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Article ; Online: Vaping tetrahydrocannabinol unmasks Brugada pattern and induces ventricular fibrillation in Brugada syndrome: a case report.

Seri, Amith / Rattanawong, Pattara / Firouzbakht, Tina / Sorajja, Dan

European heart journal. Case reports

2022 Volume 6, Issue 6, Page(s) ytac200

Abstract: Background: Fever, alcohol, and sodium channel blockers can unmask Brugada pattern and may also induce arrhythmias in Brugada syndrome. We report a case of unmasked Type-1 Brugada pattern presenting with ventricular fibrillation that was induced by a ... ...

Abstract	Background: Fever, alcohol, and sodium channel blockers can unmask Brugada pattern and may also induce arrhythmias in Brugada syndrome. We report a case of unmasked Type-1 Brugada pattern presenting with ventricular fibrillation that was induced by a tetrahydrocannabinol vaping. Case summary: A 48-year-old male with a past medical history of hypertension treated with hydrochlorothiazide and back pain controlled with tetrahydrocannabinol vaping presented with sudden cardiac arrest from ventricular fibrillation, which was terminated with defibrillation. Electrocardiogram after resuscitation showed a new Type-1 Brugada pattern compared to a previous normal baseline electrocardiogram. Echocardiography and coronary angiogram were unremarkable. Complete blood count and chemistries were unremarkable except for mild hypokalaemia (K = 3.3 mmol/L). After correction of the hypokalaemia, the Type-1 Brugada pattern persisted. Urine drug screen was positive for tetrahydrocannabinol (60 ng/mL). Genetic testing was negative for inherited arrhythmic disease and cardiomyopathy gene panels. Discussion: The patient's type-1 Brugada pattern and ventricular fibrillation were likely induced by vaping tetrahydrocannabinol. He underwent secondary prevention with an implantable cardioverter-defibrillator. He abstains from cannabis and Type-1 Brugada pattern is normalized. There was no arrhythmic event at his 18-month follow-up appointment with abstinence from tetrahydrocannabinol.
Language	English
Publishing date	2022-06-06
Publishing country	England
Document type	Case Reports
ISSN	2514-2119
ISSN (online)	2514-2119
DOI	10.1093/ehjcr/ytac200
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Article: Impact of age on hospital outcomes after catheter ablation for ventricular tachycardia.

Tan, Min Choon / Yeo, Yong Hao / Ang, Qi Xuan / Kiwan, Chrystina / Fatunde, Olubadewa / Lee, Justin Z / Tolat, Aneesh / Sorajja, Dan

Journal of arrhythmia

2024 Volume 40, Issue 2, Page(s) 317–324

Abstract: Background: The real-world data on the safety profile of ventricular tachycardia (VT) ablation among elderly patients is not well-established. This study aimed to evaluate the procedural outcomes among those aged 18-64 years versus those aged ≥65 years ... ...

Abstract	Background: The real-world data on the safety profile of ventricular tachycardia (VT) ablation among elderly patients is not well-established. This study aimed to evaluate the procedural outcomes among those aged 18-64 years versus those aged ≥65 years who underwent catheter ablation of VT. Method: Using the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent VT catheter ablation between 2017 and 2020. We divided the patients into non-elderly (18-64 years old) and elderly age groups (≥65 years old). We then analyzed the in-hospital procedural outcome and 30-day readmission between these two groups. Results: Our study included 2075 (49.1%) non-elderly patients and 2153 (50.9%) elderly patients who underwent VT ablation. Post-procedurally, elderly patients had significantly higher rates of prolonged index hospitalization (≥7 days; 35.5% vs. 29.3%, Conclusion: Elderly patients have worse in-hospital outcome, early mortality, non-home discharge, and 30-day readmission following catheter ablation for VT. There was no significant difference between elderly and non-elderly groups in the procedural complications.
Language	English
Publishing date	2024-02-05
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.12998
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Article ; Online: Mortality trends, disparities, and social vulnerability in cardiac arrest mortality in the young: A cross-sectional analysis.

Ibrahim, Ramzi / Shahid, Mahek / Srivathsan, Komandoor / Sorajja, Dan / Deshmukh, Abhishek / Lee, Justin Z

Journal of cardiovascular electrophysiology

2023 Volume 35, Issue 1, Page(s) 35–43

Abstract: Background: Cardiac arrest (CA) is a leading cause of death in the United States (US). Social determinants of health may impact CA outcomes. We aimed to assess mortality trends, disparities, and the influence of the social vulnerability index (SVI) on ... ...

Abstract	Background: Cardiac arrest (CA) is a leading cause of death in the United States (US). Social determinants of health may impact CA outcomes. We aimed to assess mortality trends, disparities, and the influence of the social vulnerability index (SVI) on CA outcomes in the young. Methods: We conducted a cross-sectional analysis of age-adjusted mortality rates (AAMRs) related to CA in the United States from the Years 1999 to 2020 in individuals aged 35 years and younger. Data were obtained from death certificates and analyzed using log-linear regression models. We examined disparities in mortality rates based on demographic variables. We also explored the impact of the SVI on CA mortality. Results: A total of 4792 CA deaths in the young were identified. Overall AAMR decreased from 0.20 in 1999 to 0.14 in 2020 with an average annual percentage change of -1.3% (p = .001). Black (AAMR: 0.30) and male populations (AAMR: 0.14) had higher AAMR compared with White (AAMR: 0.11) and female (AAMR: 0.11) populations, respectively. Nonmetropolitan (AAMR: 0.29) and Southern (AAMR: 0.26) regions were also impacted by higher AAMR compared with metropolitan (AAMR: 0.11) and other US census regions, respectively. A higher SVI was associated with greater mortality risks related to CA (risk ratio: 1.82 [95% CI, 1.77-1.87]). Conclusions: Our analysis of CA in the young revealed disparities based on demographics, with a decline in AAMR from 1999 to 2020. There is a correlation between a higher SVI and increased CA mortality risk, highlighting the importance of targeted interventions to address these disparities effectively.
MeSH term(s)	Humans ; Female ; Male ; United States/epidemiology ; Cross-Sectional Studies ; Social Vulnerability ; Eye Diseases, Hereditary ; Heart Arrest/diagnosis
Language	English
Publishing date	2023-11-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025989-2
ISSN	1540-8167 ; 1045-3873
ISSN (online)	1540-8167
ISSN	1045-3873
DOI	10.1111/jce.16112
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Article ; Online: On the road to atrial fibrillation.

Sorajja, Dan / Shen, Win-Kuang

Heart rhythm

2017 Volume 14, Issue 12, Page(s) 1862–1863

MeSH term(s)	Atrial Fibrillation ; Humans
Language	English
Publishing date	2017-11-02
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2017.09.041
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Article ; Online: Impact of Obesity on Catheter Ablation of Atrial Fibrillation: In-Hospital and 30-Day Outcomes.

Tan, Min Choon / Ang, Qi Xuan / Yeo, Yong Hao / Correia, Joaquim / Sorajja, Dan / Scott, Luis R / Cha, Yong-Mei / Lee, Justin Z

JACC. Clinical electrophysiology

2023 Volume 9, Issue 8 Pt 3, Page(s) 1816–1817

MeSH term(s)	Humans ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/surgery ; Obesity/complications ; Obesity/epidemiology ; Hospitals ; Catheter Ablation
Language	English
Publishing date	2023-06-21
Publishing country	United States
Document type	Letter
ZDB-ID	2846739-5
ISSN	2405-5018 ; 2405-500X ; 2405-500X
ISSN (online)	2405-5018 ; 2405-500X
ISSN	2405-500X
DOI	10.1016/j.jacep.2023.04.023
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Article ; Online: Sinus Node Dysfunction After Percutaneous Transcatheter Closure of Right Coronary Artery-Superior Vena Cava Fistula.

Sriramoju, Anil / Suppah, Mustafa / Chao, Chieh-Ju / Sorajja, Dan / Sweeney, John / Naidu, Sailendra / Lee, Richard

JACC. Case reports

2023 Volume 16, Page(s) 101890

Abstract: Congenital right coronary artery-superior vena cava (RCA-SVC) fistula is rare and typically does not manifest any symptoms until the fifth decade of life. The present case demonstrates a 48-year-old woman who developed Sinus node dysfunction of unknown ... ...

Abstract	Congenital right coronary artery-superior vena cava (RCA-SVC) fistula is rare and typically does not manifest any symptoms until the fifth decade of life. The present case demonstrates a 48-year-old woman who developed Sinus node dysfunction of unknown cause after Percutaneous coil embolization of the RCA-SVC fistula requiring permanent pacemaker. (
Language	English
Publishing date	2023-05-17
Publishing country	Netherlands
Document type	Case Reports
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2023.101890
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Article: Subcutaneous implantable cardioverter-defibrillator noise following left ventricular assist device implantation.

Khetarpal, Banveet Kaur / Javaid, Awad / Lee, Justin Z / Kusumoto, Fred / Mulpuru, Siva K / Sorajja, Dan / Cha, Yong-Mei / Srivathsan, Komandoor

Journal of arrhythmia

2023 Volume 39, Issue 2, Page(s) 198–206

Abstract: Background: The incidence and impact of noise in a subcutaneous implantable cardioverter defibrillator (S-ICD) after left ventricular assist device (LVAD) implantation is not well established.: Methods: We performed a retrospective study of patients ... ...

Abstract	Background: The incidence and impact of noise in a subcutaneous implantable cardioverter defibrillator (S-ICD) after left ventricular assist device (LVAD) implantation is not well established. Methods: We performed a retrospective study of patients implanted with LVAD and with a pre-existing S-ICD between January 2005 and December 2020 at the three Mayo Clinic centers (Minnesota, Arizona, and Florida). Results: Of the 908 LVAD patients, a pre-existing S-ICD was present in 9 patients (mean age 49.1 ± 13.7 years, 66.7% males), 100% with Boston Scientific third-generation EMBLEM MRI S-ICD, 11% with HeartMate II (HM II), 44% with HeartMate 3 (HM 3), and 44% with HeartWare (HW) LVAD. The incidence of noise from LVAD-related electromagnetic interference (EMI) was 33% and was only seen with HM 3 LVAD. Multiple measures attempted to resolve noise, including using alternative S-ICD sensing vector, adjusting S-ICD time zone, and increasing LVAD pump speed, were unsuccessful, necessitating S-ICD device therapies to be turned off permanently. Conclusions: The incidence of LVAD-related S-ICD noise is high in patients with concomitant LVAD and S-ICD with significant impact on device function. As conservative management failed to resolve the EMI, the S-ICDs had to be programmed off to avoid inappropriate shocks. This study highlights the importance of awareness of LVAD-SICD device interference and the need to improve S-ICD detection algorithms to eliminate noise.
Language	English
Publishing date	2023-02-12
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.12826
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Article ; Online: An Evidence-Based Approach to Anticoagulation Therapy Comparing Direct Oral Anticoagulants and Vitamin K Antagonists in Patients With Atrial Fibrillation and Bioprosthetic Valves: A Systematic Review, Meta-Analysis, and Network Meta-Analysis.

Suppah, Mustafa / Kamal, Abdallah / Saadoun, Rakan / Baradeiya, Ahmed M A / Abraham, Bishoy / Alsidawi, Said / Sorajja, Dan / Fortuin, F David / Arsanjani, Reza

The American journal of cardiology

2023 Volume 206, Page(s) 132–150

Abstract: Direct oral anticoagulants (DOACs) are a newer class of anticoagulants that inhibit factor Xa or factor IIa and include drugs such as rivaroxaban, apixaban, edoxaban, betrixaban, and dabigatran. Although vitamin K antagonists (VKAs) have been ... ...

Abstract	Direct oral anticoagulants (DOACs) are a newer class of anticoagulants that inhibit factor Xa or factor IIa and include drugs such as rivaroxaban, apixaban, edoxaban, betrixaban, and dabigatran. Although vitamin K antagonists (VKAs) have been traditionally used to prevent thromboembolic events, DOACs have gained popularity because of their faster onset and offset of action and reduced need for monitoring. This study aimed to provide more data for anticoagulants in patients with atrial fibrillation with bioprosthetic heart valves by incorporating all available trials to date. A search was performed across 5 electronic databases to identify relevant studies. We analyzed the data using a pooled risk ratio for categorical outcomes and used the I
MeSH term(s)	Humans ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Network Meta-Analysis ; Anticoagulants/therapeutic use ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Thromboembolism/epidemiology ; Thromboembolism/etiology ; Thromboembolism/prevention & control ; Fibrinolytic Agents/therapeutic use ; Intracranial Hemorrhages ; Vitamin K ; Administration, Oral
Chemical Substances	Anticoagulants ; Fibrinolytic Agents ; Vitamin K (12001-79-5)
Language	English
Publishing date	2023-09-11
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.07.141
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Article: Adverse events in cryoballoon ablation for pulmonary vein isolation: Insight from the Food and Drug Administration Manufacturer and User Facility Device Experience.

Tan, Min Choon / Tan, Jian Liang / Lee, Wei Jun / Srivathsan, Komandoor / Sorajja, Dan / El Masry, Hicham / Scott, Luis R / Lee, Justin Z

Journal of arrhythmia

2023 Volume 39, Issue 5, Page(s) 784–789

Abstract: Background: Real-world clinical data on the adverse events related to the use of cryoballoon catheter for pulmonary vein isolation remains limited.: Objective: To report and describe the adverse events related to the use of Artic Front cryoballoon ... ...

Abstract	Background: Real-world clinical data on the adverse events related to the use of cryoballoon catheter for pulmonary vein isolation remains limited. Objective: To report and describe the adverse events related to the use of Artic Front cryoballoon catheters (Arctic Front, Arctic Front Advance, and Arctic Front Advance Pro) reported in the Food and Drug Administration's (FDA) Manufacturers and User Defined Experience (MAUDE) database. Methods: We reviewed all the adverse events reported to the FDA MAUDE database over a 10.7-year study period from January 01, 2011 to September 31, 2021. All events were independently reviewed by two physicians. Results: During the study period, a total of 320 procedural-related adverse events reported in the MAUDE database were identified. The most common adverse event was transient or persistent phrenic nerve palsy (PNP), accounting for 48% of all events. This was followed by cardiac perforation (15%), pulmonary vein stenosis (8%), transient ischemic attack or stroke (6%), vascular injury (4%), transient or persistent ST-elevation myocardial infarction (3%), hemoptysis (2%), pericarditis (2%), and esophageal ulcer or fistula (1%). There were six reported intra-procedural death events as a result of cardiac perforation. Conclusion: The two most common procedural adverse events associated with cryoballoon ablation were PNP and cardiac perforation. All cases of procedural mortality were due to cardiac perforation.
Language	English
Publishing date	2023-07-24
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2696593-8
ISSN	1883-2148 ; 1880-4276
ISSN (online)	1883-2148
ISSN	1880-4276
DOI	10.1002/joa3.12898
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Article ; Online: The electrocardiographic manifestations of pectus excavatum before and after surgical correction.

Farina, Juan M / Yinadsawaphan, Thanaboon / Jaroszewski, Dawn E / Aly, Mohamed R / Botros, Michael / Cheema, Kamal P / Fatunde, Olubadewa A / Sorajja, Dan

Journal of electrocardiology

2023 Volume 82, Page(s) 19–26

Abstract: Background: Pectus excavatum (PEx) can cause cardiopulmonary limitations due to cardiac compression and displacement. There is limited data on electrocardiogram (ECG) alterations before and after PEx surgical repair, and ECG findings suggesting ... ...

Abstract	Background: Pectus excavatum (PEx) can cause cardiopulmonary limitations due to cardiac compression and displacement. There is limited data on electrocardiogram (ECG) alterations before and after PEx surgical repair, and ECG findings suggesting cardiopulmonary limitations have not been reported. The aim of this study is to explore ECG manifestations of PEx before and after surgery including associations with exercise capacity. Methods: A retrospective review of PEx patients who underwent primary repair was performed. ECGs before and after surgical correction were evaluated and the associations between preoperative ECG abnormalities and cardiopulmonary function were investigated. Results: In total, 310 patients were included (mean age 35.1 ± 11.6 years). Preoperative ECG findings included a predominant negative P wave morphology in V1, and this abnormal pattern significantly decreased from 86.9% to 57.4% (p < 0.001) postoperatively. The presence of abnormal P wave amplitude in lead II (>2.5 mm) significantly decreased from 7.1% to 1.6% postoperatively (p < 0.001). Right bundle branch block (RBBB) (9.4% versus 3.9%, p < 0.001), rsr' patterns (40.6% versus 12.9%, p < 0.001), and T wave inversion in leads V1-V3 (62.3% vs 37.7%, p < 0.001) were observed less frequently after surgery. Preoperative presence of RBBB (OR = 4.8; 95%CI 1.1-21.6) and T wave inversion in leads V1-3 (OR = 2.3; 95%CI 1.3-4.2) were associated with abnormal results in cardiopulmonary exercise testings. Conclusion: Electrocardiographic abnormalities in PEx are frequent and can revert to normal following surgery. Preoperative RBBB and T wave inversion in leads V1-3 suggested a reduction in exercise capacity, serving as a marker for the need for further cardiovascular evaluation of these patients.
MeSH term(s)	Humans ; Young Adult ; Adult ; Middle Aged ; Electrocardiography ; Funnel Chest/complications ; Funnel Chest/surgery ; Heart ; Bundle-Branch Block ; Exercise Test/adverse effects
Language	English
Publishing date	2023-11-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	410286-1
ISSN	1532-8430 ; 0022-0736
ISSN (online)	1532-8430
ISSN	0022-0736
DOI	10.1016/j.jelectrocard.2023.11.007
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