Are you ready for winter? The employment rates shown are those of the U.S. Federal Gov't Although the yield of these tests is relatively low, VT is occasionally documented.S4.2.2-4 A 24-hour continuous Holter recording is appropriate when symptoms occur at least once a day or when quantitation of PVCs/NSVT is desired to assess possible VA-related depressed ventricular function. Approximately 70% of SCAs occur in the home, and the rate of survival to hospital discharge after AED placement by emergency medical services is significantly lower for arrest at home (12%) versus public settings (34%).S11.3-11 However, in an RCT of AEDS, home AED placement did not improve the survival of patients recovering from an anterior MI.S11.3-12 Appropriate device location to reduce time delay after onset of SCA is critical. ACC/AHA/HRS 2006 key data elements and definitions for electrophysiological studies and procedures: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards. Early decision (ED) or early acceptance is a type of early admission used in college admissions in the United States for admitting freshmen to undergraduate programs.It is used to indicate to the university or college that the candidate considers that institution to be their top choice through a binding commitment to enroll (i.e., if offered admission under an ED program, and the financial The Cardiac Arrhythmia Suppression Trial II Investigators. When a pathogenic mutation is identified in an index patient, the genetic status of each family member can be readily ascertained. 05/08/2021postreply Thus, frequent PVCs may be a reversible cause of LV dysfunction that can be effectively treated with catheter ablation. () 12-lead ECG and Exercise Testing e286, 4.2.2. Although many deaths, classified as sudden, are indeed due to lethal VA, others may be due to bradyarrhythmias, pulseless electrical activity, and sudden hemodynamic deterioration.S7.7.1-7S7.7.1-9, Medical therapy with neurohormonal agents decreases the risk of SCD by reducing both the incidence of VA and disease progression.S7.7.1-7,S7.7.1-10S7.7.1-12 Despite GDMT for HFrEF, some patients remain at risk for SCD, and an ICD may be helpful. Serving pizza, dinner, subs, panini, pasta, philly steak. Contact Us Ewunetie was last seen around 3 a.m. near a residential building on the New Jersey campus, according to the university. This medication, developed and FDA-approved as an antianginal agent, provides relatively specific late sodium channel current blockade in addition to less potent blockade of the phase 3 repolarizing potassium current; that is, the rapid delayed rectifier potassium current; IKr. Defibrillators for Treatment of VA and SCD e295, 5.4.2. In a multicenter cohort, inducible sustained VT in patients with TOF was an independent risk factor for subsequent clinical VT or SCDS10.8-19; patients in that early study had cardiomegaly and prior palliative shunts. However, such mutation-negative family members must have an echocardiogram to ensure genotype and phenotype concordance. The universitys class of 2025 has a scant 4.3% acceptance rate for regular decision (RD) applicants, admitting just 1,907 applicants out of a pool of 44,481. 2018;138:e272e391. A 25% added yield in diagnosis has been described after an unrevealing external ambulatory monitor.S4.2.3-5 In a study of patients with syncope, the implantable monitor had a greater diagnostic yield than conventional testing with external monitoring, tilt table testing and electrophysiological study.S4.2.3-2 A systematic review in patients with syncope concluded that use of these devices provide a higher rate of diagnosis and a trend toward reduction in syncope relapse after diagnosis, as compared with conventional management.S4.2.3-3 A prospective study of patients after MI, with LVEF <40%, demonstrated NSVT (>16 beats long) in 13%, VT (>30 s) in 3% and VF in 3% of patients.S4.2.3-1 It is important to accurately correlate the symptoms with the arrhythmias detected by implanted cardiac monitors. Combining this data with millions of reviews from students and alumni, Niche then assigns each school a rank. For more on AHA statements and guidelines development, visit https://professional.heart.org/statements. It is unknown, however, whether early pharmacological treatment of mutation-positive, asymptomatic subjects can prevent or delay manifestation of the disease or whether genetic testing ultimately improves survival. -yaolan00- Various population studies, primarily focused on SCD due to ischemic heart disease, have demonstrated age gradients in SCD risk among men and women.S10.6-8S10.6-10 These include a 10-year lag in SCD incidence in women compared with men. Terms of Use "We hold her family and all others who loved her close to our hearts," the group said. Commonly Used QT-Prolonging MedicationsS7.9.1.1-59,S7.9.1.1-62, *A more complete list is maintained at: www.crediblemeds.org.S7.9.1.1-59. On initial discovery, an evaluation for structural heart disease is warranted with physical examination, an ECG, and imaging, usually with echocardiography. In 1 report, the presence of inflammation and RV involvement on PET scanning was associated with increased risk of death or e g of relatives.S7.6-10 Electrophysiological studies in a series of 76 patients with evidence of cardiac sarcoid found that 11% had inducible VT. During a median follow-up of 5 years, 75% of patients with inducible VT had spontaneous VT or death compared with 1.5% of those who did not have inducible VT.S7.6-18. () Universe Ewunetie said authorities told him the investigation will take time. These recommendations were: Readers should refer to these sections for the updated text. Changes in ion channel or transporter function and/or expression and cell to cell coupling secondary to the underlying pathology may alter the initiation or propagation of the cardiac action potential. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. -- After a median follow up of 34 months, the patients who presented with heart block had fewer HF hospitalization, yet fatal cardiac events, including sustained VAs, were similar to those with VT and/or HF, suggesting that the risk of fatal cardiac events is high regardless of the initial clinical presentation.S7.6-13 In the same study, administration of steroids led to some clinical improvement, with some patients recovering conduction, yet steroid effectiveness was not universal and did not seem to be protective against adverse cardiac events.S7.6-13. Colors correspond to Class of Recommendation in Table 1. Ablation reduces the frequency of recurrent VT, although 27% to 55% of patientsS7.3-27,S7.3-28 have at least 1 recurrence; ablation of VT in arrhythmogenic right ventricular cardiomyopathy patients does not eliminate the need for an ICD in appropriate candidates. During a median follow-up of 5.6 years, ICD reduced SCD from 8.4% to 4.3%, but there was no difference in all-cause mortality.S7.2.2-11 Several meta-analyses have been published.S7.2.2-12,S7.2.2-13 One provided data on ICDs with and without CRT and showed survival benefit from the ICD.S7.2.2-13 The second used patient level data from 2 trials and adopted a more robust approach to reducing heterogeneity by excluding patients with CRT and those randomized to antiarrhythmic medications; a 25% relative risk reduction in mortality with an ICD was shown.S7.2.2-12. -greenoasis- Patients with long QT syndrome and recurrent syncope while receiving a beta blocker have an increased risk of SCA or appropriate ICD shocksS7.9.1.1-9 and escalation of therapy is warranted to prevent SCD. Secondary prevention indications for an ICD in patients with a heart transplant are identical to those in other patients. In asymptomatic patients with otherwise unexplained prolonged QTc 480 ms on serial ECGs, genetic testing may help confirm the diagnosis and supplement prognostic information in addition to clinical symptoms and QTc duration.S7.9.1.1-5,S7.9.1.1-18S7.9.1.1-20,S7.9.1.1-30,S7.9.1.1-35,S7.9.1.1-54S7.9.1.1-56, In a prospective, observational study of patients with suspected long QT syndrome, patients with a history of syncope or cardiac arrest and either an affected first-degree relative or a borderline or prolonged QTc interval underwent exercise treadmill testing and bicycle exercise, with ECGs recorded before, during, and after exercise, as well as in different positions.S7.9.1.1-27 long QT syndrome was confirmed by genetic testing in all affected individuals. Most HCM is caused by an autosomal dominant mutation in genes that encode sarcomere proteins or sarcomere-associated proteins. The mechanisms underlying SCD in patients with a heart transplant include damage to the conduction system itself and VA due to coronary vasculopathy or during episodes of acute rejection. The frequency of conduction abnormalities often warrants a device that provides bradycardia pacing as well. 05/08/2021postreply Rare case reports exist of fever prolonging the QT interval in patients with long QT syndrome type 2; fever should be reduced with antipyreticsS7.9.1.1-61 (Table 10). Modified from Shleifer JW, et al.S5.1.5.2-2. The man accused of beating House Speaker Nancy Pelosis husband appears to have made racist and often rambling posts online. Youll find a clear trend when it comes to MBA admissions. Median follow-up was 12 months. In other diseases, such as Brugada syndrome, the role of a clear monogenic disease-causing mutation is less certain, and the genotype does not provide therapeutic or prognostic information for the proband.S4.2.6-5,S4.2.6-10S4.2.6-12 In arrhythmogenic right ventricular cardiomyopathy, some desmosomal mutation positive individuals do not develop disease, indicating that additional mutations and environmental interactions likely influence the clinical development of disease.S4.2.6-13S4.2.6-16 Importantly, the absence of an identified disease-causing genetic mutation does not exclude the presence of disease, and as such, ongoing monitoring and decision-making are done based on the clinical phenotype. Ingersoll B, Dvortcsak A, Whalen C, Sikora D. The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. 2017 [4], It was in answer to criticisms of early decision that, starting in 2004, Yale and Stanford switched from early decision to single-choice early action. Another study of 63 patients with recurrent VT after MI demonstrated acute success with catheter ablation in 83% of mappable VTs and 40% of nonmappable VTs.S7.1.3-8 Superiority of ablation over escalating medication therapy for patients with recurrent VT despite antiarrhythmic medications was shown by the VANISH trial.S7.1.3-4 See Section 5.6. Names are listed in alphabetical order within each category of review. (0 bytes) Table 11. In NICM, the reentrant circuits are more variable in location, often involve the epicardial surface of either ventricle and frequently extending into the midmyocardium where ablation may be difficult to achieve from either surface. The substrate may be structural remodeling secondary to an underlying disease process, and often includes a scar secondary to a prior MI or surgical repair, or patchy fibrosis in the setting of cardiomyopathy or hypertrophy. (1286 bytes) Last Wills & Estates Defining the role of the ICD in patients with HCM, arrhythmogenic right ventricular cardiomyopathy, cardiac sarcoidosis, and inherited cardiac channelopathies in prospective studies (preferably RCT). Although randomized studies are unavailable, coronary angiography has an important role in establishing or excluding the presence of significant obstructive ischemic heart disease in patients with SCA or those with life-threatening VA.S4.3.1-1S4.3.1-4 Recurrent polymorphic VT or VF can be due to ongoing myocardial ischemia that resolves with coronary revascularization. Bundle-branch reentrant VT can occur in any form of heart disease associated with slow infra-Hisian conduction. The yield of genetic testing is higher if a family history of SCD at a young age is present. There is increasing evidence supporting the association of late gadolinium enhancement on cardiac MRI with the risk of sudden death and it is included as a risk modifier.S7.4-37S7.4-39 LV aneurysm may be associated with a risk of sustained monomorphic VT.S7.4-40 Age is also an important consideration, as sudden death risk is greater in those <30 years of age, and low in patients whose initial presentation is after the age of 60 years,S7.4-5,S7.4-26.S7.4-41. In athletes, VAs range from isolated PVCs, couplets, and NSVT, to sustained VT and SCA leading to SCD.S10.1-1 Infrequent PVCs and short runs of repetitive NSVT, especially in the absence of structural heart disease, are more common in nonathletes, but they are generally benign, requiring only a limited workup and rarely lead to disqualification for sports.S10.1-2,S10.1-3 In contrast, longer runs of NSVT, especially when exercise-induced, and sustained VT and SCA/SCD are infrequent, but they have a higher incidence in athletes than that reported for the general population in the corresponding age groups. Treatment of recurrent VA in patients with ischemic heart disease or NICM. (0 bytes) 05/08/2021postreply 15:41:56, There are insufficient data from RCTs regarding the value of the ICD in patients with NYHA class IV. The rate is determined by the integration of the maximum diastolic potential at the end of repolarization, the slope of phase 4 depolarization, and the threshold potential. In some cases, the data from pediatric patients beyond infancy helped to inform this guideline. 21:58:24, Although guidelines may be used to inform regulatory or payer decisions, their intent is to improve patients quality of care and align with patients interests. Law School Profiles Some present primarily as a NICM (eg, Duchenne, Becker, and limb-girdle types 2C, 2F, and 2I), while others present primarily as conduction system degeneration with a variable association with cardiomyopathy (eg, myotonic dystrophy types 1 and 2, Emery-Dreifuss, limb-girdle type 1B; summarized in Table 9).S7.8-15 Because SCD can occur either due to VA or due to bradyarrhythmias from rapid and unpredictable progression of conduction system disease, the clinician is faced with the challenge of identifying those patients who would benefit from prophylactic pacemaker or ICD implantation. It's named by Niche as thebest liberal arts college in America. () 146, Issue Suppl_1, Basic, Translational, and Clinical Research, Correction to: 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Want to apply for MS in CS for Spring 2023. 05/08/2021postreply MUSTT allowed enrollment of patients who were 4 days after an acute MI or revascularization. This trial randomized 1116 patients with NICM LVEF <35% and class II, III, or IV (if CRT was planned) HF to an ICD or no ICD. After the club had closed and all of the duty responsibilities had been fulfilled, Misrach -- as well as the other members on duty -- left for the night," the club wrote to the paper. Wearable cardioverter-defibrillators have been used in peripartum cardiomyopathy while awaiting repeat assessment of recovery of ventricular function.S10.2-16 The subcutaneous implantable cardioverter-defibrillator is a potential alternative to conventional ICDs, although data are unavailable to support a recommendation. Ventricular arrhythmias and the His-Purkinje system. Syncope or SCA may be the first manifestation of structural or electrical heart disease,S4.1-14 and some SCA victims have preceding sentinel syncope episodes.S4.1-15 Syncope, or its forewarnings of dizziness, lightheadedness, or near-syncope, may constitute a risk factor for SCA and SCD.S4.1-2 The initial evaluation at any age focuses on detection or exclusion of heart disease. Rotors and the dynamics of cardiac fibrillation. () Applicability is limited by the lack of precise quantification of late gadolinium enhancement burden that may allow for more nuanced risk stratification. Whether a wearable cardioverter-defibrillator may provide protection while medical therapy is being evaluated has not been assessed but is of interest.S7.1.1.1-10 An ICD can terminate VT/VF initiated by spasm, potentially preventing SCD. Recurrent ICD shocks and VT storm and treatment-related adverse events were lower in the ablation group. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Long-term outcome of non-sustained ventricular tachycardia in structurally normal hearts. MIT, in Cambridge, Massachusetts, has a 4% acceptance rate and boasts 96 Nobel laureates. 2,3 Depression in adolescents is a major risk factor for suicide, the second-to-third leading cause of death in this age group, 4 with more than half of adolescent suicide victims In all cases, treatment of the underlying condition must accompany management of cardiac arrhythmias. The acceptance rate at UCLA is 14%. Protection of Rights Patients with coronary artery spasm who survive an SCA are a high-risk population.S7.1.1.1-5 Recurrent VA, even life-threatening, may be prevented if coronary artery spasm can be effectively addressed with risk factor modification, smoking cessation, and ongoing treatment with nitrates and dihydropyridine calcium channel blockers.S7.1.1.1-9 However, SCA or VA can recur despite medical therapy or if compliance is poor. 08:50:22, *Figure based on formula: Incremental cost-effectiveness ratio = $50000/QALYs. AHA/ACC/HHS strategies to enhance application of clinical practice guidelines in patients with cardiovascular disease and comorbid conditions: from the American Heart Association, American College of Cardiology, and US Department of Health and Human Services. This relationship between the ICD and improved survival persisted even after adjusting for potential confounders.S7.1.2-7, There are insufficient data from RCTs regarding the value of the ICD in patients with NYHA class IV HF. Asymptomatic patients with arrhythmogenic right ventricular cardiomyopathy and no VA or ventricular dysfunction are generally observed without antiarrhythmic therapy other than beta-blocker therapy, with ongoing periodic reassessment for the development of arrhythmias or ventricular dysfunction.S7.3-46,S7.3-47 Atenolol was shown to reduce VA in 1 study.S7.3-15 Ambulatory monitoring and/or exercise testing can be performed to assess adequacy of beta-blocking dosing. 05/08/2021postreply Patients with wide QRS complex tachycardia and known structural heart disease should be presumed to have VT until proven otherwise. Swarthmore College in Pennsylvania has an 8% acceptance rate. Nonetheless, more dramatic symptoms, particularly in patients with known or discovered structural or electrical heart disease should prompt focused investigation for possible association with VA (Table 6). The non-profit groupMinds Matter Clevelandsaid they were "devastated" by the loss of Ewunetie, a member of its class of 2020. This systematic review will strive to determine which patients are most likely to benefit from a test, medication, device, or treatment strategy and to what degree. Colors correspond to Class of Recommendation in Table 1. See Sections 7.1 and 7.2 for the indications on ICDs in patients with reduced LVEF. Business Entity Forms, Law School Rankings Genetic counseling should precede genetic testing of family members to enhance their understanding of the usefulness and cost of testing.S7.4-18,S7.4-20,S7.4-43 On the basis of family history, clinical screening, and pedigree analyses, the pattern of inheritance is ascertained to identify and manage relatives at risk.S7.4-13,S7.4-14,S7.4-18,S7.4-19,S7.4-43S7.4-45 Because familial HCM is a dominant disorder, the risk that an affected patient will transmit disease to each offspring is 50%. The number of ED admits has also doubled at NYU and Boston University over this period, and although the increase of ED admits at other schools has been less dramatic, that increase has nonetheless reduced the number of RD admits meaningfully because half the class or more is now being filled by ED admits. Having an ICD can allow for prompt termination of VA before significant hemodynamic consequences occur. Data on ICDs in patients with an LVAD are from observational series. The potential for clinical antiarrhythmic efficacy is supported by basic studies and experimental models.S5.1.5.2-6 Clinical data are scant. VA, syncope, and SCD may occur at a relatively young age, particularly in the second and third decades of life and often occurring during physical activity.S7.3-1,S7.3-16,S7.3-22,S7.3-41 Sustained VT is an important predictor of SCA and SCD or appropriate ICD shocks in patients with arrhythmogenic right ventricular cardiomyopathy.S7.3-10,S7.3-13 In patients receiving an ICD for primary prevention, appropriate ICD shocks are reported in 24% to 48% of patients.S7.3-9,S7.3-10,S7.3-12,S7.3-13 As sustained VT in arrhythmogenic right ventricular cardiomyopathy patients is monomorphic in 55% to 90% of episodes based on ICD interrogation or electrophysiological studies,S7.3-12,S7.3-36 antitachycardia pacing algorithms are used to terminate VT. The data shown under Has a role in treating patients with CPVT, Cardiac: Sinus node dysfunction, AVB, drug-induced Brugada syndrome, monomorphic VT in patients with a myocardial scar, exacerbation of HF, No marked effect on most intervals; QTc can slightly shorten, Cardiac: Bradycardia, hemodynamic collapse, AVB, sinus arrest, T, VF, PVC, has a role in patients with LQT3, Cardiac: TdP; AVB, hypotension and exacerbation of HF, VT, PVC (in the absence of structural heart disease), Cardiac: HF, AVB, drug-induced Brugada syndrome, T, VF, (including short QT syndrome, Brugada), Cardiac: Bradycardia, hypotension, HF, syncope, TdP, VT (specifically RVOT, verapamil-sensitive idiopathic LVT), Cardiac: Hypotension, edema, HF, AVB, bradycardia, exacerbation of HFrEF, Survival from a cardiac arrest due to VT or VF, Spontaneous sustained VT causing syncope or hemodynamic compromise, Family history of SCD associated with HCM, Abnormal blood pressure response during exercise, 30% of deaths, uncertain bradycardia versus tachycardia, X-linked and autosomal dominant or recessive, Fontan repair for univentricular physiology, Duke Clinical Research Institute; Duke UniversityProfessor of Medicine, Vanderbilt University Medical CenterProfessor; Brigham and Womens HospitalDirector of Clinical Cardiac EP, 4.1, 4.2.2, 4.2.3, 5, 10.1, 5.4, 5.6, 6, 7, 8, 9 (except 9.7), 13, 15, Mayo ClinicProfessor of Medicine, Pediatrics, and Pharmacology; Long QT Syndrome/Genetic Heart Rhythm Clinic and the Mayo Clinic Windland Smith Rice Sudden Death Genomics LaboratoryDirector, 4.1, 4.2.2, 4.2.3, 5 (except 5.1.5.2, 5.5), 6, 7, 8, 9, 10 (except 10.2) 11, 13, 15, University of Pennsylvania Health SystemProfessor of Medicine; Associate Director of EP, 4.1, 4.2.2, 4.2.3, 5.3, 5.4, 5.5.1, 5.6, 6, 7, 8, 9 (expect 9.7), 10 (except 10.3), 13, 15, University at BuffaloSUNY Distinguished Professor; Charles and Mary Bauer Professor and Chair, 4.1, 4.2.2, 4.2.3, 5.1.1, 5.1.2, 5.1.3, 5.1.4, 5.2, 5.4, 5.6, 6, 7, 8, 9, 10, 12, 13, 15, Getz Professor of Cardiology Feinberg School of Medicine Northwestern University, University of MarylandAssociate Professor of Medicine, 4.1, 4.2 (except 4.2.6), 4.3, 5.3, 5.4, 5.6, 6, 7, 8, 9 (except 9.7), 10.1, 11, 13, 15, University of CalgaryProfessor of Medicine, 4.2, 5.2.2, 5.3.2, 6.4.1, 6.4.2, 6.4.4, 6.5, 6.7, 7, 8, 9, 10, 11 (except 11.7), 13, 15, Duke Clinical Research Institute; Duke UniversityProfessor of Medicine; Director, Cardiac Care Unit, 4, 5.1 (except 5.1.5), 5.2, 5.3, 5.4, 5.6, 6, 7, 8, 9, 12, 13, 15, Mayo ClinicProfessor Emeritus of Medicine, Stanford University School of MedicineProfessor of Health and Research Policy, and of Cardiovascular Medicine, UT Southwestern Medical CenterProfessor of Internal Medicine; Clinical Cardiac EPFellowship Program Director, University of Alabama at BirminghamProfessor Emeritus, University of Wisconsin School of Medicine and Public HealthDirector, Clinical EP and Cardiac Arrhythmia Service, Associate Professor of Medicine, Ahmanson-UCLA Cardiomyopathy CenterDirector; UCLA Division of CardiologyCo-Chief, MedtronicIMPROVE-HF (Steering Committee), 4.1, 4.2.2, 4.2.3, 5.1 (except 5.1.5.1), 5.2, 5.3, 5.4, 5.6, 6, 7, 8, 9, 10, 12, 13, 15, University of Colorado School of MedicineAssociate Professor of Medicine, University of Miami Miller School of MedicineProfessor of Medicine and Physiology, University of Wisconsin Hospital and ClinicsChair, Department of Medicine, Professor of MedicineHarvard Medical SchoolBeth Israel Deaconess Medical Center, Professor of MedicineCardiovascular Division University of PennsylvaniaChief of Cardiology SectionPhiladelphia VA Medical Center, Defendant, Amiodarone pulmonary toxicity, 2016, Adjunct Professor of MedicineDes Moines UniversityProfessor EmeritusUniversity of Iowa, Division Chief of Pediatric CardiologyChildrens National Medical Center, Chief of CardiologyLondon Health Sciences Center, Content ReviewerACC/AHA Task Force on Clinical Practice Guidelines, Professor of MedicineBaylor College of Medicine DirectorCardiac Care UnitMichael E. DeBakey Medical Center, Defendant, Catheterization Laboratory Procedure, 2016, Content ReviewerACC Heart Failure and Transplant Council, Director Heart Failure and Mechanical Support ProgramGeorge Washington University, ProfessorCollege of Pharmacy Purdue UniversityAdjunct ProfessorSchool of Medicine Indiana University, Plaintiff, Drug-induced torsades de pointes, 2017, Interim HeadDivision of Cardiology QEII Health Sciences CentreProfessor of MedicineDalhousie University, Associate Professor of MedicineJohns Hopkins University School of Medicine, Professor of NursingColumbia University Medical Center, Chief of CardiologyVirginia Commonwealth University Medical Center, University of HoustonCollege of Pharmacology, Accreditation Council for Clinical Lipidology, University of Houston College of Pharmacology, Professor of MedicineUniversity of Washington, ProfessorDepartment of Cardiac SciencesLibin Cardiovascular Institute of AlbertaUniversity of CalgaryAlberta Health Services, I Medizinische KlinikKlinikum Mannheim GmbHUniversittsklinikum, German Centre for Cardiovascular Research, Professor of MedicineUniversity of Arizona College of MedicineTucson, Content ReviewerSports and Exercise EP Council, DirectorComplex Ablation ProgramUniversity of Washington, Methodist DeBakey Heart and Vascular Center, Jefferson Medical CollegeChristiana Care Health System, Professor of MedicineTufts University School of Medicine, Associate Professor of MedicineWestern UniversityLondon Health Sciences Centre, Yale University School of MedicineSection of Cardiology, Tel Aviv Medical CenterDepartment of Cardiology, Boston Scientific European Strategy Advisory Board, Dupont Hospital for ChildrenNemours Cardiac Center, Familial Hypercholesterolemia Foundation, Familial Hypercholestrolemia Foundation, Professore Ordinario di CardiologiaUniversit di PaviaDirettore ScientificoIstituti Clinici Scientifici MaugeriPavia, Italia, Professor of MedicineConsultantMayo Clinic Arizona, Phoenix Campus, Official ReviewerACC/AHA Task Force on Clinical Practice Guidelines Lead Reviewer, Assistant Professor of MedicineDivision of CardiologyHarborview Medical CenterUniversity of Washington School of Medicine. 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