D J Wright

Publications (3)8.22 Total impact

• Article: Implantable cardioverter defibrillator: what a hospital practitioner needs to know.

  K Albouaini, T Mudawi, J R Pyatt, D J Wright
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  ABSTRACT: The implantable cardioverter defibrillator (ICD) has undergone a remarkable transformation in the last three decades, both in generator size and functionality. This, coupled with improvements in lead design, allows the simplicity of defibrillator implantation to approach that of pacemakers, with outpatient placement now feasible. Nowadays, the majority of new ICD implants are performed on primary prevention grounds with device longevity of more than 7 years. In this article, we will concisely explain the evolution of this treatment, the implantation technique, arrhythmia detection and patient follow-up. In addition, we will review the relevant clinical trials as well as prescription guidelines.
  European Journal of Internal Medicine 10/2009; 20(6):591-7. · 2.00 Impact Factor
• Article: Cardiac resynchronisation therapy: evidence based benefits and patient selection.

  K Albouaini, M Egred, A Rao, A Alahmar, D J Wright
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  ABSTRACT: Despite the improvement in pharmacologic treatment of heart failure, many patients continue to have severe persistent symptoms, and their prognosis remains poor. One of the most recent advances in heart failure management is the concept of cardiac resynchronization therapy (CRT) with right and left ventricular pacing. Large clinical trials have demonstrated morbidity and mortality benefits of CRT in patients with moderate to severe drug refractory heart failure (New York Heart Association (NYHA) functional class III or IV), and ejection fraction < or = 35% with QRS duration > or = 120 ms. Despite the documented benefits, 20-30% of patients selected to have CRT do not respond to this treatment. Echocardiography will probably play a more important role in better selecting patients with mechanical dyssynchrony who are more likely to respond to CRT. This article reviews the available evidence for CRT as well as the way to select responders to this rather invasive therapy.
  European Journal of Internal Medicine 05/2008; 19(3):165-72. · 2.00 Impact Factor
• Article: Cardiopulmonary exercise testing and its application.

  K Albouaini, M Egred, A Alahmar, D J Wright
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  ABSTRACT: Cardiopulmonary exercise testing (CPET) has become an important clinical tool to evaluate exercise capacity and predict outcome in patients with heart failure and other cardiac conditions. It provides assessment of the integrative exercise responses involving the pulmonary, cardiovascular and skeletal muscle systems, which are not adequately reflected through the measurement of individual organ system function. CPET is being used increasingly in a wide spectrum of clinical applications for evaluation of undiagnosed exercise intolerance and for objective determination of functional capacity and impairment. This review focuses on the exercise physiology and physiological basis for functional exercise testing and discusses the methodology, indications, contraindications and interpretation of CPET in normal people and in patients with heart failure.
  Heart (British Cardiac Society) 11/2007; 93(10):1285-92. · 4.22 Impact Factor