Electrophysiology

Overview

The group works to continuously improve research methods and knowledge as well as to foster expertise in electrophysiology outcomes research and clinical trials.

Specific research goals include:

  • Gaining a better understanding of the fundamental electrophysiologic mechanisms involved in the initiation, maintenance, and termination of supraventricular and ventricular tachycardia
  • Investigating new treatment approaches to patients with tachyarrhythmias, including drugs, electrical devices, catheter ablation, and surgery
  • Examining the outcomes of patients with different rhythm disorders and the effect of various therapeutic approaches on their outcomes
  • Designing and performing new clinical trials addressing the effectiveness of antiarrhythmic medications, devices, and ablative procedures
  • Identifying tests that effectively stratify patients for risk of sudden cardiac death and to develop clinically useful predictive models based on these tests
  • Evaluating the effectiveness, cost-effectiveness, and health policy implications of screening and therapeutic interventions for sudden cardiac death prevention, and using these evaluations to develop clinical guidelines for implementation of these interventions
  • Evaluating patients with familial arrhythmias or a family history of sudden death

Examples of research projects include:

  • Leadership of a number of trials of device therapy with pacemakers, implantable cardioverter defibrillators, and heart failure devices
  • Clinical investigation of pharmacologic agents for the control and suppression of arrhythmias
  • Outcomes research in patients with atrial and ventricular arrhythmias
  • Risk stratification for sudden cardiac death
  • Procedure-based database to capture all patients undergoing procedures at Duke University Medical Center
  • The use and development of new mapping techniques for arrhythmia ablation
  • Genomics research examining gene expression differences in patients treated with biventricular pacemakers

Collaborations

To facilitate the development and implementation of new therapeutic modalities and modification of current diagnostic and therapeutic approaches, close collaboration is maintained with a number of groups, including:

These collaborations allow the integration of very basic "bench" research to be available to the practicing clinician.

Selected Publications

  • Reynolds MR, Shah J, Essebag V, Olshansky B, Friedman PA, Hadjis T, Lemery R, Bahnson TD, Cannom DS, Josephson ME, Zimetbaum P. Patterns and Predictors of Warfarin Use in Patients With New-Onset Atrial Fibrillation from the FRACTAL Registry. Am J Cardiol 2006; 97:538–543.
  • Mark DB, Nelson CL, Anstrom A, Al-Khatib SM, Tsiatis A, Clapp-Channing N, Davidson-Ray L, Lee KL, Bardy GH for the SCD-HeFT Investigators. Cost effectiveness of defibrillator therapy and amiodarone in chronic stable heart failure: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). Circulation 2006; 114:135-142.
  • Teplitsky L, Hegland DD, Bahnson TD. Catheter Based Cryoablation and Radiofrequency Ablation for Atrial Fibrillation Results in Conductive Heat Transfer from and to the Esophagus. Hearet Rhythm Society, Vol 3 Issue 1S S242 May 2006.
  • Nielsen TD, Smith W, Teplitsky L, Kay GN, Bahnson TD. Pulmonary Vein Triggers of Atrial Fibrilation may be Detectable on the Surface Electrocardiogram. Heart Rhythm Society Supplement 191, Vol 3 Issue 1S 3-40 May 2006.
  • Perzanowski C, Teplitsky L, Hranitzky PM, Bahnson TD. Real-time monitoring of luminal esophageal temperature during left atrial radiofrequency catheter ablation for atrial fibrillation: observations about esophageal heating during ablation at the pulmonary vein ostia and posterior left atrium. Journal of Cardiovascular Electrophysiology. 17(2):166-70, 2006 Feb.
  • Al-Khatib SM, Lucas L, Jollis JG, Malenka DJ, Wennberg DE. Relation between patients’ outcomes and volume of cardioverter defibrillator implantations performed at hospitals treating medicare beneficiaries. J Am Coll Cardiol 2005; 46:1,536-40.
  • Strickberger AS, Ip J, Saksena S, Curry K, Bahnson TD, Ziegler PD. Relationship Between Atrial Tachyarrhythmias and Symptoms. Heart Rhythm 2005; 2(2):125-131.
  • Al-Khatib SM, Sanders GD, Mark DB, Lee KL, Bardy GH, Bigger JT, Buxton AE, Connolly S, Kadish A, Moss A, Feldman AM, Ellenbogen KA, Singh S, Califf RM. Implantable cardioverter defibrillators and cardiac resynchronization therapy in patients with left ventricular dysfunction: randomized trial evidence through 2004. Am Heart J 2005; 149:1020-34.
  • Bahnson, TD. Clinician's Commentary: Pulmonary Vein diameter, Cross-sectional Area and Shape. Radiology 2005; 235(1):49.
  • Al-Khatib SM, Anstrom K, Eisenstein E, Peterson E, Jollis J, Li Y, O’Connor C, Lee KL, Shaw L, Mark D, Califf RM. Clinical and Economic Implications of the Multi-center Automatic Defibrillator Implantation Trial II. Ann Int Med 2005; 142:593-600.
  • Teplitsky L, Perzanowski C, Durrani S, Berman A, Hranitzky P, and Bahnson TD. Radiofrequency Catheter Ablation for Atrial Fibrillation Produces Delayed and Long Lasting Elevation of Luminal Esophageal Temperature Independent of Lesion Duration and Power. Heart Rhythm Society, Vol 2 Issue 1S S8-9 May 2005.
  • Bahnson TD, Teplitsky L, Perzanowski C. Radiofrequency Energy Delivery at the Pulmonary Vein Os can Produce Rapid Elevation of Luminal Esophageal Temperature. Heart Rhythm Society, Vol 2 Issue 1S (5) S19, May 2005.
  • Teplitsky L, Wolf PD, Bahnson TD. Esophageal Heating During Radiofrequency Catheter Ablation for Atrial Fibrillation is Critically Dependent on the Atrial-Esophagus Fat Layer Thickness. Circulation Vol 112 (17) II-392, Oct. 25, 2005.
  • Bahnson TD, Grant AO. To be or not to be in sinus rhythm: What do we really know? Annals of Internal Medicine 2004; 141(9):727-729.
  • Al-Khatib SM, Shaw L, O’Connor C, Califf RM. Atrial fibrillation in congestive heart failure: Is rhythm control therapy superior to rate control therapy? Am J Cardiol 2004; 94:797-800.
  • Al-Khatib SM, Allen La Pointes N, Kramer JM, Califf RM. What Clinicians should know about the QT-interval. JAMA 2003; 289:2120-2127.
  • Grant AO, Carboni MP, Neplioueva V, Starmer CF, Memmi M, Napolitano C, Priori S. Long QT syndrome, Brugada syndrome, and conduction system disease are linked to a single sodium channel mutation. Journal of Clinical Investigation 110 (8):1201-1209, 2002.
  • Campbell KR, Whitehill JM, Hesselson A, Gallagher P, Assar MD, Bahnson TD. Dual-site or Bi-atrial Pacing Does Not Enhance Atrial Activation As Compared to Pacing from Novel Single Right Atrial Sites in Humans. Journal of the American College of Cardiology 39(5) Suppl A: 85A, 2002.
  • Al-Khatib SM, Granger CC, Huang Y, Lee KL, Califf RM, Simoons M, Armstrong P, Van de Werf F, White H, Simes J, Moliterno DJ, Topol EJ, Harrington RA. Sustained ventricular arrhythmias among patients with acute coronary syndromes with no ST-segment elevation: incidence, predictors, and outcomes. Circulation 2002; 106: 309-312.
  • Anderson ME, Al-Khatib SM, Roden DM, and Califf RM. Cardiac Repolarization: current knowledge, critical gaps, and new approaches to drug development and patient management. American Heart Journal 2002; 144:769-781.

Faculty

Sana M. Al-Khatib, MD
Tristram D. Bahnson, MD
Augustus O. Grant, MD, ChB, PhD
Ruth A. Greenfield, MD
Patrick M. Hranitzky, MD

Contact Information

Office: 7521 North Pavilion Building, Durham, NC, 27715 
Campus mail: DUMC Box 3850, Durham, NC, 27715 
Phone: 919-668-8649