; 12:39-45. [PMID: 32067646 DOI: 10.1016/j.ccep.2019.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Left atrial appendage closure is an increasingly used means of achieving thromboprophylaxis in atrial fibrillation, particularly in patients with contraindications to anticoagulation. Left atrial appendage anatomy is highly variable, and preprocedural imaging is critical to choosing the correct device and approach for left atrial appendage closure. This article reviews the common endocardial and epicardial closure systems, including anatomic considerations, advantages and disadvantages, as well as complications to be avoided.
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Sugumar H, Nanayakkara S, Chieng D, Wong GR, Parameswaran R, Anderson RD, Al-Kaisey A, Nalliah CJ, Azzopardi S, Prabhu S, Voskoboinik A, Lee G, McLellan AJ, Ling LH, Morton JB, Kalman JM, Kistler PM. Arrhythmia recurrence is more common in females undergoing multiple catheter ablation procedures for persistent atrial fibrillation: Time to close the gender gap. Heart Rhythm 2019; 17:692-698. [PMID: 31866381 DOI: 10.1016/j.hrthm.2019.12.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Female gender is associated with an increased recurrence of atrial fibrillation (AF) after catheter ablation (CA). Although AF is more common in men, women constitute a significant proportion with persistent atrial fibrillation (PsAF). OBJECTIVE The purpose of this study was to determine whether multiple ablation procedures improves arrhythmia outcomes in females with PsAF compared to men. METHODS We performed a multicenter observational study to determine long-term arrhythmia outcomes in patients undergoing >1 CA for PsAF. CA involved pulmonary vein (PV) isolation with additional ablation including linear, posterior wall isolation, electrogram-guided, or a combination of these. RESULTS A total of 281 patients had >1 ablation procedure for PsAF and were included in this analysis (mean age 58.7 ± 9.3 years; 86 [30.6%] female; left atrial [LA] area 27.0 ± 5.3 cm2; PsAF duration 1.7 ± 1.7 years). At mean follow-up of 45.5 ± 31.8 months, freedom from recurrent AF was present in 148 patients(52.7%) after 2.2 ± 0.5 procedures. After multivariate analysis, female gender (hazard ratio [HR] 2.10; P <.001) and enduring PV isolation (HR 1.64; P = .01) were independently associated with AF recurrence. Enduring PV isolation was significantly higher in women than in men (33.7% vs 19.5%; P = .01). CONCLUSION Female gender was independently and strongly associated with arrhythmia recurrence in patients undergoing multiple procedures for PsAF. PV reconnection was less likely, and fewer reconnected PVs occurred in women. Further studies are required to better understand the mechanisms responsible for AF in females to assist in closing the gender gap in the success of CA.
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Kistler PM, Voskoboinik A. Catheter Ablation: First-Line Therapy for Atrial Fibrillation in Systolic Heart Failure? JACC Clin Electrophysiol 2019; 4:636-637. [PMID: 29798791 DOI: 10.1016/j.jacep.2018.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 03/22/2018] [Indexed: 11/18/2022]
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Voskoboinik A, Koh Y, Kistler PM. Cardiovascular effects of caffeinated beverages. Trends Cardiovasc Med 2019; 29:345-350. [DOI: 10.1016/j.tcm.2018.09.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/24/2018] [Accepted: 09/29/2018] [Indexed: 12/12/2022]
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Voskoboinik A, Kistler PM. Author's reply: Caffeinated beverages and cardiovascular disease. Trends Cardiovasc Med 2019; 29:484. [PMID: 31351839 DOI: 10.1016/j.tcm.2019.07.007] [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: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 10/26/2022]
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Anderson RD, Kumar S, Parameswaran R, Wong G, Voskoboinik A, Sugumar H, Watts T, Sparks PB, Morton JB, McLellan A, Kistler PM, Kalman J, Lee G. Differentiating Right- and Left-Sided Outflow Tract Ventricular Arrhythmias. Circ Arrhythm Electrophysiol 2019; 12:e007392. [DOI: 10.1161/circep.119.007392] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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115
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Sugumar H, Prabhu S, Voskoboinik A, Young S, Gutman SJ, Wong GR, Parameswaran R, Nalliah CJ, Lee G, McLellan AJ, Taylor AJ, Ling LH, Kalman JM, Kistler PM. Atrial Remodeling Following Catheter Ablation for Atrial Fibrillation-Mediated Cardiomyopathy. JACC Clin Electrophysiol 2019; 5:681-688. [DOI: 10.1016/j.jacep.2019.03.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 11/30/2022]
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Voskoboinik A, Kalman E, Plunkett G, Knott J, Moskovitch J, Sanders P, Kistler PM, Kalman JM. A comparison of early versus delayed elective electrical cardioversion for recurrent episodes of persistent atrial fibrillation: A multi-center study. Int J Cardiol 2019; 284:33-37. [DOI: 10.1016/j.ijcard.2018.10.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/30/2018] [Accepted: 10/22/2018] [Indexed: 10/28/2022]
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117
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Sugumar H, Nanayakkara S, Prabhu S, Voskoboinik A, Kaye DM, Ling LH, Kistler PM. Pathophysiology of Atrial Fibrillation and Heart Failure. Cardiol Clin 2019; 37:131-138. [DOI: 10.1016/j.ccl.2019.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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118
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Parameswaran R, Voskoboinik A, Gorelik A, Lee G, Kistler PM, Sanders P, Kalman JM. Clinical impact of rotor ablation in atrial fibrillation: a systematic review. Europace 2019; 20:1099-1106. [PMID: 29340595 DOI: 10.1093/europace/eux370] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 12/19/2017] [Indexed: 11/14/2022] Open
Abstract
Aims Rotor mapping and ablation have gained favour over the recent years as an emerging ablation strategy targeting drivers of atrial fibrillation (AF). Their efficacy, however, has been a topic of great debate with variable outcomes across centres. The aim of this study was to systematically review the recent medical literature to determine the medium-term outcomes of rotor ablation in patients with paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation (PeAF). Methods and results A systematic search of the contemporary scientific literature (PubMed and EMBASE) was performed in August 2017. Only studies assessing arrhythmia-free survival from rotor ablation of AF were included. We used the random-effects model to assess the primary outcome of pooled medium-term single-procedure AF-free survival for both PAF and PeAF. Success rates from multiple procedures and complication rates were also examined. We included 11 observational studies (4 PAF and 10 PeAF) with a total of 556 patients (166 PAF and 390 PeAF). Pooled single-procedure freedom from AF was 37.8% [95% confidence interval 5.6-86.3%] at a mean follow-up period of 13.8 ± 1.8 months for PAF and 59.2% (95% CI 41.4-74.9%) at a mean follow-up period of 12.9 ± 6 months for PeAF. There was a marked heterogeneity between studies (I2 = 93.8% for PAF and 88.3% for PeAF). The mean complication rate of rotor ablation among the reported studies was 3.4%. Conclusion The wide variability in success rate between different centres performing rotor ablations suggests that the optimal ablation strategy, particularly targeting rotors, is unclear. Results from randomized studies are necessary before this technique can be considered as an established clinical tool.
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Voskoboinik A, Kistler PM. RESPONSE TO LETTER TO EDITOR. J Cardiovasc Electrophysiol 2019; 30:1764. [PMID: 30916442 DOI: 10.1111/jce.13909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 03/03/2019] [Indexed: 11/28/2022]
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Voskoboinik A, Kistler PM. Reply to the Editor- Mediterranean diet and wine intake could improve atrial function in patients with atrial fibrillation. Heart Rhythm 2019; 16:e55-e56. [PMID: 30878579 DOI: 10.1016/j.hrthm.2019.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Indexed: 11/18/2022]
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Voskoboinik A, Wong G, Lee G, Nalliah C, Hawson J, Prabhu S, Sugumar H, Ling LH, McLellan A, Morton J, Kalman JM, Kistler PM. Moderate alcohol consumption is associated with atrial electrical and structural changes: Insights from high-density left atrial electroanatomic mapping. Heart Rhythm 2019; 16:251-259. [DOI: 10.1016/j.hrthm.2018.10.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Indexed: 10/27/2022]
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Voskoboinik A, Kalman J, Nicholls T, Nanayakkara S, Wong G, Prabhu S, Nalliah C, Sugumar H, Stub D, Kaye D, Wong M, Kotschet E, Taylor A, Kistler P. Alcohol Abstinence in Moderate Drinkers with Atrial Fibrillation: Results from the Alcohol-AF Randomised Controlled Trial. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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123
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Wong G, Nalliah C, Voskoboinik A, Lee G, Prabhu S, Sugumar H, Parameswaran R, Anderson R, McLellan A, Ling L, Morton J, Johnson R, Kistler P, Fatkin D, Kalman J. Genetic Susceptibility to Atrial Fibrillation at the chr 4q25 Locus is Associated with Left Atrial Electrical Remodelling. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Anderson R, Kumar S, Parameswaran R, Wong G, Voskoboinik A, Sugumar H, Watts T, Sparks P, Morton J, McLellan A, Kistler P, Kalman J, Lee G. Differentiating Right- and Left-Sided Outflow Tract Ventricular Arrhythmias – A Review of “Classical” ECG Signatures and Prediction Algorithms. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Voskoboinik A, Moskovitch J, Plunkett G, Bloom J, Wong G, Nalliah C, Prabhu S, Sugumar H, Paramasweran R, McLellan A, Ling L, Goh C, Noaman S, Fernando H, Wong M, Taylor AJ, Kalman JM, Kistler PM. Cardioversion of atrial fibrillation in obese patients: Results from the Cardioversion‐BMI randomized controlled trial. J Cardiovasc Electrophysiol 2018; 30:155-161. [DOI: 10.1111/jce.13786] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/03/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
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