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Darrel Francis

Ahran D Arnold, James P Howard, Kayla Chiew, William J Kerrigan, Felicity de Vere, Hannah T Johns, Leonid Churlilov, Yousif Ahmad, Daniel Keene, Matthew J Shun-Shin, Graham D Cole, Prapa Kanagaratnam, S M Afzal Sohaib, Amanda Varnava, Darrel P Francis, Zachary I Whinnett
Aims: Right ventricular pacing for left ventricular outflow tract gradient reduction in hypertrophic obstructive cardiomyopathy (HOCM) remains controversial. We undertook a meta-analysis for echocardiographic and functional outcomes. Methods and Results: 34 studies comprising 1135 patients met eligibility criteria. In the 4 blinded randomized controlled trials (RCTs), pacing reduced gradient by 35% (95% CI 23.2 - 46.9, p < 0.0001), but there was only a trend towards improved NYHA class (odds ratio [OR] 1...
January 31, 2019: European Heart Journal. Quality of Care & Clinical Outcomes
Darrel P Francis, Brahmajee K Nallamothu
No abstract text is available yet for this article.
January 3, 2019: New England Journal of Medicine
Adam Hartley, Mit Shah, Alexandra N Nowbar, Christopher Rajkumar, James P Howard, Darrel P Francis
No abstract text is available yet for this article.
December 13, 2018: BMJ: British Medical Journal
Ahran D Arnold, Matthew J Shun-Shin, Daniel Keene, James P Howard, S M Afzal Sohaib, Ian J Wright, Graham D Cole, Norman A Qureshi, David C Lefroy, Michael Koa-Wing, Nick W F Linton, Phang Boon Lim, Nicholas S Peters, D Wyn Davies, Amal Muthumala, Mark Tanner, Kenneth A Ellenbogen, Prapa Kanagaratnam, Darrel P Francis, Zachary I Whinnett
BACKGROUND: His bundle pacing is a new method for delivering cardiac resynchronization therapy (CRT). OBJECTIVES: The authors performed a head-to-head, high-precision, acute crossover comparison between His bundle pacing and conventional biventricular CRT, measuring effects on ventricular activation and acute hemodynamic function. METHODS: Patients with heart failure and left bundle branch block referred for conventional biventricular CRT were recruited...
December 18, 2018: Journal of the American College of Cardiology
Bo Shen, Gursimran Kochhar, Udayakumar Navaneethan, Xiuli Liu, Francis A Farraye, Yago Gonzalez Lama, David Bruining, Darrell S Pardi, Martin Lukas, Martin Bortlik, Kaicun Wu, Ajit Sood, David A Schwartz, William J Sandborn
Interventional (or therapeutic) inflammatory bowel disease (IBD) endoscopy has an expanding role in the treatment of disease and surgical adverse events. Endoscopic therapy has been explored and used in the management of strictures, fistulas/abscesses, colitis-associated neoplasia, post-surgical acute or chronic leaks, and obstructions. The endoscopic therapeutic modalities include balloon dilation, stricturotomy, stent placement, fistulotomy, fistula injection and clipping, sinusotomy, endoscopic mucosal resection, and endoscopic submucosal dissection...
October 23, 2018: Gastrointestinal Endoscopy
Rasha K Al-Lamee, Alexandra N Nowbar, Darrel P Francis
The adverse consequences of stable coronary artery disease (CAD) are death, myocardial infarction (MI) and angina. Trials in stable CAD show that percutaneous coronary intervention (PCI) does not reduce mortality. PCI does appear to reduce spontaneous MI rates but at the expense of causing some periprocedural MI. Therefore, the main purpose of PCI is to relieve angina. Indeed, patients and physicians often choose PCI rather than first attempting to control symptoms with anti-anginal medications as recommended by guidelines...
January 2019: Heart: Official Journal of the British Cardiac Society
João Ferreira-Martins, James Howard, Becker Al-Khayatt, Joseph Shalhoub, Afzal Sohaib, Matthew J Shun-Shin, Paul G Novak, Rick Leather, Laurence D Sterns, Christopher Lane, Phang Boon Lim, Prapa Kanagaratnam, Nicholas S Peters, Darrel P Francis, Markus B Sikkel
OBJECTIVE: We tested whether ablation methodology and study design can explain the varying outcomes in terms of atrial fibrillation (AF)-free survival at 1 year. BACKGROUND: There have been numerous paroxysmal AF ablation trials, which are heterogeneous in their use of different ablation techniques and study design. A useful approach to understanding how these factors influence outcome is to dismantle the trials into individual arms and reconstitute them as a large meta-regression...
September 19, 2018: Journal of Cardiovascular Electrophysiology
Min-Young Kim, Markus B Sikkel, Ross J Hunter, Guy A Haywood, David R Tomlinson, Muzahir H Tayebjee, Rheeda L Ali, Chris D Cantwell, Hanney Gonna, Belinda C Sandler, Elaine Lim, Guy Furniss, Dimitrios Panagopoulos, Gordon Begg, Gurpreet Dhillon, Nicola J Hill, James O'Neill, Darrel P Francis, Phang Boon Lim, Nicholas S Peters, Nick W F Linton, Prapa Kanagaratnam
INTRODUCTION: The ganglionated plexuses (GPs) of the intrinsic cardiac autonomic system are implicated in arrhythmogenesis. GP localization by stimulation of the epicardial fat pads to produce atrioventricular dissociating (AVD) effects is well described. We determined the anatomical distribution of the left atrial GPs that influence atrioventricular (AV) dissociation. METHODS AND RESULTS: High frequency stimulation was delivered through a Smart-Touch catheter in the left atrium of patients undergoing atrial fibrillation (AF) ablation...
August 31, 2018: Journal of Cardiovascular Electrophysiology
Yousif Ahmad, Matthias Götberg, Christopher Cook, James P Howard, Iqbal Malik, Ghada Mikhail, Angela Frame, Ricardo Petraco, Christopher Rajkumar, Ozan Demir, Juan F Iglesias, Ravinay Bhindi, Sasha Koul, Nearchos Hadjiloizou, Robert Gerber, Punit Ramrakha, Neil Ruparelia, Nilesh Sutaria, Gajen Kanaganayagam, Ben Ariff, Michael Fertleman, Jon Anderson, Andrew Chukwuemeka, Darrel Francis, Jamil Mayet, Patrick Serruys, Justin Davies, Sayan Sen
OBJECTIVES: In this study, a systematic analysis was conducted of phasic intracoronary pressure and flow velocity in patients with severe aortic stenosis (AS) and coronary artery disease, undergoing transcatheter aortic valve replacement (TAVR), to determine how AS affects: 1) phasic coronary flow; 2) hyperemic coronary flow; and 3) the most common clinically used indices of coronary stenosis severity, instantaneous wave-free ratio and fractional flow reserve. BACKGROUND: A significant proportion of patients with severe aortic stenosis (AS) have concomitant coronary artery disease...
October 22, 2018: JACC. Cardiovascular Interventions
Christopher M Cook, Yousif Ahmad, James P Howard, Matthew J Shun-Shin, Amarjit Sethi, Gerald J Clesham, Kare H Tang, Sukhjinder S Nijjer, Paul A Kelly, John R Davies, Iqbal S Malik, Raffi Kaprielian, Ghada Mikhail, Ricardo Petraco, Firas Al-Janabi, Grigoris V Karamasis, Shah Mohdnazri, Reto Gamma, Rasha Al-Lamee, Thomas R Keeble, Jamil Mayet, Sayan Sen, Darrel P Francis, Justin E Davies
BACKGROUND: Recently, the therapeutic benefits of percutaneous coronary intervention (PCI) have been challenged in patients with stable coronary artery disease (SCD). OBJECTIVES: The authors examined the impact of PCI on exercise responses in the coronary circulation, the microcirculation, and systemic hemodynamics in patients with SCD. METHODS: A total of 21 patients (mean age 60.3 ± 8.4 years) with SCD and single-vessel coronary stenosis underwent cardiac catheterization...
August 28, 2018: Journal of the American College of Cardiology
Yousif Ahmad, James Howard, Ahran Arnold, Matthew Shun-Shin, Christopher Cook, Darrel Francis, Sayan Sen
No abstract text is available yet for this article.
October 14, 2018: European Heart Journal
Jason L Sperry, Francis X Guyette, Joshua B Brown, Mark H Yazer, Darrell J Triulzi, Barbara J Early-Young, Peter W Adams, Brian J Daley, Richard S Miller, Brian G Harbrecht, Jeffrey A Claridge, Herb A Phelan, William R Witham, A Tyler Putnam, Therese M Duane, Louis H Alarcon, Clifton W Callaway, Brian S Zuckerbraun, Matthew D Neal, Matthew R Rosengart, Raquel M Forsythe, Timothy R Billiar, Donald M Yealy, Andrew B Peitzman, Mazen S Zenati
BACKGROUND: After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting. METHODS: To determine the efficacy and safety of prehospital administration of thawed plasma in injured patients who are at risk for hemorrhagic shock, we conducted a pragmatic, multicenter, cluster-randomized, phase 3 superiority trial that compared the administration of thawed plasma with standard-care resuscitation during air medical transport...
July 26, 2018: New England Journal of Medicine
Michel Accad, Darrel Francis
No abstract text is available yet for this article.
July 16, 2018: BMJ: British Medical Journal
Daniel Keene, Ahran Arnold, Matthew J Shun-Shin, James P Howard, Sm Afzal Sohaib, Philip Moore, Mark Tanner, Norman Quereshi, Amal Muthumala, Badrinathan Chandresekeran, Paul Foley, Francisco Leyva, Shaumik Adhya, Emanuela Falaschetti, Hilda Tsang, Pugal Vijayaraman, John G F Cleland, Berthold Stegemann, Darrel P Francis, Zachary I Whinnett
AIMS: In patients with heart failure and a pathologically prolonged PR interval, left ventricular (LV) filling can be improved by shortening atrioventricular delay using His-bundle pacing. His-bundle pacing delivers physiological ventricular activation and has been shown to improve acute haemodynamic function in this group of patients. In the HOPE-HF (His Optimized Pacing Evaluated for Heart Failure) trial, we are investigating whether these acute haemodynamic improvements translate into improvements in exercise capacity and heart failure symptoms...
October 2018: ESC Heart Failure
Tom Jackson, Radoslaw Lenarczyk, Maciej Sterlinski, Adam Sokal, Darrell Francis, Zachary Whinnett, Frederic Van Heuverswyn, Marc Vanderheyden, Joeri Heynens, Berthold Stegemann, Richard Cornelussen, Christopher Aldo Rinaldi
Background: We sought to determine whether presence, amount and distribution of scar impacts the degree of acute hemodynamic response (AHR) with multisite pacing.Multi-vein pacing (MVP) or multipolar pacing (MPP) with a multi-electrode left ventricular (LV) lead may offer benefits over conventional biventricular pacing in patients with myocardial scar. Methods: In this multi-center study left bundle branch block patients underwent an hemodynamic pacing study measuring LV dP/dtmax ...
June 2018: IJC Heart & Vasculature
Christopher J Broyd, Fausto Rigo, Sukhjinder Nijjer, Sayan Sen, Ricardo Petraco, Rasha Al-Lamee, Nicolas Foin, Andrew Chukwuemeka, Jon Anderson, Jessica Parker, Iqbal S Malik, Ghada W Mikhail, Darrel P Francis, Kim Parker, Alun D Hughes, Jamil Mayet, Justin E Davies
AIM: Severe aortic stenosis frequently involves the development of left ventricular hypertrophy (LVH) creating a dichotomous haemodynamic state within the coronary circulation. Whilst the increased force of ventricular contraction enhances its resultant relaxation and thus increases the distal diastolic coronary "suction" force, the presence of LVH has a potentially opposing effect on ventricular-coronary interplay. The aim of this study was to use non-invasive coronary wave intensity analysis (WIA) to separate and measure the sequential effects of outflow tract obstruction relief and then LVH regression following intervention for aortic stenosis...
June 23, 2018: Acta Physiologica
Rasha Al-Lamee, James P Howard, Matthew J Shun-Shin, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Sukhjinder Nijjer, Ricardo Petraco, John Davies, Thomas Keeble, Kare Tang, Iqbal S Malik, Christopher Cook, Yousif Ahmad, Andrew S P Sharp, Robert Gerber, Christopher Baker, Raffi Kaprielian, Suneel Talwar, Ravi Assomull, Graham Cole, Niall G Keenan, Gajen Kanaganayagam, Joban Sehmi, Roland Wensel, Frank E Harrell, Jamil Mayet, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND: There are no data on how fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are associated with the placebo-controlled efficacy of percutaneous coronary intervention (PCI) in stable single-vessel coronary artery disease. METHODS: We report the association between prerandomization invasive physiology within ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina), a placebo-controlled trial of patients who have stable angina with angiographically severe single-vessel coronary disease clinically eligible for PCI...
October 23, 2018: Circulation
Zachary I Whinnett, S M Afzal Sohaib, Mark Mason, Edward Duncan, Mark Tanner, David Lefroy, Mohamed Al-Obaidi, Sue Ellery, Francisco Leyva-Leon, Tim Betts, Mark Dayer, Paul Foley, Jon Swinburn, Martin Thomas, Raj Khiani, Tom Wong, Zaheer Yousef, Dominic Rogers, Paul R Kalra, Vignesh Dhileepan, Katherine March, James Howard, Andreas Kyriacou, Jamil Mayet, Prapa Kanagaratnam, Michael Frenneaux, Alun D Hughes, Darrel P Francis
OBJECTIVES: BRAVO (British Randomized Controlled Trial of AV and VV Optimization) is a multicenter, randomized, crossover, noninferiority trial comparing echocardiographic optimization of atrioventricular (AV) and interventricular delay with a noninvasive blood pressure method. BACKGROUND: Cardiac resynchronization therapy including AV delay optimization confers clinical benefit, but the optimization requires time and expertise to perform. METHODS: This study randomized patients to echocardiographic optimization or hemodynamic optimization using multiple-replicate beat-by-beat noninvasive blood pressure at baseline; after 6 months, participants were crossed over to the other optimization arm of the trial...
May 11, 2018: JACC. Cardiovascular Imaging
Rufael Chekol, Viswas Raja Solomon, Elahe Alizadeh, Wendy Bernhard, Darrell Fisher, Wayne Hill, Kris Barreto, John Francis DeCoteau, Angel Casaco Parada, Clarence Ronald Geyer, Humphrey Fonge
Rationale: Epidermal growth factor receptor (EGFR) upregulation is associated with enhanced proliferation and drug resistance in a number of cancers. Nimotuzumab is a humanized monoclonal antibody with high affinity for EGFR. The objective of this study was to determine if 89 Zr-DFO-nimotuzumab could be suitable for human use as a PET probe for quantifying EGFR in vivo . Methods: To evaluate the pharmacokinetics, biodistribution, microPET imaging, radiation dosimetry, and normal tissue toxicity in tumor and non-tumor bearing mice of 89 Zr-desferoxamine-nimotuzumab (89 Zr-DFO-nimotuzumab) of a product prepared under GMP conditions...
March 30, 2018: Oncotarget
Sean L Zheng, Alistair J Roddick, Rochan Aghar-Jaffar, Matthew J Shun-Shin, Darrel Francis, Nick Oliver, Karim Meeran
Importance: The comparative clinical efficacy of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, glucagon-like peptide 1 (GLP-1) agonists, and dipeptidyl peptidase 4 (DPP-4) inhibitors for treatment of type 2 diabetes is unknown. Objective: To compare the efficacies of SGLT-2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors on mortality and cardiovascular end points using network meta-analysis. Data Sources: MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, and published meta-analyses from inception through October 11, 2017...
April 17, 2018: JAMA: the Journal of the American Medical Association
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