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Articles by H. Calkins
Total Records ( 2 ) for H. Calkins
  R Jain , D Dalal , A Daly , C Tichnell , C James , A Evenson , T Abraham , B. Y Tan , H Tandri , S. D Russell , D Judge and H. Calkins
 

Background— The purpose of this study was to reevaluate the ECG features of arrhythmogenic right ventricular dysplasia (ARVD). The second objective was to evaluate the sensitivity and specificity of the standard and newly proposed diagnostic ECG markers in the presence of a right bundle-branch block (RBBB).

Methods and Results— One hundred patients with ARVD (57 men; aged 39±15 years) and 57 controls (21 men; aged 40±17 years) were included. Among the 100 patients with ARVD, a complete RBBB was present in 17 patients, and 15 patients had an incomplete RBBB. T-wave inversion through V3 demonstrated optimal sensitivity and specificity in both ARVD patients without a complete RBBB or incomplete RBBB (71% [95% confidence interval, 58% to 81%] and 96% [95% confidence interval, 81% to 100%], respectively) and in ARVD patients with incomplete RBBB (73% [95% confidence interval, 45% to 92%] and 95% [95% confidence interval, 77% to 100%], respectively). Between ARVD patients and controls with a complete RBBB, the only 2 parameters that differed were the prevalence of T-wave inversion through V4 (59% versus 12%, respectively; P<0.05) and an r'/s ratio in V1 <1 (88% versus 14%, respectively; P<0.005). In ARVD patients with complete RBBB, the most sensitive and specific parameter was an r'/s ratio <1.

Conclusions— We evaluated comprehensively the diagnostic value of ECG markers for ARVD. On the basis of the findings, we propose an algorithm, with examination of QRS morphology being the first step, for ECG evaluation of ARVD patients. Definite criteria are then applied on the basis of the presence of no RBBB, incomplete RBBB, and complete RBBB to obtain the best diagnostic utility of the ECG.

  K Chilukuri , D Dalal , J. E Marine , D Scherr , C. A Henrikson , A Cheng , S Nazarian , D Spragg , R Berger and H. Calkins
  Aims

Obstructive sleep apnoea (OSA) is a risk factor for atrial fibrillation (AF) recurrence after catheter ablation. The purpose of this study is to determine whether OSA assessed by the simple tool, the Berlin Questionnaire (BQ), is useful in predicting the efficacy of catheter ablation of AF.

Methods and results

The patient population consisted of 210 consecutive patients [mean age 58 ± 10 years, 167 (80%) male, 119 (57%) paroxysmal] who underwent catheter ablation of AF and completed the BQ. Clinical success was defined as at least 90% reduction in AF burden after 3-month blanking period. Mean duration of follow-up was 25 ± 12 months. One hundred and one of the 118 (85%) patients at low risk for OSA had clinical success as opposed to 64 of the 92 (70%) patients at high risk for OSA on BQ (P = 0.005). On multivariate analysis, only high-risk for OSA on BQ emerged as an independent predictor of procedural failure (OR 4.53, CI: 1.21–16.87, P = 0.02).

Conclusion

High risk of OSA on BQ predicts procedural failure after catheter ablation of AF. We recommend the use of BQ for risk-stratifying patients for OSA prior to AF ablation procedures and to identify patients for formal sleep study assessment.

 
 
 
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