Sekar Jayaprakash

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BACKGROUND Atrial electrical remodeling may be important for the initiation and perpetuation of atrial arrhythmias. Whether paroxysmal atrial flutter (AFL) and chronic AFL cause electrical remodeling of the atria has not been conclusively determined. METHODS AND RESULTS Before radiofrequency ablation of paroxysmal AFL, 15 patients in sinus rhythm were(More)
BACKGROUND Evidence suggests that an increased incidence of atrial fibrillation occurs in patients undergoing single-chamber ventricular pacing (VVI) when compared with those undergoing single-chamber atrial pacing (AAI) or those having dual-chamber atrioventricular pacing (DDD). The mechanism for this is unknown. We hypothesized that long-term loss of(More)
OBJECTIVES This study examined the effect of radiofrequency ablation (RFA) on left atrial (LA) and left atrial appendage (LAA) function in humans with chronic atrial flutter (AFL). BACKGROUND Atrial stunning and the development of spontaneous echocardiographic contrast (SEC) is a consequence of electrical cardioversion of AFL to sinus rhythm. This(More)
OBJECTIVES This study examined the effect of brief duration atrial fibrillation on left atrial and left atrial appendage mechanical function in humans with structural heart disease. BACKGROUND Left atrial dysfunction and the development of spontaneous echo contrast (SEC) may follow the cardioversion of atrial fibrillation (AF) to sinus rhythm. This(More)
BACKGROUND Inappropriate sinus tachycardia (IST) is a rare form of supraventricular arrhythmia. It can cause disabling symptoms and may be refractory to medical treatment. In symptomatic drug refractory patients, sinus node excision or total ablation of the sinus node with permanent pacemaker implantation was the only therapeutic option. Recently,(More)
Several large prospective randomized trials have demonstrated that anticoagulation with warfarin reduces the risk of thromboembolic stroke in high risk patients with chronic AF by approximately 70%. Large numbers of patients with permanent pacemakers have AF, and anticoagulation rates in this population have not been described. In a prospective analysis of(More)
BACKGROUND Atrial flutter is a common arrhythmia which frequently recurs after cardioversion and is relatively difficult to control with antiarrhythmic agents. AIMS To evaluate the success rate, recurrence rate and safety of radiofrequency, (RF) ablation for atrial flutter in a consecutive series of patients with drug refractory chronic or paroxysmal(More)
The use of dual chamber pacing in patients with atrioventricular block and paroxysmal supraventricular tachyarrhythmias may present a clinical dilemma because of the rapid and erratic triggering of ventricular pacing. To avoid this, a variety of pacing methods have now been described, including the use of retriggerable atrial refractory periods or dual(More)
Transvenous pacing in patients with Ebstein's anomaly is challenging due to anatomical abnormalities of the tricuspid valve and right heart chambers. This paper describes the various transvenous ventricular lead placement options for permanent pacing in patients with Ebstein's anomaly. In Ebstein's anomaly, stable long-term ventricular pacing can be(More)