Scholars@Duke
Albert Y. Sun

Albert Y. Sun

Associate Professor of Medicine
Medicine, Cardiology

Selected Publications

Appropriate and inappropriate ICD shocks in patients with LVADs: Prevalence, associated factors, and etiologies.

Journal Article Heart Rhythm · July 23, 2024 BACKGROUND: Implantable cardioverter-defibrillator (ICD) shocks are a common complication after left ventricular assist device (LVAD) implantation; however, data on their frequency and causes are limited. OBJECTIVE: The purpose of this study was to define ... Full text Link to item Cite

Incidence and Predictors of Relapse After Weaning Immune Suppressive Therapy in Cardiac Sarcoidosis.

Journal Article Am J Cardiol · October 1, 2023 Cardiac sarcoidosis (CS) is a relapsing-remitting disease, and immune suppression (IS) is the mainstay of therapy. Predictors of relapse for patients with CS in remission are not well characterized. We assessed incidence of relapse in consecutive patients ... Full text Link to item Cite

Use of Ripple mapping to enhance localization and ablation of outflow tract premature ventricular contractions.

Journal Article J Cardiovasc Electrophysiol · July 2023 INTRODUCTION: Accurate localization of septal outflow tract premature ventricular contractions (PVCs) is often difficult due to frequent mid-myocardial or protected origin. Compared with traditional activation mapping, CARTO Ripple mapping provides visuali ... Full text Link to item Cite

Prevalence and Phenotypic Burden of Monogenic Arrhythmias Using Integration of Electronic Health Records With Genetics.

Journal Article Circulation. Genomic and precision medicine · October 2022 BackgroundInherited primary arrhythmia syndromes and arrhythmogenic cardiomyopathies can lead to sudden cardiac arrest in otherwise healthy individuals. The burden and expression of these diseases in a real-world, well-phenotyped cardiovascular po ... Full text Cite

Imaging Considerations and Clinical Implications of Mitral Annular Disjunction.

Journal Article Circ Cardiovasc Imaging · September 2022 Mitral annular disjunction is increasingly recognized as an important anatomic feature of mitral valve disease. The presence of mitral annular disjunction, defined as separation between the left atrial wall at the point of mitral valve insertion and the le ... Full text Link to item Cite

Electronic alerts to initiate anticoagulation dialogue in patients with atrial fibrillation.

Journal Article Am Heart J · March 2022 IMPORTANCE: The benefit of an electronic support system for the prescription and adherence to oral anticoagulation therapy among patients with atrial fibrillation (AF) and atrial flutter at heightened risk for of stroke and systemic thromboembolism is uncl ... Full text Link to item Cite

Leadless pacemaker implantation after lead extraction for cardiac implanted electronic device infection.

Journal Article J Cardiovasc Electrophysiol · March 2022 BACKGROUND: Cardiac implanted electronic device (CIED) pocket and systemic infection remain common complications with traditional CIEDs and are associated with high morbidity and mortality. Leadless pacemakers may be an attractive pacing alternative for ma ... Full text Link to item Cite

Optimizing mechanically sensed atrial tracking in patients with atrioventricular-synchronous leadless pacemakers: A single-center experience.

Journal Article Heart Rhythm O2 · October 2021 BACKGROUND: Atrioventricular (AV)-synchronous single-chamber leadless pacing using a mechanical atrial sensing algorithm produced high AV synchrony in clinical trials, but clinical practice experience with these devices has not yet been described. OBJECTIV ... Full text Open Access Link to item Cite

Electrical storm in patients with left ventricular assist devices: Risk factors, incidence, and impact on survival.

Journal Article Heart Rhythm · August 2021 BACKGROUND: Ventricular arrhythmias (VAs) and electrical storm (ES) are recognized complications following left ventricular assist device (LVAD) implantation; however, their association with long term-outcomes remains poorly understood. OBJECTIVE: The purp ... Full text Link to item Cite

Stellate Ganglion Blockade: an Intervention for the Management of Ventricular Arrhythmias.

Journal Article Curr Hypertens Rep · October 23, 2020 PURPOSE OF REVIEW: To highlight the indications, procedural considerations, and data supporting the use of stellate ganglion blockade (SGB) for management of refractory ventricular arrhythmias. RECENT FINDINGS: In patients with refractory ventricular arrhy ... Full text Open Access Link to item Cite

Subcutaneous implantable cardioverter-defibrillator troubleshooting in patients with a left ventricular assist device: A case series and systematic review.

Journal Article Heart Rhythm · September 2020 BACKGROUND: There are limited data on the performance of the subcutaneous implantable cardioverter-defibrillator (S-ICD) in patients with a left ventricular assist device (LVAD). OBJECTIVE: The purpose of this study was to describe the clinical course and ... Full text Link to item Cite

Catheter ablation of atrial fibrillation in cardiac amyloidosis.

Journal Article Pacing Clin Electrophysiol · September 2020 BACKGROUND: Cardiac amyloidosis is a progressive infiltrative disease involving deposition of amyloid fibrils in the myocardium and cardiac conduction system that frequently manifests with heart failure (HF) and arrhythmias, most frequently atrial fibrilla ... Full text Link to item Cite

Identification of Undetected Monogenic Cardiovascular Disorders.

Journal Article J Am Coll Cardiol · August 18, 2020 BACKGROUND: Monogenic diseases are individually rare but collectively common, and are likely underdiagnosed. OBJECTIVES: The purpose of this study was to estimate the prevalence of monogenic cardiovascular diseases (MCVDs) and potentially missed diagnoses ... Full text Link to item Cite

Catheter ablation of atrial fibrillation in patients with diabetes mellitus.

Journal Article Heart Rhythm O2 · August 2020 BACKGROUND: Diabetes mellitus (DM) is an independent risk factor for atrial fibrillation (AF). Few studies have compared clinical outcomes after catheter ablation between patients with and those without DM. OBJECTIVE: The purpose of this study was to compa ... Full text Open Access Link to item Cite

STIM1-Ca2+ signaling in coronary sinus cardiomyocytes contributes to interatrial conduction.

Journal Article Cell Calcium · May 2020 Pacemaker action potentials emerge from the sinoatrial node (SAN) and rapidly propagate through the atria to the AV node via preferential conduction pathways, including one associated with the coronary sinus. However, few distinguishing features of these t ... Full text Open Access Link to item Cite

Stellate Ganglion Blockade for the Treatment of Refractory Ventricular Arrhythmias.

Journal Article JACC Clin Electrophysiol · May 2020 OBJECTIVES: This study sought to describe our institutional experience with establishing a neurocardiology service in an attempt to provide autonomic modulation as a treatment for ventricular arrhythmias (VAs). BACKGROUND: Treatment-refractory VAs are comm ... Full text Link to item Cite

Safety and efficacy outcomes of left atrial posterior wall isolation compared to pulmonary vein isolation and pulmonary vein isolation with linear ablation for the treatment of persistent atrial fibrillation.

Journal Article Am Heart J · February 2020 BACKGROUND: Pulmonary wall isolation (PWI) is increasingly used as an adjunctive lesion set to compliment pulmonary vein isolation (PVI), especially in patients with persistent atrial fibrillation (AF). The objective was to compare outcomes of catheter abl ... Full text Link to item Cite

Effectiveness of catheter ablation of atrial fibrillation according to heart failure etiology.

Journal Article J Arrhythm · February 2020 BACKGROUND: Catheter ablation is an important rhythm control therapy in patients with atrial fibrillation (AF) with concomitant heart failure (HF). The objective of this study was to assess the comparative efficacy of AF ablation patients with ischemic vs ... Full text Open Access Link to item Cite

Predicting atrial fibrillation recurrence after ablation in patients with heart failure: Validity of the APPLE and CAAP-AF risk scoring systems.

Journal Article Pacing Clin Electrophysiol · November 2019 BACKGROUND: Compared with medical therapy, catheter ablation of atrial fibrillation (AF) in patients with heart failure (HF) improves cardiovascular outcomes. Risk scores (CAAP-AF and APPLE) have been developed to predict the likelihood of AF recurrence af ... Full text Open Access Link to item Cite

Should His Bundle Pacing Be Preferred over Cardiac Resynchronization Therapy Following Atrioventricular Junction Ablation?

Journal Article Cardiol Clin · May 2019 Atrial fibrillation (AF) and heart failure (HF) are associated with high morbidity and mortality, which is particularly detrimental when patients develop rapid ventricular rates (RVR). Atrioventricular junction (AVJ) ablation with pacemaker implantation ha ... Full text Link to item Cite

New high-density and automated mapping systems

Chapter · April 5, 2019 Three-dimensional electroanatomical mapping (EAM) systems realistically made it feasible to map focal or reentrant arrhythmias from one of the cardiac chambers. The importance of optimized detailed and accurate mapping within the regions previously conside ... Full text Cite

The paradox of innovation with leadless pacing.

Journal Article J Cardiovasc Electrophysiol · December 2018 Full text Link to item Cite

Ranolazine in High-Risk Patients With Implanted Cardioverter-Defibrillators: The RAID Trial.

Journal Article J Am Coll Cardiol · August 7, 2018 BACKGROUND: Ventricular tachycardia (VT) and ventricular fibrillation (VF) remain a challenging problem in patients with implantable cardioverter-defibrillators (ICDs). OBJECTIVES: This study aimed to determine whether ranolazine administration decreases t ... Full text Link to item Cite

Multi-ethnic genome-wide association study for atrial fibrillation.

Journal Article Nat Genet · June 11, 2018 Atrial fibrillation (AF) affects more than 33 million individuals worldwide1 and has a complex heritability2. We conducted the largest meta-analysis of genome-wide association studies (GWAS) for AF to date, consisting of more than half a million individual ... Full text Link to item Cite

Catheter ablation of atrial fibrillation in patients with heart failure and preserved ejection fraction.

Journal Article Heart Rhythm · May 2018 BACKGROUND: Few studies have examined outcomes of catheter ablation for atrial fibrillation (AF) in patients with heart failure (HF) with preserved ejection fraction (HFpEF). OBJECTIVE: The purpose of this study was to compare outcomes of AF ablation in pa ... Full text Link to item Cite

Frequency and Outcomes of Reduced Dose Non-Vitamin K Antagonist Anticoagulants: Results From ORBIT-AF II (The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II).

Journal Article J Am Heart Assoc · February 16, 2018 BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are indicated for stroke prevention in atrial fibrillation (AF) but require lower doses in certain patients. We sought to describe the frequency, appropriateness (according to Food and Drug A ... Full text Link to item Cite

Stellate ganglion blockade for the treatment of refractory ventricular arrhythmias: A systematic review and meta-analysis.

Journal Article J Cardiovasc Electrophysiol · December 2017 INTRODUCTION: Treatment refractory ventricular arrhythmias (VAs) are often driven and exacerbated by heightened sympathetic tone. We aim to conduct a systematic review and meta-analysis of published studies of a temporary percutaneous stellate ganglion blo ... Full text Link to item Cite

Risk of atrioesophageal fistula formation with contact force-sensing catheters.

Journal Article Heart Rhythm · September 2017 BACKGROUND: Atrioesophageal fistula formation is a rare but life-threatening complication of atrial fibrillation ablation. Contact force (CF)-sensing catheters improve procedural effectiveness. However, the impact of the implementation of CF-sensing techno ... Full text Link to item Cite

Large-scale analyses of common and rare variants identify 12 new loci associated with atrial fibrillation.

Journal Article Nat Genet · June 2017 Atrial fibrillation affects more than 33 million people worldwide and increases the risk of stroke, heart failure, and death. Fourteen genetic loci have been associated with atrial fibrillation in European and Asian ancestry groups. To further define the g ... Full text Link to item Cite

Autonomic Modulation for the Treatment of Ventricular Arrhythmias: Therapeutic Use of Percutaneous Stellate Ganglion Blocks.

Journal Article J Cardiovasc Electrophysiol · April 2017 Ventricular tachycardia (VT), ventricular fibrillation (VF), and electrical storm are commonly encountered emergency conditions in cardiac and surgical intensive care units. In most cases, recurrent ventricular arrhythmias or electrical storm are associate ... Full text Link to item Cite

Intermittent Capture of the Left Bundle With Permanent His Bundle Pacing: Mechanistic Insights and Implications for an Emerging Field.

Journal Article J Cardiovasc Electrophysiol · November 2016 We present a case of a patient with elevated His lead capture thresholds and intermittent recruitment of the left bundle. The patient underwent a noninvasive electrophysiology study and was determined to have a left bundle branch block due to postrepolariz ... Full text Link to item Cite

Long QT Syndrome and Seizures.

Journal Article JACC Clin Electrophysiol · June 2016 Full text Link to item Cite

STIM1-Ca2+ signaling modulates automaticity of the mouse sinoatrial node.

Conference Proc Natl Acad Sci U S A · October 13, 2015 Cardiac pacemaking is governed by specialized cardiomyocytes located in the sinoatrial node (SAN). SAN cells (SANCs) integrate voltage-gated currents from channels on the membrane surface (membrane clock) with rhythmic Ca(2+) release from internal Ca(2+) s ... Full text Link to item Cite

Race, common genetic variation, and therapeutic response disparities in heart failure.

Journal Article JACC Heart Fail · December 2014 Because of its comparatively recent evolution, Homo sapiens exhibit relatively little within-species genomic diversity. However, because of genome size, a proportionately small amount of variation creates ample opportunities for both rare mutations that ma ... Full text Link to item Cite

Outcomes of atrioesophageal fistula following catheter ablation of atrial fibrillation treated with surgical repair versus esophageal stenting.

Journal Article J Cardiovasc Electrophysiol · June 2014 INTRODUCTION: Atrioesophageal fistula (AEF) is a rare but devastating complication of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Surgical repair and esophageal stents are available treatment options for AEF. We report outcomes of ... Full text Link to item Cite

Inherited arrhythmia disorders

Chapter · October 24, 2013 Cite

The genetics of the J wave patterns.

Journal Article J Electrocardiol · 2013 Full text Link to item Cite

Long-term in vivo imaging of multiple organs at the single cell level.

Journal Article PLoS One · 2013 Two-photon microscopy has enabled the study of individual cell behavior in live animals. Many organs and tissues cannot be studied, especially longitudinally, because they are located too deep, behind bony structures or too close to the lung and heart. Her ... Full text Link to item Cite

Early repolarization: a sword in the haystack?

Journal Article Heart Rhythm · August 2012 Full text Link to item Cite

A VGF-derived peptide attenuates development of type 2 diabetes via enhancement of islet β-cell survival and function.

Journal Article Cell Metab · July 3, 2012 Deterioration of functional islet β-cell mass is the final step in progression to Type 2 diabetes. We previously reported that overexpression of Nkx6.1 in rat islets has the dual effects of enhancing glucose-stimulated insulin secretion (GSIS) and increasi ... Full text Link to item Cite

Dissection of a quantitative trait locus for PR interval duration identifies Tnni3k as a novel modulator of cardiac conduction.

Journal Article PLoS genetics · January 2012 Atrio-ventricular conduction disease is a common feature in Mendelian rhythm disorders associated with sudden cardiac death and is characterized by prolongation of the PR interval on the surface electrocardiogram (ECG). Prolongation of the PR interval is a ... Full text Cite

Predictors of mortality in patients with chronic kidney disease and an implantable defibrillator: an EPGEN substudy.

Journal Article Europace · December 2011 AIMS: Chronic kidney disease (CKD) is increasingly prevalent, and is an independent risk factor for cardiovascular mortality. Clinical trials of the implantable cardioverter-defibrillator (ICD) have demonstrated a survival benefit over medical therapy for ... Full text Link to item Cite

The S1103Y cardiac sodium channel variant is associated with implantable cardioverter-defibrillator events in blacks with heart failure and reduced ejection fraction.

Journal Article Circ Cardiovasc Genet · April 2011 BACKGROUND: Risk-stratifying heart failure patients for primary prevention implantable cardioverter-defibrillators (ICDs) remains a challenge, especially for blacks, who have an increased incidence of sudden cardiac death but have been underrepresented in ... Full text Link to item Cite

Rationale and design of the Duke Electrophysiology Genetic and Genomic Studies (EPGEN) biorepository.

Journal Article Am Heart J · November 2009 BACKGROUND: Disturbances in cardiac rhythm can lead to significant morbidity and mortality. Many arrhythmias are known to have a heritable component, but the degree to which genetic variation contributes to disease risk and morbidity is poorly understood. ... Full text Link to item Cite