Publications by authors named "Lohit Garg"
Bipolar radiofrequency ablation for refractory scar-related interatrial septal tachycardias: a multicenter study.
J Interv Card Electrophysiol
September 2025
Background: Catheter ablation of scar-related interatrial septal atrial tachycardias (IAS-ATs) is challenging and can be refractory to conventional unipolar radiofrequency catheter ablation (RFCA).
Aim: This multicenter study investigated the safety and efficacy of bipolar radiofrequency catheter ablation (Bi-RFCA) in patients with IAS-AT refractory to conventional unipolar RFCA.
Methods: Consecutive patients with scar-related IAS-AT refractory to conventional unipolar RFA across three electrophysiological centers were included in the study.
Background: Patients with arrhythmogenic mitral valve prolapse syndrome are at increased risk for life-threatening ventricular arrhythmias, but studies have been limited by small sample sizes. We sought to assemble an international arrhythmogenic mitral valve prolapse syndrome registry to delineate the clinical, imaging, and treatment characteristics of patients with arrhythmogenic mitral valve prolapse syndrome who survived sudden cardiac arrest (SCA) or had sustained ventricular tachycardia (VT) or ventricular fibrillation.
Methods: In this descriptive registry, we characterized patients with arrhythmogenic mitral valve prolapse syndrome who survived SCA, sustained VT, or ventricular fibrillation.
Burden of Premature Ventricular Complexes and Risk of Cardiomyopathy: A Cross-Sectional Study.
JACC Clin Electrophysiol
May 2025
Background: The association between premature ventricular complexes (PVCs) and ventricular function has been described in several observational studies, where it has been implied that a higher burden of PVCs plays a causative role in reducing left ventricular ejection fraction (LVEF). To date, however, few studies have examined the association of PVCs and cardiomyopathy on a population level.
Objectives: In this treatment-agnostic, cross-sectional study, the authors examined the association of PVC burden with depressed LVEF.
Atrial fibrillation (AF) is the leading cause of arrhythmia-related morbidity and mortality. Recurrent symptoms, hospitalizations, and cost burden to patients have necessitated treatments beyond antiarrhythmic drugs (AADs) for patients with AF. Catheter ablation has proven to be effective over medical therapy alone; however the recurrence rates for atrial tachyarrhythmias post-ablation remain significant, particularly in patients with persistent and long-standing persistent AF.
View Article and Find Full Text PDFBackground: Myotonic dystrophy type 1 (DM1) is associated with progressive conduction disease. Furthermore, DM1 patients are at risk ventricular arrhythmias (VAs), although prediction remains difficult. The 2022 Heart Rhythm Expert Consensus Statement gives a IIb recommendation to the use of electrophysiology study (EPS) to risk-stratify patients for VAs.
View Article and Find Full Text PDFBackground: Cardiac implantable electronic device (CIED) procedures can cause significant postoperative pain. Opioid use for postoperative pain is associated with risk of persistent use. The benefits of pectoral nerve (PECs) blocks have been established for other chest wall surgeries, but adoption in electrophysiology has been limited.
View Article and Find Full Text PDFBackground: Identification of patients at risk for atrial fibrillation (AF) after typical atrial flutter (tAFL) ablation is important to guide monitoring and treatment.
Objective: The purpose of this study was to create and validate a risk score to predict AF after tAFL ablation METHODS: We identified patients who underwent tAFL ablation with no AF history between 2017 and 2022 and randomly allocated to derivation and validation cohorts. We collected clinical variables and measured conduction parameters in sinus rhythm on an electrophysiology recording system (CardioLab, GE Healthcare).
Article Synopsis
- A study on arrhythmogenic right ventricular cardiomyopathy (ARVC) found that a significant number of patients (34%) experienced atrial arrhythmias (AAs) even after undergoing ventricular tachycardia (VT) ablation.
- The most common types of AAs were atrial fibrillation, typical atrial flutter, and atypical flutter, with many patients requiring further ablation procedures to manage these issues effectively.
- A risk score was developed to predict the likelihood of typical atrial flutter, which can help identify patients who might benefit from specific interventions during VT ablation.
Background: Cardiac stereotactic body radiotherapy (SBRT) has emerged as a promising noninvasive treatment for refractory ventricular tachycardia (VT).
Objective: The purpose of this study was to describe the safety and effectiveness of SBRT for VT in refractory to extensive ablation.
Methods: After maximal medical and ablation therapy, patients were enrolled in a prospective registry.
PRIME score for prediction of permanent pacemaker implantation after transcatheter aortic valve replacement.
Catheter Cardiovasc Interv
December 2023
Article Synopsis
- The study aimed to create an easy-to-use scoring system to assess the risk of needing a permanent pacemaker (PPM) after transcatheter aortic valve replacement (TAVR).
- Atrial block, a common issue related to TAVR, prompted the need for a more clinically applicable risk prediction model, as existing models weren't suitable for pre-procedure planning.
- The resulting PRIME score was developed using five key pre-procedure variables and demonstrated high accuracy in predicting PPM needs in both training and validation groups.
Right versus left-sided implantation of left bundle branch area pacemaker insertion.
J Interv Card Electrophysiol
March 2024
Utility of Very High-Output Pacing to Identify VT Circuits in Patients Manifesting Traditionally Inexcitable Scar.
JACC Clin Electrophysiol
December 2023
Article Synopsis
- Entrainment and standard pacing techniques are often ineffective in identifying critical components of ventricular tachycardia (VT) in patients with dense myocardial scarring.
- This study evaluated the effectiveness of very high-output pacing (V-HOP), which uses higher power (50 mA) to stimulate heart tissue, for locating these critical areas when standard methods failed.
- Results showed V-HOP successfully identified critical components in most patients and guided effective ablation procedures, leading to a high success rate without serious complications.
Article Synopsis
- The COVID-19 pandemic changed how we think about health and safety, especially using masks.
- The paper talks about "mask mirroring," where doctors wear masks like their patients to show respect and build trust.
- This approach helps create a safer healthcare environment, showing empathy and making patients feel comfortable while getting care.
As the atrial fibrillation (AF) recurrence rate remains high after pulmonary vein isolation (PVI), additional left atrial posterior wall isolation (PWI) has been studied in randomized controlled trials, however, the results are conflicting. We performed an updated meta-analysis by searching online databases for the randomized controlled trials comparing the PWI + PVI group to the PVI alone group in patients with AF. The outcomes of interest were AF recurrence, all atrial arrhythmia recurrence, and atrial flutter/atrial tachycardia (AT) recurrence.
View Article and Find Full Text PDFArticle Synopsis
- The study analyzed data from over 52,000 patients diagnosed with atrial fibrillation between 2010 and 2020 to determine the best rhythm-management strategies for individuals.
- Researchers utilized a form of artificial intelligence called tabular Q-learning to predict optimal treatments based on outcomes such as mortality and treatment sustainability, while also clustering patients into distinct groups for better analysis.
- Findings revealed that rhythm-control strategies led to better outcomes than rate-control strategies, particularly when the treatment matched the Q-learning recommendations, indicating a promising method for improving clinical decision-making in atrial fibrillation management.
Evaluating temperature gradients across the posterior left atrium with radiofrequency ablation.
J Cardiovasc Electrophysiol
April 2023
Article Synopsis
- Esophageal injury is a recognized risk during catheter ablation procedures, and new methods to reduce this risk are being evaluated through temperature gradient studies.
- Researchers conducted experiments using a porcine heart model to analyze how different ablation techniques affected temperature changes in the left atrium and surrounding tissues, specifically focusing on the esophagus.
- Results showed that standard ablation techniques resulted in a significantly higher temperature increase at the anterior wall of the esophagus compared to high-power short duration approaches, indicating potential risks with different methods.
Article Synopsis
- The study investigates the impact of having sinus rhythm (SR) at the time of catheter ablation (CA) on long-term outcomes for patients with persistent atrial fibrillation (PersAF).
- Results show that patients who presented in SR had better freedom from atrial arrhythmias (AAs) after the procedure compared to those who presented in atrial fibrillation (AF).
- The findings suggest that achieving SR before ablation can improve overall arrhythmia outcomes and prolong the time until recurrent AF.
A Force Awakens: Return of Needle Catheter Radiofrequency Ablation for Targeting Intramural Ventricular Arrhythmias.
Circ Arrhythm Electrophysiol
September 2022
Article Synopsis
- Unipolar electrograms (UniEGMs) are often used for localizing focal arrhythmias, but their effectiveness in ablation of deeper premature ventricular contractions (PVCs) is questionable.
- This study compared bipolar electrograms (BiEGMs) to UniEGMs in guiding the successful ablation of PVCs originating from both the right ventricular outflow tract (RVOT) and intramural outflow tracts.
- Results showed that BiEGMs provided a better identification of activation times, particularly for intramural PVCs, highlighting their superior role in successful ablation compared to UniEGMs.
Utility of Prolonged Duration Endocardial Ablation for Ventricular Arrhythmias Originating From the Left Ventricular Summit.
JACC Clin Electrophysiol
April 2022
Article Synopsis
- This study examined whether using prolonged duration (PD) radiofrequency ablation (RFA) can enhance the outcomes of catheter ablation (CA) for left ventricular summit (LVS) ventricular arrhythmias (VAs).
- The research included 102 patients over four years, comparing standard RFA to PD RFA, with results showing higher procedural success and clinical outcomes with PD RFA.
- The findings suggest that PD RFA is a safe and effective approach for treating difficult LVS VAs that do not respond to standard RFA techniques.
Running the Risk: Exercise and Arrhythmogenic Cardiomyopathy.
Curr Treat Options Cardiovasc Med
October 2021
Purpose Of Review: The purpose of this review is to summarize what is known about the relationship between exercise and arrhythmogenic right ventricular cardiomyopathy (ARVC) with regard to disease onset, diagnosis, progression, and clinical severity. This relationship forms the basis of the management recommendations for restricting physical activity in individuals with and at risk for ARVC.
Recent Findings: While ARVC can be challenging to diagnose, there are several diagnostic testing and imaging modalities that may help distinguish athletic heart remodeling from ARVC.
A 74-year old woman underwent "mini-mitral" valve surgery via a right thoracotomy. The pulmonary artery catheter could not be removed thereafter and was found to be pierced by the atriotomy suture. Removal was performed by percutaneously lacerating the catheter above and below the suture, leaving behind a small segment.
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