Mazda Biria

Publications (13)23.79 Total impact

• Article: Atrial fibrillation ablation in patients with gastroesophageal reflux disease or irritable bowel syndrome-the heart to gut connection!

  Yeruva Madhu Reddy, Dhssraj Singh, Darbhamulla Nagarajan, Jayasree Pillarisetti, Mazda Biria, Hemant Boolani, Martin Emert, Vineela Chikkam, Kay Ryschon, James Vacek, Sudha Bommana, Donita Atkins, Atul Verma, Mojtaba Olyaee, Buddhadeb Dawn, Dhanunjaya Lakkireddy
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  ABSTRACT: PURPOSE: An association between atrial fibrillation (AF) and gastroesophageal reflux disease (GERD) and/or irritable bowel syndrome (IBS) is increasingly being identified; yet the role of radiofrequency catheter ablation (RFA) of AF has not been systematically evaluated in these patient populations. METHODS: We performed a prospective matched case-control study of AF patients with GERD and/or IBS who underwent RFA for AF in two centers in North America. AF patients with GERD and/or IBS (gastrointestinal [GI] group) were matched by age, gender, and type of AF at each of the centers with an equal number of AF patients without GERD or IBS (non-GI group). RESULTS: Sixty patients were included in the study with 30 in each group. Mean age of the population was 45 years with 14 (47 %) males and 21 (87 %) patients with paroxysmal AF in each group. More patients in the GI group had identifiable GI triggers for AF episodes. During RFA, more patients in the GI group had a "vagal response" compared to non-GI group (60 vs 13 %; p < 0.001). Left atrial scar as identified by electroanatomical mapping was more common in patients in the non-GI group compared to the GI group (57 vs 27 %; p = 0.018). At 1-year follow-up, 56 (93 %) of the patients were free from AF with no difference between both groups. CONCLUSIONS: Majority of AF patients with GERD and/or IBS have triggered AF and a positive vagal response during RFA. RFA is equally effective in this patient population when compared to those without GERD or IBS.
  Journal of Interventional Cardiac Electrophysiology 06/2013; · 1.17 Impact Factor
• Article: Mapping and ablation of ventricular arrhythmias with magnetic navigation: comparison between 4- and 8-mm catheter tips

  Luigi Di Biase, J. David Burkhardt, Dhanunjaya Lakkireddy, Jayasree Pillarisetti, Esam Nuri Baryun, Mazda Biria, Rodney Horton, Javier Sanchez, G. Joseph Gallinghouse, Shane Bailey, Salwa Beheiry, Richard Hongo, Steven Hao, Gery Tomassoni, Andrea Natale
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  ABSTRACT: IntroductionRemote magnetic navigation (RMN) has been reported as an effective and safe tool to overcome the need for advanced operator skill in the treatment of complex arrhythmias. We report a series of patients undergoing radiofrequency catheter ablation of ventricular arrhythmias (VAs) using RMN with either a 4-mm catheter tip or an 8-mm catheter tip at four different centers. MethodsSixty-five patients with clinical and symptomatic history of Vas were included. Two different magnetic catheters were used to deliver radiofrequency applications remotely. When ablation with the RMN catheters failed, a manual irrigated catheter was used to eliminate the VAs. Post-ablation pacing maneuvers were utilized to verify the inducibility of Vas. ResultsTwenty-eight patients (43%) had ischemic cardiomyopathy [coronary artery disease (CAD)], 16 patients (25%) had non-ischemic cardiomyopathy [idiopathic dilated cardiomyopathy (IDC)], and 21 patients (32%) had structurally normal hearts (SNH) or right ventricle outflow tract tachycardia (RVOT). In patients with structural heart disease (CAD, IDC), success was achieved in 22% with the 4-mm catheter tip and in 59% with the 8-mm catheter tip (p=0.014). In patients with SNH/RVOT, success was achieved in 85% with the 4-mm catheter tip and in 87% with the 8-mm catheter tip (p=1.00). ConclusionsOur findings showed that, with RMN, there is an increased success related to the catheter tip utilized. However, in patients with right ventricular outflow origin, the standard 4-mm tip provided adequate lesions for successful ablation in most patients.
  Journal of Interventional Cardiac Electrophysiology 04/2012; 26(2):133-137. · 1.17 Impact Factor
• Article: Multi-organ effects of Conducted Electrical Weapons (CEW) -- a review.

  Mazda Biria, Sudharani Bommana, Mark Kroll, Dorin Panescu, Dhanunjaya Lakkireddy
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  ABSTRACT: Since the introduction of the Conducted Electrical Weapons (CEW) several studies have been conducted and multiple reports have been published on safety of these devices from a medical point of view. Use of these devices in different situations and reported deaths attracts media attention and causes general anxiety around these devices. These devices have several limitations- such as rate of fire or maximum effective range in comparison to fire arms. Here we wish to review medical publications regarding the safety of these devices based on different systems.
  Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2010; 2010:1266-70.
• Source

  Available from: narod.ru

  Article: Incidence of left ventricular function improvement after primary prevention ICD implantation for non-ischaemic dilated cardiomyopathy: a multicentre experience.

  Atul Verma, Zaev Wulffhart, Dhanunjaya Lakkireddy, Yaariv Khaykin, Alexander Kaplan, Bradley Sarak, Mazda Biria, Jayasree Pillarisetti, Pradeep Bhat, Luigi Di Biase, Otto Constantini, Kara Quan, Andrea Natale
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  ABSTRACT: The SCD-HeFT study demonstrated a benefit of primary prevention implantable cardioverter-defibrillator (ICD) implantation in patients with non-ischaemic dilated cardiomyopathy (NIDCM). However, NIDCM may improve spontaneously, even after waiting 6-9 months on optimal medical treatment. To assess the incidence of left ventricular (LV) function improvement in patients receiving primary prevention ICDs for NIDCM. All patients with NIDCM receiving primary prevention ICDs (non-cardiac resynchronisation therapy) from 2005 to the present at our institutions were retrospectively studied. All patients had NIDCM confirmed by a lack of significant stenoses on coronary angiography, a lack of significant valvular abnormalities on echo, and LV dysfunction with ejection fraction (EF) <35%. All patients had to have had a diagnosis of NIDCM for at least 9 months and be receiving optimal medical treatment for at least 3 months before implant according to the guidelines. All patients had at least New York Heart Association (NYHA) II symptoms. Baseline and follow-up EF was documented by quantitative echo and/or multi-gated acquisition scan. 332 patients were identified by a database search. Patients were aged 67+/-11 years, 75% of them were male, NYHA 2.3+/-0.7, with EF 25+/-13%, and LV diastolic diameter 61+/-10 mm. Time from initial NIDCM diagnosis to implant was 11+/-6 months and duration of medical treatment before implant was 8+/-5 months. Treatment at the time of implant included ACE inhibitors or ARBs (85%), beta blockers (77%), spironolactone (53%), loop diuretic (63%) and digoxin (50%). Repeat EF assessment was available in 309/332 (93%) 8+/-6 months after implant. EF improved to >35% in 37/309 (12%) patients. Patients who improved had a shorter time from diagnosis to implant (9+/-3 vs 13+/-5 months respectively, p=0.03). No other significant predictors were identified for patients with improved EF. In spite of following guidelines for implantation of primary prevention ICDs in patients with NIDCM, a substantial number of patients (12%) experience improvement in LV function to levels above those recommended for ICD implant. A shorter time from diagnosis to implant may predict post-implant improvement.
  Heart (British Cardiac Society) 11/2009; 96(7):510-5. · 4.22 Impact Factor
• Article: Integrity of vascular access: the story of a broken sheath!

  Jayasree Pillarisetti, Mazda Biria, Amber Balda, Namratha Reddy, Loren Berenbom, Dhanunjaya Lakkireddy
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  ABSTRACT: A 31-year-old female underwent an electrophysiology procedure wherein 4 vascular sheaths were placed. Following the procedure, as one of the vascular sheaths was pulled out, clinicians noted that it was broken. Emergent fluoroscopy revealed part of the vascular sheath was left behind in the soft tissue and was removed surgically. This case report describes the complications associated with vascular sheaths and reiterates the correct methods of handling them.
  Journal of vascular nursing: official publication of the Society for Peripheral Vascular Nursing 10/2009; 27(3):75-7.
• Article: Use of complex fractionated atrial electrogram mapping system in mapping and ablating the atrial flutter of a transplanted heart.

  Mazda Biria, Mark Burnett, Subbareddy Vanga, Caroline Murray, Wallace Ray, Dhanunjaya Lakkireddy
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  ABSTRACT: Atrial flutter in donor part of orthotopic heart transplant has been reported and treated by radiofrequency ablation in the past. Complex fractionated atrial electrogram (CFE) mapping has been used to simplify the ablation of chronic atrial fibrillation. Here, we report a case with atrial flutter in an orthotopic heart transplant whose circuit mapping was difficult. Using CFE helped us to define the arrhythmia circuit easily and perform curative ablation.
  Pacing and Clinical Electrophysiology 10/2008; 31(9):1223-5. · 1.35 Impact Factor
• Article: Intracardiac echo-guided radiofrequency catheter ablation of atrial fibrillation in patients with atrial septal defect or patent foramen ovale repair: a feasibility, safety, and efficacy study.

  Dhanunjaya Lakkireddy, Umamahesh Rangisetty, Subramanya Prasad, Atul Verma, Mazda Biria, Loren Berenbom, Rhea Pimentel, Martin Emert, Thomas Rosamond, Tamer Fahmy, Dimpi Patel, Luigi Di Biase, Robert Schweikert, David Burkhardt, Andrea Natale
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  ABSTRACT: Intracardiac Echo-Guided Radiofrequency Catheter. Patients with atrial septal defect (ASD) are at higher risk for atrial fibrillation (AF) even after repair. Transseptal access in these patients is perceived to be difficult. We describe the feasibility, safety, and efficacy of pulmonary vein antral isolation (PVAI) in these patients. We prospectively compared post-ASD/patent foramen ovale (PFO) repair patients (group I, n = 45) with age-gender-AF type matched controls (group II, n = 45). All the patients underwent PVAI through a double transseptal puncture with a roving circular mapping catheter technique guided by intracardiac echocardiography (ICE). The short-term (3 months) and long-term (12 month) failure rates were assessed. In group I, 23 (51%) had percutaneous closure devices and 22 (49%) had a surgical closure. There was no significant difference between group I and II in the baseline characteristics. Intracardiac echo-guided double transseptal access was obtained in 98% of patients in group I and in 100% of patients in group II. PVAI was performed in all patients, with right atrial flutter ablation in 7 patients in group I and in 4 patients in group II. Over a mean follow-up of 15 +/- 4 months, group I had higher short-term (18% vs 13%, P = 0.77) and long-term recurrence (24% vs 18%, P = 0.6) than group II. There was no significant difference in the perioperative complications between the two groups. Echocardiography at 3 months showed interatrial communication in 2 patients in group I and 1 patient in group II, which resolved at 12 months. Percutaneous AF ablation using double transseptal access is feasible, safe, and efficacious in patients with ASD and PFO repairs.
  Journal of Cardiovascular Electrophysiology 08/2008; 19(11):1137-42. · 3.06 Impact Factor
• Article: Recurrent positional syncope as the primary presentation of superior vena cava syndrome after pacemaker implantation.

  Mazda Biria, Radhika Gupta, Dhanunjaya Lakkireddy, Kamal Gupta
  Heart rhythm: the official journal of the Heart Rhythm Society 06/2008; 6(1):144-5. · 4.56 Impact Factor
• Article: Percutaneous coronary intervention in a patient with acute ST-elevation myocardial infarction and hemophilia A.

  David Quintero, Mazda Biria, David G Meyers
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  ABSTRACT: We report the first case of myocardial infarction in a hemophilia patient which was not directly precipitated by infusion of a clotting factor, and the second hemophilia patient with infarction treated with primary coronary artery stenting. Anticoagulation and platelet inhibition are problematic in such patients. At 2 years after infarction, our patient has experienced neither ischemic nor bleeding complications.
  The Journal of invasive cardiology 06/2008; 20(5):240-1. · 1.84 Impact Factor
• Article: A modified technique for carotid cannulation via the transfemoral approach, during angioplasty and stent placement.

  Kamal Gupta, Mazda Biria, Ali Mortazavi
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  ABSTRACT: We report a modified technique for advancing a catheter or sheath into the right common carotid artery when the aortic arch anatomy is unfavorable.A standard 0.035-inch guidewire is passed into the right subclavian artery, and a diagnostic catheter is threaded over it, deep into the right axillary and brachial artery. This wire is exchanged for a stiffer wire (for example, a super-stiff Amplatz), and the catheter is removed. This stiff wire acts as an anchor and provides enough support for a sheath or a guide catheter to be easily advanced into the right brachiocephalic artery, up to its bifurcation into the subclavian and common carotid arteries. Another wire is then buddy-wired through the guide or sheath into the common carotid artery and is placed in a branch of the external carotid artery. The stiff wire is now slowly withdrawn from the subclavian artery, and as soon as its tip exits the subclavian ostium, the guide or sheath is advanced into the common carotid artery.This simple modification can improve the success rate of carotid cannulation via the femoral approach without increasing procedural risks.
  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital 02/2008; 35(3):286-8. · 0.65 Impact Factor
• Article: Do statins have a role in the management of diastolic dysfunction?

  Mazda Biria, Patricia A Howard, James Vacek
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  ABSTRACT: Diastolic dysfunction of the left ventricle is an increasingly recognized clinical entity that may in some cases cause overt congestive heart failure. Currently, treatment of these patients is based on limited studies in patients with symptomatic heart failure. HMG-CoA reductase inhibitor (statin) drugs, which are primarily used for the treatment of hyperlipidemia, have been shown to have additional pharmacologic properties that may be beneficial in other disease states such as heart failure. Here, we wish to review the current knowledge of the mechanism of action of statins and the probable implications for asymptomatic patients with diastolic dysfunction. We discuss the causes and settings of diastolic dysfunction, the potential role of statin therapy in the treatment of diastolic dysfunction, and potential mechanisms by which statins may show benefit. The use of statins in the setting of diastolic dysfunction, both for treatment of established heart failure as well as to prevent progression of subclinical disease to overt symptomatic expression, is an area of substantial research interest with direct clinical application.
  American Journal of Cardiovascular Drugs 02/2008; 8(5):297-303. · 1.77 Impact Factor
• Article: Dissection of left anterior descending artery following a motor vehicle accident.

  Mazda Biria, Vinod Raxwal, David Wilson
  Clinical Cardiology 10/2007; 32(7):E10. · 2.15 Impact Factor
• Article: Subclavian-vertebral artery bifurcation stenting using drug-eluting stents: a report of two cases using different techniques.

  Mazda Biria, Peter Tadros, Kamal Gupta
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  ABSTRACT: Endovascular treatment of vertebral artery stenosis and subclavian artery stenosis are low-risk procedures, but there are few reports of the best approach for subclavian-vertebral artery stenoses where there is an ostial stenosis of a vertebral artery that arises from a stenosed segment of the subclavian artery. This is a report of two cases with subclavian-vertebral artery stenosis that were treated with two different techniques. One-year follow up demonstrated widely patent stents. Also, to our knowledge, this is the first report of the use of the crush-stenting technique using drug-eluting stents in subclavian-vertebral artery bifurcation lesions.
  The Journal of invasive cardiology 07/2007; 19(6):E156-9. · 1.84 Impact Factor