Bio


Linda K. Ottoboni, PhD, CNS is a member of the Stanford Arrhythmia and Electrophysiology Service and her present work is focused on the patient's response to arrhythmias. Her research area and clinical expertise are focused on improving the experience of individuals who live with arrhythmias.

Clinical Focus


  • Atrial Fibrillation - Comprehensive Approach to Management
  • Cardiovascular Arrhythmias- Prevention and Symptom Management
  • Clinical Nurse Specialist

Academic Appointments


Honors & Awards


  • Fellow, Heart Rhythm Society (2010)

Professional Education


  • PhD, University of California, San Francisco, School of Nursing (2017)
  • Board Certification: American Association of Critical Care Nurses, Clinical Nurse Specialist (2015)
  • Board Certification: International Board of Heart Rhythm Examiners, Clinical Nurse Specialist (2005)
  • Masters, University of California San Francisco, Cardiovascular Clinical Nurse Specialist, Physiological Nursing (1987)

Current Research and Scholarly Interests


My early qualitative work was to determine how individual’s experience their lives with atrial fibrillation (AFib). It validated that managing the presence or absence of their cardiac arrhythmia was inadequate and resources/strategies were needed to enable them to live life fully with their arrhythmia. This work provided the foundation for the development of a conceptual model to advance the science of supporting individuals to achieve an optimal quality of life with AFib. I am working collaboratively with other AFib nurse scientists on the development of a conceptual model.

My continued interest in the clinical and psychological outcomes of individuals with Implantable Cardioverter Defibrillators (ICDs) prompted the design and implementation of a longitudinal data base for ICD patients at Stanford to examine associations between activity, cardiovascular status, and patient reported outcomes (Quality of Life, Anxiety, and Depression) in individuals with ICDs: ACPRO-ICD. The aims of the study are to learn more about the challenges of living with an ICD and identify those resources perceived as supportive that are provided or desired.

Clinical Trials


  • Meditation and Education That is Nurse Delivered for Symptom Management in Paroxysmal Atrial Fibrillation (PAF) Recruiting

    The aim of this project is to determine whether the entire intervention (Mindfulness meditation, AF education, and weekly phone visits) that is nurse delivered to individuals with paroxysmal atrial fibrillation is more effective than a combination, single or no intervention in the reduction of overall AF symptoms, anxiety, and negative illness perception; or the improvement of quality of life (QOL) and functional status.

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  • Feasibility Study to Improve AF Outcomes Using a Digital Application for CV Risk Reduction Not Recruiting

    The pilot portion of this study is to determine the feasibility of utilizing AF CARE to provide lifestyle modification support to patients with atrial fibrillation (AF). The prospective, RCT portion of this study compare cardiovascular risk factors (CVRF), AF knowledge, AF Symptom Severity and Burden, and QOL between and within the wait list group and the AF CARE group at baseline, 3, 6, and 12 months.

    Stanford is currently not accepting patients for this trial. For more information, please contact Linda K Ottoboni, PhD, 650-498-5914.

    View full details

All Publications


  • Decisional Balance among Potential Implantable Cardioverter Defibrillator Recipients: Development of the ICD-Decision Analysis Scale (ICD-DAS) PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY Hazelton, A. G., Sears, S. F., Ford, J., Cahill, J., Nekkanti, R., DeAntonio, H., Ottoboni, L., Norton, L., Wang, P. 2014; 37 (1): 63-72

    Abstract

    Sudden cardiac death is a well-documented public health problem and the implantable cardioverter defibrillator (ICD) has demonstrated benefit in reducing mortality. Prospective patients must identify and evaluate the ICD's pros and cons and produce a personal decision. The purpose of this study was to create and evaluate a measure of patient-evaluated pros and cons of the ICD, and its relationship to patient decision regarding ICD implantation.The ICD-decision analysis scale (ICD-DAS) was created and tested in prospective ICD recipients (N = 104). Factor analysis was performed to evaluate interitem relationships, and subsequently, identified subscales; additional psychosocial measures were used to predict the ICD decision. A two-factor measure for ICD decision making was established with two subscales: ICD Pros and ICD Cons. The subscales have high internal consistency and were strong predictors of intent to choose an ICD. Other psychosocial measures were not significantly predictive of ICD Choice, yet simultaneous entry of ICD Pros and Cons subscales resulted in a significant increase in R(2) , F(2, 59) = 19.36, P < 0.001. The full model was significantly greater than zero, F(11, 70) = 5.017, P < 0.001, R(2)  = 0.48.The ICD-DAS provides the first empirically tested and clinically useful approach to understanding the specific pros and cons for prospective ICD patients. The measure can assist clinicians with patient-centered discussions regarding sudden cardiac arrest treatments. The ICD-DAS will allow for the provision of tailored education or counseling and may be used to predict postdecision outcomes.

    View details for DOI 10.1111/pace.12253

    View details for Web of Science ID 000329258600008

    View details for PubMedID 24219117

  • PHLEBITIS IN AMIODARONE ADMINISTRATION: INCIDENCE, CONTRIBUTING FACTORS, AND CLINICAL IMPLICATIONS AMERICAN JOURNAL OF CRITICAL CARE Norton, L., Ottoboni, L. K., Varady, A., Yang-Lu, C., Becker, N., Cotter, T., Pummer, E., Haynes, A., Forsey, L., Matsuda, K., Wang, P. 2013; 22 (6): 498-505

    Abstract

    Intravenous amiodarone is an important treatment for arrhythmias, but peripheral infusion is associated with direct irritation of vessel walls and phlebitis rates of 8% to 55%. Objectives To determine the incidence and factors contributing to the development of amiodarone-induced phlebitis in the coronary care unit in an academic medical center and to refine the current practice protocol.Medical records from all adult patients during an 18-month period who received intravenous amiodarone while in the critical care unit were reviewed retrospectively. Route of administration, location, concentration, and duration of amiodarone therapy and factors associated with occurrence of phlebitis were examined. Descriptive statistics and regression methods were used to identify incidence and phlebitis factors.In the final sample of 105 patients, incidence of phlebitis was 40%, with a 50% recurrence rate. All cases of phlebitis occurred in patients given a total dose of 3 g via a peripheral catheter, and one-quarter of these cases (n = 10) developed at dosages less than 1 g. Pain, redness, and warmth were the most common indications of phlebitis. Total dosage given via a peripheral catheter, duration of infusion, and number of catheters were significantly associated with phlebitis.Amiodarone-induced phlebitis occurred in 40% of this sample at higher drug dosages. A new practice protocol resulted from this study. An outcome study is in progress.

    View details for DOI 10.4037/ajcc2013460

    View details for Web of Science ID 000328167700012

    View details for PubMedID 24186821

  • Heart Rhythm Society Scientific and Clinical Documents Committee Viewpoint. Heart rhythm Cha, Y. M., Bhakta, D., Barbhaiya, C. R., Chung, E. H., Fisher, J. D., Fix, A. M., Ghia, K. K., Glikson, M., Hart, S. A., Hushcha, S. V., Kannankeril, P. J., Kramer, D. B., Mendenhall, G. S., Morin, D. P., Ottoboni, L. K., Pathak, R. K., Pillarisetti, J., Rajagopalan, B., Russo, A. M., See, V. Y., Shah, M. J., Sridhar, A. R., Patton, K. K. 2024; 21 (6): 975-977

    View details for DOI 10.1016/j.hrthm.2024.02.042

    View details for PubMedID 38816149

  • Antiarrhythmic drug loading at home using remote monitoring: a virtual feasibility study during COVID-19 social distancing. European heart journal. Digital health Shah, R. L., Kapoor, R., Bonnett, C., Ottoboni, L. K., Tacklind, C., Tsiperfal, A., Perez, M. V. 2021; 2 (2): 259-262

    Abstract

    The epidemiological necessity for distancing during the COVID-19 pandemic has resulted in postponement of non-emergent hospitalizations and increase use of telemedicine. The feasibility of virtual antiarrhythmic drug (AAD) loading specifically with digital QTc electrocardiographic monitoring (EM) in conjunction with telemedicine video visits is not well established. We tested the hypothesis that existing digital health technologies and virtual communication platforms could provide EM and support medically guided AAD loading for patients with symptomatic tachyarrhythmia in the ambulatory setting, while reducing physical contact between patient and healthcare system. A prospective pilot, case series was approved by the institutional ethics committee, entailing three subjects with symptomatic arrhythmia during the COVID-19 pandemic who were enrolled for virtual AAD loading at home. Clinicians met with participants twice daily via video visits conducted after QTc analysis (Kardia 6L mobile sensor) and telemetry review (Mobile Cardiac Outpatient Telemetry of silent arrhythmias). Participants received direct instruction to either terminate the study or proceed with the next single dose of AAD. All participants completed contactless loading of five AAD doses, without untoward event. Scheduled video visits allowed dialogue and participant counselling where decision-making was guided by remote review of EM. Participant adherence with transmissions and scheduled visits was 98.3%; a single electrocardiogram was delayed beyond the 2 hours of post-dose schedule. This virtual approach reduced overall expenditures based on retrospective comparison with previous AAD load hospitalizations. We found that a 'virtual hospitalization' for AAD loading with remote EM and twice-daily virtual rounding is feasible using existing digital health technologies.

    View details for DOI 10.1093/ehjdh/ztab034

    View details for PubMedID 37155657

    View details for PubMedCentralID PMC8083679

  • Antiarrhythmic Drug Loading at Home Using Remote Monitoring: A Virtual Feasibility Study During COVID-19 Social Distancing European Heart Journal Digital Health Shah, R. L., Kapoor, R., Bonnett, C., Ottoboni, L. K., Tacklind, C., Tsiperfal, A., Perez, M. V. 2021

    View details for DOI 10.1093/ehjdh/ztab034