All Publications

  • Safety of transvenous cardiac defibrillator and magnetic titanium beads system for gastroesophageal reflux disease: a case report. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Vasireddi, S. K., Greif, S., Fazal, M., Wei, C., Gomez, S., Shah, S., Rogers, A. J., Narayan, S. M., Wang, P. J., Kapoor, R., Baykaner, T. 2023

    View details for DOI 10.1007/s10840-023-01604-x

    View details for PubMedID 37421563

    View details for PubMedCentralID 3667475

  • Comparative arrhythmia patterns among patients on tyrosine kinase inhibitors. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Wei, C., Fazal, M., Loh, A., Kapoor, R., Gomez, S. E., Shah, S., Rogers, A. J., Narayan, S. M., Wang, P. J., Witteles, R. M., Perino, A. C., Cheng, P., Rhee, J. W., Baykaner, T. 2023


    Tyrosine kinase inhibitors (TKIs) are widely used in the treatment of hematologic malignancies. Limited studies have shown an association between treatment-limiting arrhythmias and TKI, particularly ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor. We sought to comprehensively assess the arrhythmia burden in patients receiving ibrutinib vs non-BTK TKI vs non-TKI therapies.We performed a retrospective analysis of consecutive patients who received long-term cardiac event monitors while on ibrutinib, non-BTK TKIs, or non-TKI therapy for a hematologic malignancy between 2014 and 2022.One hundred ninety-three patients with hematologic malignancies were included (ibrutinib = 72, non-BTK TKI = 46, non-TKI therapy = 75). The average duration of TKI therapy was 32 months in the ibrutinib group vs 64 months in the non-BTK TKI group (p = 0.003). The ibrutinib group had a higher prevalence of atrial fibrillation (n = 32 [44%]) compared to the non-BTK TKI (n = 7 [15%], p = 0.001) and non-TKI (n = 15 [20%], p = 0.002) groups. Similarly, the prevalence of non-sustained ventricular tachycardia was higher in the ibrutinib group (n = 31, 43%) than the non-BTK TKI (n = 8 [17%], p = 0.004) and non-TKI groups (n = 20 [27%], p = 0.04). TKI therapy was held in 25% (n = 18) of patients on ibrutinib vs 4% (n = 2) on non-BTK TKIs (p = 0.005) secondary to arrhythmias.In this large retrospective analysis of patients with hematologic malignancies, patients receiving ibrutinib had a higher prevalence of atrial and ventricular arrhythmias compared to those receiving other TKI, with a higher rate of treatment interruption due to arrhythmias.

    View details for DOI 10.1007/s10840-023-01575-z

    View details for PubMedID 37256462

  • PO-04-075 TRANSVENOUS CARDIAC DEFIBRILLATOR WITHOUT INTERACTION WITH THE MAGNETIC TITANIUM BEADS SYSTEM FOR GASTROESOPHAGEAL REFLUX DISEASE Health Rhythm Vasireddi, S. K., Loh, A., Greif, S. R., Fazal, M., Wei, C., Gomez, S., Shah, S., Wang, P. J., Narayan, S. M., Kapoor, R., Baykaner, T. 2023; 20 (5)
  • Patient Education Strategies to Improve Risk of Stroke in Patients with Atrial Fibrillation CURRENT CARDIOVASCULAR RISK REPORTS Nunes, J. C., Shah, S., Fazal, M., Gomez, S., Wei, C., Wang, P. J., Stafford, R. S., Baykaner, T. 2022; 16 (12): 249-258
  • Tyrosine kinase inhibitor-associated ventricular arrhythmias: a case series and review of literature. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Fazal, M., Wei, C., Chuy, K. L., Hussain, K., Gomez, S. E., Ba, S. S., Pietrasik, G., Yadav, N., Ghazizadeh, Z., Kapoor, R., Witteles, R. M., Blackmon, A., Wang, P. J., John, R. M., Narayan, S. M., Cheng, P., Rhee, J., Baykaner, T. 2022


    BACKGROUND: Tyrosine kinase inhibitors (TKIs) have been increasingly used as first-line therapy in hematologic and solid-organ malignancies. Multiple TKIs have been linked with the development of cardiovascular complications, especially atrial arrhythmias, but data on ventricular arrhythmias (VAs) is scarce.METHODS: Herein we describe five detailed cases of VAs related to TKI use in patients with varied baseline cardiovascular risk factors between 2019 and 2022 at three centers. Individual chart review was conducted retrospectively.RESULTS: Patient ages ranged from 43 to 83years. Three patients were on Bruton's TKI (2 ibrutinib and 1 zanubrutinib) at the time of VAs; other TKIs involved were afatinib and dasatinib. Three patients had a high burden of non-sustained ventricular tachycardia (NSVT) requiring interventions, whereas two patients had sustained VAs. While all patients in our case series had significant improvement in VA burden after TKI cessation, two patients required new long-term antiarrhythmic drug therapy, and one had an implantable defibrillator cardioverter (ICD) placed due to persistent VAs after cessation of TKI therapy. One patient reinitiated TKI therapy after control of arrhythmia was achieved with antiarrhythmic drug therapy.CONCLUSIONS: Given the expanding long-term use of TKIs among a growing population of cancer patients, it is critical to acknowledge the association of TKIs with cardiovascular complications such as VAs, to characterize those at risk, and deploy preventive and therapeutic measures to avoid such complications and interference with oncologic therapy. Further efforts are warranted to develop monitoring protocols and optimal treatment strategies for TKI-induced VAs.

    View details for DOI 10.1007/s10840-022-01400-z

    View details for PubMedID 36411365

  • Racial, ethnic, and sex disparities in atrial fibrillation management: rate and rhythm control. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing Gomez, S. E., Fazal, M., Nunes, J. C., Shah, S., Perino, A. C., Narayan, S. M., Tamirisa, K. P., Han, J. K., Rodriguez, F., Baykaner, T. 2022


    BACKGROUND: Atrial fibrillation (AF) affects around 6 million Americans. AF management involves pharmacologic therapy and/or interventional procedures to control rate and rhythm, as well as anticoagulation for stroke prevention. Different populations may respond differently to distinct management strategies. This review will describe disparities in rate and rhythm control and their impact on outcomes among women and historically underrepresented racial and/or ethnic groups.METHODS: This is a narrative review exploring the topic of sex and racial and/or ethnic disparities in rate and rhythm management of AF. We describe basic terminology, summarize AF epidemiology, discuss diversity in clinical research, and review landmark clinical trials.RESULTS: Despite having higher rates of traditional AF risk factors, Black and Hispanic adults have lower risk of AF than non-Hispanic White (NHW) patients, although those with AF experience more severe symptoms and report lower quality-of-life scores than NHW patients with AF. NHW patients receive antiarrhythmic drugs, cardioversions, and invasive therapies more frequently than Black and Hispanic patients. Women have lower rates of AF than men, but experience more severe symptoms, heart failure, stroke, and death after AF diagnosis. Women and people from diverse racial and ethnic backgrounds are inadequately represented in AF trials; prevalence findings may be a result of underdetection.CONCLUSION: Race, ethnicity, and gender are social determinants of health that may impact the prevalence, evolution, and management of AF. This impact reflects differences in biology as well as disparities in treatment and representation in clinical trials.

    View details for DOI 10.1007/s10840-022-01383-x

    View details for PubMedID 36224481