Julia H Indik

Interests

Research

Arrhythmogenic right ventricular cardiomyopathyLeft atrial voltage in relation to atrial fibrillation

Teaching

Electrophysiology

Courses

No activities entered.

Scholarly Contributions

Books

• Woosley, R., & Indik, J. H. (2004). Antiarrhythmic Drugs.
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  Woosley R and Indik JH. Antiarrhythmic Drugs In: Fuster, V, Alexander RW, and O’Rourke RA eds. Hurst’s The Heart, New York: McGraw Hill; 2004: 949-974. (Book Chapter reviewing state of the field)

Chapters

• Indik, J. H. (2018). Arrhythmogenic Right Ventricular Cardiomyopathy. In Heart Failure in the Child and Young Adult: From Bench to Bedside(pp 291-296). Elsevier.
• Sorrell, V. L., Indik, J. H., Kalra, N., & Marcus, F. (2011). Right Ventricular Cardiomyopathies. In Multimodal Cardiovascular Imaging: Principles and Clinical Applications(pp 322-353).
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  Sorrell VL, Indik JH, Kalra N,and Marcus FM; Chapter 19: Right Ventricular Cardiomyopathies; pp 322-353; In Multimodal Cardiovascular Imaging: Principles and Clinical Applications; McGraw Hill; New York, New York; 2011; Pahlm O and Wagner GS Eds.
• Wichter, T., Indik, J. H., & Daliento, L. (2007). Diagnostic Role of Angiography. In Arrhythmogenic RV Cardiomyopathy/Dysplasia(pp 147-158).
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  Wichter T, Indik J, Daliento L: Diagnostic Role of Angiography. In Marcus FI, Nava A, Thiene G (eds). Arrhythmogenic RV Cardiomyopathy/Dysplasia. Milan: Springer Verlag, 2007

Journals/Publications

• Chung, M. K., Patton, K. K., Lau, C. P., Dal Forno, A. R., Al-Khatib, S. M., Arora, V., Birgersdotter-Green, U. M., Cha, Y. M., Chung, E. H., Cronin, E. M., Curtis, A. B., Cygankiewicz, I., Dandamudi, G., Dubin, A. M., Ensch, D. P., Glotzer, T. V., Gold, M. R., Goldberger, Z. D., Gopinathannair, R., , Gorodeski, E. Z., et al. (2023). 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure. Heart rhythm, 20(9), e17-e91.
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  Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.
• Chung, M. K., Patton, K. K., Lau, C. P., Dal Forno, A. R., Al-Khatib, S. M., Arora, V., Birgersdotter-Green, U. M., Cha, Y. M., Chung, E. H., Cronin, E. M., Curtis, A. B., Cygankiewicz, I., Dandamudi, G., Dubin, A. M., Ensch, D. P., Glotzer, T. V., Gold, M. R., Goldberger, Z. D., Gopinathannair, R., , Gorodeski, E. Z., et al. (2023). 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure. Journal of arrhythmia, 39(5), 681-756.
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  Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.
• Indik, J. H. (2023). Introducing the 2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure: Are we entering a new age in pacing?. Heart rhythm O2, 4(9), 523-525.
• Indik, J. H. (2023). Rhythm Control Treatment for Atrial Fibrillation Is Not Just for the Healthy. Circulation. Arrhythmia and electrophysiology, 16(5), e011949.
• Indik, J. H., & Calkins, H. (2023). Frank Marcus (March 23, 1928-December 21, 2022). Heart rhythm, 20(3), 486-487.
• Perino, A. C., Wang, P. J., Lloyd, M., Zanon, F., Fujiu, K., Osman, F., Briongos-Figuero, S., Sato, T., Aksu, T., Jastrzebski, M., Sideris, S., Rao, P., Boczar, K., Yuan-Ning, X., Wu, M., Namboodiri, N., Garcia, R., Kataria, V., De Pooter, J., , Przibille, O., et al. (2023). Worldwide survey on implantation of and outcomes for conduction system pacing with His bundle and left bundle branch area pacing leads. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 66(7), 1589-1600.
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  Adoption and outcomes for conduction system pacing (CSP), which includes His bundle pacing (HBP) or left bundle branch area pacing (LBBAP), in real-world settings are incompletely understood. We sought to describe real-world adoption of CSP lead implantation and subsequent outcomes.
• Lee, K. S., Natarajan, B., Wong, W. X., Yousman, W., Koester, S., Nyotowidjojo, I., Lee, J. Z., Kern, K. B., Acharya, D., Fortuin, D., Hung, O., Voelker, W., & Indik, J. H. (2022). A randomized controlled trial of simulation training in teaching coronary angiographic views. BMC medical education, 22(1), 644.
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  Simulation technology has an established role in teaching technical skills to cardiology fellows, but its impact on teaching trainees to interpret coronary angiographic (CA) images has not been systematically studied. The aim of this randomized controlled study was to test whether structured simulation training, in addition to traditional methods would improve CA image interpretation skills in a heterogeneous group of medical trainees.
• Ajmal, M., Hutchinson, M. D., Lee, K., & Indik, J. H. (2021). Outcomes in patients implanted with a Watchman device in relation to choice of anticoagulation and indication for implant. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing.
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  Patients with atrial fibrillation are increasingly prescribed a direct oral anticoagulant (DOAC) over warfarin and seek to avoid anticoagulation even without a history of major bleeding. This study explores the outcomes of patients implanted with a Watchman device in relation to anticoagulation choice (warfarin versus DOAC) in the post-procedure period and a history of bleeding.
• Indik, J. H. (2021). Radiation Safety Is Not a No-Brainer. JACC. Clinical electrophysiology, 7(2), 171-173.
• Dhakal, B. P., Skinner, K. A., Kumar, K., Lotun, K., Shetty, R., Kazui, T., Lee, K., & Indik, J. H. (2020). Arrhythmias in Relation to Mortality After Transcatheter Aortic Valve Replacement. The American journal of medicine, 133(11), 1336-1342.e1.
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  The purpose of this study was to identify predictors of mortality and potentially modifiable factors related to arrhythmias in patients that undergo transcatheter aortic valve replacement (TAVR). Patients that undergo TAVR are at risk for complete heart block requiring pacemaker implant. Additionally, other arrhythmias, specifically atrial fibrillation (AF), are common in this population. It is unclear how arrhythmias and their management contribute to mortality risk.
• Dhakal, B. P., Sweitzer, N. K., Indik, J. H., Acharya, D., & William, P. (2020). SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart. Heart, lung & circulation, 29(7), 973-987.
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  Coronavirus disease (COVID-19) is a serious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The symptoms of the disease range from asymptomatic to mild respiratory symptoms and even potentially life-threatening cardiovascular and pulmonary complications. Cardiac complications include acute myocardial injury, arrhythmias, cardiogenic shock and even sudden death. Furthermore, drug interactions with COVID-19 therapies may place the patient at risk for arrhythmias, cardiomyopathy and sudden death. In this review, we summarise the cardiac manifestations of COVID-19 infection and propose a simplified algorithm for patient management during the COVID-19 pandemic.
• Gupta, A., Fei, Y. D., Kim, T. Y., Xie, A., Batai, K., Greener, I., Tang, H., Ciftci-Yilmaz, S., Juneman, E. B., Indik, J. H., Shi, G., Christensen, J., Gupta, G., Hillery, C. A., Kansal, M., Parikh, D. S., Zhou, T., Yuan, J. X., Kanthi, Y., , Bronk, P., et al. (2020). IL-18 mediates sickle cell cardiomyopathy and ventricular arrhythmias. Blood.
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  Previous reports indicate IL18 is a novel candidate gene for diastolic dysfunction in sickle cell disease (SCD)-related cardiomyopathy. We hypothesize that IL-18 mediates the development of cardiomyopathy and ventricular tachycardia (VT) in SCD. Compared to control (CTR) mice, a "humanized" mouse model of SCD exhibited increased cardiac fibrosis, prolonged action potential duration (APD), higher VT inducibility in vivo, higher cardiac NFκB phosphorylation and circulating IL-18 levels, as well as reduced voltage-gated potassium channel expression, translating to reduced outward potassium current (Ito) in isolated cardiomyocytes. IL-18 administration to isolated mice hearts resulted in VTs, originating from the right ventricle, and further reduced Ito in SCD mice cardiomyocytes. Sustained IL-18 inhibition via IL-18 binding protein resulted in decreased cardiac fibrosis and NFκB phosphorylation, improved diastolic function, normalized electrical remodeling and attenuated IL-18-mediated VT in SCD mice. Patients with SCD and either myocardial fibrosis or increased QTc displayed greater IL18 gene expression in peripheral blood mononuclear cells (PBMC), with QTc strongly correlated with plasma IL-18 levels. PBMC-derived IL18 gene expression was increased in non-surviving over surviving subjects. IL-18 is a mediator of sickle cell cardiomyopathy and VT in mice and a novel therapeutic target in patients at risk for sudden death.
• Yousefian, O., Dhakal, B. P., Garza, H., & Indik, J. H. (2020). Misplacement of single lead pacemaker into left ventricle via direct aortic puncture through the lung and approach for removal. Poster presentation (accepted but cancelled due to COVID-19) for the annual scientific sessions of the American College of Cardiology March 2020. J Am Coll Cardiology, 75, 2628. doi:DOI:10.1016/S0735-1097(20)33255-1
• Towbin, J. A., McKenna, W. J., Abrams, D. J., Ackerman, M. J., Calkins, H., Darrieux, F. C., Daubert, J. P., de Chillou, C., DePasquale, E. C., Desai, M. Y., Estes, N. A., Hua, W., Indik, J. H., Ingles, J., James, C. A., John, R. M., Judge, D. P., Keegan, R., Krahn, A. D., , Link, M. S., et al. (2019). 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy. Heart rhythm.
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  Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloid and sarcoidosis, Chagas' disease and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation which may be associated with ventricular dilatation and/or impaired systolic function. This expert consensus statement provides the clinician with guidance on evaluation and management of ACM and includes clinically relevant information on genetics and disease mechanisms. PICO (Patient, Intervention, Comparison, Outcome) questions were utilized to evaluate contemporary evidence and provide clinical guidance related to exercise in arrhythmogenic right ventricular cardiomyopathy. Recommendations were developed and approved by an expert writing group, after a systematic literature search with evidence tables, and discussion of their own clinical experience, to present the current knowledge in the field. Each recommendation is presented using the Class of Recommendation and Level of Evidence system formulated by the ACC and AHA and is accompanied by references and explanatory text, to provide essential context. The ongoing recognition of the genetic basis of ACM provides the opportunity to examine the diverse triggers and potential common pathway for the development of disease and arrhythmia.
• Towbin, J. A., McKenna, W. J., Abrams, D. J., Ackerman, M. J., Calkins, H., Darrieux, F. C., Daubert, J. P., de Chillou, C., DePasquale, E. C., Desai, M. Y., Estes, N. A., Hua, W., Indik, J. H., Ingles, J., James, C. A., John, R. M., Judge, D. P., Keegan, R., Krahn, A. D., , Link, M. S., et al. (2019). 2019 HRS expert consensus statement on evaluation, risk stratification, and management of arrhythmogenic cardiomyopathy: Executive summary. Heart rhythm, 16(11), e373-e407.
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  Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive, or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloidosis, sarcoidosis, Chagas disease, and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation that may be associated with ventricular dilatation and/or impaired systolic function. This expert consensus statement provides the clinician with guidance on evaluation and management of ACM and includes clinically relevant information on genetics and disease mechanisms. PICO questions were utilized to evaluate contemporary evidence and provide clinical guidance related to exercise in arrhythmogenic right ventricular cardiomyopathy. Recommendations were developed and approved by an expert writing group, after a systematic literature search with evidence tables, and discussion of their own clinical experience, to present the current knowledge in the field. Each recommendation is presented using the Class of Recommendation and Level of Evidence system formulated by the American College of Cardiology and the American Heart Association and is accompanied by references and explanatory text to provide essential context. The ongoing recognition of the genetic basis of ACM provides the opportunity to examine the diverse triggers and potential common pathway for the development of disease and arrhythmia.
• Indik, J. H. (2018). Arrhythmic Risk Stratification for Arrhythmogenic Right Ventricular Cardiomyopathy: Should We Ask Who Is at High Risk or Who Is at Low Risk?. Circulation. Arrhythmia and electrophysiology, 11(2), e006160.
• Indik, J. H. (2018). Is it Like Night and Day, or Weekend?. Journal of the American College of Cardiology, 71(4), 412-413.
• Indik, J. H., Kalb, B., Martin, D. R., & Ott, P. (2018).

  MRI of patients with implanted cardiac devices.

  . Journal of magnetic resonance imaging : JMRI, 47(3), 595-603. doi:10.1002/jmri.25824
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  Cardiac implanted electronic devices (CIEDs) have historically been regarded as a contraindication for performing magnetic resonance imaging (MRI), limiting the availability of this exam for large numbers of patients who may have otherwise benefited from the unique diagnostic capabilities of MRI. Interactions between CIEDs and the magnetic field associated with MRI systems have been documented, and include potential effects on CIED function, lead heating, and force/torque on the generator. Several device manufacturers have developed "MR-Conditional" CIEDs with specific hardware and software design changes to optimize the device for the MR environment. However, a substantial body of evidence has been accumulating that suggests that MRI may be safely performed in patients with either conditional or nonconditional CIEDs. Institutional policies and procedures, including preexam screening and assessment by skilled electrophysiology personnel and intraexam monitoring, allow MRI to be safely performed in CIED patients, as evidenced by at least two, large multicenter prospective studies and multiple smaller, single-institution studies. Cross-departmental collaboration and a robust safety infrastructure at sites that perform MRI should allow for the safe imaging of CIED patients who have a clinical indication for the study, regardless of the conditionality status of the device..5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;47:595-603.
• Nyotowidjojo, I. S., Skinner, K., Shah, A. S., Bisla, J., Singh, S., Khoubyari, R., Ott, P., Kalb, B. T., & Indik, J. H. (2018). Thoracic versus nonthoracic MR imaging for patients with an MR nonconditional cardiac implantable electronic device. Pacing and Clinical Electrophysiology.. Pacing and Clinical Electrophysiology, 41(6), 589-96.
• Nyotowidjojo, I. S., Skinner, K., Shah, A. S., Bisla, J., Singh, S., Khoubyari, R., Ott, P., Kalb, B., & Indik, J. H. (2018). Thoracic versus nonthoracic MR imaging for patients with an MR nonconditional cardiac implantable electronic device. Pacing and clinical electrophysiology : PACE, 41(6), 589-596.
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  Observational studies have explored the safety of magnetic resonance (MR) scanning of patients with cardiac implantable electronic devices (CIEDs) that are not Food and Drug Administration approved for MR scanning ("nonconditional"). However, concern has been raised that MR scanning that includes the thoracic region may pose a higher risk. This study examines the safety of MR scanning of thoracic versus nonthoracic regions of patients with CIEDs.
• Indik, J. H., Duhigg, L. M., McDonald, F. S., Lipner, R. S., Rubright, J. D., Haist, S. A., Botkin, N. F., & Kuvin, J. T. (2017). Performance on the Cardiovascular In-Training Examination in Relation to the ABIM Cardiovascular Disease Certification Examination. Journal of the American College of Cardiology, 69(23), 2862-2868.
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  The American College of Cardiology In-Training Exam (ACC-ITE) is incorporated into most U.S. training programs, but its relationship to performance on the American Board of Internal Medicine Cardiovascular Disease (ABIM CVD) Certification Examination is unknown. ACC-ITE scores from third-year fellows from 2011 to 2014 (n = 1,918) were examined. Covariates for regression analyses included sex, age, medical school country, U.S. Medical Licensing Examination Step, and ABIM Internal Medicine Certification Examination scores. A secondary analysis examined fellows (n = 511) who took the ACC-ITE in the first and third years. ACC-ITE scores were the strongest predictor of ABIM CVD scores (p < 0.0001), and the most significant predictor of passing (p < 0.0001). The change in ACC-ITE scores from first to third year was a strong predictor of the ABIM CVD score (p < 0.001). The ACC-ITE is strongly associated with performance on the ABIM CVD Certification Examination.
• Indik, J. H., Gimbel, J. R., Abe, H., Alkmim-Teixeira, R., Birgersdotter-Green, U., Clarke, G. D., Dickfeld, T. L., Froelich, J. W., Grant, J., Hayes, D. L., Heidbuchel, H., Idriss, S. F., Kanal, E., Lampert, R., Machado, C. E., Mandrola, J. M., Nazarian, S., Patton, K. K., Rozner, M. A., , Russo, R. J., et al. (2017). 2017 HRS expert consensus statement on magnetic resonance imaging and radiation exposure in patients with cardiovascular implantable electronic devices. Heart rhythm, 14(7), e97-e153.
• Indik, J. H., Patton, K. K., Beardsall, M., Chen-Scarabelli, C. A., Cohen, M. I., Dickfeld, T. L., Haines, D. E., Helm, R. H., Krishnan, K., Nielsen, J. C., Rickard, J., Sapp, J. L., & Chung, M. (2017). HRS Clinical Document Development Methodology Manual and Policies: Executive summary. Heart rhythm, 14(10), e495-e500.
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  The Heart Rhythm Society (HRS) has been developing clinical practice documents in collaboration and partnership with other professional medical societies since 1996. The HRS formed a Scientific and Clinical Documents Committee (SCDC) with the sole purpose of managing the development of these documents from conception through publication. The SCDC oversees the process for developing clinical practice documents, with input and approval from the HRS Executive Committee and the Board of Trustees. As of May 2017, the HRS has produced more than 80 publications with other professional organizations. This process manual is produced to publicly and transparently declare the standards by which the HRS develops clinical practice documents, which include clinical practice guidelines, expert consensus statements, scientific statements, clinical competency statements, task force policy statements, and proceedings statements. The foundation for this process is informed by the Institute of Medicine's standards for developing trustworthy clinical practice guidelines; the new criteria from the National Guidelines Clearinghouse, effective June 2014; SCDC member discussions; and a review of guideline policies and methodologies used by other professional organizations.
• Kalb, B., Indik, J. H., Ott, P., & Martin, D. R. (2017). MRI of patients with implanted cardiac devices. Journal of magnetic resonance imaging : JMRI.
  More info

  Cardiac implanted electronic devices (CIEDs) have historically been regarded as a contraindication for performing magnetic resonance imaging (MRI), limiting the availability of this exam for large numbers of patients who may have otherwise benefited from the unique diagnostic capabilities of MRI. Interactions between CIEDs and the magnetic field associated with MRI systems have been documented, and include potential effects on CIED function, lead heating, and force/torque on the generator. Several device manufacturers have developed "MR-Conditional" CIEDs with specific hardware and software design changes to optimize the device for the MR environment. However, a substantial body of evidence has been accumulating that suggests that MRI may be safely performed in patients with either conditional or nonconditional CIEDs. Institutional policies and procedures, including preexam screening and assessment by skilled electrophysiology personnel and intraexam monitoring, allow MRI to be safely performed in CIED patients, as evidenced by at least two, large multicenter prospective studies and multiple smaller, single-institution studies. Cross-departmental collaboration and a robust safety infrastructure at sites that perform MRI should allow for the safe imaging of CIED patients who have a clinical indication for the study, regardless of the conditionality status of the device.
• Tracy, C. M., Crossley, G. H., Bunch, T. J., Chow, G. V., Leiserowitz, A., Indik, J. H., Kusumoto, F., Mendes, L. A., Munger, T. M., Murali, S., Patton, K. K., Russo, A. M., Scheinman, M., Schoenhard, J. A., & Winterfield, J. R. (2017). 2017 ACC/HRS Lifelong Learning Statement for Clinical Cardiac Electrophysiology Specialists: A Report of the ACC Competency Management Committee. Heart rhythm.
• Tracy, C. M., Crossley, G. H., Bunch, T. J., Chow, G. V., Leiserowitz, A., Indik, J. H., Kusumoto, F., Mendes, L. A., Munger, T. M., Murali, S., Patton, K. K., Russo, A. M., Scheinman, M., Schoenhard, J. A., & Winterfield, J. R. (2017). 2017 ACC/HRS Lifelong Learning Statement for Clinical Cardiac Electrophysiology Specialists: A Report of the ACC Competency Management Committee. Journal of the American College of Cardiology.
• Indik, J. H. (2016). True or False: Prognosis Is Excellent for Sudden Cardiac Death Survivors Due to Variant Angina. Journal of the American College of Cardiology, 68(2), 146-8.
• Indik, J. H., & Alpert, J. S. (2016). Detection of pulmonary embolism by D-dimer assay, spiral computed tomography, and magnetic resonance imaging. Progress in cardiovascular diseases, 42(4), 261-72.
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  Pulmonary embolism (PE) remains difficult to diagnose. Ventilation perfusion lung scan, the standard diagnostic test for PE, has poor overall sensitivity. The gold standard examination, pulmonary angiography, is invasive and has some risk, making clinicians reluctant to refer patients. In recent years, new diagnostic modalities have been investigated, including D-Dimer assays, spiral computed tomography (CT), and magnetic resonance imaging (MRI). The authors reviewed the literature and noted that the D-Dimer assays by ELISA or rapid ELISA design are approximately 90% to 95% sensitive, but are not specific for the diagnosis of pulmonary embolism. Spiral CT has been studied with conflicting results; however, in the largest studies the reported sensitivities are greater than approximately 85%. Electron beam CT is an alternative technique, which has not been as extensively studied. MRI is also useful for imaging the pulmonary arterial vasculature, but remains experimental. Although a more accurate assessment of the sensitivity of these new modalities will need to wait until a large angiographically controlled study, such as the planned PIOPED II, can be done, D-Dimer assay and spiral CT are often useful in the detection of pulmonary embolism. The authors make recommendations for their use in a diagnostic algorithm, as alternatives to the standard ventilation perfusion lung scan.
• Indik, J. H., Nair, V., Rafikov, R., Nyotowidjojo, I. S., Bisla, J., Kansal, M., Parikh, D. S., Robinson, M., Desai, A., Oberoi, M., Gupta, A., Abbasi, T., Khalpey, Z., Patel, A. R., Lang, R. M., Dudley, S. C., Choi, B., Garcia, J. G., Machado, R. F., & Desai, A. A. (2016). Associations of Prolonged QTc in Sickle Cell Disease. PloS one, 11(10), e0164526.
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  Sudden death is a leading cause of mortality in sickle cell disease, implicating ventricular tachyarrhythmias. Prolonged QTc on an electrocardiogram (ECG), commonly seen with myocardial ischemia, is a known risk for polymorphic ventricular tachycardia (VT). We hypothesized that prolonged QTc is associated with mortality in sickle cell disease. ECG were analyzed from a cohort of 224 sickle patients (University of Illinois at Chicago, UIC) along with available laboratory, and echocardiographic findings, and from another cohort of 38 patients (University of Chicago, UC) for which cardiac MRI and free heme values were also measured. In the UIC cohort, QTc was potentially related to mortality with a hazard ratio (HR) of 1.22 per 10ms, (P = 0.015), and a HR = 3.19 (P = 0.045) for a QTc>480ms. In multivariate analyses, QTc remained significantly associated with survival after adjusting for inpatient ECG status (HR 1.26 per 10ms interval, P = 0.010) and genotype status [HR 1.21 per 10ms interval, P = 0.037). QTc trended toward association with mortality after adjusting for both LDH and hydroxyurea use (HR 1.21 per 10ms interval, P = 0.062) but was not significant after adjusting for TRV. In univariate analyses, QTc was related to markers of hemolysis including AST (P = 0.031), hemoglobin (P = 0.014), TR velocity (P = 0.036), higher in inpatients (P
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes Iii, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., & Al-Khatib, S. M. (2016). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart rhythm : the official journal of the Heart Rhythm Society, 13(4), e136-221.
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes Iii, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., & Al-Khatib, S. M. (2016). 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart rhythm : the official journal of the Heart Rhythm Society, 13(4), e92-135.
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., & Al-Khatib, S. M. (2016). 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology, 67(13), e27-e115.
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., Al-Khatib, S. M., & , E. R. (2016). 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, 133(14), e506-74.
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., Al-Khatib, S. M., & , E. R. (2016). 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation, 133(14), e471-505.
• Rose, K., Martin Goble, M., Berger, S., Courson, R., Fosse, G., Gillary, R., Halowich, J., Indik, J. H., Konig, M., Lopez-Anderson, M., Murphy, M. K., Newman, M. M., Ranous, J., Sasson, C., Taras, H., & Thompson, A. (2016). Cardiac Emergency Response Planning for Schools: A Policy Statement. NASN school nurse (Print), 31(5), 263-70.
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  A sudden cardiac arrest in school or at a school event is potentially devastating to families and communities. An appropriate response to such an event-as promoted by developing, implementing, and practicing a cardiac emergency response plan (CERP)-can increase survival rates. Understanding that a trained lay-responder team within the school can make a difference in the crucial minutes between the time when the victim collapses and when emergency medical services arrive empowers school staff and can save lives. In 2015, the American Heart Association convened a group of stakeholders to develop tools to assist schools in developing CERPs. This article reviews the critical components of a CERP and a CERP team, the factors that should be taken into account when implementing the CERP, and recommendations for policy makers to support CERPs in schools.
• Wilkoff, B. L., Fauchier, L., Stiles, M. K., Morillo, C. A., Al-Khatib, S. M., Almendral, J., Aguinaga, L., Berger, R. D., Cuesta, A., Daubert, J. P., Dubner, S., Ellenbogen, K. A., Estes, N. A., Fenelon, G., Garcia, F. C., Gasparini, M., Haines, D. E., Healey, J. S., Hurtwitz, J. L., , Keegan, R., et al. (2016). 2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 18(2), 159-83.
• Zipes, D. P., Calkins, H., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Gupta, A., Indik, J. H., Kusumoto, F. M., Lindsay, B. D., Marine, J. E., Mehta, L. S., Mendes, L. A., Miller, J. M., Munger, T. M., Sauer, W. H., Shen, W., , Stevenson, W. G., et al. (2016). 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (A Revision of the ACC/AHA 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion). Heart rhythm : the official journal of the Heart Rhythm Society, 13(1), e3-e37.
• Desai, A., Choi, B., Dudley, S. C., Kittles, R., Machado, R. F., Garcia, J. G., Hillery, C., Indik, J. H., Goldman, S., Juneman, E. B., Groth, J., Nair, N., Rutledge, C., Kanady, J., Fleming, I., Batai, K., Weigand, K., Shi, G., Kim, T. Y., , Gupta, G., et al. (2018). IL-18 is a novel mediator of prolonged QTc and ventricular arrhythmias associated with Sickle Cell Disease. Proceedings of the National Academy of Sciences.
• Enakpene, E. O., Riaz, I. B., Shirazi, F. M., Raz, Y., & Indik, J. H. (2015). The Long QT Teaser: Loperamide Abuse. American Journal of Medicine, 128, 1083-1086.
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  The source of a 25-year-old woman's puzzling signs and symptoms could not be determined until a search of her home yielded the answer. She had no known medical problems when she presented to the Emergency Department with a 2-week history of persistent abdominal discomfort. A routine work-up for abdominal pain was unrevealing. An electrocardiogram (ECG) showed sinus rhythm at a rate of 69 beats per minute with a QT interval of 492 ms, a corrected QT interval of 527 ms, an intraventricular conduction defect with a QRS interval of 170 ms, and nonspecific T-wave abnormalities (Figure 1).
• Enakpene, E. O., Riaz, I. B., Shirazi, F. M., Raz, Y., & Indik, J. H. (2015). The long QT teaser: loperamide abuse. The American journal of medicine, 128(10), 1083-6.
• Indik, J. H. (2015). Can we improve outcomes by using active compression-decompression and impedance threshold devices during resuscitation?. Critical care medicine, 43(4), 929-30.
• Indik, J. H., Conover, Z., McGovern, M., Silver, A. E., Spaite, D. W., Bobrow, B. J., & Kern, K. B. (2015). Amplitude-spectral area and chest compression release velocity independently predict hospital discharge and good neurological outcome in ventricular fibrillation out-of-hospital cardiac arrest. Resuscitation, 92, 122-8.
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  In out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation (VF) the frequency-based waveform characteristic, amplitude-spectral area (AMSA) is associated with hospital discharge and good neurological outcome, yet AMSA is also known to increase in response to chest compressions (CC). In addition to rate and depth, well performed CC provides good chest recoil without leaning, reflected in the release velocity (RV). We hypothesized that AMSA is associated with hospital discharge and good neurological outcome independent of CC quality.
• Indik, J. H., Conover, Z., McGovern, M., Silver, A. E., Spaite, D. W., Bobrow, B. J., & Kern, K. B. (2015). Amplitude-spectral area and chest compression release velocity independently predict hospital discharge and good neurological outcome in ventricular fibrillation out-of-hospital cardiac arrest.. Resuscitation, 122-128.
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  In out-of-hospital cardiac arrest (OHCA) with ventricular fibrillation (VF) the frequency-based waveform characteristic, amplitude-spectral area (AMSA) is associated with hospital discharge and good neurological outcome, yet AMSA is also known to increase in response to chest compressions (CC). In addition to rate and depth, well performed CC provides good chest recoil without leaning, reflected in the release velocity (RV). We hypothesized that AMSA is associated with hospital discharge and good neurological outcome independent of CC quality.
• JT, K., A, S., L, F., J, D., A, K., D, P., B, R., & Indik, J. H. (2015). The Cardiovascular In-Training Examination: Development, Implementation, Results, and Future Directions. Journal of American College of Cardiology, 1218-28.
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  The American College of Cardiology (ACC), in collaboration with the National Board of Medical Examiners (NBME), developed the first standardized in-training examination (ITE) for cardiovascular disease fellows-in-training (FITs). In addition to testing knowledge, this examination uses the newly developed ACC Curricular Milestones to provide specific, competency-based feedback to program directors and FITs. The ACC ITE has been administered more than 5,000 times since 2011.
• Khalpey, Z., Marsh, K. M., Ferng, A., Riaz, I. B., Friedman, M., Indik, J., Avery, R., Jokerst, C., & Oliva, I. (2015). First in man: amniotic patch reduces postoperative inflammation. The American journal of medicine, 128(1), e5-6.
• Kuvin, J. T., Soto, A., Foster, L., Dent, J., Kates, A. M., Polk, D. M., Rosenzweig, B., & Indik, J. (2015). The cardiovascular in-training examination: development, implementation, results, and future directions. Journal of the American College of Cardiology, 65(12), 1218-28.
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  The American College of Cardiology (ACC), in collaboration with the National Board of Medical Examiners (NBME), developed the first standardized in-training examination (ITE) for cardiovascular disease fellows-in-training (FITs). In addition to testing knowledge, this examination uses the newly developed ACC Curricular Milestones to provide specific, competency-based feedback to program directors and FITs. The ACC ITE has been administered more than 5,000 times since 2011.
• M, M., D, A., F, C., Z, C., R, H., & Indik, J. H. (2015). The ventricular fibrillation waveform approach to direct postshock chest compressions in a swine model of VF arrest.. Journal of Emergency Medicine, 48, 373-81.
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  In retrospective swine and human investigations of ventricular fibrillation (VF) cardiac arrest, the amplitude-spectral area (AMSA), determined from the VF waveform, can predict defibrillation and a return of spontaneous circulation (ROSC).
• McGovern, M., Allen, D., Chaudhry, F., Conover, Z., Hilwig, R., & Indik, J. H. (2015). The ventricular fibrillation waveform approach to direct postshock chest compressions in a swine model of VF arrest. The Journal of emergency medicine, 48(3), 373-81.
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  In retrospective swine and human investigations of ventricular fibrillation (VF) cardiac arrest, the amplitude-spectral area (AMSA), determined from the VF waveform, can predict defibrillation and a return of spontaneous circulation (ROSC).
• O'Gara, P. T., Adams, J. E., Drazner, M. H., Indik, J. H., Kirtane, A. J., Klarich, K. W., Newby, L. K., Scirica, B. M., & Sundt, T. M. (2015). COCATS 4 Task Force 13: Training in Critical Care Cardiology. Journal of the American College of Cardiology, 65(17), 1877-86.
• PT, O., JE 3rd, A., MH, D., Indik, J. H., AJ, K., KW, K., LK, N., BM, S., & TM 3rd, S. (2015). COCATS 4 Task Force 13: Training in Critical Care Cardiology. Journal of American College of Cardiology, 65, 1877-1886.
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  The field of critical care cardiology has evolved considerably over the past 2 decades. The coronary care unit of the 1970s and 1980s was populated most frequently by patients with acute—and often uncomplicated—myocardial infarction or unstable angina. Detection and rapid treatment of arrhythmias were the primary goals of therapy. Today, patients with acute coronary syndromes, including those with ST-elevation myocardial infarction who have undergone primary percutaneous coronary intervention, may be managed at some institutions in step-down units with continuous telemetry monitoring. At all institutions, contemporary critical care cardiology is increasingly focused on the management of patients with advanced hemodynamic compromise, complex ventricular arrhythmias, and established or incipient multiorgan failure, thus demanding a broader and more in-depth knowledge base and refined skill set than that expected of care providers in years past. In addition, at many institutions, increasing numbers of patients undergoing transcatheter valve therapies or ventricular assist devices are cared for in cardiac intensive care units. A premium is placed, not only on the ability to participate in or lead interdisciplinary care teams in this environment, but also on the skills needed to ensure orderly transitions of care once patients are ready for transfer to less intensive hospital units or directly to a rehabilitation facility. The competencies important for the cardiovascular medicine fellow to achieve during critical care cardiology training have not been included in previous iterations of COCATS and are provided here in recognition of the need to define them within the context of this evolving and complex field. Many of the competencies pertinent to critical care cardiology will be acquired during other rotations; these include cardiac catheterization, electrophysiology, and advanced heart failure. In addition, this report addresses the evolving framework of competency-based medical education described by the ACGME Outcomes Project and the 6 general competencies endorsed by ACGME and ABMS. The background and overarching principles governing fellowship training are provided in the COCATS 4 Introduction, and readers should become familiar with this foundation before considering the details of training in a subdiscipline like critical care cardiology. The Steering Committee and Task Force recognize that implementation of these changes in training requirements will occur incrementally. .For most areas of cardiovascular medicine, 3 levels of training are delineated:▪Level I training is the basic training required to become a competent cardiovascular consultant. This level of training is required of all cardiovascular fellows and can be accomplished as part of a standard 3-year training program in cardiovascular medicine. Cardiovascular fellows should be well equipped to manage the majority of patients in a critical care cardiology environment.▪Level II training refers to additional training in 1 or more areas that enables some cardiovascular specialists to perform or interpret specific diagnostic tests and procedures or render more specialized care for patients and conditions. This level of training is recognized for those areas in which an accepted instrument or benchmark, such as a qualifying examination, is available to measure specific knowledge, skills, or competence. Level II training in selected areas may be achieved by some trainees during the standard 3-year cardiology fellowship, depending on the trainee’s career goals and use of elective rotations. It is anticipated that during a standard 3-year cardiovascular fellowship training program, sufficient time will be available for trainees to receive Level II training in a specific subspecialty. Additional training of this type would signify a strong career interest in critical care cardiology. There are currently challenges to measurement and verification of these additional competencies that require further adjudication. Although some fellows may obtain enhanced procedural skills in the context of a 3-year cardiovascular medicine fellowship by spending additional time (3 to 6 months) dedicated to critical care cardiology experiences, there is currently no Level II designation in this field of cardiology.▪Level III training requires advanced training and experience beyond the cardiovascular fellowship to acquire specialized knowledge and competencies in performing, interpreting, and training others to perform specific procedures or render advanced specialized care at a high level of skill. For critical care cardiology, Level III training involves completion of a 1-year clinical fellowship in critical care medicine within the Department of Medicine in addition to the 3-year cardiovascular medicine fellowship (1).
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes 3rd, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W. K., Tracy, C. M., & Al-Khatib, s. M. (2015). ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary. American College of Cardiology/American Heart Association Task Force on Clinical Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
• Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A., Field, M. E., Goldberger, Z. D., Hammill, S. C., Indik, J. H., Lindsay, B. D., Olshansky, B., Russo, A. M., Shen, W., Tracy, C. M., & Al-Khatib, S. M. (2015). 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Journal of the American College of Cardiology.
• Zipes, D. P., Calkins, H., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Grupta, A., Indik, J. H., Kusumoto, F. M., Lindsay, B. D., Marine, J. E., Mehta, L. S., Mendes, L. A., Miller, J. M., Munger, T. M., Sauer, W. H., Shen, W., , Stevenson, W. G., et al. (2015). 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac. American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
• Zipes, D. P., Calkins, H., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Gupta, A., Indik, J. H., Kusumoto, F. M., Lindsay, B. D., Marine, J. E., Mehta, L. S., Mendes, L. A., Miller, J. M., Munger, T. M., Sauer, W. H., Shen, W., , Stevenson, W. G., et al. (2015). 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (A Revision of the ACC/AHA 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion). Circulation. Arrhythmia and electrophysiology, 8(6), 1522-51.
• Zipes, D. P., Calkins, H., Daubert, J. P., Ellenbogen, K. A., Field, M. E., Fisher, J. D., Fogel, R. I., Frankel, D. S., Gupta, A., Indik, J. H., Kusumoto, F. M., Lindsay, B. D., Marine, J. E., Mehta, L. S., Mendes, L. A., Miller, J. M., Munger, T. M., Sauer, W. H., Shen, W., , Stevenson, W. G., et al. (2015). 2015 ACC/AHA/HRS Advanced Training Statement on Clinical Cardiac Electrophysiology (A Revision of the ACC/AHA 2006 Update of the Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion). Journal of the American College of Cardiology, 66(24), 2767-802.
• Conover, Z., Kern, K. B., Silver, A. E., Bobrow, B. J., Spaite, D. W., & Indik, J. H. (2014). Resumption of chest compressions after successful defibrillation and risk for recurrence of ventricular fibrillation in out-of-hospital cardiac arrest. Circulation. Arrhythmia and electrophysiology, 7(4), 633-9.
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  Prior investigation of out-of-hospital cardiac arrest has raised the concern that ventricular fibrillation (VF) recurrence may be triggered by chest compression (CC) resumption. We investigated predictors of VF recurrence after defibrillation, including timing of CC resumption.
• Indik, J. H., Conover, Z., Kern, K. B., Silver, A. E., Bobrow, B. J., & Spaite, D. W. (2014). Response to letter regarding, "resumption of chest compressions after successful defibrillation and risk for recurrence of ventricular fibrillation in out-of-hospital cardiac arrest". Circulation. Arrhythmia and electrophysiology, 7(6), 1278.
• Indik, J. H., Conover, Z., McGovern, M., Silver, A. E., Spaite, D. W., Bobrow, B. J., & Kern, K. B. (2014). Association of amplitude spectral area of the ventricular fibrillation waveform with survival of out-of-hospital ventricular fibrillation cardiac arrest. Journal of the American College of Cardiology, 64(13), 1362-9.
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  Previous investigations of out-of-hospital cardiac arrest (OHCA) have shown that the waveform characteristic amplitude spectral area (AMSA) can predict successful defibrillation and return of spontaneous circulation (ROSC) but has not been studied previously for survival.
• Kusumoto, F. M., Calkins, H., Boehmer, J., Buxton, A. E., Chung, M. K., Gold, M. R., Hohnloser, S. H., Indik, J., Lee, R., Mehra, M. R., Menon, V., Page, R. L., Shen, W., Slotwiner, D. J., Stevenson, L. W., Varosy, P. D., & Welikovitch, L. (2014). HRS/ACC/AHA expert consensus statement on the use of implantable cardioverter-defibrillator therapy in patients who are not included or not well represented in clinical trials. Circulation, 130(1), 94-125.
• Kusumoto, F. M., Calkins, H., Boehmer, J., Buxton, A. E., Chung, M. K., Gold, M. R., Hohnloser, S. H., Indik, J., Lee, R., Mehra, M. R., Menon, V., Page, R. L., Shen, W., Slotwiner, D. J., Stevenson, L. W., Varosy, P. D., Welikovitch, L., , H. R., , A. C., & , A. H. (2014). HRS/ACC/AHA expert consensus statement on the use of implantable cardioverter-defibrillator therapy in patients who are not included or not well represented in clinical trials. Journal of the American College of Cardiology, 64(11), 1143-77.
• Kusumoto, F. M., Calkins, H., Boehmer, J., Buxton, A. E., Chung, M. K., Gold, M. R., Hohnloser, S. H., Indik, J., Lee, R., Mehra, M. R., Menon, V., Page, R. L., Shen, W., Slotwiner, D. J., Warner Stevenson, L., Varosy, P. D., & Welikovitch, L. (2014). HRS/ACC/AHA expert consensus statement on the use of implantable cardioverter-defibrillator therapy in patients who are not included or not well represented in clinical trials. Heart rhythm : the official journal of the Heart Rhythm Society, 11(7), 1271-303.
• Indik, J., & Indik, J. H. (0). Pacing problems. Cardiology in review, 11(4).
• Indik, J. H., Dallas, W. J., Gear, K., Tandri, H., Bluemke, D. A., Moukabary, T., & Marcus, F. I. (2012). Right ventricular volume analysis by angiography in right ventricular cardiomyopathy. The international journal of cardiovascular imaging, 28(5), 995-1001.
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  Imaging of the right ventricle (RV) for the diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is commonly performed by echocardiography or magnetic resonance imaging (MRI). Angiography is an alternative modality, particularly when MRI cannot be performed. We hypothesized that RV volume and ejection fraction computed by angiography would correlate with these quantities as computed by MRI. RV volumes and ejection fraction were computed for subjects enrolled in the North American ARVC/D Registry, with both RV angiography and MRI studies. Angiography was performed in the 30° right anterior oblique (RAO) and 60° left anterior oblique (LAO) views. Angiographic volumes were computed by RAO view and two-view (RAO and LAO) formulae. 17 subjects were analyzed (11 men and 6 women), with 15 subjects classified as affected, and two as unaffected by modified Task Force criteria. The correlation coefficient of MRI to the two-view angiographic analysis was 0.72 (P = 0.003) for end-diastolic volume and 0.68 (P = 0.005) for ejection fraction. Angiographically derived volumes were larger than MRI derived volume (P = 0.009) and with the slope in a linear relationship equal to 0.8 for end diastolic volume, and 0.9 for RV ejection fraction (P < 0.001), computed by the two view formula. End-diastolic volumes and ejection fractions of the RV obtained by dual view angiography correlate with these quantities by MRI. RV end-diastolic volumes are larger by RV angiography in comparison with MRI.
• Shanmugasundaram, M., Valles, A., Kellum, M. J., Ewy, G. A., & Indik, J. H. (2012). Analysis of amplitude spectral area and slope to predict defibrillation in out of hospital cardiac arrest due to ventricular fibrillation (VF) according to VF type: Recurrent versus shock-resistant. RESUSCITATION, 83(10), 1242-1247.
• Shanmugasundaram, M., Valles, A., Kellum, M. J., Ewy, G. A., & Indik, J. H. (2012). Analysis of amplitude spectral area and slope to predict defibrillation in out of hospital cardiac arrest due to ventricular fibrillation (VF) according to VF type: recurrent versus shock-resistant. Resuscitation, 83(10), 1242-7.
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  In out-of-hospital cardiac arrest (OHCA) due to ventricular fibrillation (VF), VF may recur during resuscitation (recurrent VF) or fail to defibrillate (shock-resistant VF). While retrospective studies have suggested that amplitude spectral area (AMSA) and slope predict defibrillation, it is unknown whether the predictive power is influenced by VF type. We hypothesized that in witnessed OHCA with initial rhythm of VF that the utility for AMSA and slope to predict defibrillation would differ between shock-resistant and recurrent VF.
• Indik, J. H., Allen, D., Gura, M., Dameff, C., Hilwig, R. W., & Kern, K. B. (2011). Utility of the ventricular fibrillation waveform to predict a return of spontaneous circulation and distinguish acute from post myocardial infarction or normal Swine in ventricular fibrillation cardiac arrest. Circulation. Arrhythmia and electrophysiology, 4(3), 337-43.
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  In cardiac arrest, the ventricular fibrillation (VF) waveform, particularly amplitude spectral area (AMSA) and slope, predicts the return of spontaneous circulation (ROSC), but it is unknown whether the predictive utility differs in an acute myocardial infarction (MI), prior MI, or normal myocardium and if the waveform can distinguish the underlying myocardial state. We hypothesized that in a swine model of VF cardiac arrest, AMSA and slope predict ROSC after a shock independent of substrate and distinguish an acute from nonacute MI state.
• Indik, J., Banna, M., & Indik, J. H. (2011). Risk stratification and prevention of sudden death in patients with heart failure. Current treatment options in cardiovascular medicine, 13(6).
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  For almost the past decade, recommendations for the use of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death have been based upon the left ventricular ejection fraction (LVEF). Current guidelines recommend an ICD for heart failure patients with LVEF ≤35% and NYHA functional class of II or III; however, because the majority of heart failure patients who qualify for ICD implantation based on these criteria will never have an event requiring ICD therapy over several years of follow-up, additional methods of risk stratification for sudden death are clearly needed. Additionally, most of the nearly 300,000 cardiac arrests that occur each year occur in patients without heart failure or significant left ventricular dysfunction. To improve the identification of patients at risk for sudden death, several criteria other than ejection fraction have been proposed and studied. Markers of autonomic tone, including heart rate turbulence and QT dynamicity, have shown some ability to predict total mortality but not arrhythmic events. Microvolt T-wave alternans testing was initially thought to be highly predictive of life-threatening arrhythmias, but prospective large sub-studies of the MADIT II and SCD-HeFT trials have failed to show a predictive value for T-wave alternans testing. Newer markers for risk are based upon the detection of myocardial fibrosis, which forms the substrate for re-entrant and malignant ventricular tachyarrhythmias. Markers of collagen turnover or quantification of myocardial scar by MRI may hold the best promise for identifying patients at highest risk for sudden cardiac death and may also identify patients at high risk but with an ejection fraction above 35%, who are not currently recommended for ICD implantation.
• Zuercher, M., Kern, K. B., Indik, J. H., Loedl, M., Hilwig, R. W., Ummenhofer, W., Berg, R. A., & Ewy, G. A. (2011). Epinephrine improves 24-hour survival in a swine model of prolonged ventricular fibrillation demonstrating that early intraosseous is superior to delayed intravenous administration. Anesthesia and analgesia, 112(4), 884-90.
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  Vasopressors administered IV late during resuscitation efforts fail to improve survival. Intraosseous (IO) access can provide a route for earlier administration. We hypothesized that IO epinephrine after 1 minute of cardiopulmonary resuscitation (CPR) (an "optimal" IO scenario) after 10 minutes of untreated ventricular fibrillation (VF) cardiac arrest would improve outcome in comparison with either IV epinephrine after 8 minutes of CPR (a "realistic" IV scenario) or placebo controls with no epinephrine.
• Indik, J. H. (2010). When palpitations worsen. The American journal of medicine, 123(6), 517-9.
• Indik, J. H., & Woosley, R. L. (2010). Pharmacokinetics/Pharmacodynamics of Antiarrhythmic Drugs. Cardiac electrophysiology clinics, 2(3), 341-358.
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  This article describes the pharmacology of antiarrhythmic medications. Although these medications are broadly considered in terms of their blockade of either sodium or potassium channels, they act by a variety of pharmacodynamic mechanisms. Elimination may be via hepatic metabolism or renal mechanisms, or a combination. In particular, interactions between antiarrhythmic medications and other drugs that interfere with hepatic metabolism by P450 enzymes is a source for toxicity.
• Indik, J. H., Allen, D., Shanmugasundaram, M., Zuercher, M., Hilwig, R. W., Berg, R. A., & Kern, K. B. (2010). Predictors of resuscitation in a swine model of ischemic and nonischemic ventricular fibrillation cardiac arrest: superiority of amplitude spectral area and slope to predict a return of spontaneous circulation when resuscitation efforts are prolonged. Critical care medicine, 38(12), 2352-7.
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  We have demonstrated that a return of spontaneous circulation in the first 3 mins of resuscitation in swine is predicted by ventricular fibrillation waveform (amplitude spectral area or slope) when untreated ventricular fibrillation duration or presence of acute myocardial infarction is unknown. We hypothesized that in prolonged resuscitation efforts that return of spontaneous circulation immediately after a second or later shock with postshock chest compression is independently predicted by end-tidal CO2, coronary perfusion pressure, and ventricular fibrillation waveform measured before that shock in a swine model of ischemic and nonischemic ventricular fibrillation arrest.
• Indik, J. H., Kellum, M., Shanmugasundaram, M., & Ewy, G. A. (2010). Epinephrine Does Not Increase the Likelihood of Recurrent Ventricular Fibrillation in Witnessed Out Of Hospital Cardiac Arrest.. Circulation, 122(21), A228.
• Indik, J., Kellum, M. J., Shanmugasundaram, M., & Ewy, G. A. (2010). Epinephrine Does Not Increase the Likelihood of Recurrent Ventricular Fibrillation in Witnessed Out Of Hospital Cardiac Arrest. CIRCULATION, 122(21).
• Meaney, P. A., Nadkarni, V. M., Kern, K. B., Indik, J. H., Halperin, H. R., & Berg, R. A. (2010). Rhythms and outcomes of adult in-hospital cardiac arrest. Critical care medicine, 38(1), 101-8.
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  To determine the relationship of electrocardiographic rhythm during cardiac arrest with survival outcomes.
• Shanmugasundaram, M., Kellum, M. J., Ewy, G. A., & Indik, J. H. (2010). In Out of Hospital Cardiac Arrest Due to Ventricular Fibrillation Amplitude Spectral Area, Amsa, and Slope Predict Defibrillation in Shock Resistant Vf but Not Recurrent Vf. CIRCULATION, 122(21).
• Shanmugasundaram, M., Kellum, M., Ewy, G. A., & Indik, J. H. (2010). In Out of Hospital Cardiac Arrest Due to Ventricular Fibrillation Amplitude Spectral Area, Amsa, and Slope Predict Defibrillation in Shock Resistant Vf but Not Recurrent Vf.. Circulation, 122(21), A12812.
• Indik, J. H. (2009). Hypothermia: is it just for ventricular fibrillation?. Critical care medicine, 37(12), 3175-6.
• Indik, J. H., & Alpert, J. S. (2009). The patient with atrial fibrillation. The American journal of medicine, 122(5), 415-8.
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  Atrial fibrillation is a frequently encountered arrhythmia, particularly affecting the elderly. Patients at significant risk for stroke should be considered for anticoagulation with warfarin. Management of atrial fibrillation revolves around either controlling the ventricular rate response or trying to maintain sinus rhythm with either pharmacologic or nonpharmacologic therapies. There are many treatment options to consider, based upon the patient's expectations, symptoms, and comorbid conditions. Therefore, the treatment of atrial fibrillation must be individualized.
• Indik, J. H., Hilwig, R. W., Zuercher, M., Kern, K. B., Berg, M. D., & Berg, R. A. (2009). Preshock cardiopulmonary resuscitation worsens outcome from circulatory phase ventricular fibrillation with acute coronary artery obstruction in swine. Circulation. Arrhythmia and electrophysiology, 2(2), 179-84.
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  Some clinical studies have suggested that chest compressions before defibrillation improve survival in cardiac arrest because of prolonged ventricular fibrillation (VF; ie, within the circulatory phase). Animal data have also supported this conclusion, and we have previously demonstrated that preshock chest compressions increase the VF median frequency and improve the likelihood of a return of spontaneous circulation in normal swine. We hypothesized that chest compressions before defibrillation in a swine model of acute myocardial ischemia would also increase VF median frequency and improve resuscitation outcome.
• Indik, J. H., Shanmugasundaram, M., Allen, D., Valles, A., Kern, K. B., Hilwig, R. W., Zuercher, M., & Berg, R. A. (2009). Predictors of resuscitation outcome in a swine model of VF cardiac arrest: A comparison of VF duration, presence of acute myocardial infarction and VF waveform. Resuscitation, 80(12), 1420-3.
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  Factors that affect resuscitation to a perfusing rhythm (ROSC) following ventricular fibrillation (VF) include untreated VF duration, acute myocardial infarction (AMI), and possibly factors reflected in the VF waveform. We hypothesized that resuscitation of VF to ROSC within 3min is predicted by the VF waveform, independent of untreated VF duration or presence of acute MI.
• Shanmugasundaram, M., Indik, J. H., Kern, K. B., Allen, D., Hilwig, R. W., & Berg, R. (2009). Predictors of resuscitation in a swine model of VF cardiac arrest: superiority of amplitude spectral area (AMSA) to predict a return of spontaneous circulation when resuscitation efforts are prolonged. Circulation, 120(supplemental), S 671.
• Berg, R. A., Hilwig, R. W., Berg, M. D., Berg, D. D., Samson, R. A., Indik, J. H., & Kern, K. B. (2008). Immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation. Resuscitation, 78(1), 71-6.
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  This study was designed to test the hypothesis that immediate post-shock chest compressions improve outcome from prolonged ventricular fibrillation (VF) compared with typical "hands off" period (i.e., delayed post-shock compressions) associated with AED use.
• Indik, J. H., Donnerstein, R. L., Hilwig, R. W., Zuercher, M., Feigelman, J., Kern, K. B., Berg, M. D., & Berg, R. A. (2008). The influence of myocardial substrate on ventricular fibrillation waveform: a swine model of acute and postmyocardial infarction. Critical care medicine, 36(7), 2136-42.
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  In cardiac arrest resulting from ventricular fibrillation, the ventricular fibrillation waveform may be a clue to its duration and predict the likelihood of shock success. However, ventricular fibrillation occurs in different myocardial substrates such as ischemia, heart failure, and structurally normal hearts. We hypothesized that ventricular fibrillation is altered by myocardial infarction and varies from the acute to postmyocardial infarction periods.
• Indik, J. H., Peters, C. M., Donnerstein, R. L., Ott, P., Kern, K. B., & Berg, R. A. (2008). Direction of signal recording affects waveform characteristics of ventricular fibrillation in humans undergoing defibrillation testing during ICD implantation. Resuscitation, 78(1), 38-45.
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  In cardiac arrest due to prolonged ventricular fibrillation (VF), defibrillation is more likely to result in a perfusing rhythm if chest compressions are performed first. Furthermore, the VF waveform can predict the shockability of VF and thus automated external defibrillators (AEDs) are being designed to analyze the VF waveform to direct therapies. However, it is unknown whether the VF waveform is dependent on recording direction, which could be altered by incorrect placement of AED patches.
• Indik, J. H., Wichter, T., Gear, K., Dallas, W. J., & Marcus, F. I. (2008). Quantitative assessment of angiographic right ventricular wall motion in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Journal of cardiovascular electrophysiology, 19(1), 39-45.
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  Angiography of the right ventricle (RV) is a standard, reference technique to diagnose wall motion abnormalities in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). RV wall motion is usually assessed by qualitative, visual impression, and has lacked a quantitative basis for defining abnormalities. Since the normal RV has a markedly asymmetric movement, angiographic interpretation can differ, even among experienced clinicians. The purpose of this study was to quantify RV wall motion based on contrast ventriculography in patients with ARVD/C and to specify the severity and location of wall motion abnormalities, as compared with normal subjects.
• Indik, J. H. (2007). A racing heart. The American journal of medicine, 120(4), 325-7.
• Indik, J. H. (2007). Troubleshooting pacemakers. The American journal of medicine, 120(8), 673-4.
• Indik, J. H. (2007). VT or not VT?. The American journal of medicine, 120(2), 146-7.
• Indik, J. H., Donnerstein, R. L., Berg, R. A., Hilwig, R. W., Berg, M. D., & Kern, K. B. (2007). Ventricular fibrillation frequency characteristics are altered in acute myocardial infarction. Critical care medicine, 35(4), 1133-8.
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  Future automated external defibrillators are being designed to direct rescue efforts (chest compressions first vs. defibrillation) by inferring the duration of ventricular fibrillation based on its waveform characteristics such as frequency content. This approach assumes that the ventricular fibrillation waveform is an appropriate surrogate for ventricular fibrillation duration and is not affected by structural heart disease. We hypothesized that an acute myocardial infarction may alter the frequency content of ventricular fibrillation.
• Marcus, F. I., Sorrell, V., Zanetti, J., Bosnos, M., Baweja, G., Perlick, D., Ott, P., Indik, J., He, D. S., & Gear, K. (2007). Accelerometer-derived time intervals during various pacing modes in patients with biventricular pacemakers: comparison with normals. Pacing and clinical electrophysiology : PACE, 30(12), 1476-81.
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  Changes due to biventricular pacing have been documented by shortening of QRS duration and echocardiography. Compared to normal ventricular activation, the presence of left bundle branch block (LBBB) results in a significant change in cardiac cycle time intervals. Some of these have been used to quantify the underlying cardiac dyssynchrony, assess the effects of biventricular pacing, and guide programming of ventricular pacing devices. This study evaluates a simple noninvasive method using accelerometers attached to the skin to measure cardiac time intervals in biventricularly paced patients.
• Indik, J. H. (2006). Block times two. The American journal of medicine, 119(4), 312-4.
• Indik, J. H., Donnerstein, R. L., Kern, K. B., Goldman, S., Gaballa, M. A., & Berg, R. A. (2006). Ventricular fibrillation waveform characteristics are different in ischemic heart failure compared with structurally normal hearts. Resuscitation, 69(3), 471-7.
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  For prolonged VF, perfusion of the myocardium by pre-shock chest compressions can improve myocardial readiness for successful defibrillation. Characteristics of the VF waveform correlate with the duration of VF when there is no structural heart disease. A "smart" automated external defibrillator (AED) could therefore analyze the VF waveform, determine if VF has been prolonged, and then direct rescuers to either deliver a shock first or chest compressions first. We hypothesized that ischemic heart failure might alter the waveform content of ventricular fibrillation compared with normal hearts, complicating the determination of VF duration.
• Indik, J. H., Pearson, E. C., Fried, K., & Woosley, R. L. (2006). Bazett and Fridericia QT correction formulas interfere with measurement of drug-induced changes in QT interval. Heart rhythm : the official journal of the Heart Rhythm Society, 3(9), 1003-7.
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  The QT interval on the ECG is prolonged by more than 50 marketed drugs, an effect that has been associated with syncope and/or sudden cardiac death due to an arrhythmia. Because changes in heart rate also change the QT interval, it has become standard practice to use a correction formula, such as the Bazett formula, to normalize the QT interval to a heart rate of 60 bpm, that is, the rate-corrected QT or QTc. Numerous other formulas have been devised to make this correction, including the Fridericia, Hodges, and Framingham formulas.
• Indik, J. H. (2005). A pointed clue. The American journal of medicine, 118(11), 1221-2.
• Indik, J. H. (2005). Evolution of a T wave. The American journal of medicine, 118(12), 1352-3.
• Indik, J. H. (2005). Moving to a slow beat. The American journal of medicine, 118(5), 480-1.
• Indik, J. H. (2005). Syncope in a man with a pacemaker. The American journal of medicine, 118(2), 111-2.
• Indik, J. H. (2005). What is the real rhythm?. The American journal of medicine, 118(8), 838-9.
• Indik, J. H. (2005). When minutes go missing. The American journal of medicine, 118(6), 606-8.
• Indik, J. H., & Ott, P. (2005). An 18-year-old man with peculiar QRS complexes. The American journal of medicine, 118(3), 222-4.
• Indik, J. H., & Ott, P. (2005). An elderly woman with AV block in sinus rhythm and conducted atrial tachycardia. Pacing and clinical electrophysiology : PACE, 28(1), 67-70.
• Indik, J. H., Dallas, W. J., Ovitt, T., Wichter, T., Gear, K., & Marcus, F. I. (2005). Do patients with right ventricular outflow tract ventricular arrhythmias have a normal right ventricular wall motion? A quantitative analysis compared to normal subjects. Cardiology, 104(1), 10-5.
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  Patients with ventricular ectopy from the right ventricular (RV) outflow tract (RVOT) are often referred for RV angiography to exclude disorders such as arrhythmogenic RV cardiomyopathy/dysplasia (ARVC/D). This is usually based on a qualitative assessment of the wall motion. We present a method to quantify the wall motion and to apply this method to compare patients with RVOT ectopy to normal subjects.
• Indik, J., & Indik, J. H. (2005). A treatment option for some failing hearts. The American journal of medicine, 118(4).
• Indik, J. H. (2004).

  A 38-year-old woman with dizziness.

  . Cardiology in review, 12(2), 63-4. doi:10.1097/01.crd.0000111847.17897.6c
• Indik, J. H. (2004). The evolution and revolution of the implantable cardioverter defibrillator. Expert review of cardiovascular therapy, 2(4), 461-4.
• Indik, J. H., Donnerstein, R. L., Berg, M. D., Samson, R. A., & Berg, R. A. (2004). Ventricular fibrillation frequency characteristics and time evolution in piglets: a developmental study. Resuscitation, 63(1), 85-92.
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  Derived variables of ventricular fibrillation, such as the frequency distribution by fast Fourier transformation and its evolution over time, have been used to determine the optimum timing for defibrillation. We hypothesized that these frequency variables would differ among neonatal, young child and older child populations due to cardiac developmental and size differences. Such differences may have important implications for developing defibrillation algorithms for pediatric patients and for extrapolating adult defibrillation algorithms to children in VF.
• Huang, M., Roeske, W. R., Hu, H., Indik, J. H., & Marcus, F. I. (2003). Postural position and neurocardiogenic syncope in late pregnancy. The American journal of cardiology, 92(10), 1252-3.
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  A 23-year-old woman at 34 weeks' gestation developed recurrent syncope due to profound sinus arrest captured on electrocardiography. Syncopal events occurred in the same sitting position. An echocardiogram revealed severe collapse of the inferior vena cava each time the patient changed her posture from a supine to a sitting position, which was related to the syncope.
• Indik, J. H., & Marcus, F. I. (2003). Arrhythmogenic right ventricular cardiomyopathy/dysplasia. Indian pacing and electrophysiology journal, 3(3), 148-56.
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  Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is characterized by the patchy replacement of myocardium by fatty or fibrofatty tissue. These changes lead to structural abnormalities including right ventricular enlargement and wall motion abnormalities that can be detected by echocardiography, angiography, and cine MRI. ARVC/D is a genetically heterogeneous disorder, since it has been linked to several chromosomal loci. Myocarditis may also be a contributing etiological factor. Patients are typically diagnosed during adolescence or young adulthood. Presenting symptoms are generally related to ventricular arrhythmias. Concern for the risk of sudden cardiac death may lead to the implantation of an intracardiac defibrillator. An ongoing multicenter international registry should further our understanding of this disease.
• Indik, J. H., Indik, J. H., Smith, D., Smith, D., Sobonya, R., Sobonya, R., Marcus, F. I., & Marcus, F. I. (2003). Arrhythmogenic Right Ventricular Dysplasia: A case report of identical twins with heart failure. Pacing and Clinical Electrophysiology, 1387-1390.
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  Indik J.H., Smith D, Sobonya R. and Marcus F. Arrhythmogenic Right Ventricular Dysplasia: A case report of identical twins with heart failure. Pacing and Clinical Electrophysiology 2003;25:1387-1390
• Indik, J. H., Ott, P., & Butman, S. (2003). Syncope with ST-segment Abnormalities Resembling Brugada Syndrome due to Reversible Myocardial Ischemia. Pacing and Clinical Electrophysiology, 1270-1273.
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  Indik J.H., Ott P., Butman S. Syncope with ST-segment Abnormalities Resembling Brugada Syndrome due to Reversible Myocardial Ischemia. Pacing and Clinical Electrophysiology 2003;25: 1270-1273
• Indik, J. H., Ott, P., & Butman, S. M. (2002). Syncope with ST-segment abnormalities resembling Brugada syndrome due to reversible myocardial ischemia. Pacing and clinical electrophysiology : PACE, 25(8), 1270-3.
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  This report describes a case of syncope with an initial ECG that showed ST-segment elevation in the right precordial leads suggestive of Brugada syndrome. Procainamide infusion induced a significant increase in the ST-segment abnormalities, further increasing the suspicion for this syndrome. Cardiac catheterization showed lesions in the proximal left anterior descending artery and distal right coronary artery. Following percutaneous coronary intervention at these sites, the ST-segment abnormalities resolved and a repeat procainamide challenge was negative. Electrophysiological study did not provoke any ventricular arrhythmias. Silent myocardial ischemia may result in ECG changes that resemble those seen in patients with Brugada syndrome.
• Indik, J. H., Smith, D. E., Sobonya, R. E., & Marcus, F. I. (2002). Arrhythmogenic right ventricular cardiomyopathy/dysplasia: a case report of identical twins with heart failure. Pacing and clinical electrophysiology : PACE, 25(9), 1387-90.
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  Arrhythmogenic right ventricular cardiomyopathy/dysplasia is characterized by the progressive replacement of myocardium by fatty or fibrofatty tissue. Presenting symptoms are generally related to ventricular arrhythmias, including sudden cardiac death. Heart failure due to right ventricular and sometimes left ventricular dysfunction is uncommon in the early stages of the disease, but is known to occur in advanced cases. This case report describes identical adolescent twins with presenting symptoms related predominantly to right heart failure.
• Indik, J. H., Goldman, S., & Gaballa, M. A. (2001). Oxidative stress contributes to vascular endothelial dysfunction in heart failure. American journal of physiology. Heart and circulatory physiology, 281(4), H1767-70.
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  Congestive heart failure (HF) is characterized by inadequate nitric oxide (NO) production in the vasculature. Because NO is degraded by oxygen radicals, we hypothesized that NO is degraded faster in HF from inadequate peripheral arterial antioxidant reserves. HF was induced in male Sprague-Dawley rats by left coronary artery ligation. Vascular endothelial function was evaluated by measuring the NO-mediated vasorelaxation response to acetylcholine (ACh; 10(-9)-10(-4) M) in excised aortas. This was repeated with the free radical generator pyrogallol (20 microM) and again with pyrogallol and superoxide dismutase (SOD; 60 U/ml). Aortic and myocardial SOD activity was also determined. ACh-induced vasorelaxation was reduced in HF (n = 9) compared with normal control rats (n = 11; P < 0.001). Pyrogallol further reduced vasorelaxation in HF: 74 +/- 11% at 10(-4) M ACh versus 58 +/- 10% in normal control rats (P < 0.004). There was a trend (P = 0.06) toward reduced SOD activity in HF aortas. In conclusion, altered NO-dependent vasorelaxation in HF is in part due to excessive degradation of NO and is likely related to reduced vascular SOD activity.
• Indik, ., & Alpert, . (2000). Post-Myocardial Infarction Pericarditis. Current treatment options in cardiovascular medicine, 2(4), 351-356.
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  Post-myocardial infarction pericarditis occurs in approximately 5% to 6% of patients who receive thrombolytic agents. It should be suspected in any patient with pleuropericardial pain. A pericardial friction rub may or may not be present. Differentiation of pericarditis from recurrent angina may be difficult, but a careful history and evaluation of serial electrocardiograms can help distinguish the two entities. Dressler's syndrome, pericarditis that occurs at least 1 week following myocardial infarction, is now exceedingly rare. Most cases of pericarditis have a benign course; however, because pericarditis is associated with larger infarcts, overall long-term mortality rate is increased. Rare complications include hemopericardium, cardiac tamponade, and constrictive pericarditis. Therapy is directed toward relief of pain, which usually responds well to nonsteroidal anti- inflammatory agents (eg, aspirin or ibuprofen).
• Indik, J. H., & Masters, L. (1998). What appears to be cancer. Archives of internal medicine, 158(12), 1374-7.
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  We describe a case of multiple hepatic pyogenic abscesses with an unusual presentation. The typical signs and symptoms of fever and pain in the right upper quadrant were absent. Instead, the chief complaint was muscle weakness and myalgias accompanied by weight loss. Findings from an ultrasonogram of the abdomen revealed multiple hepatic lesions consistent with metastases. Hence, the initial presumptive diagnosis was metastatic malignancy with unknown primary tumor. It was only when purulent material was unexpectedly encountered when a needle biopsy was performed that the true diagnosis of pyogenic liver abscess was recognized. While liver abscess is rare, it should not be forgotten in the differential diagnosis for multiple hepatic lesions seen on imaging studies.
• Indik, J. H., & Reed, K. L. (1994). Correlations in umbilical blood flow Doppler velocities in the human fetus during breathing. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 4(5), 361-6.
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  We hypothesized that changes in intrathoracic pressure during fetal breathing episodes result in quantifiable variations in umbilical arterial and venous blood flow velocities, and that these variations are related to compliance properties of each system. We further hypothesized that these variations in velocities are different in fetuses with normal and abnormal umbilical arterial Doppler velocities. Umbilical arterial and venous Doppler velocities were measured simultaneously during breathing episodes in 15 normal fetuses and 14 fetuses with elevated systolic-to-diastolic (S/D) umbilical arterial Doppler velocity ratios. Umbilical arterial end-diastolic velocity changes were less than umbilical venous velocity changes in normal fetuses, but were significantly greater in four fetuses with elevated S/D ratios (p < 0.004). Furthermore, umbilical arterial diastolic velocity minima preceded umbilical venous velocity minima by a time lag that was greater in fetuses with elevated S/D ratios (p < 0.002). These results suggest that differences in umbilical arterial and venous velocity variation during fetal breathing episodes may be related in part to vascular compliance, which may be altered in fetuses with abnormal umbilical arterial Doppler velocity.
• Indik, J. H., Indik, R. A., & Cetas, T. C. (1994). Fast and efficient computer modeling of ferromagnetic seed arrays of arbitrary orientation for hyperthermia treatment planning. International journal of radiation oncology, biology, physics, 30(3), 653-62.
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  Effective hyperthermia treatment planning requires an ability to predict temperatures quickly and accurately from an arbitrary distribution of power. Our purpose was to design such a fast executing computer code, MGARRAY, to compute steady-state temperatures from ferromagnetic seed heating, allowing seeds to have arbitrary orientations and to be curved to permit more realistic modeling of clinical situations. We further required flexibility for the tissue domain, allowing inhomogeneity with respect to thermal conductivity and blood perfusion, as well as an arbitrary shaped boundary.
• Indik, R. A., & Indik, J. H. (1994). A New Computer Method to Quickly and Accurately Compute Steady State Temperatures from Ferromagnetic Seed Heating. Medical Physics, 1135-1144.
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  Indik, R.A. and Indik, J.H. A New Computer Method to Quickly and Accurately Compute Steady State Temperatures from Ferromagnetic Seed Heating. Medical Physics, 1994;21, 1135-1144
• Indik, J. H., Chen, V., & Reed, K. L. (1991). Association of umbilical venous with inferior vena cava blood flow velocities. Obstetrics and gynecology, 77(4), 551-7.
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  The fetal cardiac and placental circulations are interconnected through the umbilical venous and arterial vasculature. We hypothesized that alterations in umbilical venous blood flow velocities are present in fetuses with abnormal umbilical arterial circulation, and further, that changes in inferior vena cava blood flow velocities occur with, and might explain, these variations in umbilical venous blood flow velocities. Umbilical venous and inferior vena cava blood flow velocities were examined in 15 normal fetuses and in 59 fetuses with abnormalities that included absent end-diastolic umbilical artery blood flow velocities (N = 21) or abnormal heart rates (N = 27). Inferior vena cava velocities were also analyzed in 11 other fetuses with anomalies or known growth or placental abnormalities who had abnormal umbilical venous blood flow velocities. In normal fetuses, variations in umbilical venous velocities occurred during fetal activity or with fetal breathing; however, no variation in velocity corresponded with heart rate. Eleven of 21 fetuses with absent end-diastolic velocities in the umbilical artery demonstrated decreases in umbilical venous velocities ("venous pulsations") during arterial diastole. Blood flow velocities in the reverse direction, from the right atrium into the inferior vena cava with atrial contraction, were significantly greater in these fetuses than in those without umbilical venous pulsations (27.5 +/- 14.9% and 7.5 +/- 5.7% of total forward flow velocity, respectively; P less than .001). Venous pulsations were also seen in fetuses with abnormally fast or slow heart rates; reverse flow with atrial contraction in the inferior vena cava was likewise greater than normal in these fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)
• HEISLER, J., & WHITE, S. (1990). SATELLITE DISRUPTION AND SHELL FORMATION IN GALAXIES. MONTHLY NOTICES OF THE ROYAL ASTRONOMICAL SOCIETY, 243(2), 199-208.
• Indik, J. H., & Reed, K. L. (1990). Variation and correlation in human fetal umbilical Doppler velocities with fetal breathing: evidence of the cardiac-placental connection. American journal of obstetrics and gynecology, 163(6 Pt 1), 1792-6.
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  Doppler velocity waveforms in the human fetal umbilical vein and artery were analyzed during episodes of fetal breathing. Heart rate, systolic and diastolic velocities were measured from the umbilical artery waveform. Diastolic velocity varied the most with a mean (+/- SD) coefficient of variation of 16.0% +/- 5.0%. The coefficient of variation of systolic velocity was 7.8% +/- 2.4% and of heart rate was 5.0% +/- 1.8%. We also found that umbilical arterial flow was related to umbilical venous flow, implying an interdependence between fetal cardiovascular blood flow and placental blood flow. During breathing, venous flow varies because of changes in intrathoracic pressure in the fetus. This variation in umbilical venous velocity may affect the umbilical arterial diastolic velocity through alterations in placental filling, and may affect the umbilical arterial systolic velocity through alterations in ventricular filling, which by the Frank-Starling mechanism changes stroke volume. The interdependency of umbilical venous and umbilical arterial blood flow velocities must be considered in the interpretation of the significance of umbilical artery Doppler velocity measurements.
• HEISLER, J., & TREMAINE, S. (1989). HOW DATING UNCERTAINTIES AFFECT THE DETECTION OF PERIODICITY IN EXTINCTIONS AND CRATERS. ICARUS, 77(1), 213-219.
• HEISLER, J., HOGAN, C. J., & WHITE, S. (1989). SUPERCLUSTERING OF QUASI-STELLAR OBJECT ABSORPTION CLOUDS. ASTROPHYSICAL JOURNAL, 347(1), 52-58.
• HEISLER, J., & OSTRIKER, J. P. (1988). MODELS OF THE QUASAR POPULATION .1. A NEW LUMINOSITY FUNCTION. ASTROPHYSICAL JOURNAL, 325(1), 103-113.
• HEISLER, J., & OSTRIKER, J. P. (1988). MODELS OF THE QUASAR POPULATION .2. THE EFFECTS OF DUST OBSCURATION. ASTROPHYSICAL JOURNAL, 332(2), 543-574.
• HEISLER, J., TREMAINE, S., & ALCOCK, C. (1987). THE FREQUENCY AND INTENSITY OF COMET SHOWERS FROM THE OORT CLOUD. ICARUS, 70(2), 269-288.
• HEISLER, J., & ALCOCK, C. (1986). DO STARS THAT LOSE MASS EXPAND OR CONTRACT - A SEMIANALYTICAL APPROACH. ASTROPHYSICAL JOURNAL, 306(1), 166-169.
• HEISLER, J., TREMAINE, S., & BAHCALL, J. N. (1986). ESTIMATING THE MASSES OF GALAXY GROUPS - ALTERNATIVES TO THE VIRIAL-THEOREM. ASTROPHYSICAL JOURNAL, 298(1), 8-17.
• HEISLER, J., MERRITT, D., & SCHWARZSCHILD, M. (1985). RETROGRADE CLOSED ORBITS IN A ROTATING TRIAXIAL POTENTIAL. ASTROPHYSICAL JOURNAL, 258(2), 490-498.
• HEISLER, J., & TREMAINE, S. (1984). THE INFLUENCE OF THE GALACTIC TIDAL FIELD ON THE OORT COMET CLOUD. ICARUS, 65(1), 13-26.
• Ehlers, C. L., Indik, J. H., Koob, G. F., & Bloom, F. E. (1983). The effect of single and repeated electroconvulsive shock (ECS) on locomotor activity in rats. Progress in neuro-psychopharmacology & biological psychiatry, 7(2-3), 217-22.
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  Locomotor activity following administration of apomorphine (0.1 mg/kg), and amphetamine (1 mg/kg) was studied in rats receiving single and multiple electroconvulsive shock (ECS). Three groups of rats were utilized, one half of each group received sham treatment and the other half received either 1,5, or 10 daily ECS. Significant enhancement of the locomotor response to amphetamine, but not apomorphine, was seen in rats given repeated ECS as compared to controls. This study suggests that the number of ECS, is an important variable in ECS enhancement of locomotor response to amphetamine.
• OSTRIKER, J. P., & HEISLER, J. (1982). ARE COSMOLOGICALLY DISTANT OBJECTS OBSCURED BY DUST - A TEST USING QUASARS. ASTROPHYSICAL JOURNAL, 278(1), 1-10.

Presentations

• Indik, J. H. (2015, February). Arrhythmias and Sudden Death/ Healtht Heart Day. Public Lecture. University of Arizona Medical Center, Tucson, Az.
• Indik, J. H. (2015, January). Academic Half Day: Atrial Fibrillation. Grand Rounds: Department of Internal Medicine. University of Arizona.
• Indik, J. H. (2013, January). Clinicopathological Conference (CPC). Grand rounds - Department of Internal Medicine. University of Arizona.
• Indik, J. H. (2013, January). New Anticoagulants. Grand Rounds: Department of Internal Medicine. University of Arizona.
• Indik, J. H. (2009, January). Arrhythmias and Sudden Death. Public Lecture. Green Valley, Arizona.
• Indik, J. H. (2008, February). Arrhythmias and Sudden Death. Public Lecture. Tucson, Arizona.
• Indik, J. H. (2006, October). Arrhythmias and Sudden Death. Public Lecture. Tucson, Arizona.
• Indik, J. H. (2006, September). Research in ventricular fibrillation in acute myocardial infarction. Presentation at Frontiers in Medical Research Cardiovascular Datablitz. University of Arizona.
• Indik, J. H. (2005, January). Arrhythmias and Sudden Death. Public Lecture. University of Arizona.
• Indik, J. H. (2005, January). Clinicopathological Conference (CPC). Grand rounds - Department of Internal Medicine. University of Arizona.
• Indik, J. H. (2005, March). Long QT Syndrome, The Basic Science. Lecture given at the Indian Health Service to the public from the Salt River Tribe.
• Indik, J. H. (2004, November). Arrhythmias and Sudden Death. Public Lecture.
• Indik, J. H. (2003, November). Arrhythmias and sudden death. Sarver Heart Public Lectures.

Poster Presentations

• Indik, J. H. (2017, November). Risks and Outcomes for Patients that Undergo Thoracic Versus Non-Thoracic Magnetic Resonance Imaging Who Have a Magnetic Resonance Non Conditional Cardiac Implantable Electronic Device.. American Heart Association Scientific Sessions November 2017. Anaheim, CA.

Case Studies

• Indik, J. H. (2010. When Palpitations Worsen(pp 517-519).
• Indik, J. H. (2007. A Racing Heart(pp 325-327).
• Indik, J. H. (2007. Troubleshooting pacemakers(pp 673-374).
• Indik, J. H. (2007. VT or not VT(pp 146-147).
• Indik, J. H. (2008. Not just slow: double trouble(pp 19-20).
• Indik, J. H. (2006. Block Time Two(pp 312-314).
• Indik, J. H. (2005. A Treatment option for some failing hearts(pp 368-370).
• Indik, J. H. (2005. A man with syncope and ST segment elevation(pp 111-112).
• Indik, J. H. (2005. A patient with septic shock and a regular, narrow complex rhythm(pp 57-58).
• Indik, J. H. (2005. A pointed clue(pp 1221-1222).
• Indik, J. H. (2005. An 18 year old man with peculiar QRS complexes(pp 222-224).
• Indik, J. H. (2005. Diagnosing chest pain(pp 23-24).
• Indik, J. H. (2005. Evolution of a T wave(pp 1352-1353).
• Indik, J. H. (2005. Moving to a slow beat(pp 480-481).
• Indik, J. H. (2005. Syncope in a man with a pacemaker(pp 111-112).
• Indik, J. H. (2005. What is the real rhythm(pp 1221-1222).
• Indik, J. H. (2005. When minutes go missing(pp 606-608).
• Indik, J. H. (2004. A narrow complex tachycardia in a man with palpitations for many years(pp 285-286).
• Indik, J. H. (2004. Decompensated heart failure in a patient with an intracardiac defibrillator(p. 125).
• Indik, J. H. (2004. Spontaneous conversion of atrial fibrillation in the setting of biventricular pacing(pp 1-2).
• Indik, J. H. (2004. Two-to-One Atrioventricular Block: Where is the Block?(pp 183-184).
• Indik, J. H. (2003. A Not-So-Narrow Complex Tachycardia.(pp 247-248).
• Indik, J. H. (2003. A Revealing Holter Monitor(pp 299-300).
• Indik, J. H. (2003. Alternating Bundle Block(pp 56-57).
• Indik, J. H. (2003. Irregular wide complex tachycardia(pp 1-2).
• Indik, J. H. (2002. A slow rhythm following mitral valve surgery(p. 197).
• Indik, J. H. (2002. Two hearts are better than one?(p. 261).
• Indik, J. H. (2002. What are the vital signs?(pp 319-320).

Others

• Indik, J. H. (2015, April 2015). Can we improve outcomes by using active compression-decompression and impedance threshold devices during resuscitation?.
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  Active compression-decompression resuscitation and impedance threshold device for out-of-hospital cardiac arrest: a systematic review and metaanalysis of randomized controlled trials.
• Indik, J., & Indik, J. H. (0). A 38-year-old woman with dizziness. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A man with syncope and ST segment elevation. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A narrow complex tachycardia in a man with palpitations for many years. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A not-so-narrow complex tachycardia. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A patient with septic shock and a regular, narrow complex rhythm. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A revealing Holter monitor. Cardiology in review.
• Indik, J., & Indik, J. H. (0). A slow rhythm following mitral valve surgery. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Alternating bundle branch block. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Decompensated heart failure in a patient with an intracardiac defibrillator. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Irregular wide complex tachycardia. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Spontaneous conversion of atrial fibrillation in the setting of biventricular pacing. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Syncope and a positive tilt table test. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Two hearts are better than one?. Cardiology in review.
• Indik, J., & Indik, J. H. (0). Two-to-one atrioventricular block: where is the block?. Cardiology in review.
• Indik, J., & Indik, J. H. (0). What are the vital signs?. Cardiology in review.
• Indik, J. H. (2012, -). Modules a) Evaluation of the patient with syncope b) Pharmacology of antiarrhythmic medications c) pharmacology of medications for cardiac arrest.
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  Indik JH. ACCSAP 8th edition (2012): Modules a) Evaluation of the patient with syncope b) Pharmacology of antiarrhythmic medications c) pharmacology of medications for cardiac arrest
• Indik, J. H., & Woosley, R. (2010, -). Pharmacokinetics/pharmacodynamics of Antiarrhythmic Drugs.
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  Indik JH and Woosley R. Pharmacokinetics/pharmacodynamics of Antiarrhythmic Drugs; pp 341-358; In Cardiac Electrophysiology Clinics: Advances in Antiarrhythmic Drug Therapy; W.B. Saunders (A Division of Elsevier Inc.); Philadelphia, PA; 2010; Kowey PR and Naccarelli GV Eds.
• Indik, J., Peters, C. M., & Indik, J. H. (2009, Jan). Disorder on the court. The American journal of medicine.
• Indik, J., & Indik, J. H. (2008, Jan). Not just slow: double trouble. The American journal of medicine.
• Berg, R. A., Hilwig, R. W., Zuercher, M., Berg, M. D., Indik, J. H., Ewy, G. A., Kern, K. B., Berg, R. A., Hilwig, R. W., Zuercher, M., Berg, M. D., Indik, J. H., Ewy, G. A., & Kern, K. B. (2007, Jan). Pre-shock CPR worsens outcome from circulatory phase VF with acute coronary artery obstruction in swine.. Circulation.
• Indik, J. H., Donnerstein, R. L., Feigelman, J., Hilwig, R. W., Zuercher, M., Kern, K. B., Berg, M. D., Berg, R. A., Indik, J. H., Donnerstein, R. L., Feigelman, J., Hilwig, R. W., Zuercher, M., Kern, K. B., Berg, M. D., & Berg, R. A. (2007, Jan). Waveform characteristics of ventricular fibrillation are altered in post-myocardial infarction swine.. Circulation.
• Indik, J. H., Peters, C. M., Donnerstein, R. L., Kern, K. B., Ott, P., Berg, R. A., Indik, J. H., Peters, C. M., Donnerstein, R. L., Kern, K. B., Ott, P., & Berg, R. A. (2007, Jan). Direction of signal recording affects amplitude based measures of venticular fibrillation in humans undergoing defibrillation testing during ICD implantation.Direction of signal recording affects amplitude based measures of venticular fibrillation in humans undergoing defibrillation testing during ICD implantation.. Circulation.
• Indik, J. H. (2006, April). Sudden Cardiac Death.
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  Appearance on the television news program, Arizona illustrated, KUAT, Tucson.
• Indik, J., Sabbath, A. M., & Indik, J. H. (2006, Nov). Sudden death on the treadmill. The American journal of medicine.
• Indik, J., & Indik, J. H. (2005, Jan). Diagnosing chest pain. The American journal of medicine.
• Indik, J., & Indik, J. H. (2005, Oct). A chilling tale. The American journal of medicine.
• Indik, J., Ott, P., & Indik, J. H. (2004, Oct). Two hearts and one defibrillator. Journal of cardiovascular electrophysiology.
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  A patient who had undergone heterotopic heart transplantation and placement of an implantable cardioverter defibrillator in his native heart underwent generator change. Defibrillation testing induced ventricular fibrillation in his donor heart. To prevent this potentially lethal complication, defibrillator shock therapy must be synchronized to the donor heart R wave.
• Indik, J. H., & Alpert, J. (2000, January). Detection of Pulmonary Embolism by D-Dimer Assay, Spiral CT and MRI. Prog. In Cardiovascular Dis..
• Indik, J. H., & Reed, K. (1993, January). Umbilical Venous Pulsations can Indicate Problems with Forward Blood Flow Through the Heart. In Fetal Cardiac Function eds. Arduini, D., Rizzo G. and Romanini, C.. Parthenon Publication.