Browsing by Author "Singh, Rajeev"

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    Left Bundle Branch Block–Induced Cardiomyopathy in a Transplanted Heart Treated With His Bundle Pacing
    (Elsevier, 2020-08-12) Khaira, Kavita B.; Singh, Rajeev; Devabhaktuni, Subodh; Simon, Joel W.; Dandamudi, Gopi; Medicine, School of Medicine
    A 70-year-old male with prior orthotopic heart transplant developed left bundle branch block followed by new-onset left ventricular systolic dysfunction. He underwent His bundle pacing for cardiac resynchronization therapy with complete normalization of his ejection fraction. This is the first reported case of left bundle branch block–induced cardiomyopathy in a transplanted heart.
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    Variation in Hospital-use and Outcomes Associated with Pulmonary Artery Catheterization in Heart Failure in the United States
    (American Heart Association, 2016-11) Khera, Rohan; Pandey, Ambarish; Kumar, Nilay; Singh, Rajeev; Bano, Shah; Golwala, Harsh; Kumbhani, Dharam J.; Girotra, Saket; Fonarow, Gregg C.; Medicine, School of Medicine
    Background There has been an increase in the use of pulmonary artery (PA) catheters in heart failure (HF) in the United States in recent years. However, patterns of hospital-use and trends in patient outcomes are not known. Methods and Results In the National Inpatient Sample 2001–2012, using ICD-9 codes we identified 11,888,525 adult (≥18 years) HF hospitalizations nationally, of which an estimated 75,209 (SE 0.6%) received a PA catheter. In 2001, the number of hospitals with ≥1 PA catheterization was 1753, decreasing to 1183 in 2011. The mean PA catheter use per hospital trended from 4.9/year in 2001 (limits 1–133) to 3.8/year in 2007 (limits 1–46), but increased to 5.5/year in 2011 (limits 1–70). During 2001–2006, PA catheterization declined across hospitals; however, in 2007–2012 there has been a disproportionate increase at hospitals with large bedsize, teaching programs, and advanced HF capabilities. The overall in-hospital mortality with PA catheter use was higher than without PA catheter use (13.1% vs. 3.4%, P<0.0001), however, in propensity-matched analysis, differences in mortality between these groups have attenuated over time – risk-adjusted odds ratio for mortality for PA-catheterization, 1.66 (95% CI 1.60–1.74) in 2001–2003 down to 1.04 (95% CI 0.97– 1.12) in 2010–2012. Conclusions There is substantial hospital-level variability in PA catheterization in HF along with increasing volume at fewer hospitals overrepresented by large, academic hospitals with advanced HF capabilities. This is accompanied by a decline in excess mortality associated with PA catheterization.
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    Warden Procedure in a 77-year-old Man
    (Elsevier, 2019) Hopkins, Kali A.; Farber, Mark O.; Singh, Rajeev; Kay, W. Aaron; Herrmann, Jeremy L.; Brown, John W.; Medicine, School of Medicine
    Partial anomalous pulmonary venous return (PAPVR) is a rare congenital heart defect characterized by one or more but not all of the pulmonary veins draining somewhere other than the left atrium thereby creating a left-to-right shunt. Over time, patients may develop right-sided volume overload and its subsequent complications. We present a case of isolated PAPVR in an older patient who underwent a Warden procedure at age 77 years with rapid improvement in right ventricular size and function.