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Mayo clinic heart

David Snipelisky, Yogesh N V Reddy, Kevin Manocha, Aalok Patel, Shannon M Dunlay, Paul A Friedman, Thomas M Munger, Samuel J Asirvatham, Douglas L Packer, Yong-Mei Cha, Suraj Kapa, Peter A Brady, Peter A Noseworthy, Joseph J Maleszewski, Siva K Mulpuru
BACKGROUND: Patients with advanced heart failure (HF) are predisposed to ventricular arrhythmias (VA), particularly following implantation of an LVAD. There is minimal evidence for appropriate management strategies. OBJECTIVES: This study aimed to compare the burden of VA and response to ablation performed either before or following left ventricular assist device (LVAD) implantation. METHODS: We created a retrospective cohort of patients who underwent both VA ablation and HeartMate II (Thoratec, CA) LVAD implantation at Mayo Clinic (Rochester, MN)...
October 21, 2016: Journal of Cardiovascular Electrophysiology
Shannon M Dunlay, Jacob J Strand, Sara E Wordingham, John M Stulak, Angela J Luckhardt, Keith M Swetz
BACKGROUND: Despite the ability of left ventricular assist device as destination therapy (DT-LVAD) to prolong survival for many patients with advanced heart failure, little is known about the eventual end-of-life care that patients with DT-LVAD receive. METHODS AND RESULTS: All patients undergoing DT-LVAD at the Mayo Clinic in Rochester, Minnesota, from January 1, 2007, to September 30, 2014, who subsequently died before July 1, 2015, were included. Information about end-of-life care was obtained from documentation in the electronic medical record...
October 2016: Circulation. Heart Failure
A Dias, E Franco, S Janzer, Nikoloz Koshkelashvili, V Bhalla, Manolo Rubio, Sarah Amanullah, Kathy Hebert, Vincent M Figueredo
Takotsubo cardiomyopathy (TTS) is a peculiar clinical condition often affecting postmenopausal women after a stressful trigger. The underlying mechanisms have not been completely elucidated but several hypotheses have been advanced, with catecholamine cardiotoxicity, microvascular dysfunction and coronary artery spasm each suggested to play a role. The incidence of stroke after TTS appears to range from 0% to 7.7%, and interestingly TTS has been described as both a cause and a complication of stroke. We sought to assess the incidence and predictors of stroke during the index event (peri-index event stroke) in a heterogeneous TTS population...
July 2016: Functional Neurology
A Dias, E Franco, S Janzer, Nikoloz Koshkelashvili, V Bhalla, Manolo Rubio, Sarah Amanullah, Kathy Hebert, Vincent M Figueredo
Takotsubo cardiomyopathy (TTS) is a peculiar clinical condition often affecting postmenopausal women after a stressful trigger. The underlying mechanisms have not been completely elucidated but several hypotheses have been advanced, with catecholamine cardiotoxicity, microvascular dysfunction and coronary artery spasm each suggested to play a role. The incidence of stroke after TTS appears to range from 0% to 7.7%, and interestingly TTS has been described as both a cause and a complication of stroke. We sought to assess the incidence and predictors of stroke during the index event (peri-index event stroke) in a heterogeneous TTS population...
September 26, 2016: Functional Neurology
Niyada Naksuk, Tiffany Hu, Chayakrit Krittanawong, Charat Thongprayoon, Sunita Sharma, Jae Yoon Park, Andrew N Rosenbaum, Prakriti Gaba, Ammar M Killu, Alan M Sugrue, Thoetchai Peeraphatdit, Vitaly Herasevich, Malcolm R Bell, Peter A Brady, Suraj Kapa, Samuel J Asirvatham
BACKGROUND: Although electrolyte disturbances may affect cardiac action potential, little is known about the association between serum magnesium and QTc interval as well as clinical outcomes. METHODS: A consecutive 8,498 patients admitted to the Mayo Clinic Hospital - Rochester cardiac care unit (CCU), from January 1, 2004 through December 31, 2013, with two or more documented serum magnesium levels, was studied in order to test the hypothesis that serum magnesium levels are associated with in-hospital mortality, sudden cardiac death and corrected QT interval (QTc) interval...
September 14, 2016: American Journal of Medicine
Xin-Miao Huang, Hai-Xia Fu, Li Zhong, Jiang Cao, Samuel J Asirvatham, Larry M Baddour, M Rizwan Sohail, Vuyisile T Nkomo, Rick A Nishimura, Kevin L Greason, Rakesh M Suri, Paul A Friedman, Yong-Mei Cha
BACKGROUND: Lead-related or valve-related endocarditis can complicate cardiovascular implantable electronic device (CIED) infection in patients with both CIED and prosthetic valves. The objective of this study was to determine the outcomes of transvenous lead extraction for CIED infection in patients with prosthetic valves. METHODS AND RESULTS: We retrospectively screened 794 transvenous lead extraction procedures, between September 1, 2001 and August 31, 2012, at Mayo Clinic to identify patients with prosthetic valves who underwent lead extraction for infection...
September 2016: Circulation. Arrhythmia and Electrophysiology
Shannon M Dunlay, Joan M Griffin, Margaret M Redfield, Véronique L Roger
BACKGROUND: Recent data suggest that patient activation, or having the knowledge, skills, and confidence to engage and manage one's own health, favorably impacts patient behaviors and health outcomes. However, the role of activation in patients with heart failure is unknown. OBJECTIVES: The aims of this study are to measure the level of activation of patients hospitalized with acute decompensated heart failure (ADHF) and to determine whether activation is associated with in-hospital and early postdischarge outcomes...
September 13, 2016: Journal of Cardiovascular Nursing
Cynthia M Stonnington, Betty Darby, Angela Santucci, Pamela Mulligan, Patricia Pathuis, Andrea Cuc, Joseph G Hentz, Nan Zhang, David Mulligan, Amit Sood
Solid organ and stem cell transplant patients and their caregivers report a substantial level of distress. Mindfulness-based stress reduction has been shown to alleviate distress associated with transplant, but there is limited experience in this population with other mindfulness-based interventions, or with combined transplant patient and caregiver interventions. We evaluated a novel, 6-week mindfulness-based resilience training (MBRT) class for transplant patients and their caregivers that incorporates mindfulness practice, yoga, and neuroscience of stress and resilience...
September 12, 2016: Clinical Transplantation
Kamonpun Ussavarungsi, Augustine S Lee, Charles D Burger
OBJECTIVES: Pulmonary hypertension (PH) is commonly observed in patients with diffuse parenchymal lung disease (DPLD). The purpose of this study was to explore the influence of the 6-minute walk test (6MWT) as a simple, non-invasive tool to assess right ventricular (RV) function in patients with DPLD and to identify the need for an echocardiogram (ECHO) to screen for PH. METHODS: We retrospectively reviewed 48 patients with PH secondary to DPLD, who were evaluated in the PH clinic at the Mayo Clinic in Jacksonville, Florida, from January 1999 to December 2014...
September 2016: Oman Medical Journal
Megan D Herbers, Joseph A Heaser
BACKGROUND: The high risk and low volume of medical emergencies, combined with long periods between training sessions, on 2 progressive care units at Mayo Clinic, Rochester, Minnesota, established the importance of transforming how nursing staff are trained to respond to medical emergencies. OBJECTIVES: To increase confidence levels and improve nursing performance during medical emergencies via in situ simulation. METHODS: An in situ, mock code quality improvement program was developed and implemented to increase nurses' confidence while improving nursing performance when responding to medical emergencies...
September 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Martha Grogan, Christopher G Scott, Robert A Kyle, Steven R Zeldenrust, Morie A Gertz, Grace Lin, Kyle W Klarich, Wayne L Miller, Joseph J Maleszewski, Angela Dispenzieri
BACKGROUND: Wild-type transthyretin cardiac amyloidosis (ATTRwt) is increasingly recognized as an important cause of heart failure. OBJECTIVES: The purpose of this study was to determine the natural history of ATTRwt and the predictors of survival. METHODS: We retrospectively reviewed patients diagnosed with ATTRwt at the Mayo Clinic through 2013 and recorded clinical data and survival data. Factors affecting overall survival (OS) were identified, and a prognostic staging system was developed...
September 6, 2016: Journal of the American College of Cardiology
Yogesh N V Reddy, Vojtech Melenovsky, Margaret M Redfield, Rick A Nishimura, Barry A Borlaug
BACKGROUND: High-output heart failure (HF) is an unusual cause of cardiac failure that has not been well-characterized. OBJECTIVES: This study sought to characterize the etiologies, pathophysiology, clinical and hemodynamic characteristics, and outcomes of high-output HF in the modern era. METHODS: We performed a retrospective analysis of all consecutive patients referred to the Mayo Clinic catheterization laboratory for hemodynamic assessment between 2000 and 2014...
August 2, 2016: Journal of the American College of Cardiology
Frederick North, Samuel Fox, Rajeev Chaudhry
BACKGROUND: Risk calculation is increasingly used in lipid management, congestive heart failure, and atrial fibrillation. The risk scores are then used for decisions about statin use, anticoagulation, and implantable defibrillator use. Calculating risks for patients and making decisions based on these risks is often done at the point of care and is an additional time burden for clinicians that can be decreased by automating the tasks and using clinical decision-making support. METHODS: Using Morae Recorder software, we timed 30 healthcare providers tasked with calculating the overall risk of cardiovascular events, sudden death in heart failure, and thrombotic event risk in atrial fibrillation...
2016: BMC Medical Informatics and Decision Making
Kavitha N Pundi, Krishna Pundi, David J Driscoll, Joseph A Dearani, Zhuo Li, Sonja H Dahl, Bassem N Mora, Patrick W O'Leary, Richard C Daly, Frank Cetta, Jonathan N Johnson
We performed a retrospective review of outcomes after heart transplantation during long-term follow-up of a surgical cohort of 1138 Fontan patients who were followed at the Mayo Clinic. Follow-up information was obtained from medical records and a clinical questionnaire that was mailed to patients not known to be deceased at the initiation of the study. Forty-four of 1138 Fontan patients with initial or subsequent evaluation at Mayo had cardiac transplantation between 1988 and 2014 (mean age at transplantation was 23...
July 10, 2016: Pediatric Transplantation
Alexander C Egbe, Heidi M Connolly, Joseph A Dearani, Crystal R Bonnichsen, Talha Niaz, Thomas G Allison, Jonathan N Johnson, Joseph T Poterucha, Sameh M Said, Naser M Ammash
BACKGROUND: To determine if Fontan conversion (FC) resulted in improvement in exercise capacity (EC), and to determine the role of cardiopulmonary exercise test (CPET) in risk stratification of patients undergoing FC. METHODS: A retrospective review of patients who underwent CPET prior to FC at Mayo Clinic from 1994 to 2014. The patients who also underwent post-operative CPET were selected for the analysis of improvement in EC defined as 10% increase in baseline peak oxygen consumption (VO2)...
October 1, 2016: International Journal of Cardiology
Martha Grogan, Morie Gertz, Arleigh McCurdy, Lindsey Roeker, Robert Kyle, Sudhir Kushwaha, Richard Daly, Joseph Dearani, Richard Rodeheffer, Robert Frantz, Martha Lacy, Suzanne Hayman, Christopher McGregor, Brooks Edwards, Angela Dispenzieri
AIM: To determine the outcome of orthotopic heart transplantation (OHT) in immunoglobulin light chain (AL) amyloidosis. METHODS: The medical records of patients with AL who underwent orthotopic heart transplantation at the Mayo Clinic in Rochester Minnesota from 1992 to 2011 were reviewed. Patients met at least one of the following at: New York Heart Association class IV heart failure, ventricular thickness > 15 mm, ejection fraction < 40%. Selection guidelines for heart transplant included age < 60 years, absence of multiple myeloma and significant extra-cardiac organ involvement...
June 24, 2016: World Journal of Transplantation
Brett W Sperry, Asad Ikram, Rory Hachamovitch, Jason Valent, Michael N Vranian, Dermot Phelan, Mazen Hanna
BACKGROUND: Light-chain amyloidosis (AL) with cardiac involvement carries a poor prognosis; median untreated survival is <6 months. Three-drug therapy with bortezomib, dexamethasone, and an alkylating agent (BDex+AA) is associated with improved biomarker response rates in AL amyloidosis. OBJECTIVES: This study sought to evaluate the effect of BDex+AA as a first-line treatment strategy on mortality in patients with symptomatic heart failure from AL cardiac amyloidosis...
June 28, 2016: Journal of the American College of Cardiology
Luka Lipar, Komandoor Srivathsan, Luis Roberto Scott
BACKGROUND: Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. METHODS: One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed...
September 15, 2016: International Journal of Cardiology
Alexander C Egbe, Sushil A Luis, Ratnasari Padang, Carole A Warnes
BACKGROUND: A direct comparison of outcomes between moderate mixed aortic valve disease (MAVD) and isolated aortic stenosis (AS) or aortic regurgitation (AR) has not been performed, making evidence-based recommendations difficult in patients with MAVD. OBJECTIVES: This study sought to determine adverse event (AE) occurrence (the primary endpoint), defined as New York Heart Association functional class III/IV symptoms, aortic valve replacement, or cardiac death, and to compare AE rates between MAVD and isolated AS or AR...
May 24, 2016: Journal of the American College of Cardiology
Dania Mohty, Cyrille Boulogne, Julien Magne, Nicolas Varroud-Vial, Sylvain Martin, Hind Ettaif, Bahaa M Fadel, Frank Bridoux, Victor Aboyans, Thibaud Damy, Arnaud Jaccard
BACKGROUND: Cardiac involvement in systemic light-chain amyloidosis (AL) imparts an adverse impact on outcome. The left atrium (LA), by virtue of its anatomical location and muscular wall, is commonly affected by the amyloid process. Although LA infiltration by amyloid fibrils leads to a reduction in its pump function, the infiltration of the left ventricular (LV) myocardium results in diastolic dysfunction with subsequent increase in filling pressures and LA enlargement. Even though left atrial volume (LAV) is an independent prognostic marker in many cardiomyopathies, its value in amyloid heart disease remains to be determined...
September 2016: European Heart Journal Cardiovascular Imaging
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