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Article: A Practical Guide to Ultrasound-guided Venous Access During Implantation of Pacemakers and Defibrillators.

Qin, Dingxin / Ptaszek, Leon M

The Journal of innovations in cardiac rhythm management

2022 Volume 13, Issue 2, Page(s) 4873–4877

Abstract: Ultrasound (US) guidance has been shown to be a safe and effective option for gaining access to the axillary vein during implantation of cardiovascular implantable electronic devices (CIEDs). However, US-based technique has not been universally adopted ... ...

Abstract	Ultrasound (US) guidance has been shown to be a safe and effective option for gaining access to the axillary vein during implantation of cardiovascular implantable electronic devices (CIEDs). However, US-based technique has not been universally adopted in CIED implantations performed in cardiac electrophysiology (EP) laboratories, despite potential advantages over other vascular access techniques. For this reason, not all cardiac electrophysiologists have been trained to use US guidance during CIED implantation. This review is intended to provide a practical guide to the use of US guidance to obtain axillary vein access in the EP laboratory setting.
Language	English
Publishing date	2022-02-15
Publishing country	United States
Document type	Journal Article
ISSN	2156-3977
ISSN	2156-3977
DOI	10.19102/icrm.2022.130204
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Article ; Online: Management of Atrial Fibrillation in the Emergency Department.

Bode, Weeranun / Ptaszek, Leon M

Current cardiology reports

2021 Volume 23, Issue 12, Page(s) 179

Abstract: Purpose of review: Atrial fibrillation (AF) is the most common arrhythmia in adults and is responsible for 600,000 emergency department (ED) visits each year in the USA. Over 60% of these patients are admitted to inpatient units. The prevalence of AF is ...

Abstract	Purpose of review: Atrial fibrillation (AF) is the most common arrhythmia in adults and is responsible for 600,000 emergency department (ED) visits each year in the USA. Over 60% of these patients are admitted to inpatient units. The prevalence of AF is increasing, resulting in higher numbers of AF-related ED visits and inpatient admissions. These trends underscore the need for improvements in the efficiency of AF management in the ED. Recent findings: Several treatment protocols have been developed to address challenges associated with AF management in the ED, including: initiation of oral anticoagulant (OAC) therapy, cardioversion, and arranging for outpatient follow-up. Studies of these protocols have demonstrated that they can be utilized safely and effectively. Published treatment protocols for AF in the ED have been shown to reduce unnecessary hospital admissions and improve adherence to guideline-directed OAC therapy. Widespread adoption of AF treatment protocols could improve patient outcomes and reduce the costs associated with inpatient AF treatment.
MeSH term(s)	Adult ; Anticoagulants/therapeutic use ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Emergency Service, Hospital ; Hospitalization ; Humans ; Retrospective Studies
Chemical Substances	Anticoagulants
Language	English
Publishing date	2021-10-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2055373-0
ISSN	1534-3170 ; 1523-3782
ISSN (online)	1534-3170
ISSN	1523-3782
DOI	10.1007/s11886-021-01611-2
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Article ; Online: Outcomes of Patients With Takotsubo Syndrome Compared With Type 1 and Type 2 Myocardial Infarction.

Khaloo, Pegah / Ledesma, Pablo A / Nahlawi, Acile / Galvin, Jennifer / Ptaszek, Leon M / Ruskin, Jeremy N

Journal of the American Heart Association

2023 Volume 12, Issue 18, Page(s) e030114

Abstract: Background Takotsubo syndrome (TS) and myocardial infarction (MI) share similar clinical and laboratory characteristics but have important differences in causes, demographics, management, and outcomes. Methods and Results In this observational study, the ...

Abstract	Background Takotsubo syndrome (TS) and myocardial infarction (MI) share similar clinical and laboratory characteristics but have important differences in causes, demographics, management, and outcomes. Methods and Results In this observational study, the National Inpatient Sample and National Readmission Database were used to identify patients admitted with TS, type 1 MI, or type 2 MI in the United States between October 1, 2017, and December 31, 2019. We compared patients hospitalized with TS, type 1 MI, and type 2 MI with respect to key features and outcomes. Over the 27-month study period, 2 035 055 patients with type 1 MI, 639 075 patients with type 2 MI, and 43 335 patients with TS were identified. Cardiac arrest, ventricular fibrillation, and ventricular tachycardia were more prevalent in type 1 MI (4.02%, 3.2%, and 7.2%, respectively) compared with both type 2 MI (2.8%, 0.8%, and 5.4% respectively) and TS (2.7%, 1.8%, and 5.3%, respectively). Risk of mortality was lower in TS compared with both type 1 MI (3.3% versus 7.9%; adjusted odds ratio [OR], 0.3;
MeSH term(s)	Humans ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/epidemiology ; Takotsubo Cardiomyopathy/therapy ; Anterior Wall Myocardial Infarction ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Myocardial Infarction/therapy ; Inpatients ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/epidemiology ; Ventricular Fibrillation/therapy
Language	English
Publishing date	2023-09-08
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.030114
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Article ; Online: Case 9-2019: A 62-Year-Old Man with Atrial Fibrillation, Depression, and Worsening Anxiety.

Chen, Justin A / Ptaszek, Leon M / Celano, Christopher M / Beach, Scott R

The New England journal of medicine

2019 Volume 380, Issue 12, Page(s) 1167–1174

MeSH term(s)	Adrenergic beta-Antagonists/therapeutic use ; Alcohol Drinking/psychology ; Antidepressive Agents/therapeutic use ; Anxiety Disorders/complications ; Anxiety Disorders/drug therapy ; Aripiprazole/therapeutic use ; Arrhythmias, Cardiac/etiology ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/psychology ; Depressive Disorder, Major/complications ; Depressive Disorder, Major/drug therapy ; Diagnosis, Differential ; Electrocardiography/drug effects ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial ; Sotalol/therapeutic use
Chemical Substances	Adrenergic beta-Antagonists ; Antidepressive Agents ; Aripiprazole (82VFR53I78) ; Sotalol (A6D97U294I)
Language	English
Publishing date	2019-03-22
Publishing country	United States
Document type	Case Reports ; Clinical Conference ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMcpc1900140
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Article ; Online: Outcomes of Patients Hospitalized With Cardiovascular Implantable Electronic Device-Related Infective Endocarditis, Prosthetic Valve Endocarditis, and Native Valve Endocarditis: A Nationwide Study, 2003 to 2017.

Khaloo, Pegah / Uzomah, Uwajachukwumma A / Shaqdan, Ayman / Ledesma, Pablo A / Galvin, Jennifer / Ptaszek, Leon M / Ruskin, Jeremy N

Journal of the American Heart Association

2022 Volume 11, Issue 17, Page(s) e025600

Abstract: Background Most published reports describing outcomes of patients with cardiovascular implantable electronic device-related infective endocarditis (CIED-IE) are single-center studies with small patient sample sizes. The goal of this study was to utilize ... ...

Abstract	Background Most published reports describing outcomes of patients with cardiovascular implantable electronic device-related infective endocarditis (CIED-IE) are single-center studies with small patient sample sizes. The goal of this study was to utilize population-based data to assess trends in CIED-IE hospitalization and to compare outcomes between patients hospitalized with CIED-IE, prosthetic valve endocarditis (PVE), and native valve endocarditis (NVE). Methods and Results A query of the National (Nationwide) Inpatient Sample (NIS) database between 2003 and 2017 identified 646 325 patients hospitalized with infective endocarditis in the United States of whom 585 974 (90%) had NVE, 27 257 (4.2%) had CIED-IE, and 26 111 (4%) had PVE. There was a 509% increase in CIED-IE hospitalizations in the United States from 2003 to 2017 (
MeSH term(s)	Electronics ; Endocarditis/diagnosis ; Endocarditis/epidemiology ; Endocarditis/therapy ; Endocarditis, Bacterial/diagnosis ; Endocarditis, Bacterial/epidemiology ; Endocarditis, Bacterial/therapy ; Heart Valve Prosthesis/adverse effects ; Hospitalization ; Humans ; Prosthesis-Related Infections/diagnosis ; Prosthesis-Related Infections/epidemiology ; Prosthesis-Related Infections/therapy ; Retrospective Studies
Language	English
Publishing date	2022-08-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.122.025600
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Article ; Online: Author Correction: A phase 1 trial of lipid-encapsulated mRNA encoding a monoclonal antibody with neutralizing activity against Chikungunya virus.

August, Allison / Attarwala, Husain Z / Himansu, Sunny / Kalidindi, Shiva / Lu, Sophia / Pajon, Rolando / Han, Shu / Lecerf, Jean-Michel / Tomassini, Joanne E / Hard, Marjie / Ptaszek, Leon M / Crowe, James E / Zaks, Tal

Nature medicine

2022 Volume 28, Issue 5, Page(s) 1095–1096

Language	English
Publishing date	2022-04-22
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1220066-9
ISSN	1546-170X ; 1078-8956
ISSN (online)	1546-170X
ISSN	1078-8956
DOI	10.1038/s41591-022-01817-z
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Article ; Online: MAUDE Database Analysis of Post-Approval Outcomes following Left Atrial Appendage Closure with the Watchman Device.

Ledesma, Pablo A / Uzomah, Uwajachukwumma A / Yu, Xuejing / Shaqdan, Ayman / Khaloo, Pegah / Galvin, Jennifer / Mansour, Moussa / Ptaszek, Leon M / Ruskin, Jeremy N

The American journal of cardiology

2021 Volume 152, Page(s) 78–87

Abstract: Left atrial appendage closure (LAAC) is an important strategy to reduce stroke risk in patients with non-valvular atrial fibrillation (AF) who are at high risk of bleeding on long-term anticoagulation. Real-world assessments of the safety of the Watchman ...

Abstract	Left atrial appendage closure (LAAC) is an important strategy to reduce stroke risk in patients with non-valvular atrial fibrillation (AF) who are at high risk of bleeding on long-term anticoagulation. Real-world assessments of the safety of the Watchman LAAC device remain limited. The objective of this study was to determine the frequency and timing of adverse events associated with Watchman LAAC device implants performed after FDA approval. Adverse events associated with Watchman LAAC implants performed between March 2015 and March 2019 were identified through a search of the FDA Manufacturer and User Facility Device Experience (MAUDE) database. During the study period, 3,652 unique adverse events were identified. An estimated 43,802 Watchman implants were performed in the United States during the study period. The overall adverse event rate was 7.3% and the mortality rate was 0.4%. Of the 159 unique types of adverse events identified, pericardial effusion was most common (1.4%). Most adverse events (73%) occurred intraoperatively (59%) or within 1 day of the procedure (15%). However, 19% of deaths, 24% of strokes and 27% of device embolizations occurred >1 month after implantation. The rates of most Watchman-related adverse events reported in the MAUDE database were comparable to those observed in clinical trials. A majority of adverse events occurred within 1 day of implant. In conclusion, while the absolute event rates were low, a significant proportion of device embolizations, strokes, and deaths occurred >1 month after Watchman implant.
MeSH term(s)	Atrial Appendage/surgery ; Atrial Fibrillation/complications ; Atrial Fibrillation/surgery ; Cardiac Surgical Procedures ; Cardiac Tamponade/epidemiology ; Databases, Factual ; Device Approval ; Equipment Failure/statistics & numerical data ; Humans ; Hypotension/epidemiology ; Intraoperative Complications/epidemiology ; Mortality ; Pericardial Effusion/epidemiology ; Postoperative Complications/epidemiology ; Prostheses and Implants ; Prosthesis Failure ; Prosthesis Implantation ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Thrombosis/epidemiology ; Time Factors
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2021.04.015
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Article ; Online: Safe and effective delivery of high-power, short-duration radiofrequency ablation lesions with a flexible-tip ablation catheter.

Ptaszek, Leon M / Koruth, Jacob / Santangeli, Pasquale / Piccini, Jonathan P / Ranjan, Ravi / Mahapatra, Srijoy / Pipenhagen, Catherine / Fish, Jeffrey M / Moon, L Boyce / Ambrosius, Nicholas M / Boudlali, Hana / Jensen, James A

Heart rhythm O2

2022 Volume 4, Issue 1, Page(s) 42–50

Abstract: Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially ...

Abstract	Background: High-power, short-duration (HPSD) radiofrequency ablation (RFA) may reduce ablation time. Concerns that catheter-mounted thermocouples (TCs) can underestimate tissue temperature, resulting in elevated risk of steam pop formation, potentially limit widespread adoption of HPSD ablation. Objective: The purpose of this study was to compare the safety and efficacy of HPSD and low-power, long-duration (LPLD) RFA in the context of pulmonary vein isolation (PVI). Methods: An open-irrigated ablation catheter with a contact force sensor and a flexible-tip electrode containing a TC at its distal end (TactiFlex Results: A total of 545 ablations were delivered: 252 with LPLD (0 steam pops) and 293 with HPSD RFA (2 steam pops) ( Conclusion: An investigational ablation catheter effectively delivered RFA lesions. Ablation time required to achieve PVI with HPSD with this catheter was >3-fold shorter than with LPLD RFA.
Language	English
Publishing date	2022-10-25
Publishing country	United States
Document type	Journal Article
ISSN	2666-5018
ISSN (online)	2666-5018
DOI	10.1016/j.hroo.2022.10.009
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Article ; Online: Distinct etiologies of high-sensitivity troponin T elevation predict different mortality risks for patients hospitalized with COVID-19.

Khaloo, Pegah / Shaqdan, Ayman / Ledesma, Pablo A / Uzomah, Uwajachukwumma A / Galvin, Jennifer / Ptaszek, Leon M / Ruskin, Jeremy N

International journal of cardiology

2021 Volume 351, Page(s) 118–125

Abstract: Background: Cardiovascular events in the context of COVID-19 infection increase the risk of negative patient outcomes, but large cohort studies describing this association are limited. The purpose of the current study was to investigate the potential ... ...

Abstract	Background: Cardiovascular events in the context of COVID-19 infection increase the risk of negative patient outcomes, but large cohort studies describing this association are limited. The purpose of the current study was to investigate the potential associations between cardiovascular events and mortality in patients hospitalized due to COVID-19. Methods: A retrospective chart review was performed in 2450 patients hospitalized for confirmed COVID-19 infection within a single hospital network between March 15 and June 15, 2020. Logistic regression analysis was used to identify predictors of mortality. Results: In the study population, 57% of patients had elevated high sensitivity troponin (hs-TnT) levels. Acute heart failure occurred in 23% of patients and arrhythmias were observed in 8% of patients. Of the 1401 patients with elevated hs-TnT levels, a primary cardiac etiology (e.g., myocardial infarction) was identified in 653 (47%) patients. In the remaining 748 (53%) patients, there was evidence of a primary non-cardiac etiology for hs-TnT elevation such as renal failure (n = 304) and critical illness (n = 286). Elevated hs-TnT was associated with increased risk of mortality. A significantly higher mortality rate was observed for hs-TnT elevation associated with a primary cardiac etiology (OR 4.6, 95% CI: 2.7-7.6; P < 0.001) than a primary non-cardiac etiology (OR 2.7, 95% CI: 1.6-4.5; P < 0.001). Conclusions: Elevated hs-TnT in the context of COVID-19 infection is associated with a significantly increased mortality risk. Hs-TnT elevation in the context of a primary cardiac etiology confers a nearly 2-fold higher mortality risk than hs-TnT elevation due to a primary non-cardiac etiology.
MeSH term(s)	Biomarkers ; COVID-19 ; Humans ; Prognosis ; Retrospective Studies ; SARS-CoV-2 ; Troponin T
Chemical Substances	Biomarkers ; Troponin T
Language	English
Publishing date	2021-12-21
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2021.12.029
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Article ; Online: Case Records of the Massachusetts General Hospital. Case 19-2015. A 71-Year-Old Man with Chest Pain and Shortness of Breath.

Dudzinski, David M / Prabhakar, Anand M / Ptaszek, Leon M / Vlahakes, Gus J

The New England journal of medicine

2015 Volume 372, Issue 25, Page(s) 2438–2446

MeSH term(s)	Aged ; Cardiomyopathies/etiology ; Cardiomyopathies/therapy ; Chest Pain/etiology ; Defibrillators, Implantable/adverse effects ; Diagnosis, Differential ; Dyspnea/etiology ; Foreign-Body Migration/complications ; Foreign-Body Migration/diagnostic imaging ; Heart Failure/complications ; Hemothorax/diagnostic imaging ; Hemothorax/etiology ; Humans ; Male ; Myocardial Infarction/complications ; Pericardial Effusion/etiology ; Prosthesis Failure ; Tomography, X-Ray Computed
Language	English
Publishing date	2015-06-18
Publishing country	United States
Document type	Case Reports ; Clinical Conference ; Journal Article
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMcpc1415757
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