Peter Ott

Interests

Research

Dr. Ott’s research interests are the electrophysiologic effects of heart failure, treatment of atrial fibrillation and treatment of cardiac arrhythmias with catheter ablation.In addition performance of clinical research in device based heart failure therapy .

Teaching

Teaching activities which include regular lectures throughout the years to cardiology and non-cardiology residents/fellows and clinical faculty on arrhythmia topics. Lectures to residents, fellows and community physicians, RNs and NPs which include multiple per year, in regards to topics of arrhythmia diagnosis and treatment – cardiac devices, lead extraction – atrial fibrillation therapy – EKG diagnosis. Also, special “EP Boot Camp” lectures for new cardiology fellows and medicine residents.

Courses

No activities entered.

Scholarly Contributions

Books

• Ott, P. (2007). The AHA clinical cardiac consult. – 2nd Edition and 3rd Edition. Lippincott, Williams and Wilkins.
• Ott, P. (2004). Cardiology for the Primary Care Physician, 3rd edition; Evaluation of the patient resuscitated from cardiac arrest.. Current Medicine. doi:10.1007/978-1-4615-6601-4
• Ott, P. (2000). Arrhythmogenic right ventricular dysplasia/cardiomyopathy. In Molecular Genetics of Cardiac Electrophysiology.. Kluwer Academic Publishers.

Chapters

• Ott, P., & Prystowsky, E. N. (2001). Evaluation of the Patient Resuscitated from Cardiac Arrest. In .. Current Medicine Group. doi:10.1007/978-1-4615-6601-4_10
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  Sudden cardiac death is the most common cause of mortality in adults less than age 65 years of age. Coronary artery disease is the most common cause of cardiac arrest. Survivors of cardiac arrest should undergo a complete history and physical examination as well as cardiac catheterization and electrophysiologic testing. An implantable cardioverter defibrillator (ICD) is often necessary to prevent sudden cardiac death. Antiarrhythmic drug therapy, alone or with the ICD, is often useful. Survivors of cardiac arrest are at a high risk for a recurrent episode if not treated properly, so referral to a clinical electrophysiologist is suggested.

Journals/Publications

• Ott, P. (2022). Inefficient Diastolic Filling in Dual-chamber Pacemaker Recipients: Impact of Atrio-Ventricular Interval Shortening (AVI-SHORT study)
  
  . Journal of Interventional Cardiac Electrophysiology.
• Ott, P. (2022). Title: Inefficient Diastolic Filling in Dual-chamber Pacemaker Recipients: Impact of Atrio-Ventricular Interval Shortening (AVI-SHORT study). Journal of Interventional Cardiac Electrophysiology.
• Seckeler, M. D., White, S. C., Klewer, S. E., & Ott, P. (2019). Transjugular Transseptal Approach for Left Ventricular Pacing Lead in an Adult With Criss-Cross Heart. JACC. Clinical electrophysiology, 5(8), 998-999.
• Martin, D. R., Ott, P., Martin, D. R., Kalb, B., & Indik, J. H. (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., & 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.
• Ott, P. (2018). Sub-clinical Atrial Fibrillation: Diagnosis and therapeutic challenges. J Clin Exp Cardiology.
• Ott, P. (2018). The Wearable Cardioverter Defibrillator: Still without a Compelling Indication. Journal of Cardiology & Cardiovascular Therapy, 9(1). doi:10.19080/jocct.2018.09.555754
• Wolinsky, D., Wickemeyer, W., White, L. L., Whang, W., Whalen, S., Weiss, R., Valderrabano, M., Tsai, W. K., Trichon, B., Treasure, C. B., Tishler, S., Thadani, U., Svinarich, J. T., Sumner, A., Staniloae, C., Spencer, R., Sobolski, J., Skopicki, H., Simpson, P., , Silver, K. H., et al. (2018). Sudden Death in Patients With Coronary Heart Disease Without Severe Systolic Dysfunction.. JAMA cardiology, 3(7), 591-600. doi:10.1001/jamacardio.2018.1049
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  The majority of sudden and/or arrhythmic deaths (SAD) in patients with coronary heart disease occur in those without severe systolic dysfunction, for whom strategies for sudden death prevention are lacking..To provide contemporary estimates of SAD vs other competing causes of death in patients with coronary heart disease without severe systolic dysfunction to search for high-risk subgroups that might be targeted in future trials of SAD prevention..This prospective observational cohort study included 135 clinical sites in the United States and Canada. A total of 5761 participants with coronary heart disease who did not qualify for primary prevention implantable cardioverter defibrillator therapy based on left ventricular ejection fraction (LVEF) of more than 35% or New York Heart Association (NYHA) heart failure class (LVEF >30%, NYHA I)..Clinical risk factors measured at baseline including age, LVEF, and NYHA heart failure class..Primary outcome of SAD, which is a composite of SAD and resuscitated ventricular fibrillation arrest..The mean (SD) age of the cohort was 64 (11) years. During a median of 3.9 years, the cumulative incidence of SAD and non-SAD was 2.1% and 7.7%, respectively. Sudden and/or arrhythmic death was the most common mode of cardiovascular death accounting for 114 of 202 cardiac deaths (56%), although noncardiac death was the primary mode of death in this population. The 4-year cumulative incidence of SAD was lowest in those with an LVEF of more than 60% (1.0%) and highest among those with LVEF of 30% to 40% (4.9%) and class III/IV heart failure (5.1%); however, the cumulative incidence of non-SAD was similarly elevated in these latter high-risk subgroups. Patients with a moderately reduced LVEF (40%-49%) were more likely to die of SAD, whereas those with class II heart failure and advancing age were more likely to die of non-SAD. The proportion of deaths due to SAD varied widely, from 14% (18 of 131 deaths) in patients with NYHA II to 49% (37 of 76 deaths) in those younger than 60 years..In a contemporary population of patients with coronary heart disease without severe systolic dysfunction, SAD accounts for a significant proportion of overall mortality. Moderately reduced LVEF, age, and NYHA class distinguished SAD and non-SAD, whereas other markers were equally associated with both modes of death. Absolute and proportional risk of SAD varied significantly across clinical subgroups, and both will need to be maximized in future risk stratification efforts.
• 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.
• Ott, P. (2017). The wearable cardioverter defibrillator: Still without a compelling indication. Cardiovascular Disorders and Medicine.
• Skinner, K., Singh, S., Shah, A., Ott, P., Nyotowidjojo, I., Khoubyari, R., Kalb, B., Indik, J. H., & Bisla, J. (2017). Abstract 14602: 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. Circulation.
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  Background: Observational studies have explored MR scanning of patients with cardiac implantable electronic devices (CIEDs) not FDA approved for MR scanning (“non-conditional”). However, concerns r...
• Ott, P. (2016). Cardiac resynchronization therapy: a new therapy for advanced congestive heart failure. The American journal of geriatric cardiology, 14(1), 31-4.
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  Despite medical therapy, many patients with advanced systolic dysfunction remain highly symptomatic. In these patients the presence of a left bundle branch block on electrocardiogram indicates significant dyssynchrony of ventricular contraction. Cardiac resynchronization, by means of biventricular pacing, results in important clinical benefits. Due to the risk for malignant ventricular arrhythmias, this technology is best combined with an implantable cardioverter defibrillator.
• Ott, P. (2016). Subclinical atrial fibrillation: A new entity and what it means?. Journal of electrocardiology.
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  New device technologies allow for detection of clinically silent atrial fibrillation. This new entity has been associated with increased risk for stroke, even if detected for only relatively brief time periods. Current practice guidelines do not provide recommendations on how to approach this new clinical entity.
• Ott, P., Oommen, C., Kandala, J., & Hamoud, N. (2016). CHRONOTROPIC INCOMPETENCE IN ICD RECIPIENTS: IMPLICATIONS FOR DEVICE SELECTION. Journal of the American College of Cardiology, 67(13), 858. doi:10.1016/s0735-1097(16)30859-2
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  The current subcutaneous ICD system lacks the capability of cardiac pacing. ICD recipients with chronotropic incompetence (CI) benefit from pacing, however the prevalence of CI is underappreciated in ICD recipients. Analysis of the heart rate histogram (HRH) data, stored in the device log, has been
• Sametinger, J., Rozenblit, J. W., Ott, P., & Lysecky, R. (2015). Security challenges for medical devices. Communications of The ACM, 58(4), 74-82. doi:10.1145/2667218
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  Implantable devices, often dependent on software, save countless lives. But how secure are they?
• Ott, P. (2014). "Cardiac Arrhythmia Visualization in a Virtual Heart for Electrophysiology Education" SummerSim '14 Proceedings of the 2014 Summer Simulation Multiconference. The Society of Modeling & Simulation International.
• Doraiswamy, V. A., Hegde, V., Bhatt, R., Mosier, J., & Ott, P. (2010). Carotid artery puncture, myocardial injury, and ventricular arrhythmia. Southern medical journal, 103(9), 967-8.
• Freund, N. S., Brody, E. A., & Ott, P. (2008). Moving parts. The American journal of medicine, 121(7), 586-8.
• 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.
• Day, J. D., Doshi, R. N., Belott, P., Birgersdotter-Green, U., Behboodikhah, M., Ott, P., Glatter, K. A., Tobias, S., Frumin, H., Lee, B. K., Merillat, J., Wiener, I., Wang, S., Grogin, H., Chun, S., Patrawalla, R., Crandall, B., Osborn, J. S., Weiss, J. P., , Lappe, D. L., et al. (2007). Inductionless or limited shock testing is possible in most patients with implantable cardioverter- defibrillators/cardiac resynchronization therapy defibrillators: results of the multicenter ASSURE Study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations). Circulation, 115(18), 2382-9.
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  Implantable cardioverter-defibrillators and cardiac resynchronization therapy defibrillators have relied on multiple ventricular fibrillation (VF) induction/defibrillation tests at implantation to ensure that the device can reliably sense, detect, and convert VF. The ASSURE Study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations) is the first large, multicenter, prospective trial comparing vulnerability safety margin testing versus defibrillation safety margin testing with a single VF induction/defibrillation.
• 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.
• Ott, P. (2007). Are Ventricular Fibrillation Waveform Characteristics Dependent upon ECG Lead? A Study in Patients Undergoing Defibrillation Testing During ICD Implantation.. Heart Rhythm, 4, S227.
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  Are Ventricular Fibrillation Waveform Characteristics Dependent upon ECG Lead? A Study in Patients Undergoing Defibrillation Testing During ICD Implantation. Heart Rhythm
• Ott, P. (2007). Left bundle branch block is not good for your heart. Heart rhythm : the official journal of the Heart Rhythm Society, 4(3), 314-5.
• Ott, P., & Freund, N. S. (2007). Brugada-pattern EKG in a febrile patient. The Journal of emergency medicine, 33(3), 281-2.
• Ott, P., Kirk, M. M., Koo, C., He, D. S., Bhattacharya, B., & Buxton, A. (2007). Coronary sinus and fossa ovalis ablation: effect on interatrial conduction and atrial fibrillation. Journal of cardiovascular electrophysiology, 18(3), 310-7.
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  Interatrial conduction occurs via discrete pathways along the coronary sinus musculature, fossa ovalis region, and Bachman's bundle. We assessed the feasibility of altering interatrial conduction by selectively ablating two of these conduction pathways using a novel mesh electrode ablation catheter.
• Ott, P., Koo, C., Kirk, M. M., He, D. S., Buxton, A. E., & Bhattacharya, B. (2007). Response to the editor [2]. Journal of Cardiovascular Electrophysiology, 18(6), E18-E18. doi:10.1111/j.1540-8167.2007.00851.x
• Peters, C. M., Ott, P., Kern, K. B., Indik, J. H., Donnerstein, R. L., & Berg, R. A. (2007). Abstract 7: Direction of Signal Recording Affects Amplitude Based Measures of Ventricular Fibrillation in Humans Undergoing Defibrillation Testing During ICD Implantation. Circulation, 116.
• Ott, P., & Malasky, B. R. (2006). A puzzling telemetry tracing.. 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, 8(6), 459. doi:10.1093/europace/eul045
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  A 69-year-old female was admitted with the diagnosis of a non-ST-segment elevation myocardial infarction and placed on cardiac telemetry. Her resting ECG showed sinus rhythm and voltage criteria for left ventricular hypertrophy. A tracing was recorded by the telemetry monitor (Philips Med Systems) ( Figure 1 ); the patient was asymptomatic. What is the mechanism for the sudden change in QRS morphology? Figure 1 Telemetry monitor tracing (25 mm/s) displaying lead II (top, channel 1) …
• Ott, P., & Marcus, F. (2006). The Brugada syndrome: can we predict the risk?. Journal of cardiovascular electrophysiology, 17(6), 608-9.
• Ott, P., & Marcus, F. I. (2006). Atrial fibrillation after coronary artery bypass graft surgery. Journal of electrocardiology, 39(1), 55-6.
• Ott, P., & Marcus, F. I. (2006). Electrocardiographic markers of sudden death. CARDIOLOGY CLINICS, 24(3), 453-+.
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  The 12-lead ECG has limited utility to predict the risk for sudden cardiac death in common cardiac diseases such as coronary artery disease and idiopathic dilated cardiomyopathy. However, it is quite useful in diagnosing less common cardiac conditions that are associated with an increased risk for sudden death.
• Ott, P., & Marcus, F. I. (2006). Electrocardiographic markers of sudden death. Cardiology clinics, 24(3), 453-69, x.
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  The 12-lead ECG has limited utility to predict the risk for sudden cardiac death in common cardiac diseases such as coronary artery disease and idiopathic dilated cardiomyopathy. However, it is quite useful in diagnosing less common cardiac conditions that are associated with an increased risk for sudden death.
• 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.
• Ott, P. (2005). Cardiac resynchronization therapy: a new therapy for advanced congestive heart failure.. The American journal of geriatric cardiology, 14(1), 31-4. doi:10.1111/j.1076-7460.2005.03351.x
  More info

  Despite medical therapy, many patients with advanced systolic dysfunction remain highly symptomatic. In these patients the presence of a left bundle branch block on electrocardiogram indicates significant dyssynchrony of ventricular contraction. Cardiac resynchronization, by means of biventricular pacing, results in important clinical benefits. Due to the risk for malignant ventricular arrhythmias, this technology is best combined with an implantable cardioverter defibrillator.
• Ott, P. (2005). Most patients may safely undergo inductionless or limited shock testing at ICD implantation.. Heart Rhythm, 2, S32.
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  Most patients may safely undergo inductionless or limited shock testing at ICD implantation. Heart Rhythm
• Ott, P. (2005). Most patients may safely undergo inductionless or limited shock testing or limited shock testing at ICD implantation.. Heart Rhythm Society, 2, S32. doi:http://dx.doi.org/10.1016/j.hrthm.2005.02.109
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  Most patients may safely undergo inductionless or limited shock testing or limited shock testing at ICD implantation. Heart Rhythm Society
• Ott, P. (2004). Cardiac Resynchronization therapy with or without Implantable Cardioverter Defibrillator in advanced chronic heart failure.. New England Journal of Medicine, 2140 -2150.
• Ott, P. (2004). Coronary sinus os and fossa ovalis ablation – effect on interatrial conduction and inducibilitiy of atrial fibrillation. American College of Cardiology.
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  Coronary sinus os and fossa ovalis ablation – effect on interatrial conduction and inducibilitiy of atrial fibrillation.American College of Cardiology
• Ott, P., & Indik, J. H. (2004). Two hearts and one defibrillator. Journal of cardiovascular electrophysiology, 15(10), 1220-1.
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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.
• Wathen, M. S., DeGroot, P. J., Sweeney, M. O., Stark, A. J., Otterness, M. F., Adkisson, W. O., Canby, R. C., Khalighi, K., Machado, C., Rubenstein, D. S., Volosin, K. J., & , P. R. (2004). Prospective randomized multicenter trial of empirical antitachycardia pacing versus shocks for spontaneous rapid ventricular tachycardia in patients with implantable cardioverter-defibrillators: Pacing Fast Ventricular Tachycardia Reduces Shock Therapies (PainFREE Rx II) trial results. Circulation, 110(17), 2591-6.
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  Successful antitachycardia pacing (ATP) terminates ventricular tachycardia (VT) up to 250 bpm without the need for painful shocks in implantable cardioverter-defibrillator (ICD) patients. Fast VT (FVT) >200 bpm is often treated by shock because of safety concerns, however. This prospective, randomized, multicenter trial compares the safety and utility of empirical ATP with shocks for FVT in a broad ICD population.
• Arentz, T., Ott, P., von Rosenthal, J., Blum, T., & Kalusche, D. (2003). Effect of atrial overdrive pacing on pulmonary vein focal discharge in patients with atrial fibrillation. 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, 5(1), 25-31.
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  Recently, it has been shown that atrial fibrillation may be caused by spontaneously discharging foci located predominantly in the pulmonary veins. However, the effect of atrial overdrive pacing on these pulmonary vein foci has not been studied.
• 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
• Ott, P. (2003). Inhibition of bi-ventricular pacing: recognition, mechanisms and therapy. PACE, 26, 1083.
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  Inhibition of bi-ventricular pacing: recognition, mechanisms and therapy. PACE
• Ott, P., Marcus, F. I., Sobonya, R. E., Morady, F., Knight, B. P., & Fuenzalida, C. E. (2003). Cardiac sarcoidosis masquerading as right ventricular dysplasia. Pacing and clinical electrophysiology : PACE, 26(7 Pt 1), 1498-503.
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  Patients with cardiac sarcoidosis may present with clinical and morphological features similar to arrhythmogenic right ventricular dysplasia (ARVD) or cardiomyopathy (ARVC). Three cases of cardiac sarcoidosis are presented that clinically mimicked ARVD or ARVC until a pathology diagnosis of sarcoidosis was made at biopsy or autopsy. A diagnostic distinction, while often difficult to make, is important since treatment with corticosteroids may benefit those with sarcoidosis but is not expected to be useful in cases with ARVD or ARVC.
• 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.
• Ott, P. (2002). Circumferential CS os ablation – effect in interatrial conduction.. JACC.
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  Circumferential CS os ablation – effect in interatrial conduction.JACC
• Ott, P. (2002). Dual-loop intra-atrial re-entry tachycardia in a patient with ischaemic cardiomyopathy.. 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, 4(2), 207-10. doi:10.1053/eupc.2002.0220
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  A 65-year-old man with ischaemic cardiomyopathy (three prior coronary artery bypass surgery procedures), underwent catheter ablation for recurrent atrial flutter. Electrophysiological study initially revealed clockwise, tricuspid annulus/inferior vena cava isthmus dependent, atrial flutter. During radiofrequency energy ablation atrial flutter changed into a different atrial tachycardia without change in cycle length or interruption of the tachycardia. The new tachycardia was a right atrial free wall re-entry tachycardia. Thus the two atrial tachycardias formed a dual-loop ('figure-of-eight') re-entry circuit, possibly due to atrial scar tissue from multiple cardiac surgery procedures.
• Ott, P., Marcus, F. I., & Indik, J. H. (2002). Heart rate turbulence and fractal scaling coefficient in response to premature atrial and ventricular complexes and relationship to the degree of prematurity. Journal of the American College of Cardiology, 39, 97-98. doi:10.1016/s0735-1097(02)80420-x
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  819-5 Citation: Supplement to Journal of the American College of Cardiology, March 6, 2002, Vol. 39, Issue 5, Suppl. A Heart Rate Turbulence and Fractal Scaling Coefficient in Response to Premature Atrial and Ventricular Complexes and Relationship to the Degree of Prematurity Julia H. Indik, Peter Ott, Frank I. Marcus Sarver Heart Center, University of Arizona, Tucson, Arizona. Background: Heart rate turbulence (HRT) slope following premature ventricular beats is decreased following myocardial infarction and associated with increased mortality. The fractal scaling properties of the variation in beat-to-beat (RR) intervals measured from Holter monitoring has also been shown to predict mortality in heart failure. The relationship of HRT to the type of premature beat, atrial (PAC) or ventricular (PVC), as well as to the degree of prematurity of that beat has not been reported, nor has the fractal scaling properties of the RR interval variation following a premature beat been previously described. Methods: Holter data were analyzed from 10 normal patients between the ages of 30-75 years. HRT slope was calculated from the first twenty beats. Fractal scaling coefficients, α, were computed using a detrended fluctuation analysis of the first thirty beats. The degree of prematurity was defined as the ratio of the RR interval of the premature beat to that of the preceding interval. Results: A total of 227 PACs and 171 PVCs were analyzed from 24-hour Holters. The HRT slope (mean ±SE) was 17± 1 ms/beat for PACs and 26± 2 ms/beat for PVCs (p
• Ott, P., Marcus, F. I., & Moss, A. J. (2002). Images in cardiovascular medicine. Ventricular fibrillation during swimming in a patient with long-QT syndrome. Circulation, 106(4), 521-2.
• Marcus, F. I., Ott, P., & Marcus, F. I. (2001). Familial Mahaim syndrome.. Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 6(3), 272-5. doi:10.1111/j.1542-474x.2001.tb00117.x
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  We describe the occurrence of Mahaim syndrome in a mother and her son. The occurrence of such a rare disorder in two members of a family is noteworthy, has not been reported before, and suggests the possibility of genetic transmission. A genetic transmission of supraventricular tachycardia has been described only in rare cases for the Wolff-Parkinson-White syndrome. No such data is available for the Mahaim syndrome.
• Ott, P. (2001). Images in cardiovascular medicine: Unusual ECG.. Circulation, 103(4), 617. doi:10.1161/01.cir.103.4.617
• Ott, P. (2001). Intermittent bundle branch block.. Pacing and clinical electrophysiology : PACE, 24(10), 1559-60. doi:10.1046/j.1460-9592.2001.01559.x
• Ott, P. (2001). Mapping of arrhythmogenic pulmonary veins with multi-polar basket catheter: Implication for catheter ablation.. PACE, 24, 586.
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  Mapping of arrhythmogenic pulmonary veins with multi-polar basket catheter: Implication for catheter ablation. PACE
• Ott, P. (2000). Atrial arrhythmias after cardiac surgery: Analysis of bi-atrial recordings.. PACE, 23, 736.
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  Atrial arrhythmias after cardiac surgery: Analysis of bi-atrial recordings. PACE
• Ott, P. (2000). Pulmonary vein focal activity in patients with paroxysmal atrial stimulation: effect of atrial stimulation.. European Heart Journal, 21, 676.
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  Pulmonary vein focal activity in patients with paroxysmal atrial stimulation: effect of atrial stimulation. European Heart Journal
• Ott, P. (2000). Transmural circumferential lesions made of canine PV ostium by expandable mesh electrodes in vivo.. Circulation, 102(18), 11 - 527.
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  Transmural circumferential lesions made of canine PV ostium by expandable mesh electrodes in vivo.Circulation
• Ott, P. (2000). Ventricular Arrhythmias.. Current treatment options in cardiovascular medicine, 2(4), 323-328. doi:10.1007/s11936-996-0006-x
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  Results of recent clinical trials allow an evidence-based approach to ventricular arrhythmias (VAs). The implantable cardioverter-defibrillator (ICD) has clearly established its role in the secondary prevention of VA and should be considered first-line therapy in patients surviving episodes of potentially lethal VAs. It has also been clearly shown that in these patients, antiarrhythmic drug selection by means of serial Holter recording or electrophysiologic study does not improve survival. Antiarrhythmic drug therapy (including amiodarone) as primary prevention in high-risk patients (eg, those who have experienced a myocardial infarction or who have heart failure) has thus far not reduced the mortality rate. In contrast, use of the ICD as a primary preventative strategy has reduced the mortality rate in patients after myocardial infarction who have reduced left ventricular function, nonsustained ventricular tachycardia, and inducible ventricular tachycardia during electrophysiologic study. Thus, patients fitting this clinical profile are best served by implantation of an ICD. Monomorphic ventricular tachycardia occurs rarely in patients without heart disease. These arrhythmias are best treated with catheter ablation therapy, a treatment with a high rate of success and a low rate of complications.
• Galloway, J., Koepke, L., Ott, P., & Marcus, F. (1999). Arrhythmogenic right ventricular dysplasia in an American Indian woman: A case report. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 22(7), 1093-1096.
• Ott, P. (1999). Localization of the orifice of the pulmonary veins by unipolar and bipolar impedance measurements.. Journal Of The American College Of Cardiology.
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  Localization of the orifice of the pulmonary veins by unipolar and bipolar impedance measurements. Journal Of The American College Of Cardiology
• Ott, P. (1999). Paroxysmal atrial fibrillation of focal origin: high recurrence rate after initial successful catheter ablation. European Heart Journal.
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  Paroxysmal atrial fibrillation of focal origin: high recurrence rate after initial successful catheter ablation.
• Kalusche, D., Ott, P., Arentz, T., Stockinger, J., Betz, P., & Roskamm, H. (1998). AV nodal re-entry tachycardia in elderly patients: clinical presentation and results of radiofrequency catheter ablation therapy. Coronary artery disease, 9(6), 359-63.
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  Modification of AV nodal conduction by means of radiofrequency catheter ablation has become the accepted mode of therapy for patients with symptomatic AV nodal re-entry tachycardias (AVN-RT). The published results demonstrate high success rates and a low incidence of severe complications. However, published series have primarily dealt with relatively young patient populations. Little is known about the efficacy and risks of radiofrequency catheter ablation of AVN-RT in the elderly.
• Ott, P. (1998). Cardioversion of atrial fibrillation: effect of pre-shock RR interval. JACC.
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  Cardioversion of atrial fibrillation: effect of pre-shock RR interval.
• Ott, P. (1998). Catheter ablation of focal paroxysmal atrial fibrillation. PACE.
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  Catheter ablation of focal paroxysmal atrial fibrillation.
• Sharma, ., Ott, ., Hartz, ., Mason, ., & Marcus, . (1998). Risk Factors for Tachycardia Events Caused by Antiarrhythmic Drugs: Experience From the ESVEM Trial. Journal of cardiovascular pharmacology and therapeutics, 3(4), 269-274.
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  BACKGROUND: In the Electrophysiology Study versus Electrocardiographic Monitoring (ESVEM) trial, up to seven antiarrhythmic drugs were randomly assigned to 486 patients with a history of sustained ventricular arrhythmia. At baseline, all the patients had inducible sustained ventricular tachycardia (VT) and had >/=10 premature ventricular beats (PVBs) per hour on 48-hour Holter monitoring. A total of 1,229 drug trials were performed. Antiarrhythmic drugs were discontinued during hospitalization because of ventricular tachyarrhythmias thought to be a proarrhythmic effect of the antiarrhythmic drugs in 96 of 479 patients (20%) who received drugs. Proarrhythmic effects were defined as sustained VT, ventricular fibrillation or arrhythmic death, torsade de pointes, or distinct intolerable worsening of the baseline arrhythmia after at least three doses of the drug. METHODS AND RESULTS: Eighteen baseline characteristics were analyzed for factors that would predict a higher incidence of proarrhythmia. These included type of heart disease, previous myocardial infarction, symptom activity scale, gender, type of arrhythmia, VT/ventricular fibrillation, age, left ventricular ejection fraction (LVEF), PVB frequency, heart rate, QRS duration, and QT interval. Multiple logistic regression analysis identified increased mean PVB frequency (P =.003) and increased heart rate (P =.026) as significant predictors of proarrhythmia. Decreased LVEF (
• Ott, P. (1997). AV nodal re-entry tachycardia in elderly patients: clinical presentation and catheter ablation. Eur Heart Journal.
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  AV nodal re-entry tachycardia in elderly patients: clinical presentation and catheter ablation
• Ott, P. (1997). Do we really need to have arrhythmia documentation before accepting patients with a typical history of paroxysmal tachycardia for electrophysiologic evaluation and RF ablation procedure?. PACE.
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  Do we really need to have arrhythmia documentation before accepting patients with a typical history of paroxysmal tachycardia for electrophysiologic evaluation and RF ablation procedure?
• Ott, P. (1997). Radiation exposure in radiofrequency catheter ablation of various arrhythmias.. 5th International workshop on cardiac arrhythmias; Venice, Italy: October 1997.
• Ott, P. (1997). Superiority of a vertical sternal lead for detecting atrial activity in ambulatory ECG recordings. PACE, 15(2), 131 -134. doi:10.1111/j.1540-8159.1992.tb03055.x
• Ott, P., & Reiter, M. J. (1997). Effect of ventricular dilatation on defibrillation threshold in the isolated perfused rabbit heart. Journal of cardiovascular electrophysiology, 8(9), 1013-9.
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  Ventricular dilatation has important electrophysiologic effects, but its effect on ventricular defibrillation threshold (DFT) is unknown.
• Ott, ., & Marcus, . (1996). The Role of Digoxin in the Treatment of Chronic Congestive Heart Failure. Journal of cardiovascular pharmacology and therapeutics, 1(3), 259-264.
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  It is now well established that digoxin is an effective drug for the treatment of heart failure. Since treatment with angiotensin-converting enzyme (ACE) inhibitors reduces mortality in congestive heart failure, digoxin should be added to ACE inhibitors in patients with moderate or severe heart failure. The beneficial effects of digoxin may be due, in part, to its well-documented sympathoinhibitory effects that can avert the adverse effects of long-term excessive sympathetic adrenergic stimulation in heart failure.
• Reiter, M. J., & Ott, P. (1996). Defibrillation threshold in the isolated rabbit heart: Effect of ventricular dilatation. Journal of the American College of Cardiology, 27(2), 328. doi:10.1016/s0735-1097(96)82215-7
• Reiter, M. J., Reiter, M. J., & Ott, P. (1996). Effect of ventricular dilatation on defibrillation threshold. Journal of Investigative Medicine, 44(1).
• Reiter, M. J., Ott, P., Mann, D. E., Lindenfeld, J., Lindefeld, J., Kelly, P. A., & Damle, R. S. (1995). Tachycardia-induced cardiomyopathy in a cardiac transplant recipient: treatment with radiofrequency catheter ablation.. Journal of cardiovascular electrophysiology, 6(5), 391-5. doi:10.1111/j.1540-8167.1995.tb00412.x
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  Two years after orthotopic cardiac transplantation, a 60-year-old man presented with unexplained congestive heart failure and an incessant atrial tachycardia..Electrophysiologic evaluation identified the underlying arrhythmia as automatic atrial tachycardia with site of origin at the high anterior lateral right atrial wall. Radiofrequency catheter ablation successfully eliminated the tachycardia, which resulted in prompt improvement of this patient's congestive heart failure..This is the first reported case of tachycardia-induced cardiomyopathy in a cardiac transplant patient. Radiofrequency catheter ablation can be used successfully in this patient population.
• Marcus, F. I., Scott, W. A., Ott, P., Marcus, F. I., Hahn, E. A., Faitelson, L. H., & Caruso, A. C. (1992). Superiority of a vertical sternal lead for detection of arrhythmias during ambulatory electrocardiographic monitoring.. The American journal of cardiology, 69(6), 625-7. doi:10.1016/0002-9149(92)90153-p
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  In a preliminary study comparing 7 sets of bipolar leads with standard modified V1 and V5 leads, a vertical sternal lead system with the negative lead just below the suprasternal notch, and the positive lead over the xiphoid had the greatest P-wave area. In the current study, the vertical sternal and modified V1 leads were obtained simultaneously using 2-channel ambulatory electrocardiographic recorders in 50 consecutive patients undergoing diagnostic ambulatory electrocardiography for suspected arrhythmias. The vertical sternal lead provided tracings with a larger P-wave area compared with that of the modified V1 (0.58 +/- 0.44 vs 1.23 +/- 0.69 mm2; p less than 0.0001), and a greater QRS complex (9.23 +/- 4.16 vs 11.78 +/- 4.90 mm; p = 0.006). During premature atrial contractions and supraventricular tachycardia, P-wave visibility was significantly better in the sternal lead than in V1 (p less than 0.001). Furthermore, sternal lead tracings were superior with regard to overall quality and noise level. It is suggested that the vertical sternal lead replace the currently used modified V1 during ambulatory electrocardiographic monitoring. This lead system in conjunction with the standard modified V5 lead should be useful in the differential diagnosis of atrial arrhythmias.
• Ott, P., & Fenster, P. (1992). Should magnesium be part of the routine therapy for acute myocardial infarction?. American heart journal, 124(4), 1113-8.
• Ott, P. (1991). Superiority of a vertical sternal lead for detecting atrial activity in ambulatory ECG recordings.. PACE, 15, 131-134.
• Ott, P., & Fenster, P. (1991). Combining thrombolytic agents to treat acute myocardial infarction. American heart journal, 121(5), 1583-4.

Proceedings Publications

• Xing, D., Rozenblit, J. W., Ott, P., & Bernau, S. (2014). Cardiac arrhythmia visualization in a virtual heart for electrophysiology education. In ., 46.
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  The 3D cardiac arrhythmia visualization model in this paper was developed to assist medical students and fellows in understanding the underlying electrophysiology of cardiac arrhythmias and their treatments. In this detailed cardiac model, the user can freely move to any position of the heart and observe it from any point of view. A transparent mode is applied to facilitate a more detailed exploration of the heart. Two common types of arrhythmias, atrial flutter and atrioventricular nodal re-entrant tachycardia as well as the effects of catheter ablation treatment are represented in this model. VR920 3D glasses facilitate virtual reality immersion. The model is expected to help users to visualize abstract electrophysiology concepts and procedures, raise medical education and training levels, and, ultimately, benefit patients through better training outcomes.

Presentations

• Ott, P. (2016, Spring). "Subclinical atrial fibrillation, stroke and AF screening.". The INTERNATIONAL SOCIETY for COMPUTERIZED ELECTROCARDIOLOGY, 41st Annual Conference.. Tucson, Arizona: ISCE.
• Ott, P. (2016, Spring). Scholarly Presentation. International Society for Computerized ECG (ISCE) conference. Tucson, Arizona.
• Ott, P. (2002, May). Timing Cycles and Programming of bi-ventricular ICDs. NASPE meeting- San Diego. San Diego.
• Ott, P. (2003, February). Cardiac Resynchronization therapy. Sarver Heart Center Research Meeting. Sarver Heart Center.
• Ott, P. (2004, March). Update on ICD trials with special reference of the SCD-HeFt trial. Sarver Heart Center. Sarver Heart Center.
• Ott, P. (2005, August). Cardiac Contractility modulation. Sarver Heart Center Research meeting. Sarver Heart Center.
• Ott, P. (2006, October). All patients with EF <30% should receive an ICD. Sarver Heart Center - Grand Rounds. Sarver Heart Center.
• Ott, P. (2009, March). Atrial fibrillation, new therapy options. Sarver Heart Center- Grand Rounds. Sarver Heart Center.
• Ott, P. (2009, May). Patient Centered Approach to the evaluation and therapy of atril fibrillation. Cardiology Grand Rounds - University of AZ, AZ. University of Arizona.
• Ott, P. (2009, May). Patient centered approach to the evaluation and therapy of atril fibrillation. Medical Grand Rounds- Wilford Hall Medical Lanckland AFB, TX. Wilford Hall Medical Lanckland AFB, TX.
• Ott, P. (2009, November). Patient Centered Approach to the evaluation and therapy of atril fibrillation. Cardiology Grand Rounds- USCA, San Diego, CA. USCA, San Diego, CA.
• Ott, P. (2010, March). Patient Centered Approach to the evaluation and therapy of atrial fibrillation. Grand Rounds- Univ. of Florida, Tampa. Univ. of Florida, Tampa.
• Stokken, G., Ott, P., & Abidov, A. (2013, Spring). Myocarditis Mimicking Benign Premature Ventricular Complexes. Journal of Cardiovascular Electrophysiology.
• Ott, P. (2009, Spring / 2009). Interview: Laser sheath guided lead extraction.. Media Interview.
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  Interview: Laser sheath guided lead extraction.
• Ott, P. (2004, Spring / 2004). Interview: Sudden Cardiac Death - KNST. Media Interview.
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  Interview: Sudden Cardiac Death - KNST
• Ott, P. (2003, Spring / 2003). Interview: Role of Bi-Ventricular pacing in heart failure therapy.. Media Interview.
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  Interview: Role of Bi-Ventricular pacing in heart failure therapy.
• Ott, P. (2003, Spring / 2003). Interview: Three dimensional mapping (ESI) of cardiac arrhythmias.. Media Interview.
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  Interview: Three dimensional mapping (ESI) of cardiac arrhythmias.
• Ott, P. (1996, Spring / 1996). “Defibrillation threshold in the Langendorff perfused rabbit heart; effect of ventricular dilatation”. American College of Cardiology Scientific Sessions:.
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  American College of Cardiology Scientific Sessions:“Defibrillation threshold in the Langendorff perfused rabbit heart; effect of ventricular dilatation”

Poster Presentations

• Ott, P. (2019, October). Anti-coagulation therapy guided by implantable loop recorder monitoring. Venice Arrhythmia. Venice: Scientific Committee of Venice Arrhythmias.
• Kandala, J., Oomman, C., Hamound, N., & Ott, P. (2016, Spring). Chronotropic Incompetence in ICD Recipients: Implications Device Selection. American College of Cardiology (ACC) 65th Annual Scientific Session and Expo. Chicago, IL.
• Kandala, J., Oomman, C., Hamound, N., & Ott, P. (2016, Spring). Chronotropic Incompetence in ICD Recipients: Implications Device Selection. Arizona Chapter Meeting 2016. Phoenix, AZ: ACC.
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  SECOND PRIZE FOR THE BEST POSTER
• Ott, P. (2007, Spring / 2007). Coupled pacing: a novel pacing strategy to manage atrial fibrillation. Poster abstract presented at the annual annual scientific sessions of the Heart Rhythm Society. Heart Rhythm Society.
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  Coupled pacing: a novel pacing strategy to manage atrial fibrillation. Poster abstract presented at the annual annual scientific sessions of the Heart Rhythm Society.Heart Rhythm Society

Reviews

• Ott, P. (2006. Atrial fibrillation after coronary artery bypass surgery(pp 55-56). Chapter 39.
• Ott, P. (2006. Brugada Syndrome: Can we predict the risk?(pp 1-2). Chapter 17.
• Ott, P. (2000. Ventricular arrhythmias(pp 323-327). Chapter 2.
• Ott, P. (1999. Catheter ablation in patients with congential heart disease(pp 33-37). Chapter 7.

Case Studies

• Ott, P. (2008. Moving parts(pp 586-588).
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  Moving parts
• Ott, P. (2007. Brugada type EKG in a febrile patient(pp 281-282).
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  Brugada type EKG in a febrile patient
• Ott, P. (2006. A puzzling telemetry tracing(p. 459).
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  A puzzling telemetry tracing
• Ott, P. (2005. A young man with peculiar QRS complexes(pp 224-225).
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  A young man with peculiar QRS complexes
• Ott, P. (2005. An elderly woman with AV block in sinus rhythm and conducted atrial tachycardia(pp 67-70).
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  An elderly woman with AV block in sinus rhythm and conducted atrial tachycardia
• Ott, P. (2004. Two hearts and one defibrillator(p. 1220).
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  Two hearts and one defibrillator
• Ott, P. (2002. Double loop atrial reentry(pp 207-210).
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  Double loop atrial reentry.
• Ott, P. (2002. Syncope with ST segment abnormalities resembling Brugada syndrome due to reversible myocardial ischemia(pp 1270-1273).
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  Syncope with ST segment abnormalities resembling Brugada syndrome due to reversible myocardial ischemia.
• Ott, P. (2002. VF in a patient with long QT during swimming(p. 521).
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  VF in a patient with long QT during swimming
• Ott, P. (2001. An unusual EKG(p. 617).
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  An unusual EKG
• Ott, P. (2001. Familial Mahaim Syndrome(pp 272-275).
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  Annals of Non-invasive Electrophysiology
• Ott, P. (2001. Intermittent bundle branch block(pp 1559-1560).
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  Intermittent bundle branch block.
• Ott, P. (1999. Arrhythmogenic right ventricular dysplasia in an American Indian woman(pp 1093-1096).
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  Arrhythmogenic right ventricular dysplasia in an American Indian woman
• Ott, P. (1995. Radiofrequency catheter ablation of incessant atrial tachycardia in a cardiac transplant recipient(pp 391-395).
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  Radiofrequency catheter ablation of incessant atrial tachycardia in a cardiac transplant recipient
• Ott, P. (1992. Evaluation of electrocardiographic leads for detection of atrial activity (p-wave) in ambulatory EKG monitoring: A pilot study.(pp 1312-1314).

Others

• Ott, P. (2000, October). Atrial fibrillation, non-pharmacologic therapy. UAHSC- Medical Grand Rounds.
• Ott, P. (2015, Fall). Device detected subclinical atrial fibrillation. Tucson EP Group.
• 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.