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Spears J, Liskov S, Camm AJ, Kowey PR. How Antiarrhythmic Drugs Are Being Used in Patients With Heart Failure: Results of a Global Survey of Cardiologists. Am J Cardiol 2023; 206:60-62. [PMID: 37683578 DOI: 10.1016/j.amjcard.2023.08.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Jenna Spears
- Cardiology Division, Lankenau Heart Institute, Wynnewood, Pennsylvania
| | - Steven Liskov
- Cardiology Division, Lankenau Heart Institute, Wynnewood, Pennsylvania
| | - A John Camm
- Cardiology Clinical Academic Group, Molecular & Clinical Sciences Institute, St. George's University of London, London, United Kingdom
| | - Peter R Kowey
- Cardiology Division, Lankenau Heart Institute, Wynnewood, Pennsylvania; Department of Medicine, Jefferson Medical College, Philadelphia, Pennsylvania.
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Al Saiegh Y, Liskov S, Yan GX. Spiked Helmet Sign in the Inferior Leads. JAMA Intern Med 2023; 183:1007-1008. [PMID: 37428496 DOI: 10.1001/jamainternmed.2023.1728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
This case report describes a patient in their 80s who was admitted to the critical care unit with pulseless electrical activity cardiac arrest.
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Affiliation(s)
- Yousif Al Saiegh
- Lankenau Medical Center, Main Line Health, Wynnewood, Philadelphia, Pennsylvania
| | - Steven Liskov
- Lankenau Medical Center, Main Line Health, Wynnewood, Philadelphia, Pennsylvania
| | - Gan-Xin Yan
- Lankenau Medical Center, Main Line Health, Wynnewood, Philadelphia, Pennsylvania
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
- Fuwai Huazhong Hospital, Chinese Academy of Medical Sciences, Zhengzhou, China
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Taoutel R, Sukhon F, Liskov S, Kreidieh B, Chandhok S. Incessant atrioventricular nodal reentrant tachycardia resulting in tachycardia-induced cardiomyopathy and catastrophic embolization of left ventricular thrombus. HeartRhythm Case Rep 2022; 9:144-147. [PMID: 36970383 PMCID: PMC10030302 DOI: 10.1016/j.hrcr.2022.11.015] [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: 12/12/2022] Open
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Omondi A, Sirinvaravong N, Spears J, Sauerwein S, Taoutel R, Liskov S, Gao C, Liu T, Kowey PR, Yan GX. Marked QTc Reduction Immediately Following Direct Current Cardioversion of Atrial Fibrillation: Clinical Implications and Mechanisms. JACC Clin Electrophysiol 2022; 9:543-554. [PMID: 36752461 DOI: 10.1016/j.jacep.2022.10.031] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/12/2022] [Accepted: 10/19/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND The QTc in sinus rhythm (SR) following direct current cardioversion (DCCV) of atrial fibrillation (AF) is commonly used as a baseline QTc for patients who require initiation of antiarrhythmic drugs for rhythm control. Inaccurate baseline QTc may cause drug-induced torsades de pointes. OBJECTIVES To assess time-dependent QTc changes following DCCV. METHODS We prospectively assessed QTc changes with Bazett's QTc and Fridericia's QTc formulas in 65 patients following conversion of AF to SR. Among these 65 patients, 48 underwent DCCV and 17 spontaneously converted to SR. RESULTS There was a large and statistically significant decrease in QTc in SR immediately following DCCV in 40 patients, which occurred with an abrupt reduction in heart rate postcardioversion. This finding excluded 8 patients with ventricular-paced QRS. The mean decrease from QTc in AF was 70.7 ± 37.2 milliseconds in the QTc interval for heart rate using Bazett's formula and 33.8 ± 17.9 milliseconds in the QTc interval for heart rate using Fridericia's formula at 1-minute post-DCCV. In 17 patients with spontaneous conversion from AF to SR, the QTc reduction was comparable to those in patients with DCCV. The QTc increased with time and reached a steady state at 5 minutes following conversion. Initiation of class III drugs based on the "shortened" baseline QTc following DCCV was associated with drug-induced torsades de pointes. CONCLUSIONS In patients with AF following conversion, regardless spontaneous or DCCV, the QTc shortened significantly with decreases in heart rate, likely via the mechanism of time-dependent rate adaption of ventricular repolarization. A steady-state QTc at 5-minutes following DCCV should be used as real baseline for guidance of pharmacotherapy in patients with AF.
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Affiliation(s)
- Arthur Omondi
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Natee Sirinvaravong
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Jenna Spears
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Samuel Sauerwein
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Roy Taoutel
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Steven Liskov
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA
| | - Chuanyu Gao
- Fuwai Huazhong Hospital, Zhengzhou, Henan, China.
| | - Tong Liu
- Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peter R Kowey
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Gan-Xin Yan
- Lankenau Medical Center and Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA; Fuwai Huazhong Hospital, Zhengzhou, Henan, China; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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Olleik F, Telvizian T, Liskov S, Kreidieh B, Esberg D. Diffuse large B-cell lymphoma presenting as implantable cardioverter-defibrillator pocket swelling: A case report. HeartRhythm Case Rep 2022; 9:23-24. [PMID: 36685693 PMCID: PMC9845545 DOI: 10.1016/j.hrcr.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Farah Olleik
- Division of Internal Medicine, Lankenau Medical Center, Philadelphia, Pennsylvania,Address reprint requests and correspondence: Dr Farah Olleik, Lankenau Medical Center, 100 East Lancaster Ave, Wynnewood, PA 19096.
| | - Talar Telvizian
- Division of Internal Medicine, Lankenau Medical Center, Philadelphia, Pennsylvania
| | - Steven Liskov
- Division of Cardiology, Department of Medicine, Lankenau Medical Center, Philadelphia, Pennsylvania
| | - Bahij Kreidieh
- Division of Cardiology, Department of Medicine, Lankenau Medical Center, Philadelphia, Pennsylvania
| | - Douglas Esberg
- Division of Cardiology, Department of Medicine, Lankenau Medical Center, Philadelphia, Pennsylvania
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Liskov S, Belardinelli L, Kowey P. I'm Sorry, Ms Jones, But We Cannot Make You Feel Better Today. Circulation 2022; 146:655-656. [PMID: 36037267 DOI: 10.1161/circulationaha.122.060488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Steven Liskov
- Lankenau Heart Institute, Wynnewood, PA (S.L., P.K.)
| | | | - Peter Kowey
- Lankenau Heart Institute, Wynnewood, PA (S.L., P.K.)
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA (P.K.)
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Kreidieh B, Liskov S, Omondi A, Chandhok S. PO-702-07 TACHYCARDIA MEDIATED CARDIOMYOPATHY AND EMBOLISM OF LV THROMBUS SECONDARY TO INCESSANT SLOW/FAST AVNRT. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.1052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liskov S, Amer M, Heimann M, Keramati AR, Jarrett H. INOTROPIC SUPPORT IN THE TREATMENT OF IMPENDING LEFT ATRIAL APPENDAGE THROMBUS AFTER CARDIOVERSION FOR PERSISTENT ATRIAL FIBRILLATION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)03539-2] [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]
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Liskov S, Gray WA. Gettin' Ziggy with it. Catheter Cardiovasc Interv 2021; 98:137-138. [PMID: 34219371 DOI: 10.1002/ccd.29816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Steven Liskov
- Cardiology, Lankenau Medical Center, Wynnewood, Pennsylvania, USA
| | - William A Gray
- Interventional Cardiology, Lankenau Heart Institute, Wynnewood, Pennsylvania, USA
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Cires-Drouet RS, Nagarsheth K, Kaczorowski DJ, Toursavadkohi S, Deatrick K, Madathil RJ, Jones KM, Liskov S, Fitch J, Sayad M, Pasrija C, Mayorga-Carlin M, Herr D, Sorkin JD, Griffith B, Lal BK, Gammie JS. Catheter-based interventions versus medical and surgical approaches in acute pulmonary embolism. J Vasc Surg Venous Lymphat Disord 2021; 9:1382-1390. [PMID: 33965609 DOI: 10.1016/j.jvsv.2021.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/17/2020] [Accepted: 02/21/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Catheter-based intervention (CBI) has become an increasingly popular option for treating pulmonary embolism (PE); however, the real benefits are unknown. The purpose of the present study was to compare the outcomes of patients treated with CBI with the outcomes of those treated with medical or surgical approaches. METHODS We performed a retrospective analysis of patients admitted from October 2015 to December 2017 with a diagnosis of acute PE. We compared patients aged ≥18 years with a diagnosis of acute PE treated with CBI against a control group identified by propensity score matching. The control group was divided into those who had undergone surgical pulmonary embolectomy (SPE) as the surgical group and those who had not undergone SPE as the medical group. The primary outcome was mortality (in-hospital and overall mortality). The secondary outcomes were major bleeding, length of hospital stay, thrombus resolution, right ventricle improvement in systolic function and dilatation, and recurrent PE. RESULTS Of the 108 patients, 30 were in the CBI group and 78 were in the control group (62 in the medical group and 16 in the surgical group). The patient characteristics on admission were similar, except for the body mass index, which was greater in the CBI group (P = .03). No difference was found in clinical severity, clot burden, right ventricle function, or biomarkers. Recurrent PE was less frequent in the CBI group than in the medical group (0% vs 6.4%). Otherwise, no significant differences were found in the outcomes between the CBI and medical groups. When CBI was compared with the surgical group, SPE was associated with improved mortality (0% vs 16.6%) but a longer median length of hospital stay (median, 7 days; interquartile range, 3-12 days; vs median, 8 days; interquartile range, 6.5-17 days). CONCLUSIONS The use of CBI reduced the number of recurrent PE events compared with the medically treated patients; however, the mortality was higher than that in the surgical group.
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Affiliation(s)
- Rafael S Cires-Drouet
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Department of Medicine, University of Maryland School of Medicine, Baltimore, Md.
| | - Khanjan Nagarsheth
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - David J Kaczorowski
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - Shahab Toursavadkohi
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Baltimore Veterans Affairs Medical Center, Baltimore, Md
| | - Kristopher Deatrick
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - Ronson J Madathil
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - Kevin M Jones
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Md
| | - Steven Liskov
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Md
| | - Jeffrey Fitch
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Md
| | - Michelle Sayad
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Md
| | - Chetan Pasrija
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | | | - Daniel Herr
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - John D Sorkin
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Md; Baltimore Veterans Affairs Geriatrics Research, Education, and Clinical Center, Baltimore Veterans Affairs Medical Center, Baltimore, Md
| | - Bartley Griffith
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - Brajesh K Lal
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md; Vascular Service, Baltimore Veterans Affairs Medical Center, Baltimore, Md
| | - James S Gammie
- Department of Surgery, University of Maryland School of Medicine, Baltimore, Md
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