Publications by authors named "Eric Black-Maier"
Background: The first commercial systems for pulsed field ablation (PFA) were recently approved by the Food and Drug Administration, but their safety profile in nationwide practice remains underexplored.
Objectives: This study aimed to describe reported adverse events with PFA systems after their market release and to compare the relative proportion of complications associated with PFA vs radiofrequency (RF) ablation catheters.
Methods: We conducted a search of the Manufacturer and User Facility Device Experience database for adverse event reports involving Food and Drug Administration-approved PFA and RF catheters from January 1, 2024, to July 31, 2024.
Article Synopsis
- A study at Duke University Hospital reviewed 421 patients with left ventricular assist devices (LVADs) and implantable cardioverter-defibrillators (ICDs) to assess the frequency and causes of ICD shocks post-surgery.
- Out of these patients, 33.9% experienced at least one shock, with 77.3% deemed appropriate and 22.7% inappropriate, primarily due to supraventricular tachycardia.
- The findings suggest that better ICD programming, such as longer detection delays and higher rate cutoffs, could reduce the number of inappropriate shocks in LVAD recipients.
Article Synopsis
- Ethanol infusion into the vein of Marshall (VOM) can help treat certain heart problems, but it's tricky and can cause issues like delayed pericardial effusions.
- A study looked at 275 patients who had this procedure done at a hospital in Maine to see how changes in techniques affected complications.
- The results showed that with better techniques, the number of complications dropped significantly, especially in the later procedures compared to the early ones, even though the success rate remained high.
Article Synopsis
- Complete hardware removal is recommended for cardiovascular implantable electronic device (CIED) infections, but how often this is practiced and the results are unclear.
- A study analyzed Medicare patients with CIED infections from 2006 to 2019, focusing on implantation and lead extraction outcomes.
- Among 1,065,549 patients, only 1.1% developed infections, with a 1-year survival rate of 68.3%, highlighting that most did not undergo recommended lead extraction soon after diagnosis.
Background: There is evidence to suggest that colchicine reduces the risk of recurrent atrial fibrillation (AF) after catheter ablation; however, the tolerability and safety of colchicine in routine practice is unknown.
Methods: Patients undergoing catheter ablation for AF who received colchicine after ablation were matched 1:1 to patients who did not by age, sex, and renal function. Recurrent AF was compared between groups categorically at 12 months and via propensity weighted Cox proportional hazards models with and without a 3-month blanking period.
Efficacy and Safety of Adjunctive and Primary Use of the TightRail Mechanical Cutting Sheath for Lead Extraction.
Circ Arrhythm Electrophysiol
June 2023
Background: Rotational cutting tools are increasingly used in transvenous lead extraction. There are limited data on their safety and efficacy, particularly when used adjunctively for stalled progression. The aim of this study was to evaluate the utilization, safety, and effectiveness of mechanical rotational cutting tools for transvenous lead extraction.
View Article and Find Full Text PDFBackground: Heart failure affects >6 million people in the United States alone and is most prevalent in Black patients who suffer the highest mortality risk. Yet prior studies have suggested that Black patients are less likely to receive advanced heart failure therapy. We hypothesized that Black patients would have decreased rates of durable left ventricular assist device (LVAD) implantation within our expansive heart failure program.
View Article and Find Full Text PDFArticle Synopsis
- Two patients with a history of significant heart issues underwent extraction of devices with azygous coils in place, highlighting the lack of existing data on this procedure.
- Both patients experienced successful removal of the coils using laser technology, with no intraoperative complications reported.
- The results suggest that azygous coils can be safely removed using standard techniques similar to those used for other lead extractions, despite their varied dwell times.
Background: Wait times for catheter ablation in patients with symptomatic atrial fibrillation (AF) may influence clinical outcomes.
Objective: This study examined the relationship between the duration from AF diagnosis to ablation, or diagnosis-to-ablation time (DAT), on the clinical response to catheter ablation in a large nationwide cohort of patients.
Methods: We identified patients with new AF who underwent catheter ablation between January 2014 and December 2017 using the IBM MarketScan databases.
Can catheter ablation of atrial fibrillation reverse heart failure with preserved ejection fraction?
J Cardiovasc Electrophysiol
September 2021
A 69-year-old man with a history of coronary artery ectasia, potentially resulting from an underlying heritable connective tissue disorder, presented with ventricular fibrillation. Despite medical management of ischemia, he developed recurrent ventricular tachycardia with poor neurological recovery. We highlight challenges in the management of coronary artery ectasia.
View Article and Find Full Text PDFCatheter ablation of atrial fibrillation in patients with diabetes mellitus.
Heart Rhythm O2
August 2020
Article Synopsis
- Diabetes mellitus (DM) is linked to increased risk of recurrence in atrial fibrillation (AF) after catheter ablation, as shown in a study comparing outcomes between patients with and without DM.
- The study analyzed 351 patients and found those with DM tended to be older, heavier, and had more persistent AF, but had similar rates of complications during the procedure.
- After a median follow-up of nearly 30 months, patients with DM experienced significantly higher rates of AF recurrence, indicating that managing blood sugar levels may be crucial in these patients.
Article Synopsis
- Ventricular arrhythmias (VAs) and electrical storm (ES) are common issues after left ventricular assist device (LVAD) surgery, but their long-term effects are not well understood.
- A study at Duke University analyzed 730 LVAD patients from 2009 to 2020, finding that 10.7% experienced ES, often linked to increased mortality and occurring both shortly after and long after surgery.
- Key risk factors for developing ES included previous VAs, use of antiarrhythmic drugs, and prior ventricular tachycardia ablation, yet the best treatment options for managing ES in these patients remain unclear.
Left bundle branch block (LBBB) increases the likelihood of developing reduced left ventricular (LV) ejection fraction (EF) but predicting which patients with LBBB and normal LVEF will develop decreased LVEF remains challenging. Fifty patients with LBBB and normal LVEF were retrospectively identified. Clinical, electrocardiographic, and echocardiographic variables were compared between patients who developed a decreased LVEF and those who did not.
View Article and Find Full Text PDFCardiac Implantable Electronic Devices: A Window Into the Evolution of Conduction Disease in Cardiac Amyloidosis.
JACC Clin Electrophysiol
September 2020
Objectives: This study characterized the relationship between conduction disease and cardiac amyloidosis (CA) through longitudinal analysis of cardiac implantable electronic device (CIED) data.
Background: Bradyarrhythmias and tachyarrhythmias are commonly reported in CA and may precede a CA diagnosis, although the natural history of conduction disease in CA is not well-described.
Methods: Patients with CA (transthyretin amyloidosis cardiomyopathy [ATTR-CM] and light-chain amyloidosis [AL-CA]) and a CIED were identified within the Duke University Health System.
Cardiovascular Implantable Electronic Device Surgery Following Left Ventricular Assist Device Implantation.
JACC Clin Electrophysiol
September 2020
Article Synopsis
- This study aimed to analyze the reasons, features, and results of cardiovascular implantable electronic device (CIED) surgeries in patients who have undergone left ventricular assist device (LVAD) implantation.
- A total of 159 LVAD recipients underwent CIED surgeries between 2009 and 2019, with a higher likelihood for pocket hematomas and infections after the procedures, as well as a 20% mortality rate within one year.
- The findings highlight the need for further research to evaluate the risks versus benefits of CIED surgeries in patients with LVADs.
Reducing ECG Artifact From Left Ventricular Assist Device Electromagnetic Interference.
J Am Heart Assoc
August 2020
Background Left ventricular assist devices (LVADs) generate electromagnetic interference that causes high-frequency noise artifacts on 12-lead ECGs. We describe the causes of this interference and potential solutions to aid ECG interpretation in patients with LVAD. Methods and Results Waveform data from ECGs performed before and after LVAD implantation were passed through a fast Fourier transform to identify LVAD-related changes in the spectral profile.
View Article and Find Full Text PDFCatheter ablation of atrial fibrillation in cardiac amyloidosis.
Pacing Clin Electrophysiol
September 2020
Article Synopsis
- Cardiac amyloidosis is a disease that leads to the buildup of amyloid proteins in the heart, often causing heart failure and arrhythmias like atrial fibrillation and flutter.
- A study reviewed data from 13 patients with cardiac amyloidosis who underwent catheter ablation from 2011 to 2018, finding differences in ejection fraction and arrhythmia types between those receiving various ablation procedures.
- The results suggest that catheter ablation for AT/AF/AFL might help early to mid-stage patients, while AV node ablation seems better suited for those in advanced stages of the disease.
Objectives: The goal of this study was to assess the utility of transvenous lead extraction for cardiovascular implantable electronic device (CIED) infection in patients with a left ventricular assist device (LVAD).
Background: The use of transvenous lead extraction for the management CIED infection in patients with a durable LVAD has not been well described.
Methods: Clinical and outcomes data were collected retrospectively among patients who underwent lead extraction for CIED infection after LVAD implantation at Duke University Hospital.
Article Synopsis
- This study investigates the outcomes of patients who have both a subcutaneous implantable cardioverter-defibrillator (S-ICD) and a left ventricular assist device (LVAD) due to limited existing data on the topic.
- A retrospective study at Duke University Hospital identified four patients with S-ICD after LVAD implantation, all of whom experienced electromagnetic interference (EMI) that led to inappropriate shocks in some cases.
- The systematic review also revealed that EMI is common, especially in primary and secondary sensing vectors, but undersensing in an alternate vector may improve over time, possibly preventing the need for device surgery.
Implantable cardioverter-defibrillator lead revision following left ventricular assist device implantation.
J Cardiovasc Electrophysiol
June 2020
Introduction: Lead dysfunction can lead to serious consequences including failure to treat ventricular tachycardia or fibrillation (VT/VF). The incidence and mechanisms of lead dysfunction following left ventricular assist device (LVAD) implantation are not well-described. We sought to determine the incidence, mechanisms, timing, and complications of right ventricular lead dysfunction requiring revision following LVAD implantation.
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