Paul Khairy

..We assessed whether AF predicts appropriate implantable cardioverter-defibrillator (ICD) shocks in patients with left ventricular dysfunction and explored modulators of risk...

..In looking ahead, examples of creative methodological solutions to maximizing the efficiency of clinical trials for rare diseases are discussed, including Bayesian analyses, outcome-adaptive randomization and internal pilot studies...

..It remains unknown whether cryothermal ablation lesions display a similar pattern of growth...

..The arrhythmia burden in tetralogy of Fallot, types of arrhythmias encountered, and risk profile may change as the population ages...

..This review highlights the various types of brady- and tachyarrhythmias encountered in the more common forms of adult congenital heart disease and explores prognostic implications and therapeutic options...

..Although the present report touches on issues applicable to neonates and children with univentricular hearts, the focus is on information of interest and relevance to the adult cardiologist...

..The objective of this review is to highlight commonly confronted arrhythmia issues and themes, discuss particular challenges, review recent relevant literature, and summarize current management trends...

..The risk of systemic thromboemboli associated with transvenous leads in the presence of an intracardiac shunt is currently unknown...

..Little is known about mechanisms of sudden death and the role of implantable cardioverter defibrillators...

..We sought to assess the safety and feasibility of laser lead extraction in ACHD...

..We discuss the benefits and pitfalls of strategies such as high cutoff rates, longer detections times, antitachycardia pacing, and discriminators in reducing the incidence of inappropriate shocks and offer practical programming tips...

..Tetralogy of Fallot is the most common form of congenital heart disease in implantable cardioverter-defibrillator (ICD) recipients, yet little is known about the value of ICDs in this patient population...

..There are numerous theoretical advantages to engineering a system capable of delivering both energy forms...

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..A recalcitrant accessory pathway was successfully ablated in a patient with hemodynamically unstable supraventricular tachycardia and an extracadiac Fontan for hypoplastic left heart syndrome...

..Surface areas and volumes may be particularly sensitive to catheter tip-to-tissue contact angles with larger electrodes, as reflected by greater variability with 8 mm tips...

..Paralleling the rise in pacemaker and defibrillator implantations, lead extraction procedures are increasingly required. Concerns regarding failure and complications remain...

..The purpose of this study was to characterize pathological aspects of cardiac lesions induced by β-radiation in an animal model at various stages of evolution and in response to different dose exposures...

..Cryoablation is increasingly used to treat atrioventricular nodal reentrant tachycardia (AVNRT). It is unknown whether larger electrode-tip cryocatheters improve outcomes without compromising safety...

..We assessed whether AS is associated with outcomes of rhythm-control versus rate-control in congestive heart failure (CHF) patients with AF...

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..Pulmonary vein isolation has emerged as an effective treatment in selected patients. In this paper, the past and present roles of pulmonary vein isolation are described and the future developments of this technique are explored...

..Future directions at the Montreal Heart Institute are also briefly addressed...

..This study sought to assess the impact of rhythm- versus rate-control treatment strategies and of underlying rhythm on quality of life and functional capacity in patients with atrial fibrillation (AF) and congestive heart failure (CHF)...

..Our primary objective was to assess the impact of mineralocorticoid receptor antagonists on cardiovascular mortality in patients with AF and HF enrolled in the Atrial Fibrillation and Congestive Heart Failure (AF-CHF) trial...

..Left ventricular (LV) pacing alone may theoretically avoid deleterious effects of right ventricular pacing...

..We sought to determine the prevalence and predictors of aortic root dilatation in adults with repaired tetralogy of Fallot...

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..Pulmonary arterial hypertension (PAH) may develop in patients with atrial septal defects (ASD); however, little is known about associated risk factors and its evolution after transcatheter ASD closure...

..persistent dual atrioventricular (AV) nodal physiology with or without echo beats...

..Multicenter prospective collaborative efforts are to be encouraged...

..In the absence of a monitoring zone, device therapy would not have been expected. We explore the mechanisms by which monitoring zones could potentially contribute to inappropriate ICD therapy and offer trouble-shooting tips...

..This study assessed effects of AF-related remodeling on the atrial thrombogenic milieu by using radiofrequency ablation (RFA) to create a quantifiable prothrombotic nidus...

..While several studies have investigated electrical or mechanical determinants of synchronous contraction, few have focused on activation contraction coupling at a macroscopic level...

..This report describes concordance between cardiac MRI and this novel mapping system in arrhythmogenic RV cardiomyopathy...

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..Catheter ablation strategies targeting PVs and the posterior LA may be further refined by incorporating technology beyond standard fluoroscopy...

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..Management issues are addressed, including counseling, anesthetic considerations and the need for multidisciplinary specialized care...

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..Despite its demonstrated salutary effects on clinical evolution, left ventricular (LV) function, and overall survival, at least 30% of patients fail to respond to CRT...

..Current prognostic markers and existing diagnostic tools are discussed, and available therapeutic options are elaborated...

..Basal flow measurements and results of this modeling were reproducible 24 and 27 h later...

..Inhospital mortality is higher when ventricular fibrillation presents in the acute phase but long term prognosis is not adversely affected...

..Although the benefits of cardiac resynchronization therapy are well established in selected patients with heart failure and a prolonged QRS duration, salutary effects in patients with narrow QRS complexes remain to be demonstrated...

..The Adenosine Following Pulmonary Vein Isolation to Target Dormant Conduction Elimination (ADVICE) study is a prospective multicentre randomized trial assessing the impact of adenosine-guided PVI in preventing AF recurrences...

..Adenosine or isoproterenol are used clinically to reveal dormant PV conduction and guide additional ablation...

..We aimed to assess cardiac, obstetrical and neonatal complications in pregnant women with heart disease referred to our tertiary care center and validate a previously proposed risk index...

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..The goal of this study was to evaluate the relationship between the presence of sinus rhythm and outcomes in patients with a history of congestive heart failure (CHF) and atrial fibrillation (AF)...

..Hemidiaphragmatic paralysis is the most frequent complication associated with cryoballoon ablation for atrial fibrillation. To date, no preventive strategy has proved effective...

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..SGP and NIRS methods showed excellent reproducibility with the same intra-class correlation coefficients (0.98). In conclusion, the NIRS technique appears well suited for non-invasive evaluation of quantitative arterial forearm flow...

..In conclusion, significant advances are being made in the management of patients with AF but much more work remains to be done...

..The technique uses near-infrared spectroscopy (NIRS) to determine the rate of change of forearm tissue saturation during reactive hyperemia...

..This study sought to characterize temporal trends in all-cause mortality in patients with congenital heart disease (CHD)...

..The goal is to assess the accuracy of a recently developed GBPS algorithm...

..This review highlights recent advances across the wide spectrum of key issues encountered by adults with CHD...

..Proficient scanning is further enabled by clearly outlined study objectives with prior documentation of interventional and surgical procedures, where applicable...

..Our objectives were to characterize the Québec AF patient population at the time of diagnosis of AF, quantify medical resource use prior to and after the initial diagnosis of AF, and determine overall survival...

..Sleep aggravated hypoxia has been observed in many such patients, but it remains to be determined whether sleep disordered breathing is contributory. We, therefore, sought to assess sleep-related breathing pattern in patients with CCHD...

..We developed a new segmentation algorithm based on the invariance of the Laplacian (IL) to compute volumes and ejection fractions and compared these results with planar analysis and gradients by use of a standard algorithm (QBS)...

..We describe a novel 3-dimensional (3D) gated blood pool single photon emission computed tomography (SPECT) approach, from which a contraction homogeneity index (CHI) is derived and compared with planar phase analyses...

..Pharmacological blockade of the renin-angiotensin system improves exercise tolerance in patients with left ventricular dysfunction, yet its impact on patients with systemic right ventricles (RVs) remains unknown...

..We speculate that the increase in sympathetic activity that accompanies AV node ablation contributed to the pathophysiological process, which involves increased catecholamines and/or apical adrenoreceptor density and responsiveness...

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..The remaining peripartum and postpartum course was relatively unremarkable. Percutaneous closure of the ventricular septal defect was successfully performed postpartum...

..This review provides a contemporary overview of the current state of knowledge regarding risks attributable to EMI; highlights current limitations of implantable rhythm devices; and attempts to distinguish myths from realities...

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..Herein, we unravel the intricacies regarding monitoring zone functions and algorithms, highlight potential pitfalls, and offer practical programming tips relevant to each device manufacturer...

..These results do not preclude active involvement at later stages of the pathophysiological process, such as acceleration of existing atherosclerosis and acute plaque rupture...

..A substantial proportion, nonetheless, requires reintervention within five years, warranting meticulous follow-up...

..Inability to induce stable VT for precision mapping and certain high-risk VT locations can be significant obstacles to success...

..Both adult and pediatric algorithms are particularly misleading in non-Ebstein's CHD patients and should be interpreted with caution...

..In this patient population, inducible sustained polymorphic VT should not be disregarded as nonspecific...

..Successful radiofrequency ablation was achieved by placement of lesions in an area adjacent and inferior to the His-bundle electrogram on the left side of the septum...

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..We conclude that outcomes are not uniform among patients submitted to the Mustard and Senning procedures. Knowledge of such differences may facilitate stratification of risk and follow-up...

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..Finally, we discuss recent insights into the basic mechanisms underlying AF that have potentially significant clinical implications...

..Pregnant women with congenital heart disease are at increased risk for cardiac and neonatal complications, yet risk factors for adverse outcomes are not fully defined...

..The aim of this study was to determine whether the morphologic subtype of bicuspid aortic valve (BAV) is associated with valve intervention in the young...

..To better define determinants of mortality in patients with univentricular physiology, a database registry was created of patients born in 1985 or earlier with Fontan surgery who were followed up at Children's Hospital Boston...

..CONCLUSION: Transcatheter closure of patent foramen ovale may prevent a substantial proportion of cryptogenic strokes. Randomized clinical trials are needed...