1
|
Mhanna M, Beran A, Mhanna AS, Al-Abdouh A, Jabri A, Numan MJ, Alsaiqali M, Musallam R, Zerihun K, Mahmood A. Midodrine for Recurrent Vasovagal Syncope: A Systematic Review and Meta-analysis of Randomized Control Trials. Am J Ther 2024; 31:e87-e91. [PMID: 35703495 DOI: 10.1097/mjt.0000000000001513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mohammed Mhanna
- Department of Internal Medicine, The University of Toledo, Toledo, OH
| | - Azizullah Beran
- Department of Internal Medicine, The University of Toledo, Toledo, OH
| | - Asmaa S Mhanna
- Department of Child Neurology, The University of Toledo, Toledo, OH
| | - Ahmad Al-Abdouh
- Department of Internal Medicine, University of Kentucky, Lexington, KY
| | - Ahmad Jabri
- Department of Cardiology, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH
| | - Mahmoud J Numan
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Mahmoud Alsaiqali
- Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, NY
| | - Rami Musallam
- Department of Internal Medicine, St. Vincent Charity Medical Center, Cleveland, OH
| | - Kirubel Zerihun
- Department of Internal Medicine, The University of Toledo, Toledo, OH
| | - Asif Mahmood
- Department of Chief Hospital Medicine, The University of Toledo, Toledo, OH
| |
Collapse
|
2
|
Gorantla A, Alsaiqali M, Francois J, Sivakumar S, Freytes-Santiago L, Jallad A, Budzikowski AS. Comparative Effectiveness of Various Radiofrequency Ablation Catheters in the Ablation of Typical Atrial Flutter. Cardiol Ther 2023; 12:741-747. [PMID: 37864121 DOI: 10.1007/s40119-023-00336-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
INTRODUCTION Although ablation of typical atrial flutter (AFL) can be easily achieved with radiofrequency energy (RF), no studies compare the effectiveness of different ablation catheters. Our study aimed to compare the efficacy of various types of ablation catheters in treating typical AFL. METHODS We analyzed patients with AFL who underwent RF ablation by a single operator at our institution. Successful ablation was evidenced by a bidirectional conduction block (trans-isthmus conduction time ≥ 130 ms or double potentials ≥ 90 ms). Logistic regression was used to compare success rate and linear regression to compare lesion time. RESULTS Out of 222 patients, only six did not meet the success criteria (2.7%). The catheters used were non-irrigated, large-tip, internally irrigated (Chili II Boston Scientific), and externally irrigated (non-force-sensing) catheters (Cool Path, Abbott). An externally irrigated force-sensing catheter (TactiCath, Abbott) was used with > 10 gm of force and (LPLD) setting (30 W- 45 °C- 60 s), and high-power short-duration (HPSD) setting (50 W- 43 °C - 12 s). No complications were encountered. The catheter type had no statistically significant association with ablation success. With the use of externally irrigated catheter with contract force-sensing and HPSD settings, statistically significantly shortening of lesion time was achieved 758.3 s, [CI - 1128.29, - 388.35 s] followed by LPLD by 419.0 s [CI - 808.49, - 29.47 s]. CONCLUSIONS The typical atrial flutter radiofrequency ablation procedure had a high success rate, which was not influenced by the type of ablation catheter. Contact force ablation catheter and HPSD are associated with shorter total lesion time.
Collapse
Affiliation(s)
- Asher Gorantla
- Department of Medicine, SUNY Health Sciences University, Brooklyn, NY, USA
| | - Mahmoud Alsaiqali
- Department of Medicine, SUNY Health Sciences University, Brooklyn, NY, USA
| | - Jonathan Francois
- Division of Cardiovascular Medicine-EP Section, SUNY Health Sciences University, 450 Clarkson Ave, Box 1199, Brooklyn, NY, 11203, USA
| | - Shruthi Sivakumar
- Department of Medicine, SUNY Health Sciences University, Brooklyn, NY, USA
| | - Leonell Freytes-Santiago
- Division of Cardiovascular Medicine-EP Section, SUNY Health Sciences University, 450 Clarkson Ave, Box 1199, Brooklyn, NY, 11203, USA
| | - Ahmad Jallad
- Division of Cardiovascular Medicine-EP Section, SUNY Health Sciences University, 450 Clarkson Ave, Box 1199, Brooklyn, NY, 11203, USA
| | - Adam S Budzikowski
- Division of Cardiovascular Medicine-EP Section, SUNY Health Sciences University, 450 Clarkson Ave, Box 1199, Brooklyn, NY, 11203, USA.
| |
Collapse
|
3
|
Al-Sadawi MA, Aslam FM, Tao M, Alsaiqali M, Almasry IO, Fan R, Rashba EJ, Singh A. Effects of GLP-1 Agonists on mortality and arrhythmias in patients with Type II diabetes. Int J Cardiol Heart Vasc 2023; 47:101218. [PMID: 37252197 PMCID: PMC10209701 DOI: 10.1016/j.ijcha.2023.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/29/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023]
Abstract
Background Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RA) are frequently used for the management of diabetes. The impact of GLP-1 RA on cardiovascular outcomes is unclear. We aim to assess the effect of GLP-1 RA on mortality, atrial and ventricular arrhythmias, and sudden cardiac death in patients with type II diabetes. Methods We searched databases including Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar and CINAHL, from inception to May 2022, for randomized controlled trials reporting the relationship between GLP-1 RA (including albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and semaglutide) and mortality, atrial arrhythmias, and the combined incidence of ventricular arrhythmias and sudden cardiac death. The search was not restricted to time or publication status. Results A total of 464 studies resulted from literature search, of which 44 studies, including 78,702 patients (41,800 GLP-1 agonists vs 36,902 control), were included. Follow up ranged from 52 to 208 weeks. GLP-1 RA were associated with lower risk of all-cause mortality (odds ratio 0.891, 95% confidence interval 0.837-0.949; P < 0.01) and reduced cardiovascular mortality (odds ratio 0.88, 95% confidence interval 0.881-0.954; P < 0.01). GLP-1 RA were not associated with increased risk of atrial (odds ratio 0.963, 95% confidence interval 0.869-1.066; P 0.46) or ventricular arrhythmias and sudden cardiac death (odds ratio 0.895, 95% confidence interval 0.706-1.135; P 0.36). Conclusion GLP-1 RA are associated with decreased all-cause and cardiovascular mortality, and no increased risk of atrial and ventricular arrhythmias and sudden cardiac death.
Collapse
Affiliation(s)
| | - Faisal M. Aslam
- Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA
| | - Michael Tao
- Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA
| | | | | | - Roger Fan
- Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA
| | - Eric J. Rashba
- Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA
| | - Abhijeet Singh
- Cardiovascular Department, Stony Brook Medicine, Stony Brook, NY, USA
| |
Collapse
|
4
|
Alsaiqali M, Mhanna M, Chandrakumar HP, Jallad A, Budzikowski AS. COMPARATIVE EFFECTIVENESS OF RADIOFREQUENCY ABLATION CATHETERS IN THE TREATMENT OF ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND NETWORK METANALYSIS. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
5
|
Al-Sadawi M, Aslam F, Tao M, Salam S, Alsaiqali M, Singh A, Fan R, Rashba EJ. Is CRT-D superior to CRT-P in patients with nonischemic cardiomyopathy? Int J Arrhythm 2023. [DOI: 10.1186/s42444-023-00085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Abstract
Background
Recent studies have questioned the role of implanted cardiac defibrillators (ICDs) in nonischemic cardiomyopathy (NICM). Cardiac resynchronization therapy (CRT) can be delivered by a pacemaker (CRT-P) or an ICD (CRT-D). This meta-analysis assessed the effect of CRT-P versus CRT-D on mortality in patients with NICM.
Methods
Databases were searched for studies reporting the effect of CRT on all-cause mortality in patients with nonischemic cardiomyopathy (Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL). The primary endpoint was all-cause mortality. The minimum duration of follow-up required for inclusion was one year. The search was not restricted to time or publication status.
Results
The literature search identified 955 candidate studies, 15 studies and 22,763 patients were included. Mean follow-up was 53 months (17–100 months). CRT-D in NICM was associated with lower all-cause mortality (log HR − 0.169, SE 0.055; p = 0.002) compared to CRT-P. Heterogeneity: df = 15 (P 0.03), I2 = 43; test for overall effect: Z = − 3.043 (P = 0.002).
Conclusion
CRT-D in NICM was associated with lower all-cause mortality than CRT-P.
Collapse
|
6
|
Al-Sadawi M, Aslam F, Gier C, Aleem S, Ijaz H, Jacobs R, Cao K, Alsaiqali M, Singh A. The effect of gender on atrial fibrillation ablation outcomes using a propensity score matched analysis. Heart Rhythm O2 2023. [DOI: 10.1016/j.hroo.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
|
7
|
Gorantla A, Alsaiqali M, Sivakumar S, Francois J, Freytes-Santiago L, Jallad A, Budzikowski A. Effectiveness of various radiofrequency ablation catheters in the treatment of typical atrial flutter. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Although ablation of typical atrial flutter (AFL) can be easily achieved with radiofrequency energy (RF), there are no studies that compare effectiveness of different ablation catheters. Our study aimed to compare the effectiveness of various types of ablation catheters in the treatment of AFL.
Methods
We analysed patients with AFL who underwent RF ablation by a single operator at our institution. Successful ablation was evidenced by presence of bidirectional conduction block (trans-isthmus conduction time ≥130 ms, or doubling of baseline conduction time, or presence of double potentials ≥90ms). Logistic regression was used to compare success rate and linear regression to compare lesion time.
Results
Out of the 222 patients, only 6 patients did not meet success criteria (2.7%). Catheters used were 8 mm tip in 16 patients, internally irrigated (Chili II Boston Scientific) in 47 patients, externally irrigated (non-force sensing) catheters (CoolPath, Abbott) in 40 patients. Externally irrigated force sensing catheter (Tacticath, Abbott) was used with >10 gm of force and (LPLD) setting (30W-45°C-60 sec) in 50 patients, and high-power short duration (HPSD) setting (50W-43°C −12 sec,) in 70 patients. No complications were encountered. Catheter type had no statistically significant association with ablation success. In terms of lesion time, HPSD catheter statistically significantly shortened lesion time by 758.3s, [CI −1128.29, −388.35s] followed by LPLD by 419.0s [CI −808.49, −29.47s]. Table 1 shows the lesion time difference for the catheters used as compared with 8 mm tip.
Conclusions
Typical atrial flutter radiofrequency ablation procedure had a high success rate, not influenced by type of ablation catheter. Contact force ablation catheter on HPSD is associated with shorter total lesion time.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Gorantla
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - M Alsaiqali
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - S Sivakumar
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - J Francois
- Suny Downstate Medical Center , Brooklyn , United States of America
| | | | - A Jallad
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - A Budzikowski
- Suny Downstate Medical Center , Brooklyn , United States of America
| |
Collapse
|
8
|
Aslam F, Al-Sadawi M, Aleem S, Alsaiqali M, Almasry I, Singh A, Rashba E, Fan R. Effect of defibrillator on long term all-cause mortality in patients with chronic kidney disease: an updated meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The beneficial role of implantable defibrillator (ICD) in patients with chronic kidney disease (CKD) is less understood as this population is often not well represented in clinical trials.
Purpose
Evaluate the effect of ICD use in patients with CKD on long term outcomes.
Methods
Literature search was conducted for studies reporting the effect of ICD on all-cause mortality in patients with CKD, which is defined as glomerular filtration rate (GFR) <60 mL/min. The search was not restricted to time or publication status. The search included the following databases: Ovid MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL. The minimum duration of follow-up required for inclusion was one year.
Results
The literature search identified 834 studies, of which 14 studies with 70,661 patients were included. Mean follow up was 39 months (12–81 months). For all patients with CKD, ICD was associated with lower all-cause mortality (log HR −0.247, SE 0.101, p=0.015); Heterogeneity: df=13 (P<0.01), I2=97.057; Test for overall effect: Z=−2.431 (Figure 1). When further stratified based on dialysis, CKD patients without the need for dialysis had favorable outcome (log HR −0.211, SE 0.095, p=0.026); Heterogeneity: df=6 (P<0.01), I2=70.146; Test for overall effect: Z=−2.225, whereas ICD implantation in CKD patients requiring dialysis was not associated with mortality benefit (log HR −0.262, SE 0.134, p=0.051) (Figure 2A, B).
Conclusion
ICD implantation is associated with mortality benefit in patients with CKD, but this association is not present for patients requiring dialysis.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- F Aslam
- Stony Brook University Hospital , Stony Brook , United States of America
| | - M Al-Sadawi
- Stony Brook University Hospital , Stony Brook , United States of America
| | - S Aleem
- Stony Brook University Hospital , Stony Brook , United States of America
| | - M Alsaiqali
- Suny Downstate Medical Center , Brooklyn , United States of America
| | - I Almasry
- Stony Brook University Hospital , Stony Brook , United States of America
| | - A Singh
- Stony Brook University Hospital , Stony Brook , United States of America
| | - E Rashba
- Stony Brook University Hospital , Stony Brook , United States of America
| | - R Fan
- Stony Brook University Hospital , Stony Brook , United States of America
| |
Collapse
|
9
|
Li S, Alsaiqali M, Narayanaswamy M, McFarlane I. The Vicious Cycle of Hypothyroidism and Severe Proteinuria: A Case Report. Cureus 2022; 14:e28674. [PMID: 36199658 PMCID: PMC9526517 DOI: 10.7759/cureus.28674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/05/2022] Open
|
10
|
Mhanna M, Beran A, Al‐Abdouh A, Sajdeya O, Barbarawi M, Alsaiqali M, Jabri A, Al‐Aaraj A, Alharbi A, Chacko P. Steerable versus nonsteerable sheath technology in atrial fibrillation ablation: A systematic review and meta‐analysis. J Arrhythm 2022; 38:570-579. [PMID: 35936032 PMCID: PMC9347204 DOI: 10.1002/joa3.12742] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/18/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Catheter placement and stability are well‐known challenges in atrial fibrillation (AF) ablation. As a result, steerable sheaths (SS) were developed to improve catheter stabilization and maintain proper catheter–tissue contact. The purpose of this systematic review and meta‐analysis is to see if employing a SS influences procedure outcome. Method We performed a comprehensive literature search for studies that evaluated the efficacy and safety of SS compared to nonsteerable sheaths (NSS) in AF ablation. The primary outcome was the rate of atrial arrhythmia (AA) freedom by the time of the last follow‐up. The secondary outcomes were the procedure‐related complications and procedural characteristics. Risk ratio (RR) or the mean difference (MD) and corresponding 95% confidence intervals (CIs) were calculated using the random‐effects model. Results A total of 10 studies, including 967 AF patients (mean age: 59.2 ± 11.1 years, 516 patients managed with SS vs. 454 with NSS), were included. SS group showed a higher rate of freedom of AA compared to NSS (RR: 1.19; 95% CI 1.09–1.29; p < .001). Both techniques had similar rate for procedural‐related complication (RR: 1.09, 95% CI 0.50–2.39; p = .83). The SS strategy had a shorter procedure time (MD −10.6 [min], 95% CI −20.97, −0.20; p = .05) but comparable fluoroscopic and radiofrequency application times to the NSS group. Conclusions The SS for AF catheter ablation not only reduced the total procedure time but also significantly increased the rate of successful ablation while maintaining a similar safety profile when compared to the traditional NSS.
Collapse
Affiliation(s)
- Mohammed Mhanna
- Department of Internal Medicine University of Toledo Toledo Ohio USA
| | - Azizullah Beran
- Department of Internal Medicine University of Toledo Toledo Ohio USA
| | - Ahmad Al‐Abdouh
- Department of Internal Medicine University of Kentucky Lexington Kentucky USA
| | - Omar Sajdeya
- Department of Internal Medicine University of Toledo Toledo Ohio USA
| | - Mahmoud Barbarawi
- Department of Cardiovascular Medicine University of Connecticut Farmington Connecticut USA
| | - Mahmoud Alsaiqali
- Department of Internal Medicine State University of New York Downstate Medical Center Brooklyn New York USA
| | - Ahmad Jabri
- Department of Cardiology Case Western Reserve University/MetroHealth Medical Center Cleveland Ohio USA
| | - Ahmad Al‐Aaraj
- Department of Cardiology James Cook University Hospital Middlesbrough UK
| | | | - Paul Chacko
- Department of Cardiovascular Medicine University of Toledo Toledo Ohio USA
| |
Collapse
|
11
|
Ahmed R, Alsaiqali M, Gorantla A, Sivakumar S, Feinberg M, Graham-Hill S, Salciccioli L. Staphylococcus lugdunensis Infectious Endocarditis Complicated by Embolic Stroke After Colonoscopy in a 58-Year-Old Female. Cureus 2022; 14:e24572. [PMID: 35651402 PMCID: PMC9138394 DOI: 10.7759/cureus.24572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 11/17/2022] Open
Abstract
There are a significant number of colonoscopies and esophagogastroduodenoscopies (EGDs) done in the United States every year and post-endoscopic infections are frequently seen. Data demonstrating causality between endoscopic procedures and infectious endocarditis (IE) or that antibiotic prophylaxis prior to endoscopic procedures protects against IE is still lacking. Here we have presented the case of a patient who underwent diagnostic colonoscopy as part of a malignancy workup and was later found to be septic with Staphylococcus lugdunensis bacteremia and had IE. We hypothesized that the infection was most likely contracted during colonoscopy as a result of bacterial translocation from the perineal region to the bloodstream. This case report highlights the need for further studies investigating the efficacy of prophylactic antibiotics in reducing the risk of IE after colonoscopies.
Collapse
Affiliation(s)
- Rafsan Ahmed
- Department of Internal Medicine, State University of New York Downstate Medical Center, New York City, USA
| | - Mahmoud Alsaiqali
- Department of Internal Medicine, State University of New York Downstate Medical Center, New York City, USA
| | - Asher Gorantla
- Department of Internal Medicine, State University of New York Downstate Medical Center, New York City, USA
| | - Shruthi Sivakumar
- Department of Neurology, State University of New York Downstate Medical Center, New York City, USA
| | - Michelle Feinberg
- Department of Neurosurgery, Kings County Hospital Center, New York City, USA
| | | | - Louis Salciccioli
- Department of Cardiology, State University of New York Downstate Medical Center, New York City, USA
| |
Collapse
|
12
|
Beran A, Mhanna M, Srour O, Ayesh H, Khokher W, Malhas SE, Abuhelwa Z, Alsaiqali M, Eltahawy EA. LOW-DOSE ASPIRIN AND MORTALITY IN PATIENTS WITH CORONAVIRUS DISEASE 2019: A META-ANALYSIS. J Am Coll Cardiol 2022. [PMCID: PMC8972441 DOI: 10.1016/s0735-1097(22)03051-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
|
13
|
Alsaiqali M, Al-Sadawi M. CONTRAST ASSOCIATED NEPHROPATHY(CAN) IN PATIENTS WITH RENAL TRANSPLANT. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01611-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
14
|
Alsaiqali M, De Troeyer K, Casas L, Hamdi R, Faes C, Van Pottelbergh G. The Effects of Heatwaves on Human Morbidity in Primary Care Settings: A Case-Crossover Study. Int J Environ Res Public Health 2022; 19:832. [PMID: 35055653 PMCID: PMC8775418 DOI: 10.3390/ijerph19020832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This study assesses the potential acute effects of heatwaves on human morbidities in primary care settings. METHODS We performed a time-stratified case-crossover study to assess the acute effects of heatwaves on selected morbidities in primary care settings in Flanders, Belgium, between 2000 and 2015. We used conditional logistic regression models. We assessed the effect of heatwaves on the day of the event (lag 0) and X days earlier (lags 1 to X). The associations are presented as Incidence Density Ratios (IDR). RESULTS We included 22,344 events. Heatwaves are associated with increased heat-related morbidities such as heat stroke IDR 3.93 [2.94-5.26] at lag 0, dehydration IDR 3.93 [2.94-5.26] at lag 1, and orthostatic hypotension IDR 2.06 [1.37-3.10] at lag 1. For cardiovascular morbidities studied, there was only an increased risk of stroke at lag 3 IDR 1.45 [1.04-2.03]. There is no significant association with myocardial ischemia/infarction or arrhythmia. Heatwaves are associated with decreased respiratory infection risk. The IDR for upper respiratory infections is 0.82 [0.78-0.87] lag 1 and lower respiratory infections (LRI) is 0.82 [0.74-0.91] at lag 1. There was no significant effect modification by age or premorbid chronic disease (diabetes, hypertesnsion). CONCLUSION Heatwaves are associated with increased heat-related morbidities and decreased respiratory infection risk. The study of heatwaves' effects in primary care settings helps evaluate the impact of heatwaves on the general population. Primary care settings might be not suitable to study acute life-threatening morbidities.
Collapse
Affiliation(s)
- Mahmoud Alsaiqali
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Katrien De Troeyer
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
| | - Lidia Casas
- Epidemiology and Social Medicine (ESOC), University of Antwerp, 2610 Antwerp, Belgium;
| | - Rafiq Hamdi
- Royal Meteorological Institute of Belgium, B-1180 Brussels, Belgium;
| | - Christel Faes
- Data Science Institute (DSI), I-BioStat, Hasselt University, BE-3500 Hasselt, Belgium;
| | - Gijs Van Pottelbergh
- Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium; (K.D.T.); (G.V.P.)
| |
Collapse
|
15
|
Mhanna M, Beran A, Al‐Abdouh A, Ayesh H, Sajdeya O, Srour O, Alsaiqali M, Alhasanat OH, Burmeister C, Abumoawad AM, Chacko P. Hybrid convergent ablation versus endocardial catheter ablation for atrial fibrillation: A systematic review and meta-analysis. J Arrhythm 2021; 37:1459-1467. [PMID: 34887950 PMCID: PMC8637076 DOI: 10.1002/joa3.12653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/09/2021] [Accepted: 10/21/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Endocardial catheter ablation (ECA) for atrial fibrillation (AF) has limited efficacy. Hybrid convergent procedure (HCP) with both epicardial and endocardial ablation is a novel strategy for AF treatment. In this meta-analysis, we aimed to evaluate the efficacy and safety of HCP in AF ablation. METHOD We performed a comprehensive literature search for studies that evaluated the efficacy and safety of HCP compared with ECA for AF. The primary outcome was freedom of atrial arrhythmia (AA). The secondary outcome was the periprocedural complication rate. Pooled relative risk (RR) and corresponding 95% confidence intervals (CIs) were calculated using the random effects model. RESULTS A total of eight studies, including 797 AF patients (mean age: 60.7 ± 9.8 years, 366 patients with HCP vs. 431 patients with ECA alone), were included. HCP showed a higher rate of freedom of AA compared with ECA (RR: 1.48, 95% CI: 1.13-1.94, p = .004). However, HCP was associated with higher rates of periprocedural complications (RR: 3.64, 95% CI: 2.06-6.43; p = .00001). Moreover, the HCP had a longer procedure time and postprocedural hospital stay. CONCLUSIONS Although hybrid ablation was associated with a higher success rate, this should be judged for increased periprocedural adverse events and extended hospital stay. Prospective large-scale randomized trials are needed to validate these results.
Collapse
Affiliation(s)
- Mohammed Mhanna
- Department of Internal MedicineUniversity of ToledoToledoOHUSA
| | - Azizullah Beran
- Department of Internal MedicineUniversity of ToledoToledoOHUSA
| | - Ahmad Al‐Abdouh
- Department of Internal MedicineSaint Agnes HospitalBaltimoreMDUSA
| | - Hazem Ayesh
- Department of Internal MedicineUniversity of ToledoToledoOHUSA
| | - Omar Sajdeya
- Department of Internal MedicineUniversity of ToledoToledoOHUSA
| | - Omar Srour
- Department of Internal MedicineUniversity of ToledoToledoOHUSA
| | - Mahmoud Alsaiqali
- Department of Internal MedicineState University of New York Downstate Medical CenterBrooklynNYUSA
| | | | | | | | - Paul Chacko
- Department of Cardiovascular MedicineUniversity of ToledoToledoOHUSA
| |
Collapse
|