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المؤلفون: Gabriele Dell'Era, Natale Daniele Brunetti, Enrico Boggio, Pier Luigi Pellegrino, Antonio Dello Russo, Germano Gaggioli, Alessandro Guido, Mauro Biffi, Gerardo Nigro, Ernesto Ammendola, Giuseppe Patti, Mattia Laffi, Matteo Ziacchi, Federico Guerra, Pietro Palmisano, Vittorio Aspromonte, Lorenzo Pimpini, Cardiac Pacing, Michele Accogli, Francesco Santoro
المصدر: Heart Rhythm. 18:770-777
مصطلحات موضوعية: Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, Syncope, Bifascicular block, 03 medical and health sciences, Orthostatic vital signs, 0302 clinical medicine, Heart Rate, Recurrence, Physiology (medical), Internal medicine, medicine, Humans, In patient, Prospective Studies, Registries, 030212 general & internal medicine, Vasovagal syncope, Collapse (medical), Aged, biology, business.industry, Incidence, Cardiac Pacing, Artificial, Syncope (genus), Atrial fibrillation, medicine.disease, biology.organism_classification, Italy, Chronic Disease, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Atrioventricular block, Follow-Up Studies
الوصف: Background Few studies have examined the causes of syncope/collapse recurrences in patients with a previously implanted pacemaker for bradyarrhythmic syncope. Objective The purpose of this study was to assess the causes of syncope/collapse recurrences after pacemaker implantation for bradyarrhythmic syncope in a large patient population. Methods The SYNCOpal recurrences in patients treated with permanent PACing for bradyarrhythmic syncope (SYNCOPACED) registry was a prospective multicenter observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for bradyarrhythmic syncope. During follow-up, the time to the first syncope/collapse recurrence was recorded. Patients with syncope/collapse recurrences underwent a predefined diagnostic workup aimed at establishing the mechanism of syncope/collapse. Results During a median follow-up of 50 months, 213 patients (15.6%) reported at least 1 syncope/collapse recurrence. The risk of syncope/collapse recurrence was highest in patients who underwent implantation for cardioinhibitory vasovagal syncope (26.4%), followed by unexplained syncope and chronic bifascicular block (21.5%), cardioinhibitory carotid sinus syndrome (17.2%), atrial fibrillation needing pacing (15.5%), atrioventricular block (13.6%), and sinus node disease (12.5%) (P = .017). The most frequent cause of syncope/collapse recurrence was reflex syncope (27.7%), followed by orthostatic hypotension (26.3%), pacemaker or lead malfunction (5.6%), structural cardiac disease (5.2%), and atrial and ventricular tachyarrhythmias (4.7% and 3.8%, respectively). In 26.8% of cases, the mechanism of syncope/collapse remained unexplained. Conclusion In patients receiving a pacemaker for bradyarrhythmic syncope, reflex syncope and orthostatic hypotension are the most frequent mechanisms of syncope/collapse recurrence after implantation. Pacing system malfunction, structural cardiac diseases, and tachyarrhythmias are rare mechanisms. The mechanism remains unexplained in >25% of patients.
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المؤلفون: Gabriele Dell'Era, Enrico Boggio, Matteo Ziacchi, Francesco Santoro, Ernesto Ammendola, Giuseppe Patti, Mattia Laffi, Alessandro Guido, Federico Guerra, Vittorio Aspromonte, Michele Accogli, Pietro Palmisano, Germano Gaggioli, Mauro Biffi, Gerardo Nigro, Natale Daniele Brunetti, Lorenzo Pimpini, Pier Luigi Pellegrino, Antonio Dello Russo
المصدر: EP Europace. 22:1729-1736
مصطلحات موضوعية: Bradycardia, Pacemaker, Artificial, medicine.medical_specialty, Population, Syncope, law.invention, Electrocardiography, Recurrence, Tilt-Table Test, law, Physiology (medical), Internal medicine, Syncope, Vasovagal, medicine, Humans, In patient, Prospective Studies, education, education.field_of_study, biology, business.industry, Hazard ratio, Cardiac Pacing, Artificial, Syncope (genus), biology.organism_classification, Treatment Outcome, Etiology, Cardiology, Artificial cardiac pacemaker, Observational study, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
الوصف: Aims To evaluate the risk of syncopal recurrences after pacemaker implantation in a population of patients with syncope of suspected bradyarrhythmic aetiology. Methods and results Prospective, multicentre, observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for syncope of bradyarrhythmic aetiology (proven or presumed). Before pacemaker implantation, all patients underwent a cardiac work-up in order to establish the bradyarrhythmic aetiology of syncope. According to the results of the diagnostic work-up, patients were divided into three groups: Group A, patients in whom a syncope-electrocardiogram (ECG) correlation was established (n = 329, 24.1%); Group B, those in whom clinically significant bradyarrhythmias were detected without a documented syncope-ECG correlation (n = 877, 64.3%); and Group C, those in whom bradyarrhythmias were not detected and the bradyarrhythmic origin of syncope remained presumptive (n = 158, 11.6%). During a median follow-up of 50 months, 213 patients (15.6%) reported at least one syncopal recurrence. Patients in Groups B and C showed a significantly higher risk of syncopal recurrences than those in Group A [hazard ratios (HRs): 1.60 and 2.66, respectively, P Conclusion In selecting patients with syncope of suspected bradyarrhythmic aetiology for pacemaker implantation, establishing a correlation between syncope and bradyarrhythmias maximizes the efficacy of pacing and reduces the risk of syncopal recurrences.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::334ec580b9db896889ae30a4fd67f434
https://doi.org/10.1093/europace/euaa188 -
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المؤلفون: Mattia Laffi, Eleonora Prenna, Andrea Angeletti, Gabriele Dell'Era, Michele Accogli, Walter Bianchi, Cardiac Pacing, Ernesto Ammendola, Federico Guerra, Alessandro Guido, Giulia Stronati, Antonio D'Onofrio, Matteo Ziacchi, Antonio Dello Russo, Pietro Palmisano, Germano Gaggioli, Gerardo Nigro, Mauro Biffi
المصدر: Journal of cardiovascular electrophysiologyREFERENCES. 32(6)
مصطلحات موضوعية: Reoperation, medicine.medical_specialty, medicine.medical_treatment, Surgical Revision, 030204 cardiovascular system & hematology, Implantable defibrillator, Lower risk, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Medicine, Humans, 030212 general & internal medicine, Prospective Studies, business.industry, Patient Acceptance of Health Care, Implantable cardioverter-defibrillator, Surgery, Defibrillators, Implantable, Hospital treatment, Treatment Outcome, Healthcare utilization, Propensity score matching, Observational study, Cardiology and Cardiovascular Medicine, business
الوصف: INTRODUCTION Comparison data on management of device-related complications and their impact on patient outcome and healthcare utilization between subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (TV-ICD) are lacking. We designed this prospective, multicentre, observational registry to compare the rate, nature, and impact of long-term device-related complications requiring surgical revision on patient outcome and healthcare utilization between patients undergoing S-ICD or TV-ICD implantation. METHODS AND RESULTS A total of 1099 consecutive patients who underwent S-ICD or TV-ICD implantation were enrolled. Propensity matching for baseline characteristics yielded 169 matched pairs. Rate, nature, management, and impact on patient outcome of device-related complications were analyzed and compared between two groups. During a mean follow-up of 30 months, device-related complications requiring surgical revision were observed in 20 patients: 3 in S-ICD group (1.8%) and 17 in TV-ICD group (10.1%; p = .002). Compared with TV-ICD patients, S-ICD patients showed a significantly lower risk of lead-related complications (0% vs. 5.9%; p = .002) and a similar risk of pocket-related complications (0.6 vs. 2.4; p = .215) and device infection (0.6% vs. 1.2%; p = 1.000). Complications observed in S-ICD patients resulted in a significantly lower number of complications-related rehospitalizations (median 0 vs. 1; p = .013) and additional hospital treatment days (1.0 ± 1.0 vs. 6.5 ± 4.4 days; p = .048) compared with TV-ICD patients. CONCLUSIONS Compared with TV-ICD, S-ICD is associated with a lower risk of complications, mainly due to a lower risk of lead-related complications. The management of S-ICD complications requires fewer and shorter rehospitalizations.
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المؤلفون: Vittorio Aspromonte, Antonio Dello Russo, Michele Accogli, Federico Guerra, Miriam Gravellone, Gabriele Dell'Era, Natale Daniele Brunetti, Pasquale Paolisso, Giulia Stronati, Angelo Carbone, Alessandro Guido, Matteo Ziacchi, Pietro Palmisano, Roberto Floris, Giampiero Maglia, Roberto Antonicelli, Ernesto Ammendola, Gerardo Nigro, Lorenzo Pimpini, Pier Luigi Pellegrino, Giuseppe Del Giorno, Francesco Santoro, Michele Cannone
المصدر: European journal of clinical pharmacology. 77(12)
مصطلحات موضوعية: Male, medicine.medical_specialty, medicine.medical_treatment, Population, Comorbidity, Sacubitril, Ventricular Function, Left, Sudden cardiac death, Internal medicine, medicine, Humans, Pharmacology (medical), Prospective Studies, education, Aged, Pharmacology, Heart Failure, education.field_of_study, Ejection fraction, business.industry, Aminobutyrates, Biphenyl Compounds, General Medicine, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Drug Combinations, Valsartan, Heart failure, Cardiology, Female, business, Sacubitril, Valsartan, medicine.drug
الوصف: Sacubitril/valsartan has been associated with a positive reverse left ventricular remodelling in patients with heart failure with reduced ejection fraction (HFrEF). These patients may also benefit from an ICD implant. We aimed to assess EF improvement after 6 months of treatment with sacubitril/valsartan, evaluating when ICD as primary prevention was no longer indicated.Multicentre, observational, prospective study enrolling all consecutive patients with HFrEF and EF ≤ 35% with an ICD as primary prevention and starting treatment with sacubitril/valsartan (NCT03935087). Resynchronization therapy and patients experiencing appropriate ICD therapies before sacubitril/valsartan were excluded.Two-hundred-and-thirty patients were enrolled (73.9% males, mean age 64.3 ± 12.1 years) After 6 months of treatment, a reduction in left ventricular end-diastolic and end-systolic volumes was noted and LVEF increased from 28.3 ± 5.6% to 32.2 ± 6.5% (p 0.001). At 6 months, a non-ischemic aetiology of cardiomyopathy and a final dose of sacubitril/valsartan 24/26 mg twice daily were associated with a higher probability of an absolute increase of 5% in LVEF. A total of 5.3% of primary prevention patients still had an arrhythmic event in the first 6 months after treatment with sacubitril/valsartan started.Sacubitril/valsartan improves systolic function in HFrEF, mainly due to reverse left ventricular remodelling. Improvement in EF after 6 months of treatment could help prevent ICD implantation in nearly one out of four patients, with important clinical and economic implications. However, the risk of sudden cardiac death in this recovered HFrEF population has not been thoroughly studied, and the present data should be interpreted only as hypothesis-generating.
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المؤلفون: V. Carinci, Angelo Placci, Matteo Iori, G Statuto, Valeria Calvi, D Grassini, Davide Saporito, Matteo Ziacchi, Giulio Boggian, Maria Giulia Bolognesi, Mauro Biffi, Daniele Giacopelli, Elia De Maria, Ernesto Ammendola, Giuseppe Allocca
مصطلحات موضوعية: Male, Supraventricular, Time Factors, medicine.medical_treatment, Administration, Oral, 030204 cardiovascular system & hematology, 0302 clinical medicine, anticoagulation, atrial dipole, atrial fibrillation, atrial high-rate episode, implantable cardioverter-defibrillator, Aged, Anti-Arrhythmia Agents, Anticoagulants, Atrial Fibrillation, Cardiomyopathies, Catheter Ablation, Electric Countershock, Electrophysiologic Techniques, Cardiac, Female, Heart Failure, Humans, Incidence, Middle Aged, Predictive Value of Tests, Prospective Studies, Prosthesis Design, Registries, Tachycardia, Supraventricular, Treatment Outcome, Atrial Function, Defibrillators, Implantable, Tachycardia, Medicine, 030212 general & internal medicine, Incidence (epidemiology), Hazard ratio, Atrial fibrillation, Implantable cardioverter-defibrillator, Administration, Cardiology, Electrophysiologic Techniques, medicine.symptom, Implantable, Cardiology and Cardiovascular Medicine, Cardiac, Oral, medicine.medical_specialty, 03 medical and health sciences, Physiology (medical), Internal medicine, Atrial tachycardia, Fibrillation, business.industry, Atrial arrhythmias, medicine.disease, Confidence interval, business, Defibrillators
الوصف: INTRODUCTION Atrial tachycardia/fibrillation (AT/AF) episodes are common in implantable cardioverter-defibrillator (ICD) recipients and can be undetected by standard single-chamber devices. This study aims to explore whether a single-lead ICD with an atrial dipole (ICD DX; BIOTRONIK SE & Co, Berlin, Germany) could improve the AT/AF diagnosis and management as compared to standard ICD (ICD VR). METHODS AND RESULTS We selected patients without AT/AF history from the THINGS registry which included consecutive patients implanted with ICD for standard indications. The ICD VR and the ICD DX groups included 236 (62.8%) and 140 (37.2%) patients, respectively, and had no significant differences in baseline characteristics. During a median follow-up of 27 months, there were 7 AT/AF diagnoses in the ICD VR and 18 in the ICD DX group. The 2-year incidence of AT/AF diagnosis was 3.6% (95% confidence interval [CI]: 1.6%-9.6%) for the ICD VR and 11.4% (95% CI: 6.8%-18.9%) for the ICD DX group (adjusted hazard ratio [HR]: 3.85 [95% CI: 1.58-9.41]; P = .003). Initiation of oral anticoagulation (OAC) due to AT/AF diagnosis was reported in 15 patients. The 2-year incidence of OAC onset was 3.6% (95% CI: 1.6%-7.8%) for the ICD VR and 6.3% (95% CI: 3.0%-12.7%) for ICD DX group (adjusted HR: 1.99 [95% CI: 0.72-5.56]; P = .184). CONCLUSION We observed that atrial sensing capability in single-chamber ICD patients without evidence of atrial arrhythmias at implant is associated with a greater likelihood of detecting AT/AF episodes. The management of these diagnosed arrhythmias often led to clinical interventions, mainly represented by initiation of OAC therapy.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::92d33fed600a11b730e287e8bbaf24d1
http://hdl.handle.net/20.500.11769/386934 -
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المؤلفون: Rita Rinaldi, Maria Letizia Bacchi Reggiani, Maddalena Graziosi, Raffaello Ditaranto, Giovanna Lattanzi, Matteo Ziacchi, Giovanni Vitale, Mauro Biffi, Giuseppe Boriani, Ferdinando Pasquale, Luciano Potena, Massimiliano Lorenzini, Alessandra Berardini, Claudio Rapezzi, Sofia Martin Suarez, Elena Biagini
المساهمون: Ditaranto, Raffaello, Boriani, Giuseppe, Biffi, Mauro, Lorenzini, Massimiliano, Graziosi, Maddalena, Ziacchi, Matteo, Pasquale, Ferdinando, Vitale, Giovanni, Berardini, Alessandra, Rinaldi, Rita, Lattanzi, Giovanna, Potena, Luciano, Martin Suarez, Sofia, Bacchi Reggiani, Maria Letizia, Rapezzi, Claudio, Biagini, Elena
المصدر: Orphanet Journal of Rare Diseases, Vol 14, Iss 1, Pp 1-11 (2019)
Orphanet Journal of Rare Diseasesمصطلحات موضوعية: Male, 0301 basic medicine, Ventricular Tachyarrhythmias, medicine.medical_treatment, Neuromuscular disorder, Cardiomyopathy, lcsh:Medicine, Laminopathy, 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, Pharmacology (medical), Prospective Studies, Child, Genetics (clinical), Heart transplantation, Heart, Atrial fibrillation, Neuromuscular Diseases, General Medicine, Middle Aged, Lamin Type A, Ventricular tachycardias, Natural history, Cardiology, Female, Adult, Familial cardiomyopathies, medicine.medical_specialty, Adolescent, Familial cardiomyopathie, Mutation, Missense, NO, Young Adult, 03 medical and health sciences, Internal medicine, medicine, Humans, Bradyarrhythmias, Emerin, Lamin, Neuromuscular disorders, In patient, Retrospective Studies, business.industry, Research, lcsh:R, medicine.disease, Bradyarrhythmia, 030104 developmental biology, Laminin, Cardiac phenotype, business
الوصف: Objective To investigate differences in cardiac manifestations of patients affected by laminopathy, according to the presence or absence of neuromuscular involvement at presentation. Methods We prospectively analyzed 40 consecutive patients with a diagnosis of laminopathy followed at a single centre between 1998 and 2017. Additionally, reports of clinical evaluations and tests prior to referral at our centre were retrospectively evaluated. Results Clinical onset was cardiac in 26 cases and neuromuscular in 14. Patients with neuromuscular presentation experienced first symptoms earlier in life (11 vs 39 years; p p = 0.013] and 30 vs 44 years [p = 0.086] respectively), despite a similar overall prevalence of AF (57% vs 65%; p = 0.735) and atrio-ventricular (A-V) block (50% vs 65%; p = 0.500). Those with a neuromuscular presentation developed a cardiomyopathy less frequently (43% vs 73%; p = 0.089) and had a lower rate of sustained ventricular tachyarrhythmias (7% vs 23%; p = 0.387). In patients with neuromuscular onset rhythm disturbances occurred usually before evidence of cardiomyopathy. Despite these differences, the need for heart transplantation and median age at intervention were similar in the two groups (29% vs 23% [p = 0.717] and 43 vs 46 years [p = 0.593] respectively). Conclusions In patients with laminopathy, the type of disease onset was a marker for a different natural history. Specifically, patients with neuromuscular presentation had an earlier cardiac involvement, characterized by a linear and progressive evolution from rhythm disorders (AF and/or A-V block) to cardiomyopathy.
وصف الملف: STAMPA
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المؤلفون: Giuseppe Boriani, Giovanni Luca Botto, Maurizio Lunati, Mauro Biffi, T Infusino, Renato Pietro Ricci, Alessandro Capucci, Saverio Iacopino, Giovanni Morani, Domenico Facchin, Matteo Ziacchi, Luigi Padeletti, Stefano Bianchi, Maurizio Landolina
المصدر: International Journal of Cardiology. 230:275-280
مصطلحات موضوعية: Male, medicine.medical_specialty, Pediatrics, Time Factors, Population, Atrial fibrillation, Atrial fibrillation diagnosis, single chamber defibrillator, CHADS2 score, Medicine (all), Cardiology and Cardiovascular Medicine, 030204 cardiovascular system & hematology, New onset, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Internal medicine, Atrial Fibrillation, Humans, Medicine, In patient, Heart Atria, Prospective Studies, 030212 general & internal medicine, education, Prospective cohort study, education.field_of_study, business.industry, Incidence, Incidence (epidemiology), Middle Aged, Prognosis, medicine.disease, Defibrillators, Implantable, Italy, Female, Observational study, business, Follow-Up Studies, Single chamber
الوصف: Background Atrial tachyarrhythmias (AT/AF) have been associated with an increased risk of mortality, morbidity and ischemic stroke. Up to now, single chamber ICD diagnostics was not able to detect AT/AF, therefore the incidence of new onset AT/AF in patients with single chamber ICD is not known. Objective To evaluate incidence and predictors of AT/AF occurrence in patients with dual-chamber ICD with no pacing indications and no history of AT/AF that strictly mimic single chamber ICD recipient. Methods & results Consecutive dual-chamber ICD patients were prospectively followed by 47 Italian cardiologic centers in an observational research. Clinical and device data were reviewed by expert cardiologists to assess AT/AF occurrence. Multivariate regression analysis evaluated the risk of new-onset AT/AF and its association with patients' baseline characteristics and with CHADS 2 score. 428 (13.4% female, 64years old) patients were followed for a median observation period of 31months. AT/AF episodes occurred in 160 (37.4%) patients when considering at least 5min duration, in 95 (22.2%) for AT/AF ≥6h, in 47 (11.0%) for AT/AF ≥1day, in 29 (6.8%) for AT/AF ≥7days. Patients with CHADS 2 ≥2, who comprised 36% of the whole population, showed higher incidence of AT/AF ≥6h compared with patients with CHADS 2 p =0.011). Conclusions Our observations in a population of dual-chamber ICD patients with no pacing indications and no history of AT/AF, who strictly mimic single–chamber ICD recipients, highlight that AT/AF episodes occurred in the 37.5% of the population and CHADS 2 score is predictive of new-onset AT/AF.
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المؤلفون: Cinzia Valzania, Stefano Fanti, Matteo Ziacchi, Igor Diemberger, Luciana Tomasi, Giuseppe Boriani, Mauro Biffi, Francesco Fallani, J. Frisoni, Rachele Bonfiglioli, Cristian Martignani, Claudio Rapezzi
المساهمون: Valzania C., Biffi M., Bonfiglioli R., Fallani F., Martignani C., Diemberger I., Ziacchi M., Frisoni J., Tomasi L., Fanti S., Rapezzi C., Boriani G.
مصطلحات موضوعية: Male, radionuclide angiography, Ventricular Dysfunction, Right, medicine.medical_treatment, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Cardiac Resynchronization Therapy, 0302 clinical medicine, Nuclear Medicine and Imaging, Natriuretic Peptide, Brain, Natriuretic peptide, Heart failure, radionuclide angiography, technetium-99m, Prospective Studies, Ejection fraction, Fourier Analysis, medicine.diagnostic_test, Ventricular function, Heart failure, technetium-99m, Radiology, Nuclear Medicine and Imaging, Cardiology and Cardiovascular Medicine, Technetium, Middle Aged, Research Design, Cardiology, Female, Cardiomyopathies, Radiology, medicine.medical_specialty, medicine.drug_class, Rest, Cardiac resynchronization therapy, NO, 03 medical and health sciences, Radionuclide angiography, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Exercise, Rest (music), Aged, business.industry, medicine.disease, Peptide Fragments, Ventricular Function, Right, business, Technetium-99m
الوصف: Aim: We carried out this study to investigate mid-term effects of cardiac resynchronization therapy (CRT) on right ventricular (RV) function and neurohormonal response, expressed by N-terminal pro-brain natriuretic peptide (NT-proBNP), in heart failure patients stratified by baseline RV ejection fraction (RVEF). Methods and Results: Thirty-six patients with nonischemic dilated cardiomyopathy underwent technetium-99m radionuclide angiography with bicycle exercise immediately after CRT implantation (during spontaneous rhythm and after CRT activation) and 3 months later. Plasma NT proBNP was assessed before implantation and after 3 months. At baseline, RVEF was impaired (≤35%) in 14 patients, preserved (>35%) in 22. At 3 months, RVEF improved during rest and exercise (P=.02) in patients with impaired RV function, while remaining unchanged in patients with preserved RV function. Rest and exercise RV dyssynchrony decreased in both groups at follow-up (P
وصف الملف: STAMPA
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cb63258739fe81cc09f3c9502399e4ea
https://hdl.handle.net/11380/1168176 -
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المؤلفون: Andrea Angeletti, Giuseppe Boriani, Matteo Ziacchi, Mauro Biffi, Giulia Massaro, Cristian Martignani, Igor Diemberger, Giulia de Zan
المساهمون: Biffi, Mauro, de Zan, Giulia, Massaro, Giulia, Angeletti, Andrea, Martignani, Cristian, Boriani, Giuseppe, Diemberger, Igor, Ziacchi, Matteo
المصدر: Clinical cardiology. 41(9)
مصطلحات موضوعية: Male, medicine.medical_treatment, Tricuspid regurgitation, 030204 cardiovascular system & hematology, Heart Ventricle, Electrocardiography, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Prospective Studies, Lead (electronics), Aged, 80 and over, Tricuspid valve, medicine.diagnostic_test, Cardiac stimulation, General Medicine, Equipment Design, Middle Aged, medicine.anatomical_structure, Treatment Outcome, Cardiology, cardiovascular system, Female, Electrical conduction system of the heart, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Arrhythmia detection, Heart Ventricles, Cardiac resynchronization therapy, Clinical Investigations, Reproducibility of Result, Follow-Up Studie, Cardiac Resynchronization Therapy Device, 03 medical and health sciences, QRS complex, Left ventricular lead, Sensing, Aged, Arrhythmias, Cardiac, Follow-Up Studies, Heart Conduction System, Humans, Reproducibility of Results, Cardiac Resynchronization Therapy Devices, Forecasting, Internal medicine, Coronary Vein, business.industry, Prospective Studie, business
الوصف: Background: Ventricular sensing in transvenous cardiac implantable electronic devices (CIEDs) occurs conventionally from the right ventricular (RV) channel, though it evolved from epicardial sensing both in pacemakers and implantable cardioverter-defibrillators (ICDs). Hypothesis: The objective of this study was to observe the reliability of left ventricular (LV) sensing by transvenous leads placed in coronary veins. Methods: LV leads were used for sensing and arrhythmia detection in clinical situations where placement of an RV lead across the tricuspid valve was either not preferred or not feasible, or RV signal was unsuitable for arrhythmia detection, or in the event of sensing failure of an RV lead under advisory in cardiac resynchronization therapy defibrillator (CRTD) recipients. Results: Thirty-seven patients had an IS-1 LV lead connected to the RV port of CIEDs (17 pacemakers, 5 cardiac resynchronization therapy pacemaker [CRTP], 2 ICDs, and 13 CRTDs). Along a median 41 (25-67) months follow-up, lead performance remained stable; there were neither undersensing nor oversensing of non-cardiac signals. VT/VF were correctly detected and terminated by ATP and shocks (one and three patients, respectively); no inappropriate arrhythmia detection. Device reprogramming occurred in four CRTD recipients because of transient counting the QRS (short intervals) when paced in LV-only, and in two with T-wave oversensing. Conclusions: Ventricular sensing by an LV lead is feasible in transvenous devices. Sensing programmability is an unmet need: to fix RV lead sensing issues in cardiac resynchronization therapy (CRT) recipients at no risk of infection (no pocket opening); to avoid interaction with the tricuspid valve; to avoid lead redundancy in the vasculature. Moreover, it will be mandatory owing to the loss of lead interchangeability due to the adoption of DF-4 and quadripolar leads.
وصف الملف: STAMPA
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المؤلفون: Elena Raffaelli, Cristian Martignani, Matteo Ziacchi, Claudio Rapezzi, Mauro Biffi, Giuseppe Boriani, Igor Diemberger, Stefano Lorenzetti, Davide Pacini
المساهمون: Diemberger, Igor, Biffi, Mauro, Lorenzetti, Stefano, Martignani, Cristian, Raffaelli, Elena, Ziacchi, Matteo, Rapezzi, Claudio, Pacini, Davide, Boriani, Giuseppe
مصطلحات موضوعية: Male, Pacemaker, Artificial, medicine.medical_specialty, Prosthesis-Related Infections, Population, 030204 cardiovascular system & hematology, Risk Assessment, NO, Teaching hospital, Defibrillator, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Physiology (medical), Internal medicine, Long term survival, Secondary Prevention, medicine, Humans, Endocarditis, Prospective Studies, Endocarditi, 030212 general & internal medicine, education, Prospective cohort study, Device Removal, Survival analysis, Aged, Proportional Hazards Models, education.field_of_study, Infection, Lead extraction, Pacemaker, Proportional hazards model, business.industry, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Defibrillators, Implantable, Cardiology and Cardiovascular Medicine, Italy, Female, Observational study, business, Echocardiography, Transesophageal
الوصف: Aims We explored the possible predictors of long-term prognosis after transvenous lead extraction (TLE) for a cardiac implantable device related infection (CIEDI), including the modified Duke score result. Methods and results We performed a single centre prospective observational study in a population of consecutive patients referred for TLE to a teaching hospital to treat a CIEDI without associated valve-endocarditis. 121 patients were enrolled between January 2012 and March 2016. According to the modified Duke criteria, the presence of CIED-related endocarditis was rejected in 54.5%, possible in 21.5%, and definite in 24.0%. 20/121 patients died after a mean follow-up of 46.0 ± 2.5 months, while 7 patients reported hospitalization for CIEDI recurrence/relapse in the same period. Modified Duke score was significantly associated with a poor prognosis at univariate Cox regression analysis (HR 1.847, 95% CI 1.160-2.941; P = 0.010). However, the three factors independently associated with death and/or CIEDI relapse/recurrence were: a 'closed' CIED pocket (HR 2.720; 95% CI 1.135-6.520), presence of ghost at post-TLE transoesophageal echocardiography (HR 3.469; 95% CI 1.420-8.878), and a GFR
وصف الملف: ELETTRONICO
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6c01e80d70817374b6cf7a5d23c74dac
https://hdl.handle.net/11380/1167976
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