4
|
Shoemaker MB, Husser D, Roselli C, Al Jazairi M, Chrispin J, Kühne M, Neumann B, Knight S, Sun H, Mohanty S, Shaffer C, Thériault S, Rinke LL, Siland JE, Crawford DM, Ueberham L, Zardkoohi O, Büttner P, Geelhoed B, Blum S, Aeschbacher S, Smith JD, Van Wagoner DR, Freudling R, Müller-Nurasyid M, Montgomery J, Yoneda Z, Wells Q, Issa T, Weeke P, Jacobs V, Van Gelder IC, Hindricks G, Barnard J, Calkins H, Darbar D, Michaud G, Kääb S, Ellinor P, Natale A, Chung M, Nazarian S, Cutler MJ, Sinner MF, Conen D, Rienstra M, Bollmann A, Roden DM, Lubitz S. Genetic Susceptibility for Atrial Fibrillation in Patients Undergoing Atrial Fibrillation Ablation. Circ Arrhythm Electrophysiol 2020; 13:e007676. [PMID: 32078373 DOI: 10.1161/circep.119.007676] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ablation is a widely used therapy for atrial fibrillation (AF); however, arrhythmia recurrence and repeat procedures are common. Studies examining surrogate markers of genetic susceptibility to AF, such as family history and individual AF susceptibility alleles, suggest these may be associated with recurrence outcomes. Accordingly, the aim of this study was to test the association between AF genetic susceptibility and recurrence after ablation using a comprehensive polygenic risk score for AF. METHODS Ten centers from the AF Genetics Consortium identified patients who had undergone de novo AF ablation. AF genetic susceptibility was measured using a previously described polygenic risk score (N=929 single-nucleotide polymorphisms) and tested for an association with clinical characteristics and time-to-recurrence with a 3 month blanking period. Recurrence was defined as >30 seconds of AF, atrial flutter, or atrial tachycardia. Multivariable analysis adjusted for age, sex, height, body mass index, persistent AF, hypertension, coronary disease, left atrial size, left ventricular ejection fraction, and year of ablation. RESULTS Four thousand two hundred seventy-six patients were eligible for analysis of baseline characteristics and 3259 for recurrence outcomes. The overall arrhythmia recurrence rate between 3 and 12 months was 44% (1443/3259). Patients with higher AF genetic susceptibility were younger (P<0.001) and had fewer clinical risk factors for AF (P=0.001). Persistent AF (hazard ratio [HR], 1.39 [95% CI, 1.22-1.58]; P<0.001), left atrial size (per cm: HR, 1.32 [95% CI, 1.19-1.46]; P<0.001), and left ventricular ejection fraction (per 10%: HR, 0.88 [95% CI, 0.80-0.97]; P=0.008) were associated with increased risk of recurrence. In univariate analysis, higher AF genetic susceptibility trended towards a higher risk of recurrence (HR, 1.08 [95% CI, 0.99-1.18]; P=0.07), which became less significant in multivariable analysis (HR, 1.06 [95% CI, 0.98-1.15]; P=0.13). CONCLUSIONS Higher AF genetic susceptibility was associated with younger age and fewer clinical risk factors but not recurrence. Arrhythmia recurrence after AF ablation may represent a genetically different phenotype compared to AF susceptibility.
Collapse
Affiliation(s)
- M Benjamin Shoemaker
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Daniela Husser
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Carolina Roselli
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.)
| | - Meelad Al Jazairi
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Jonathan Chrispin
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (J.C., H.C.)
| | - Michael Kühne
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Benjamin Neumann
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.)
| | - Stacey Knight
- Intermountain Heart Institute, Intermountain Medical Center, Murray (S. Knight, V.J.).,Department of Medicine, University of Utah, Salt Lake City (S. Knight)
| | - Han Sun
- Department of Quantitative Health Sciences (H.S., J.B.), Lerner Research Institute, Cleveland Clinic, OH
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, Austin, TX (S.M., A.N.).,Department of Internal Medicine, Dell Medical School, Austin, TX (S.M., A.N.)
| | - Christian Shaffer
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Sébastien Thériault
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada (S.T., D.C.).,Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Canada (S.T.)
| | - Lauren Lee Rinke
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Joylene E Siland
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Diane M Crawford
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Laura Ueberham
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Omeed Zardkoohi
- Departments of Cardiovascular Medicine and Molecular Cardiology, Heart and Vascular Institute (O.Z., M.C.), Lerner Research Institute, Cleveland Clinic, OH
| | - Petra Büttner
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Bastiaan Geelhoed
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Steffen Blum
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Stefanie Aeschbacher
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.)
| | - Jonathan D Smith
- Department of Cellular and Molecular Medicine (J.D.S.), Lerner Research Institute, Cleveland Clinic, OH
| | - David R Van Wagoner
- Department of Molecular Cardiology (D.R.V.W.), Lerner Research Institute, Cleveland Clinic, OH
| | - Rebecca Freudling
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg (R.F., M.M.-N.)
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg (R.F., M.M.-N.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - Jay Montgomery
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Zachary Yoneda
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Quinn Wells
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Tariq Issa
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Peter Weeke
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Victoria Jacobs
- Intermountain Heart Institute, Intermountain Medical Center, Murray (S. Knight, V.J.)
| | - Isabelle C Van Gelder
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Gerhard Hindricks
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - John Barnard
- Department of Quantitative Health Sciences (H.S., J.B.), Lerner Research Institute, Cleveland Clinic, OH
| | - Hugh Calkins
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (J.C., H.C.)
| | - Dawood Darbar
- Division of Cardiology, Department of Medicine, University of Illinois Health, Chicago (D.D.)
| | - Greg Michaud
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (M.B.S., C.S., L.L.R., D.M.C., J.M., Z.Y., Q.W., T.I., P.W., G.M.)
| | - Stefan Kääb
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - Patrick Ellinor
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.).,Massachusetts General Hospital, Cardiac Arrhythmia Service, Boston (P.E., S.L.)
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, Austin, TX (S.M., A.N.).,Department of Internal Medicine, Dell Medical School, Austin, TX (S.M., A.N.).,Scripps Clinic, Interventional Electrophysiology, San Diego, CA (A.N.).,Division of Cardiology, Stanford University, Palo Alto, CA (A.N.).,Case Western University, Cleveland, OH (A.N.)
| | - Mina Chung
- Departments of Cardiovascular Medicine and Molecular Cardiology, Heart and Vascular Institute (O.Z., M.C.), Lerner Research Institute, Cleveland Clinic, OH
| | - Saman Nazarian
- Division of Cardiology, University of Pennsylvania Perelman School of Medicine, Philadelphia (S.N.)
| | - Michael J Cutler
- Intermountain Heart Institute, Intermountain Medical Center, Murray, UT (M.J.C.)
| | - Moritz F Sinner
- Department of Medicine, University Hospital Munich, Ludwig Maximilians University of Munich, Germany (B.N., R.F., S. Kääb, M.F.S.).,German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.M.-N., S. Kääb, M.F.S.)
| | - David Conen
- University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Cardiovascular Research Institute Basel, University Hospital Basel, Switzerland (M.K., S.B., S.A., D.C.).,Population Health Research Institute, McMaster University, Hamilton, ON, Canada (S.T., D.C.)
| | - Michiel Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (M.A.J., J.E.S., B.G., I.C.V.G., M.R.)
| | - Andreas Bollmann
- Heart Center Leipzig, Department of Electrophysiology, Leipzig Heart Institute, University of Leipzig, Germany (D.H., L.U., P.B., G.H., A.B.)
| | - Dan M Roden
- Animal, Dairy, and Veterinary Sciences, Utah State University, Logan (D.M.R.)
| | - Steven Lubitz
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Program in Medical and Population Genetics, Cambridge, MA (C.R., P.E., S.L.).,Massachusetts General Hospital, Cardiac Arrhythmia Service, Boston (P.E., S.L.)
| |
Collapse
|
7
|
Shoemaker MB, Bollmann A, Lubitz SA, Ueberham L, Saini H, Montgomery J, Edwards T, Yoneda Z, Sinner MF, Arya A, Sommer P, Delaney J, Goyal SK, Saavedra P, Kanagasundram A, Whalen SP, Roden DM, Hindricks G, Ellis CR, Ellinor PT, Darbar D, Husser D. Common genetic variants and response to atrial fibrillation ablation. Circ Arrhythm Electrophysiol 2015; 8:296-302. [PMID: 25684755 DOI: 10.1161/circep.114.001909] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 01/29/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Common single nucleotide polymorphisms (SNPs) at chromosomes 4q25 (rs2200733, rs10033464 near PITX2), 1q21 (rs13376333 in KCNN3), and 16q22 (rs7193343 in ZFHX3) have consistently been associated with the risk of atrial fibrillation (AF). Single-center studies have shown that 4q25 risk alleles predict recurrence of AF after catheter ablation of AF. Here, we performed a meta-analysis to test the hypothesis that these 4 AF susceptibility SNPs modulate response to AF ablation. METHODS AND RESULTS Patients underwent de novo AF ablation between 2008 and 2012 at Vanderbilt University, the Heart Center Leipzig, and Massachusetts General Hospital. The primary outcome was 12-month recurrence, defined as an episode of AF, atrial flutter, or atrial tachycardia lasting >30 seconds after a 3-month blanking period. Multivariable analysis of the individual cohorts using a Cox proportional hazards model was performed. Summary statistics from the 3 centers were analyzed using fixed effects meta-analysis. A total of 991 patients were included (Vanderbilt University, 245; Heart Center Leipzig, 659; and Massachusetts General Hospital, 87). The overall single procedure 12-month recurrence rate was 42%. The overall risk allele frequency for these SNPs ranged from 12% to 35%. Using a dominant genetic model, the 4q25 SNP, rs2200733, predicted a 1.4-fold increased risk of recurrence (adjusted hazard ratio,1.3 [95% confidence intervals, 1.1-1.6]; P=0.011). The remaining SNPs, rs10033464 (4q25), rs13376333 (1q21), and rs7193343 (16q22) were not significantly associated with recurrence. CONCLUSIONS Among the 3 genetic loci most strongly associated with AF, the chromosome 4q25 SNP rs2200733 is significantly associated with recurrence of atrial arrhythmias after catheter ablation for AF.
Collapse
Affiliation(s)
- M Benjamin Shoemaker
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.).
| | - Andreas Bollmann
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Steven A Lubitz
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Laura Ueberham
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Harsimran Saini
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Jay Montgomery
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Todd Edwards
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Zachary Yoneda
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Moritz F Sinner
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Arash Arya
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Philipp Sommer
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Jessica Delaney
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Sandeep K Goyal
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Pablo Saavedra
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Arvindh Kanagasundram
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - S Patrick Whalen
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Dan M Roden
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Gerhard Hindricks
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Christopher R Ellis
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Patrick T Ellinor
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Dawood Darbar
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| | - Daniela Husser
- From the Department of Medicine, Vanderbilt University, Nashville, TN (M.B.S., J.M., T.E., Z.Y., J.D., S.K.G., P.S., A.K., S.P.W., D.M.R., C.R.E., D.D.); Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany (A.B., L.U., A.A., P.S., G.H., D.H.); Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston (S.A.L., H.S., P.T.E.); and Department of Medicine, University Hospital Munich, Munich, Germany (M.F.S.)
| |
Collapse
|