Kevin A. Michael

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Pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) is successful in ∼70–80 % after repeated procedures. This suggests a subgroup of PAF patients where electrical abnormalities outside the pulmonary veins are important. Prolonged P-wave duration (PWD), a marker of atrial remodelling, may identify this subgroup. This study’s aim was to(More)
AIMS Sleep apnoea (SA) is a common problem among congestive heart failure (CHF) patients. Evidence has shown that cardiac resynchronization therapy (CRT) reduces morbidity and mortality associated with CHF. The aim of this paper was to review studies evaluating the reduction of the Apnoea-Hypopnoea Index (AHI) in patients with SA after treatment with CRT(More)
A 59 year old patient with drug refractory paroxysmal atrial fibrillation (PAF) was referred for a pulmonary vein isolation (PVI). He complained of severe chest pain during the procedure. Subtle ST segment elevation was noted in the high lateral territory (I & aVL). He had no risk factors for coronary artery disease. The event occurred prior to any ablation(More)
INTRODUCTION Pulmonary vein isolation is an effective strategy in patients with atrial fibrillation (AF). The peri-procedural use of anticoagulation is routinely employed to reduce thromboembolic risk. AIMS/METHODS The aim of this study was to compare the use of Dabigatran to the other 2 strategies involving the use of Warfarin. Single centre(More)
Obstructive sleep apnoea (OSA) is associated with cardiovascular morbidity and mortality, including atrial arrhythmias. Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA; its impact on atrial electrical remodelling has not been fully investigated. Signal-averaged p-wave (SAPW) duration is an accepted marker for atrial(More)
Subclavian vein thrombosis after pacemaker lead insertion is a well-described complication of pacemaker insertion. It is usually asymptomatic due to the presence of collateral venous flow but the clinical presentation is varied. This index case illustrates a typical clinical scenario and the value of computerised tomography (CT) in providing adequate(More)
AIMS A significant proportion of patients develop atrial fibrillation (AF) following cavotricuspid isthmus (CTI) ablation for typical atrial flutter (AFl). The objective of this study was to assess whether the presence of advanced interatrial block (aIAB) was associated with an elevated risk of AF after CTI ablation in patients with typical AFl and no prior(More)
AIM To review techniques of implantable cardioverter-defibrillators (ICD) in patients after Mustard surgery for arterial transposition. METHODS AND RESULTS Retrospective analysis of all Mustard patients receiving ICDs at our institution. Five patients (median age 24 years, range 19-35, 3 male) with systemic right ventricular dysfunction (sRV) dysfunction(More)
BACKGROUND Advanced interatrial block (aIAB) on the surface electrocardiogram (ECG), defined as a P-wave duration ≥120 milliseconds with biphasic (±) morphology in inferior leads, is frequently associated with atrial fibrillation (AF). The aim of this study was to determine whether preoperative aIAB could predict new-onset AF in patients with severe(More)