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Jonathan S Steinberg - One of the best experts on this subject based on the ideXlab platform.
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives: This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT...
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT). Background Cardiac resynchronization therapy is used in patients with atrial fibrillation (AF), prolonged QRS duration, and heart failure in the setting of ventricular dysfunction. The percentage of ventricular pacing is used as an indicator of adequate biventricular (BiV) pacing. Although device counters show a high pacing percentage, there may be ineffective capture because of underlying fusion and pseudo-fusion beats. Methods We identified 19 patients (age 72 ± 8 years, ejection fraction 18 ± 5%), with permanent AF who underwent CRT. All patients received digoxin, beta-blockers, and amiodarone for rate control; device interrogation showed >90% BiV pacing. Patients had a 12-lead Holter monitor to assess the presence of effective (>90% fully paced beats/24 h) pacing. At 12 months post-CRT, the New York Heart Association functional class was reassessed and an echocardiogram was obtained and compared with pre-CRT. Results Only 9 (47%) patients had effective pacing. The other 10 (53%) patients had 16.4 ± 4.6% fusion and 23.5 ± 8.7% pseudo-fusion beats. Long-term responders (≥1 New York Heart Association functional class improvement) to CRT had a significantly higher percentage of fully paced beats (86.4 ± 17.1% vs. 66.8 ± 19.1%; p = 0.03) than nonresponders. Conclusions Pacing counters overestimate the degree of effective BiV pacing in patients with permanent AF undergoing CRT therapy. Only patients with complete capture responded clinically to CRT. These findings have important implications for the application of CRT to patients with permanent AF and heart failure.
Ganesh S Kamath - One of the best experts on this subject based on the ideXlab platform.
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives: This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT...
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT). Background Cardiac resynchronization therapy is used in patients with atrial fibrillation (AF), prolonged QRS duration, and heart failure in the setting of ventricular dysfunction. The percentage of ventricular pacing is used as an indicator of adequate biventricular (BiV) pacing. Although device counters show a high pacing percentage, there may be ineffective capture because of underlying fusion and pseudo-fusion beats. Methods We identified 19 patients (age 72 ± 8 years, ejection fraction 18 ± 5%), with permanent AF who underwent CRT. All patients received digoxin, beta-blockers, and amiodarone for rate control; device interrogation showed >90% BiV pacing. Patients had a 12-lead Holter monitor to assess the presence of effective (>90% fully paced beats/24 h) pacing. At 12 months post-CRT, the New York Heart Association functional class was reassessed and an echocardiogram was obtained and compared with pre-CRT. Results Only 9 (47%) patients had effective pacing. The other 10 (53%) patients had 16.4 ± 4.6% fusion and 23.5 ± 8.7% pseudo-fusion beats. Long-term responders (≥1 New York Heart Association functional class improvement) to CRT had a significantly higher percentage of fully paced beats (86.4 ± 17.1% vs. 66.8 ± 19.1%; p = 0.03) than nonresponders. Conclusions Pacing counters overestimate the degree of effective BiV pacing in patients with permanent AF undergoing CRT therapy. Only patients with complete capture responded clinically to CRT. These findings have important implications for the application of CRT to patients with permanent AF and heart failure.
Zbigniew Gąsior - One of the best experts on this subject based on the ideXlab platform.
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Supraventricular Runs in 7-Day Holter Monitoring Are Related to Increased Incidence of Atrial Fibrillation in a 3-Year Follow-Up of Cryptogenic Stroke Patients Free from Arrhythmia in a 24 h-Holter
'MDPI AG', 2021Co-Authors: Andrzej Kułach, Milena Dewerenda, Michał Majewski, Anetta Lasek-bal, Zbigniew GąsiorAbstract:Introduction: Silent atrial fibrillation (AF) is a common cause of cryptogenic ischemic stroke (CIS). The 24-h-Holter is insufficient to reveal an occult arrhythmic cause of stroke and the strategy to select the patients for long-term Monitoring is missing. Objectives: The aim of the study was to evaluate 7-day-Holter Monitoring to identify cases with the arrhythmic cause of stroke in CIS patients in whom 24-h-Holter was free from arrhythmia, and to assess the relation between supraventricular (SV) runs in baseline Holter and the incidence of AF in a 3-year follow-up period. Methods: 78 patients (aged 60 ± 9 years, 45 males) with CIS and no arrhythmic findings in 24-h-Holter were enrolled. All patients had 7-day-Holter Monitoring after stroke and were followed up for 36 months, and then 7-day Holter was repeated. We assessed SV runs (≥5 QRS) in the initial 7-day Holter and analyzed the relation of the findings with clinical characteristics of novel AF episodes revealed early after stroke and during a 3-year follow-up. Results: Baseline 7-day-Holter revealed SV runs in 36% of patients and AF in 9% of cases. During a 3-year follow-up, 8 additional cases were confirmed, both in standard care and in repeated Holter (a total of 19% of AF cases). There was no difference with regard to CHADS2VASc score (3.6 ± 1.1 vs. 3.4 ± 1.5; p = NS) and left atrium parameters between patients with SV runs and the non-arrhythmic group. Patients with SV runs had a higher incidence of AF both after stroke and in a 3-year follow-up (46% vs. 4%, RR 11.6, p p < 0.001) and should be considered for extended continuous ECG Monitoring
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72 hour Holter Monitoring 7 day Holter Monitoring and 30 day intermittent patient activated heart rhythm recording in detecting arrhythmias in cryptogenic stroke patients free from arrhythmia in a screening 24 h Holter
Open Medicine, 2020Co-Authors: Andrzej Kulach, Milena Dewerenda, Michal Majewski, Anetta Lasekbal, Zbigniew GąsiorAbstract:Introduction According to recent studies, silent atrial fibrillation (AF) is a common cause of cryptogenic ischemic stroke (CIS). 12-lead electrocardiogram (ECG) and 24 h Holter are not efficient to reveal an occult arrhythmic cause of stroke. Objectives The aim of the study was to evaluate 72 h Holter, 7 day Holter Monitoring, and intermittent single-lead ECG recording in patients with CIS to identify cases with the arrhythmic cause of stroke in patients with CIS in whom 24 h ECG Holter was free from arrhythmia. Methods 72 patients (aged 60 ± 9 years, 44 males) with CIS and no arrhythmic findings in 24 h Holter were enrolled. All patients had 7 day Holter Monitoring and received handheld ECG recorder (CheckMe, Viatom) for ambulatory 30 ± 3 days ECG recording. AF, supraventricular tachycardia (SVT runs of ≥5 QRS), and other arrhythmias were assessed in the first 72 h of Holter recording, in 7 day-recording, and in handheld ECG strips. Results 72 h-recording revealed AF in four cases (5.6%) and SVT in 18 (25%) cases. 7 day Holter confirmed AF in seven patients (10%) and SVT in 27 patients (37.5%). There was no difference in regards to CHADS2VASc score between patients with SVT and non-arrhythmic group (3.6 ± 1.1 vs 3.4 ± 1.6; p = NS). Symptoms did not correlate with findings. Patient-activated handheld ECG recorders were used with good compliance. The mean number of recordings was 49 ± 30. Except for PACs, there was only one case of AF documented in 3,531 strips. Conclusions 7 day Holter performs better than 72 h and reveals supraventricular arrhythmias in every third and AF in 10% of CIS patients who were free from arrhythmia in 24 h ECG Monitoring. 30 day intermittent ECG monitor does not yield diagnostic value in CIS.
Jacqueline L Buros - One of the best experts on this subject based on the ideXlab platform.
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timing and duration of myocardial ischemia on Holter Monitoring following percutaneous coronary intervention and their association with clinical outcomes a protect timi 30 substudy analysis
American Journal of Cardiology, 2009Co-Authors: Michael C Gibson, Lauren N Ciaglo, Jacqueline L Buros, Yuri B Pride, David A Morrow, Benjamin M Scirica, Peter StoneAbstract:In patients with unstable angina, evidence of myocardial ischemia on Holter Monitoring is associated with an adverse prognosis. However, the association of duration and timing of ischemia on Holter Monitoring with outcomes after percutaneous coronary intervention (PCI) in patients with non–ST-segment elevation acute coronary syndromes (NSTEACSs) has not been systematically evaluated. PROTECT-TIMI 30 randomized 857 patients with NSTEACSs undergoing PCI to eptifibatide plus a heparin product or bivalirudin monotherapy. Patients underwent continuous Holter Monitoring following PCI, and the association between ischemia and clinical outcomes was evaluated retrospectively. Forty-three patients (5.0%) had ischemia on Holter after PCI. Any ischemia was associated with a significant increase in the incidence of death or myocardial infarction (MI) within 48 hours (32.6% vs 6.1%, odds ratio 7.5, 95% confidence interval 3.70 to 15.10, p
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diagnostic and prognostic value of ambulatory ecg Holter Monitoring in patients with coronary heart disease a review
Journal of Thrombosis and Thrombolysis, 2007Co-Authors: Michael C Gibson, Lauren N Ciaglo, Matthew C Southard, Shaun Takao, Caitlin J Harrigan, Jason S Lewis, Jason Filopei, Michelle E Lew, Sabina A Murphy, Jacqueline L BurosAbstract:Silent ischemia, the most common expression of atherosclerotic heart disease, affects approximately 30–50% of patients during their activities of daily living. The present review provides a comprehensive and practical summary of current knowledge on perioperative myocardial ischemia through MEDLINE searches up to June 2005, using keywords including “silent ischemia,” “transient ischemia,” and “Holter Monitoring.” Holter Monitoring (i.e., continuous ambulatory ST-segment Monitoring) is an effective tool for assessing the frequency and duration of silent transient myocardial ischemia, particularly in patients who are post-acute myocardial infarction (MI), those with acute coronary syndromes (ACS), and in patients in the acute post-operative period. Holter Monitoring allows for further risk stratification of patients who have a positive exercise ECG by collecting long-term ECG data on ischemic and arrhythmic events while patients perform routine activities. Both the presence and increased duration of transient ischemia as detected by continuous ST-segment Holter Monitoring are associated with increased rates of coronary events and mortality. Holter Monitoring may aid in the identification of patients and subgroups of patients with ACS who may derive the greatest benefit from antiplatelet and antithrombotic therapy. Indeed, many ongoing and upcoming trials of pharmacotherapy include ischemia on Holter Monitoring as an endpoint.
Jayanthi N Koneru - One of the best experts on this subject based on the ideXlab platform.
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives: This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT...
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the utility of 12 lead Holter Monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy
Journal of the American College of Cardiology, 2009Co-Authors: Ganesh S Kamath, Delia Cotiga, Jayanthi N Koneru, Aysha Arshad, Walter Pierce, Emad F Aziz, Anisha Mandava, Suneet Mittal, Jonathan S SteinbergAbstract:Objectives This study sought to determine the incidence of ineffective capture using 12-lead Holter Monitoring and to assess whether this affects response to cardiac resynchronization therapy (CRT). Background Cardiac resynchronization therapy is used in patients with atrial fibrillation (AF), prolonged QRS duration, and heart failure in the setting of ventricular dysfunction. The percentage of ventricular pacing is used as an indicator of adequate biventricular (BiV) pacing. Although device counters show a high pacing percentage, there may be ineffective capture because of underlying fusion and pseudo-fusion beats. Methods We identified 19 patients (age 72 ± 8 years, ejection fraction 18 ± 5%), with permanent AF who underwent CRT. All patients received digoxin, beta-blockers, and amiodarone for rate control; device interrogation showed >90% BiV pacing. Patients had a 12-lead Holter monitor to assess the presence of effective (>90% fully paced beats/24 h) pacing. At 12 months post-CRT, the New York Heart Association functional class was reassessed and an echocardiogram was obtained and compared with pre-CRT. Results Only 9 (47%) patients had effective pacing. The other 10 (53%) patients had 16.4 ± 4.6% fusion and 23.5 ± 8.7% pseudo-fusion beats. Long-term responders (≥1 New York Heart Association functional class improvement) to CRT had a significantly higher percentage of fully paced beats (86.4 ± 17.1% vs. 66.8 ± 19.1%; p = 0.03) than nonresponders. Conclusions Pacing counters overestimate the degree of effective BiV pacing in patients with permanent AF undergoing CRT therapy. Only patients with complete capture responded clinically to CRT. These findings have important implications for the application of CRT to patients with permanent AF and heart failure.