WorldCat Identities

Khairy, Paul

Overview
Works: 20 works in 27 publications in 2 languages and 30 library holdings
Genres: Academic theses 
Roles: Author, Contributor
Classifications: WG141.5.F9, 612.813
Publication Timeline
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Most widely held works by Paul Khairy
Absence of association between chlamydia pneumoniae, cytomegalovirus, Epstein-Barr virus and endothelial function by Paul Khairy( )

3 editions published between 2002 and 2004 in English and held by 6 WorldCat member libraries worldwide

"Methodology. A convenience sample of 65 male volunteers, ages 20 to 45, with no known coronary atherosclerosis or risk factors for coronary artery disease were enrolled in a seroepidemiological cross-sectional study."--
Adult congenital heart disease : long-term survival, arrhythmias, and emerging therapy by Paul Khairy( Book )

5 editions published between 2004 and 2006 in English and held by 3 WorldCat member libraries worldwide

Knowledge of Life-Long Cardiac Care by Adolescents and Young Adults with Congenital Heart Disease by The Adult Congenital Heart Association and the Adult Congenital Cardiac Care Associate Research Group( )

1 edition published in 2019 in English and held by 2 WorldCat member libraries worldwide

Cryoablation for cardiac arrhythmias( Book )

1 edition published in 2008 in English and held by 2 WorldCat member libraries worldwide

Aortic valve dysfunction and aortic dilatation in adults with coarctation of the aorta( )

1 edition published in 2013 in English and held by 2 WorldCat member libraries worldwide

Thèse. Biologie. Médecine. 2013
Healthcare system inputs and patient-reported outcomes a study in adults with congenital heart defect from 15 countries by Liesbet Van Bulck( )

1 edition published in 2020 in English and held by 1 WorldCat member library worldwide

Background: The relationship between healthcare system inputs (e.g., human resources and infrastructure) and mortality has been extensively studied. However, the association between healthcare system inputs and patient-reported outcomes remains unclear. Hence, we explored the predictive value of human resources and infrastructures of the countries' healthcare system on patient-reported outcomes in adults with congenital heart disease. Methods: This cross-sectional study included 3588 patients with congenital heart disease (median age = 31y; IQR = 16.0; 52% women; 26% simple, 49% moderate, and 25% complex defects) from 15 countries. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviors, and quality of life. The assessed inputs of the healthcare system were: (i) human resources (i.e., density of physicians and nurses, both per 1000 people) and (ii) infrastructure (i.e., density of hospital beds per 10,000 people). Univariable, multivariable, and sensitivity analyses using general linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences. Results: Sensitivity analyses showed that higher density of physicians was significantly associated with better self-reported physical and mental health, less psychological distress, and better quality of life. A greater number of nurses was significantly associated with better self-reported physical health, less psychological distress, and less risky health behavior. No associations between a higher density of hospital beds and patient-reported outcomes were observed. Conclusions: This explorative study suggests that density of human resources for health, measured on country level, are associated with patient-reported outcomes in adults with congenital heart disease. More research needs to be conducted before firm conclusions about the relationships observed can be drawn
Cardiac diagnostic work-up of ischaemic stroke( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Abstract Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown aetiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and embolic strokes of undetermined source
Transvenous Lead Extraction in Adults With Congenital Heart Disease( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Abstract : Background: Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period. Methods and Results: All consecutive TLE procedures in A-CHD were included in a monocentric prospective registry from 1996. A total of 121 leads were extracted in 49 A-CHD (median age, 38 years; 51% men) during 71 TLE procedures. Twenty-four (49%) patients had transposition of the great arteries. Main indications for extraction were infection in 34 (48%) and lead failure in 22 (31%). A laser sheath was required for 56 (46%) leads and a femoral approach for 10 (8%). Complete TLE was achieved for 111 leads (92%). In multivariable analysis, lead duration (odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P <0.01) and number of previous cardiac surgeries (odds ratio, 2.65; 95% confidence interval, 1.52-4.67; P <0.01) were predictive of TLE failure. No perioperative death or pericardial effusion was observed. Subpulmonary atrioventricular valve regurgitation increased in 8 patients (5 with transposition of the great arteries) and was independently associated with an implantable cardioverter defibrillator lead (odds ratio, 9.69; 95% confidence interval, 1.31-71.64; P =0.03) and valvular vegetation (odds ratio, 7.29; 95% confidence interval, 1.32-40.51; P =0.02). After a median of 54 (19-134) months of follow-up after the first TLE, 3 deaths occurred independently from lead management. Conclusions: Despite complex anatomic issues, TLE can be achieved successfully in most A-CHD using advanced extraction techniques. Subpulmonary atrioventricular valve regurgitation is a prevalent complication, particularly in patients with transposition of the great arteries. Abstract : Supplemental Digital Content is available in the text
Sudden cardiac death in transposition of the great arteries with a Mustard or Senning baffle: the myocardial ischemia hypothesis( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

Abstract : Purpose of review: The literature on sudden death in transposition of the great arteries (D-TGA) with atrial switch surgery is reviewed and a pathophysiological mechanism is proposed. Recent findings: Over 80% of sudden deaths in patients with D-TGA and Mustard or Senning baffles occur during exercise. Factors most consistently associated with ventricular arrhythmias and sudden death include heart failure parameters and atrial arrhythmias. Atrial arrhythmias have been observed to trigger malignant ventricular arrhythmias. Exercise may promote 1 : 1 conduction, with inordinately high ventricular rates. Reconstructed intra-atrial pathways are associated with an impaired stroke volume response to increased heart rates. A high prevalence of perfusion defects has been reported despite the absence of coronary atherosclerosis, particularly involving the inferior wall of the systemic right ventricle. Beta-blockers have been independently associated with a lower rate of ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Summary: It is hypothesized that ischemia-related ventricular arrhythmias are a common mechanism for sudden death in patients with D-TGA and atrial baffles. Ischemia may be provoked by rapid heart rates from sinus or atrial arrhythmias. Myocardial oxygen supply/demand mismatch may be exacerbated by the impaired stroke volume response, hypertrophic remodeling of the pressure-loaded systemic right ventricle, and inefficient coronary circulation
Patient-Reported Outcomes in Adults With Congenital Heart Disease Following Hospitalization (from APPROACH-IS) by Philip Moons( )

1 edition published in 2021 in English and held by 1 WorldCat member library worldwide

In this international study, we (1) compared patient-reported outcomes (PROs) in adults with congenital heart disease (CHD) who had versus had not been hospitalized during the previous 12 month, (2) contrasted PROs in patients who had been hospitalized for cardiac surgery versus nonsurgical reasons, (3) assessed the magnitude of differences between the groups (i.e., effect sizes), and (4) explored differential effect sizes between countries. APPROACH-IS was a cross-sectional, observational study that enrolled 4,028 patients from 15 countries (median age 32 years; 53% females). Self-report questionnaires were administered to measure PROs: health status; anxiety and depression; and quality of life. Overall, 668 patients (17%) had been hospitalized in the previous 12 months. These patients reported poorer outcomes on all PROs, with the exception of anxiety. Patients who underwent cardiac surgery demonstrated a better quality of life compared with those who were hospitalized for nonsurgical reasons. For significant differences, the effect sizes were small, whereas they were negligible in nonsignificant comparisons. Substantial intercountry differences were observed. For various PROs, moderate to large effect sizes were found comparing different countries. In conclusion, adults with CHD who had undergone hospitalization in the previous year had poorer PROs than those who were medically stable. Researchers ought to account for the timing of recruitment when conducting PRO research as hospitalization can impact results
A new prediction model for ventricular arrhythmias in arrhythmogenic right ventricular cardiomyopathy by Julia Cadrin-Tourigny( )

1 edition published in 2019 in English and held by 1 WorldCat member library worldwide

Aims Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients. Methods and results Five hundred and twenty-eight patients with a definite diagnosis and no history of sustained VAs/SCD at baseline, aged 38.2 +/- 15.5 years, 44.7% male, were enrolled from five registries in North America and Europe. Over 4.83 (interquartile range 2.44-9.33) years of follow-up, 146 (27.7%) experienced sustained VA, defined as SCD, aborted SCD, sustained ventricular tachycardia, or appropriate implantable cardioverter-defibrillator (ICD) therapy. A prediction model estimating annual VA risk was developed using Cox regression with internal validation. Eight potential predictors were pre-specified: age, sex, cardiac syncope in the prior 6 months, non-sustained ventricular tachycardia, number of premature ventricular complexes in 24 h, number of leads with T-wave inversion, and right and left ventricular ejection fractions (LVEFs). All except LVEF were retained in the final model. The model accurately distinguished patients with and without events, with an optimism-corrected C-index of 0.77 [95% confidence interval (CI) 0.73-0.81] and minimal over-optimism [calibration slope of 0.93 (95% CI 0.92-0.95)]. By decision curve analysis, the clinical benefit of the model was superior to a current consensus-based ICD placement algorithm with a 20.6% reduction of ICD placements with the same proportion of protected patients (P amp;lt; 0.001). Conclusion Using the largest cohort of patients with ARVC and no prior VA, a prediction model using readily available clinical parameters was devised to estimate VA risk and guide decisions regarding primary prevention ICDs (www.arvcrisk.com)
Geographical variation and predictors of physical activity level in adults with congenital heart disease by Lena Larsson( )

1 edition published in 2019 in English and held by 1 WorldCat member library worldwide

Background: Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents(METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin. Methods: 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models. Results: On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%-Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52-2.08), NYHA-class I (OR 3.10, 95%CI 1.71-5.62) and less complex disease (OR 1.46, 95%CI 1.16-1.83). In contrast, older age (OR 0.97, 95%CI 0.96-0.98), lower educational level (OR 0.41, 95%CI 0.26-0.64) and being unemployed (OR 0.57, 95%CI 0.42-0.77) were negatively associated with reaching WHO recommendations. Conclusions: A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions
Contact force with magnetic-guided catheter ablation( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Abstract Aims Achieving adequate catheter tip-tissue contact is essential for delivering robust radiofrequency (RF) ablation lesions. We measured the contact force generated by a remote magnetic-guided catheter navigation system. Methods and results A plexiglass model with an integrated scale was fashioned to mimic transvenous and retrograde access to sites in the right atrium and right and left ventricles. An 8 Fr RF ablation catheter was steered by remote magnetic guidance at fields of 0.08 and 0.10 T, with and without a long sheath positioned at the entrance of the chamber. Ten contact force readings were taken at each setting, with the scale recalibrated prior to each measurement. Generalized estimating equations were used to compare contact force measurements while adjusting for the non-independent data structure. A total of 240 contact force measurements were taken. Without a long sheath, contact forces with magnetic fields of 0.10 T (n = 60) and 0.08 T (n = 60) were similar (6.1 ± 1.4 g vs. 6.0 ± 1.3 g, P = 0.089). Contact forces were not significantly different with simulated transvenous (n = 80) and retrograde aortic (n = 40) approaches (6.2 ± 1.4 g vs. 5.7 ± 1.2 g, P = 0.132). The contact force increased substantially with a long sheath (P <0.001) and was significantly higher with 0.10 T (n = 60) vs. 0.08 T (n = 60) fields (20.4 ± 0.6 g vs. 18.0 ± 0.5 g, P <0.001). Conclusion Magnetic fields of 0.08 and 0.10 T provide stable catheter contact forces, as reflected by the small variability between measurements. The average contact force is approximately 6 g without a sheath and increases to 20 g with a long sheath positioned at the entrance of the chamber of interest
Sense of coherence in adults with congenital heart disease in 15 countries Patient characteristics, cultural dimensions and quality of life by Philip Moons( )

1 edition published in 2020 in English and held by 1 WorldCat member library worldwide

Background: Previous studies have found that sense of coherence (SOC) is positively related to quality of life (QoL) in persons with chronic conditions. In congenital heart disease (CHD), the evidence is scant. Aims: We investigated (i) intercountry variation in SOC in a large international sample of adults with CHD; (ii) the relationship between demographic and clinical characteristics and SOC; (iii) the relationship between cultural dimensions of countries and SOC; and (iv) variation in relative importance of SOC in explaining QoL across the countries. Methods: APPROACH-IS was a cross-sectional, observational study, with 4028 patients from 15 countries enrolled. SOC was measured using the 13-item SOC scale (range 13â91) and QoL was assessed by a linear analog scale (range 0â100). Results: The mean SOC score was 65.5±13.2. Large intercountry variation was observed with the strongest SOC in Switzerland (68.8±11.1) and the lowest SOC in Japan (59.9±14.5). A lower SOC was associated with a younger age; lower educational level; with job seeking, being unemployed or disabled; unmarried, divorced or widowed; from a worse functional class; and simple CHD. Power distance index and individualism vs collectivism were cultural dimensions significantly related to SOC. SOC was positively associated with QoL in all participating countries and in the total sample, with an explained variance ranging from 5.8% in Argentina to 30.4% in Japan. Conclusion: In adults with CHD, SOC is positively associated with QoL. The implementation of SOC-enhancing interventions might improve QoL, but strategies would likely differ across countries given the substantial variation in explained variance. © The European Society of Cardiology 2020
Electrophysiology for clinicians by Laurent Macle( Book )

2 editions published between 2011 and 2012 in English and held by 1 WorldCat member library worldwide

Annotation
Adenosine-guided pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation: an international, multicentre, randomised superiority trial( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Background: Catheter ablation is increasingly used to manage atrial fibrillation, but arrhythmia recurrences are common. Adenosine might identify pulmonary veins at risk of reconnection by unmasking dormant conduction, and thereby guide additional ablation to improve arrhythmia-free survival. We assessed whether adenosine-guided pulmonary vein isolation could prevent arrhythmia recurrence in patients undergoing radiofrequency catheter ablation for paroxysmal atrial fibrillation. Methods: We did this randomised trial at 18 hospitals in Australia, Europe, and North America. We enrolled patients aged older than 18 years who had had at least three symptomatic atrial fibrillation episodes in the past 6 months, and for whom treatment with an antiarrhythmic drug failed. After pulmonary vein isolation, intravenous adenosine was administered. If dormant conduction was present, patients were randomly assigned (1:1) to additional adenosine-guided ablation to abolish dormant conduction or to no further ablation. If no dormant conduction was revealed, randomly selected patients were included in a registry. Patients were masked to treatment allocation and outcomes were assessed by a masked adjudicating committee. Patients were followed up for 1 year. The primary outcome was time to symptomatic atrial tachyarrhythmia after a single procedure in the intention-to-treat population. The trial is registered withClinicalTrials.gov, numberNCT01058980 . Findings: Adenosine unmasked dormant pulmonary vein conduction in 284 (53%) of 534 patients. 102 (69·4%) of 147 patients with additional adenosine-guided ablation were free from symptomatic atrial tachyarrhythmia compared with 58 (42·3%) of 137 patients with no further ablation, corresponding to an absolute risk reduction of 27·1% (95% CI 15·9-38·2; p<0·0001) and a hazard ratio of 0·44 (95% CI 0·31-0·64; p<0·0001). Of 115 patients without dormant pulmonary vein conduction, 64 (55·7%) remained free from symptomatic atrial tachyarrhythmia (p=0·0191 vs dormant conduction with no further ablation). Occurrences of serious adverse events were similar in each group. One death (massive stroke) was deemed probably related to ablation in a patient included in the registry. Interpretation: Adenosine testing to identify and target dormant pulmonary vein conduction during catheter ablation of atrial fibrillation is a safe and highly effective strategy to improve arrhythmia-free survival in patients with paroxysmal atrial fibrillation. This approach should be considered for incorporation into routine clinical practice. Funding: Canadian Institutes of Health Research, St Jude Medical, Biosense-Webster, and M Lachapelle (Montreal Heart Institute Foundation)
Sudden cardiac death in transposition of the great arteries with a Mustard or Senning baffle( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

Abstract : Purpose of review: The literature on sudden death in transposition of the great arteries (D-TGA) with atrial switch surgery is reviewed and a pathophysiological mechanism is proposed. Recent findings: Over 80% of sudden deaths in patients with D-TGA and Mustard or Senning baffles occur during exercise. Factors most consistently associated with ventricular arrhythmias and sudden death include heart failure parameters and atrial arrhythmias. Atrial arrhythmias have been observed to trigger malignant ventricular arrhythmias. Exercise may promote 1 : 1 conduction, with inordinately high ventricular rates. Reconstructed intra-atrial pathways are associated with an impaired stroke volume response to increased heart rates. A high prevalence of perfusion defects has been reported despite the absence of coronary atherosclerosis, particularly involving the inferior wall of the systemic right ventricle. Beta-blockers have been independently associated with a lower rate of ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Summary: It is hypothesized that ischemia-related ventricular arrhythmias are a common mechanism for sudden death in patients with D-TGA and atrial baffles. Ischemia may be provoked by rapid heart rates from sinus or atrial arrhythmias. Myocardial oxygen supply/demand mismatch may be exacerbated by the impaired stroke volume response, hypertrophic remodeling of the pressure-loaded systemic right ventricle, and inefficient coronary circulation
Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multinational Collaboration by Julia Cadrin-Tourigny( )

1 edition published in 2021 in English and held by 1 WorldCat member library worldwide

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is associated with ventricular arrhythmias (VA) and sudden cardiac death (SCD). A model was recently developed to predict incident sustained VA in patients with ARVC. However, since this outcome may overestimate the risk for SCD, we aimed to specifically predict life-threatening VA (LTVA) as a closer surrogate for SCD. Methods: We assembled a retrospective cohort of definite ARVC cases from 15 centers in North America and Europe. Association of 8 prespecified clinical predictors with LTVA (SCD, aborted SCD, sustained, or implantable cardioverter-defibrillator treated ventricular tachycardia >250 beats per minute) in follow-up was assessed by Cox regression with backward selection. Candidate variables included age, sex, prior sustained VA (≥30s, hemodynamically unstable, or implantable cardioverter-defibrillator treated ventricular tachycardia; or aborted SCD), syncope, 24-hour premature ventricular complexes count, the number of anterior and inferior leads with T-wave inversion, left and right ventricular ejection fraction. The resulting model was internally validated using bootstrapping. Results: A total of 864 patients with definite ARVC (40±16 years; 53% male) were included. Over 5.75 years (interquartile range, 2.77-10.58) of follow-up, 93 (10.8%) patients experienced LTVA including 15 with SCD/aborted SCD (1.7%). Of the 8 prespecified clinical predictors, only 4 (younger age, male sex, premature ventricular complex count, and number of leads with T-wave inversion) were associated with LTVA. Notably, prior sustained VA did not predict subsequent LTVA (P=0.850). A model including only these 4 predictors had an optimism-corrected C-index of 0.74 (95% CI, 0.69-0.80) and calibration slope of 0.95 (95% CI, 0.94-0.98) indicating minimal over-optimism. Conclusions: LTVA events in patients with ARVC can be predicted by a novel simple prediction model using only 4 clinical predictors. Prior sustained VA and the extent of functional heart disease are not associated with subsequent LTVA events
Phenotypes of adults with congenital heart disease around the globe a cluster analysis by Edward Callus( )

1 edition published in 2021 in English and held by 1 WorldCat member library worldwide

OBJECTIVE: To derive cluster analysis-based groupings for adults with congenital heart disease (ACHD) when it comes to perceived health, psychological functioning, health behaviours and quality of life (QoL). METHODS: This study was part of a larger worldwide multicentre study called APPROACH-IS; a cross sectional study which recruited 4028 patients (2013-2015) from 15 participating countries. A hierarchical cluster analysis was performed using Ward's method in order to group patients with similar psychological characteristics, which were defined by taking into consideration the scores of the following tests: Sense Of Coherence, Health Behavior Scale (physical exercise score), Hospital Anxiety Depression Scale, Illness Perception Questionnaire, Satisfaction with Life Scale and the Visual Analogue Scale scores of the EQ-5D perceived health scale and a linear analogue scale (0-100) measuring QoL. RESULTS: 3768 patients with complete data were divided into 3 clusters. The first and second clusters represented 89.6% of patients in the analysis who reported a good health perception, QoL, psychological functioning and the greatest amount of exercise. Patients in the third cluster reported substantially lower scores in all PROs. This cluster was characterised by a significantly higher proportion of females, a higher average age the lowest education level, more complex forms of congenital heart disease and more medical comorbidities. CONCLUSIONS: This study suggests that certain demographic and clinical characteristics may be linked to less favourable health perception, quality of life, psychological functioning, and health behaviours in ACHD. This information may be used to improve psychosocial screening and the timely provision of psychosocial care
Adult congenital heart disease : long-term survival, arrhytmias, and emerging therapy by Paul Khairy( )

1 edition published in 2004 in French and held by 1 WorldCat member library worldwide

 
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