Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where Gerard Loughlin is active.

Publication


Featured researches published by Gerard Loughlin.


European heart journal. Acute cardiovascular care | 2015

Temporal trends in the use of reperfusion therapy and outcomes in elderly patients with first ST elevation myocardial infarction

Ana Viana-Tejedor; Gerard Loughlin; Francisco Fernández-Avilés; Héctor Bueno

Aims: To analyze secular trends in management and short and long-term prognosis of elderly presenting with ST-elevation myocardial infarction (STEMI). Methods and results: All patients ≥75 years with first STEMI admitted to our Coronary Care Unit between 1988 and 2008 were included. Baseline characteristics, clinical management, in-hospital and post-discharge outcomes in 4 time periods (1988–1993, 1994–1998, 1999–2003, 2004–2008) were compared. The final cohort consisted of 1393 patients. During the study period, there was a significant increase in the use of aspirin, β-blockers and ACE inhibitors. A significant reduction in the development of cardiogenic shock and mechanical complications was noticed. The use of reperfusion therapy increased significantly, due to a wider use of primary percutaneous coronary intervention (PPCI) while 30-days, 1-year and 5-year mortality decreased throughout the 20-year study period (p<0.001). In the multivariable logistic regression model, patients treated with PPCI showed a significantly lower 30-day (OR 0.47, 95% CI, 0.31–0.71), 1-year (OR 0.62, 95% CI 0.43–0.88) and 5-year mortality (OR 0.57, 95% CI 0.41–0.79) while patients receiving fibrinolysis showed a non-significant improvement in 30-day (OR 0.86, 95% CI 0.62–1.49), 1-year (OR 0.86, 95% CI 0.58–1.30) and 5-year mortality (OR 0.82, 95% CI 0.56–1.19). Conclusion: The use of reperfusion therapy, and particularly of PPCI, for elderly patients suffering from STEMI increased significantly during the study period. This change in therapy was associated with a marked improvement in short and long-term prognosis.


European heart journal. Acute cardiovascular care | 2015

Impact of time to cooling initiation and time to target temperature in patients treated with hypothermia after cardiac arrest

Aitor Uribarri; Héctor Bueno; Alberto Pérez-Castellanos; Gerard Loughlin; Iago Sousa; Ana Viana-Tejedor; Francisco Fernández-Avilés

Purpose: Little is known about the role of time to initiation of therapeutic hypothermia and time to target temperature (TTT) in the prognosis of patients resuscitated from cardiac arrest. Methods: A retrospective analysis was performed in 145 survivors of cardiac arrest who underwent therapeutic hypothermia between January 2003 and January 2013. The objective was to identify predictors of survival free from significant neurological sequelae (Cerebral Performance Categories Scale (CPC): >2) six months after cardiac arrest. We evaluated the effect of faster and earlier cooling. Results: Overall survival at six months was 42.1% (61 patients); 59 of these were considered to have a good neurological status (CPC≤2), and in whom therapeutic hypothermia was initiated earlier (87±17 min vs. 111±14 min; p=0.042), and the target temperature was reached at an earlier time (TTT: 316 ± 30 min vs. 365 ± 27 min; p=0.017). Multivariate analysis selected longer duration of cardiac arrest (odds ratio (OR) =1.06 per min), a non-shockable initial rhythm (OR=13.8), severe acidosis (OR=0.009 per 0.01 unit), older age (OR=1.04 per year) and longer TTT (OR=1.005 per min) as associated with poor prognosis. Conclusion: The most important prognostic factors for death or lack of neurological recovery in patients with cardiac arrest treated with therapeutic hypothermia are initial-rhythm, time from cardiac arrest to return of spontaneous circulation and arterial-pH at admission. Although the speed of cooling initiation and the time to reach target temperature may play a role, its influence on prognosis seems to be less important.


Europace | 2018

Safety and efficacy of cryoablation vs. radiofrequency ablation of septal accessory pathways: systematic review of the literature and meta-analyses

Loreto Bravo; Felipe Atienza; Gabriel Eidelman; Pablo Ávila; Mauricio Pelliza; Evaristo Castellanos; Gerard Loughlin; Tomás Datino; Esteban G Torrecilla; Jesus Almendral; Pedro L. Sánchez; Ángel Arenal; Nieves Martínez-Alzamora; Francisco Fernández-Avilés

Aims Radiofrequency ablation (RFA) of septal accessory pathways (APs) is associated with a significant rate of first procedure failures and complications. Cryoablation is an alternative energy source but there are no studies comparing both ablation techniques. We aimed to systematically review the literature and compare the efficacy and safety of cryoablation vs. RFA of septal APs. Methods and results We conducted two separate meta-analysis of cryoablation and RFA of septal APs and calculated the global estimates of the efficacy and safety. Sixty-four articles were included: 38 articles reporting RFA and 27 articles reporting cryoablation procedures. Additionally, we included the previously non-published cryoablation registry of septal APs performed at our institution. Overall, 4244 septal APs constitute our study population, 3495 in the RFA cohort and 749 in the cryoablation cohort. Acute procedural success rate of cryoablation was 86.0% (95% CI 81.6-89.4%) and RFA 89.0% (95% CI 86.8-91.0%). Recurrence rate of cryoablation was 18.1% (95% CI 14.8-21.8%) and RFA 9.9% (95% CI 8.2-12.0%). Long-term success rate after multiple ablation procedures of cryoablation was 75.9% (95% CI 68.2-82.3%) and RFA 88.4% (95% CI 84.7-91.3%). There were no reported cases of persistent atrioventricular block (AVB) with cryoablation and 2.7% (95% CI 2.2-3.4%) with RFA. Conclusion Studies of RFA for treatment of septal APs report higher efficacy rates than do studies using cryoablation, but a significantly higher rate of AVB.


Europace | 2016

Association of cardiac resynchronization therapy with the incidence of appropriate implantable cardiac defibrillator therapies in ischaemic and non-ischaemic cardiomyopathy

Gerard Loughlin; Pablo Ávila; José Martínez-Ferrer; Javier Alzueta; Xavier Viñolas; Josep Brugada; Jose M. Arizon; Ignacio Fernández-Lozano; Enrique García-Campo; Nuria Basterra; Joaquín Fernández de la Concha; Angel Arenal

Aims Cardiac resynchronization therapy (CRT) reduces the incidence of sudden cardiac death and the use of appropriate implantable cardioverter-defibrillator (ICD) therapies (AICDTs); however, this antiarrhythmic effect is only observed in certain groups of patients. To gain insight into the effects of CRT on ventricular arrhythmia (VA) burden, we compared the incidence of AICDT use in four groups of patients: patients with ischaemic cardiomyopathy vs. non-ischaemic dilated cardiomyopathy (NIDC) and patients implanted with an ICD vs. CRT-ICD. Methods and results We analysed 689 consecutive patients (mean follow-up 37 ± 16 months) included in the Umbrella registry, a multicentre prospective registry including patients implanted with ICD or CRT-ICD devices with remote monitoring capabilities in 48 Spanish Hospitals. The primary outcome was the time to first AICDT. Despite a worse clinical risk profile, NIDC patients receiving a CRT-ICD had a lower cumulative probability of first AICDT use at 2 years compared with patients implanted with an ICD [24.7 vs. 41.6%, hazard ratio (HR): 0.49, P = 0.003]; on the other hand, there were no significant differences in the incidence of first AICDT use at 2 years in ischaemic patients (22.6 vs. 21.9%, P = NS). Multivariate analysis confirmed the association of CRT with lower AICDT rates amongst NIDC patients (Adjusted HR: 0.55, CI 95% 0.35-0.87). Conclusions These data suggest that CRT is associated with significantly lower rates of first AICDT use in NIDC patients, but not in ischaemic patients. This study suggests that ICD patients with NIDC and left bundle branch block experiencing VAs may benefit from an upgrade to CRT-ICD despite being in a good functional class.


Journal of Cardiovascular Magnetic Resonance | 2015

Impact of left ventricular late enhancement on pulmonary arterial hypertension in idiopathic dilated cardiomyopathy

Esther Pérez-David; Manuel Martínez-Sellés; Raquel Yotti; Javier Bermejo; Maria Luisa Sánchez Alegre; Jesús Jiménez Borreguero; Maria José Olivera; Gerard Loughlin; Francisco Fernández Avilés

Methods 71 consecutive patients (p) with DCM, left ventricular systolic dysfunction (LVEF<35%) and normal coronary angiography followed in an outpatient HF clinic, were prospectively enrolled in two institutions. All p had to be in stable clinical condition in the last month. Exclusion criteria were: contraindications for contrast-enhanced cardiac MR (ce-CMR), significant impairment of lung function by clinical criteria or spirometry and history of thromboembolic disease. All patients underwent ECG, echo, blood test and a ce-CMR study in a Philips Intera ® 1.5 T scanner, which included cine imaging, phase contrast in the main pulmonary artery and aorta and late enhancement (LE). Postprocessing was performed with QMASS 7.2 ® (Medis, The Netherlands). PVR was calculated following the equation: 19.38 -(4.62*Ln pulmonary artery average velocity) (0.08 x RVEF %)


Journal of Cardiology Cases | 2013

Acute myocardial infarction as presentation of an infiltrative lung neoplasia

Aitor Uribarri; Adolfo Villa; Gerard Loughlin; Francisco Fernández-Avilés

We report the case of a 51-year-old woman who presented with acute myocardial infarction as initial symptom of an infiltrative lung neoplasia. The patient was admitted to our center following an out-of-hospital cardiac arrest due to ventricular fibrillation which was cardioverted. On electrocardiography an anterior wall ST-elevation was found and urgent coronary angiography was performed. Left anterior descending coronary artery was occluded and after thrombus aspiration, an image of diffuse loss of lumen diameter and absence of coronary branches was compatible with an extrinsic compression. Such findings along with a lingula consolidation on chest X-ray examination suggested a thoracic neoplasia. Enhanced-chest computed tomography showed a mass located in the lingula with extensive mediastinal infiltration involving pericardium and myocardium. Anatomopathologic examination confirmed the presence of lung adenocarcinoma. <Learning objective: In patients with neoplasms should be suspected cardiac tumor infiltration in those with acute myocardial infarction. Since differential diagnosis between true AMI electrocardiographic (ECG) changes and pseudo-AMI ECG changes in patients with secondary cardiac tumors assumed to be difficult, such TTE or IVUS findings of extra-cardiac tumor could help physicians to make an accurate diagnosis.>.


Heart Rhythm | 2014

Noninvasive identification of epicardial ventricular tachycardia substrate by magnetic resonance–based signal intensity mapping

Angel Arenal; Esther Pérez-David; Pablo Ávila; Javier Fernández-Portales; Verónica Crisóstomo; Claudia Báez; Javier Jiménez-Candil; José L. Rubio-Guivernau; Maria J. Ledesma-Carbayo; Gerard Loughlin; Javier Bermejo; Francisco M. Sánchez-Margallo; Francisco Fernández-Avilés


JACC: Clinical Electrophysiology | 2015

Scar Extension Measured by Magnetic Resonance–Based Signal Intensity Mapping Predicts Ventricular Tachycardia Recurrence After Substrate Ablation in Patients With Previous Myocardial Infarction

Pablo Ávila; Esther Pérez-David; Maite Izquierdo; Antonio Rojas-González; Juan M. Sánchez-Gómez; Maria J. Ledesma-Carbayo; M. Pilar López-Lereu; Gerard Loughlin; Jose V. Monmeneu; Esteban González-Torrecilla; Felipe Atienza; Tomás Datino; Loreto Bravo; Javier Bermejo; Francisco Fernández-Avilés; Ricardo Ruíz-Granel; Ángel Arenal


Europace | 2017

P440One-year outcomes of cardiac resynchronization therapy in non-ambulatory NYHA class IV heart failure patients

Gerard Loughlin; Esteban González-Torrecilla; Rafael Peinado; C. Alvarez; Pablo Ávila; Tomás Datino; Felipe Atienza; P. Ruiz-Hernandez; Ángel Arenal; Francisco Fernández-Avilés


Journal of Interventional Cardiac Electrophysiology | 2016

Immediate post-procedure bridging with unfractioned heparin versus low molecular weight heparin in patients undergoing radiofrequency ablation for atrial fibrillation with an interrupted oral anticoagulation strategy.

Gerard Loughlin; Tomás Datino Romaniega; Javier García-Fernández; David Calvo; Ricardo Salgado; Andres Alonso; Xin Li; Angel Arenal; Esteban González-Torrecilla; Felipe Atienza; Francisco Fernández-Avilés

Collaboration


Dive into the Gerard Loughlin's collaboration.

Top Co-Authors

Avatar
Top Co-Authors

Avatar

Felipe Atienza

Complutense University of Madrid

View shared research outputs
Top Co-Authors

Avatar

Pablo Ávila

Complutense University of Madrid

View shared research outputs
Top Co-Authors

Avatar

Tomás Datino

Complutense University of Madrid

View shared research outputs
Top Co-Authors

Avatar

Angel Arenal

University of Pennsylvania

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Esther Pérez-David

Complutense University of Madrid

View shared research outputs
Top Co-Authors

Avatar

Loreto Bravo

Complutense University of Madrid

View shared research outputs
Top Co-Authors

Avatar
Top Co-Authors

Avatar

Ángel Arenal

Complutense University of Madrid

View shared research outputs
Researchain Logo
Decentralizing Knowledge