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Hermida A, Gourraud JB, Denjoy I, Fressart V, Kyndt F, Maltret A, Khraiche D, Klug D, Mabo P, Sacher F, Maury P, Winum P, Defaye P, Clerici G, Babuty D, Elbez Y, Morgat C, Surget E, Messali A, De Jode P, Clédel A, Minois D, Maison-Blanche P, Bloch A, Leenhardt A, Probst V, Extramiana F. Type 3 long QT syndrome: Is the effectiveness of treatment with beta-blockers population-specific? Heart Rhythm 2024; 21:313-320. [PMID: 37956775 DOI: 10.1016/j.hrthm.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND The efficacy of beta-blocker treatment in type 3 long QT syndrome (LQT3) remains debated. OBJECTIVES The purpose of this study was to test the hypothesis that beta-blocker use is associated with cardiac events (CEs) in a French cohort of LQT3 patients. METHODS All patients with a likely pathogenic/pathogenic variant in the SCN5A gene (linked to LQT3) were included and followed-up. Documented ventricular tachycardia/ventricular fibrillation, torsades de pointes, aborted cardiac arrest, sudden death, and appropriate shocks were considered as severe cardiac events (SCEs). CEs also included syncope. RESULTS We included 147 patients from 54 families carrying 23 variants. Six of the patients developed symptoms before the age of 1 year and were analyzed separately. The 141 remaining patients (52.5% male; median age at diagnosis 24.0 years) were followed-up for a median of 11 years. The probabilities of a CE and an SCE from birth to the age of 40 were 20.5% and 9.9%, respectively. QTc prolongation (hazard ratio [HR] 1.12 [1.0-1.2]; P = .005]) and proband status (HR 4.07 [1.9-8.9]; P <.001) were independently associated with the occurrence of CEs. Proband status (HR 8.13 [1.7-38.8]; P = .009) was found to be independently associated with SCEs, whereas QTc prolongation (HR 1.11 [1.0-1.3]; P = .108) did not reach statistical significance. The cumulative probability of the age at first CE/SCE was not lower in patients treated with a beta-blocker. CONCLUSION In agreement with the literature, proband status and lengthened QTc were associated with a higher risk of CEs. Our data do not show a protective effect of beta-blocker treatment.
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Affiliation(s)
- Alexis Hermida
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Service de Rythmologie, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Jean-Baptiste Gourraud
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Isabelle Denjoy
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Véronique Fressart
- AP-HP, Service de Biochimie Métabolique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Florence Kyndt
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Alice Maltret
- Service de Cardiopathie Congenitale, GHPSJ Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | | | - Didier Klug
- Service de Cardiologie, Centre Hospitalier Universitaire, Lille, France
| | - Philippe Mabo
- Service de Cardiologie, Centre Hospitalier Universitaire, Rennes, France
| | - Frédéric Sacher
- Service de Rythmologie, LIRYC Institute, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - Philippe Maury
- Service de Cardiologie, Centre Hospitalier Universitaire, Toulouse, France
| | - Pierre Winum
- Service de Cardiologie, Centre Hospitalier Universitaire, Nîmes, France
| | - Pascal Defaye
- Service de Cardiologie, Centre Hospitalier Universitaire, Grenoble, France
| | - Gael Clerici
- Service de Cardiologie, Centre Hospitalier Universitaire, Saint Pierre, La Réunion, France
| | - Dominique Babuty
- Service de Cardiologie, Centre Hospitalier Universitaire, Tours, France
| | | | - Charles Morgat
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France
| | - Elodie Surget
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Anne Messali
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Patrick De Jode
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Aurélien Clédel
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Damien Minois
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Adrien Bloch
- AP-HP, Service de Biochimie Métabolique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Antoine Leenhardt
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France
| | - Vincent Probst
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Fabrice Extramiana
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France.
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Sacher F, Bacquelin R, Bessiere F, Ditac G, Duchateau J, Ait-Said M, Boveda S, Extramiana F, Delsarte L, Fauchier L, Gandjbakhch E, Garcia R, Klug D, Lellouche N, Marijon E, Martins R, Maury P, Mette C, Piot O, Taieb J, Defaye P. Position paper on sustainability in cardiac pacing and electrophysiology from the Working Group of Cardiac Pacing and Electrophysiology of the French Society of Cardiology. Arch Cardiovasc Dis 2024; 117:224-231. [PMID: 38302391 DOI: 10.1016/j.acvd.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/03/2024]
Abstract
Sustainability in healthcare, particularly within the domain of cardiac electrophysiology, assumes paramount importance for the near future. The escalating environmental constraints encountered necessitate a proactive approach. This position paper aims to raise awareness among physicians, spark critical inquiry and identify potential solutions to enhance the sustainability of our practice. Reprocessing of single-use medical devices has emerged as a potential solution to mitigate the environmental impact of electrophysiology procedures, while also offering economic advantages. However, reprocessing remains unauthorized in certain countries. In regions where it is possible, stringent regulatory standards must be adhered to, to ensure patient safety. It is essential that healthcare professionals, policymakers and manufacturers collaborate to drive innovation, explore sustainable practices and ensure that patient care remains uncompromised in the face of environmental challenges. Ambitious national/international programmes of disease prevention should be the cornerstone of the strategy. It is equally vital to implement immediate actions, as delineated in this position paper, to bring about tangible change quickly.
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Affiliation(s)
- Frédéric Sacher
- Cardiac Arrhythmia Department, Bordeaux University Hospital, 33000 Bordeaux, France; Inserm U 1045, IHU Liryc, CRCTB, université de Bordeaux, 33000 Bordeaux, France.
| | | | - Francis Bessiere
- Hospices civils de Lyon, hôpital cardiovasculaire Louis-Pradel, 69500 Bron, France; Inserm, LabTau U1032, université Claude-Bernard Lyon 1, 69003 Lyon, France
| | - Geoffroy Ditac
- Hospices civils de Lyon, hôpital cardiovasculaire Louis-Pradel, 69500 Bron, France
| | - Josselin Duchateau
- Cardiac Arrhythmia Department, Bordeaux University Hospital, 33000 Bordeaux, France; Inserm U 1045, IHU Liryc, CRCTB, université de Bordeaux, 33000 Bordeaux, France
| | | | - Serge Boveda
- Heart Rhythm Management Department, clinique Pasteur, 31076 Toulouse, France; Vrije Universiteit Brussel (VUB), 1090 Jette, Brussels, Belgium; Inserm U970, 75908 Paris, France
| | - Fabrice Extramiana
- Cardiologie, université Paris Cité, hôpital Bichat, AP-HP, 75018 Paris, France
| | - Laura Delsarte
- Service de cardiologie, CHU de Montpellier, 34295 Montpellier, France
| | - Laurent Fauchier
- Service de cardiologie, CHU de Trousseau, 37170 Chambray-lès-Tours, France; Faculté de médecine, université François-Rabelais, 37032 Tours, France
| | - Estelle Gandjbakhch
- Cardiology Department, ICAN, Sorbonne université, Pitié-Salpêtrière University Hospital, AP-HP, 75013 Paris, France
| | - Rodrigue Garcia
- Cardiology Department, entre d'investigation CIC14-02, CHU de Poitiers, 86000 Poitiers, France
| | - Didier Klug
- Service de cardiologie, CHU de Lille, 59000 Lille, France
| | - Nicolas Lellouche
- Service de cardiologie, hôpital Henri-Mondor, AP-HP, 94000 Créteil, France
| | - Eloi Marijon
- Service de cardiologie, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - Raphael Martins
- Inserm, LTSI - UMR 1099, CHU de Rennes, université de Rennes, 35000 Rennes, France
| | - Philipe Maury
- Unité Inserm U 1048, Department of Cardiology, University Hospital Rangueil, 31400 Toulouse, France
| | - Carole Mette
- Centre cardiologique du Nord Saint-Denis, 93207 Saint-Denis, France
| | - Olivier Piot
- Centre cardiologique du Nord Saint-Denis, 93207 Saint-Denis, France
| | - Jerome Taieb
- Service de cardiologie, centre hospitalier du Pays d'Aix, 13100 Aix-en-Provence, France
| | - Pascal Defaye
- Cardiology Department, Grenoble-Alpes University, University Hospital, 38043 Grenoble, France
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Waldmann V, Marquié C, Bessière F, Perrot D, Anselme F, Badenco N, Barra S, Bertaux G, Blangy H, Bordachar P, Boveda S, Chauvin M, Clémenty N, Clerici G, Combes N, Defaye P, Deharo JC, Durand P, Duthoit G, Eschalier R, Fauchier L, Garcia R, Geoffroy O, Gitenay E, Gourraud JB, Guenancia C, Iserin L, Jacon P, Jesel-Morel L, Kerkouri F, Klug D, Koutbi L, Labombarda F, Ladouceur M, Laurent G, Leclercq C, Maille B, Maltret A, Massoulié G, Mondoly P, Ninni S, Ollitrault P, Pasquié JL, Pierre B, Pujadas P, Champ-Rigot L, Sacher F, Sadoul N, Schatz A, Winum P, Milliez PU, Probst V, Marijon E. Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease. J Am Coll Cardiol 2023; 82:590-599. [PMID: 37558371 DOI: 10.1016/j.jacc.2023.05.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Very few data have been published on the use of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in patients with congenital heart disease (CHD). OBJECTIVES The aim of this study was to analyze outcomes associated with S-ICDs in patients with CHD. METHODS This nationwide French cohort including all patients with an S-ICD was initiated in 2020 by the French Institute of Health and Medical Research. Characteristics at implantation and outcomes were analyzed in patients with CHD. RESULTS From October 12, 2012, to December 31, 2019, among 4,924 patients receiving an S-ICD implant in 150 centers, 101 (2.1%) had CHD. Tetralogy of Fallot, univentricular heart, and dextro-transposition of the great arteries represented almost one-half of the population. Patients with CHD were significantly younger (age 37.1 ± 15.4 years vs 50.1 ± 14.9 years; P < 0.001), more frequently female (37.6% vs 23.0%; P < 0.001), more likely to receive an S-ICD for secondary prevention (72.3% vs 35.9%; P < 0.001), and less likely to have severe systolic dysfunction of the systemic ventricle (28.1% vs 53.1%; P < 0.001). Over a mean follow-up period of 1.9 years, 16 (15.8%) patients with CHD received at least 1 appropriate shock, with all shocks successfully terminating the ventricular arrhythmia. The crude risk of appropriate S-ICD shock was twice as high in patients with CHD compared with non-CHD patients (annual incidences of 9.0% vs 4.4%; HR: 2.1; 95% CI: 1.3-3.4); however, this association was no longer significant after propensity matching (especially considering S-ICD indication, P = 0.12). The burden of all complications (HR: 1.2; 95% CI: 0.7-2.1; P = 0.4) and inappropriate shocks (HR: 0.9; 95% CI: 0.4-2.0; P = 0.9) was comparable in both groups. CONCLUSIONS In this nationwide study, patients with CHD represented 2% of all S-ICD implantations. Our findings emphasize the effectiveness and safety of S-ICD in this particularly high-risk population. (S-ICD French Cohort Study [HONEST]; NCT05302115).
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Affiliation(s)
- Victor Waldmann
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Pediatric and Congenital Medico-Surgical Unit, Necker Hospital, Paris, France; Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France.
| | | | - Francis Bessière
- Université de Lyon, INSERM LabTau, Lyon, France; Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - David Perrot
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | - Sergio Barra
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiology Department, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | | | | | | | | | - Michel Chauvin
- ICS HENA Strasbourg, Strasbourg, France; Clinique de l'Orangerie, Strasbourg, France
| | | | | | | | | | - Jean-Claude Deharo
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, France
| | - Philippe Durand
- Centre Médico-Chirurgical Arnault Tzanck, St Laurent du Var, France
| | | | - Romain Eschalier
- Cardiology Department, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France, and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, F-63000 Clermont-Ferrand, France
| | | | - Rodrigue Garcia
- Cardiology Department, University Hospital of Poitiers, Poitiers, France; Centre d'Investigations Cliniques 1402, University Hospital of Poitiers, Poitiers, France
| | | | | | | | | | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | - Fawzi Kerkouri
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; University Hospital of Brest, Brest, France
| | | | - Linda Koutbi
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, France
| | | | - Magalie Ladouceur
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | - Baptiste Maille
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, France
| | - Alice Maltret
- Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Grégoire Massoulié
- Cardiology Department, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France, and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, F-63000 Clermont-Ferrand, France
| | | | | | | | - Jean-Luc Pasquié
- PhyMedExp, Université de Montpellier, INSERM, CNRS, CHRU de Montpellier, France
| | | | | | | | | | | | | | | | | | | | - Eloi Marijon
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Pediatric and Congenital Medico-Surgical Unit, Necker Hospital, Paris, France
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Manyam H, Burri H, Casado-Arroyo R, Varma N, Lennerz C, Klug D, Carr-White G, Kolli K, Reyes I, Nabutovsky Y, Boriani G. Smartphone-based cardiac implantable electronic device remote monitoring: improved compliance and connectivity. Eur Heart J Digit Health 2022; 4:43-52. [PMID: 36743871 PMCID: PMC9890086 DOI: 10.1093/ehjdh/ztac071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/04/2022] [Indexed: 11/13/2022]
Abstract
Aims Remote monitoring (RM) is the standard of care for follow up of patients with cardiac implantable electronic devices. The aim of this study was to compare smartphone-based RM (SM-RM) using patient applications (myMerlinPulse™ app) with traditional bedside monitor RM (BM-RM). Methods and results The retrospective study included de-identified US patients who received either SM-RM or BM-RM capable of implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators (Abbott, USA). Patients in SM-RM and BM-RM groups were propensity-score matched on age and gender, device type, implant year, and month. Compliance with RM was quantified as the proportion of patients enrolling in the RM system (Merlin.net™) and transmitting data at least once. Connectivity was measured by the median number of days between consecutive transmissions per patient. Of the initial 9714 patients with SM-RM and 26 679 patients with BM-RM, 9397 patients from each group were matched. Remote monitoring compliance was higher in SM-RM; significantly more patients with SM-RM were enrolled in RM compared with BM-RM (94.4 vs. 85.0%, P < 0.001), similar number of patients in the SM-RM group paired their device (95.1 vs. 95.0%, P = 0.77), but more SM-RM patients transmitted at least once (98.1 vs. 94.3%, P < 0.001). Connectivity was significantly higher in the SM-RM, with patients transmitting data every 1.2 (1.1, 1.7) vs. every 1.7 (1.5, 2.0) days with BM-RM (P < 0.001) and remained better over time. Significantly more SM-RM patients utilized patient-initiated transmissions compared with BM-RM (55.6 vs. 28.1%, P < 0.001). Conclusion In this large real-world study, patients with SM-RM demonstrated improved compliance and connectivity compared with BM-RM.
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Affiliation(s)
- Harish Manyam
- Corresponding author. Tel: +1 423 778 5661, Fax: +1 423 778 5664,
| | - Haran Burri
- Cardiac Pacing Unit, Cardiology Department, University Hospital of Geneva, Rue Gabrielle Perret Gentil 4, 1205 Geneva, Switzerland
| | - Ruben Casado-Arroyo
- Department of Cardiology, Université Libre de Bruxelles, 1070 Bruxelles, Belgium
| | - Niraj Varma
- Cleveland Clinic Heart and Vascular Institute, Cleveland, OH, USA
| | - Carsten Lennerz
- Department of Electrophysiology, German Heart Centre Munich, 80636 Munich, Germany
| | - Didier Klug
- Department of Cardiology, University Hospital of Lille, 59037 Lille, France
| | - Gerald Carr-White
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Kranthi Kolli
- Abbott, Global Data Science and Analytics, CA 95054, USA
| | - Ignacio Reyes
- Abbott, Global Data Science and Analytics, CA 95054, USA
| | | | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
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Ninni S, Gallot-Lavallée T, Klein C, Longère B, Brigadeau F, Potelle C, Crop F, Rault E, Decoene C, Lacornerie T, Lals S, Kouakam C, Pontana F, Lacroix D, Klug D, Mirabel X. Stereotactic Radioablation for Ventricular Tachycardia in the Setting of Electrical Storm. Circ Arrhythm Electrophysiol 2022; 15:e010955. [PMID: 36074658 DOI: 10.1161/circep.122.010955] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stereotactic body radiotherapy (SBRT) has been reported as a safe and efficient therapy for treating refractory ventricular tachycardia (VT) despite optimal medical treatment and catheter ablation. However, data on the use of SBRT in patients with electrical storm (ES) is lacking. The aim of this study was to assess the clinical outcomes associated with SBRT in the context of ES. METHODS This retrospective study included patients who underwent SBRT in the context of ES from March 2020 to March 2021 in one tertiary center (CHU Lille). The target volume was delineated according to a predefined workflow. The efficacy was assessed with the following end points: sustained VT recurrence, VT reduced with antitachycardia pacing, and implantable cardioverter defibrillator shock. RESULTS Seventeen patients underwent SBRT to treat refractory VT in the context of ES (mean 67±12.8 age, 59% presenting ischemic heart disease, mean left ventricular ejection fraction: 33.7± 9.7%). Five patients presented with ES related to incessant VT. Among these 5 patients, the time to effectiveness ranged from 1 to 7 weeks after SBRT. In the 12 remaining patients, VT recurrences occurred in 7 patients during the first 6 weeks following SBRT. After a median 12.5 (10.5-17.8) months follow-up, a significant reduction of the VT burden was observed beyond 6 weeks (-91% [95% CI, 78-103]), P<0.0001). The incidence of implantable cardioverter defibrillator shock and antitachycardia pacing was 36% at 1 year. CONCLUSIONS SBRT is associated with a significant reduction of the VT burden in the event of an ES; however, prospective randomized control trials are needed. In patients without incessant VT, recurrences are observed in half of patients during the first 6 weeks. VT tolerance and implantable cardioverter defibrillator programming adjustments should be integrated as part of an action plan defined before SBRT for each patient.
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Affiliation(s)
- Sandro Ninni
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | - Thomas Gallot-Lavallée
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | - Cédric Klein
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | - Benjamin Longère
- CHU Lille, Institut Cœur-Poumon, Service De Radiologie (B.L., F.P.)
| | - François Brigadeau
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | | | - Frederik Crop
- University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center (F.C., E.R., C.D., T.L., S.L.).,Medical Physics, Centre Oscar Lambret, Lille, France (F.C., E.R., C.D., T.L.)
| | - Erwann Rault
- University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center (F.C., E.R., C.D., T.L., S.L.).,Medical Physics, Centre Oscar Lambret, Lille, France (F.C., E.R., C.D., T.L.)
| | - Camille Decoene
- University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center (F.C., E.R., C.D., T.L., S.L.).,Medical Physics, Centre Oscar Lambret, Lille, France (F.C., E.R., C.D., T.L.)
| | - Thomas Lacornerie
- University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center (F.C., E.R., C.D., T.L., S.L.).,Medical Physics, Centre Oscar Lambret, Lille, France (F.C., E.R., C.D., T.L.)
| | - Séverine Lals
- University Department of Radiation Oncology, Oscar Lambret Comprehensive Cancer Center (F.C., E.R., C.D., T.L., S.L.)
| | - Claude Kouakam
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | - François Pontana
- CHU Lille, Institut Cœur-Poumon, Service De Radiologie (B.L., F.P.)
| | - Dominique Lacroix
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
| | - Didier Klug
- CHU Lille, Institut Cœur-Poumon, Service de Cardiologie (S.N., T.G.L., C.K., F.B., C.K., D.L., D.K.)
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Daire E, Dirani S, Klug D, Dhaenens C, Kyndt F, Fressart V, Jedraszak G. Study of the diagnostic yield of gene panels in long QT syndrome in pediatrics. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Weizman O, Marijon E, Narayanan K, Boveda S, Defaye P, Martins R, Deharo JC, Laurent G, Klug D, Sadoul N, Hocini M, Mansencal N, Anselme F, Da Costa A, Maury P, Ferrières J, Schiele F, Simon T, Danchin N. Incidence, Characteristics, and Outcomes of Ventricular Fibrillation Complicating Acute Myocardial Infarction in Women Admitted Alive in the Hospital. J Am Heart Assoc 2022; 11:e025959. [PMID: 36017613 PMCID: PMC9496428 DOI: 10.1161/jaha.122.025959] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Little data are available in women presenting with ventricular fibrillation (VF) in the setting of acute myocardial infarction (AMI). We assessed frequency, predictors of VF, and outcomes, with a special focus on women compared with men. Methods and Results Data were analyzed from the FAST‐MI (French Registry of Acute ST‐Elevation or Non‐ST‐Elevation Myocardial Infarction) program, which prospectively included 14 406 patients admitted to French cardiac intensive care units ≤48 hours from AMI onset between 1995 and 2015 (mean age, 66±14 years; 72% men; mean left ventricular ejection fraction, 52±12%; 59% with ST‐segment–elevation myocardial infarction). A total of 359 patients developed VF during AMI, including 81 women (2.0% of 4091 women) and 278 men (2.7% of 10 315 men, P=0.02). ST‐segment–elevation myocardial infarction (odds ratio [OR], 2.29 [95% CI, 1.75–2.99]; P<0.001) was independently associated with the onset of VF during AMI. In contrast, female sex (OR, 0.73 [95% CI, 0.56–0.95]; P=0.02), hypertension (OR, 0.75 [95% CI, 0.60–0.94]; P=0.01), and prior myocardial infarction (OR, 0.69 [95% CI, 0.50–0.96]; P=0.03) were protective factors. Women were less likely to have cardiac intervention than men (percutaneous coronary intervention during hospitalization 48.1% versus 66.9%, respectively; P=0.04) with a higher 1‐year mortality in women compared with men (50.6% versus 37.4%, respectively; P=0.03), including increased in‐hospital mortality (42.0% versus 32.7%, respectively; P=0.12). After adjustment, female sex was no longer associated with a worse 1‐year mortality (adjusted hazard ratio, 1.10 [95% CI, 0.75–1.61]; P=0.63). Conclusions Women have lower risk of developing VF during AMI compared with men. However, they are less likely to receive cardiac interventions than men, possibly contributing to missed opportunities of improved outcomes.
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Affiliation(s)
- Orianne Weizman
- Université Paris Cité Inserm, PARCC, F-75015 Paris France.,Faculté de Médecine Université de Lorraine Vandœuvre-lès-Nancy France
| | - Eloi Marijon
- Université Paris Cité Inserm, PARCC, F-75015 Paris France.,Cardiology Department AP-HP, European Georges Pompidou Hospital Paris France
| | | | - Serge Boveda
- Cardiology Department Clinique Pasteur Toulouse France
| | - Pascal Defaye
- Cardiology Department CHU Grenoble La Tronche France
| | | | | | | | - Didier Klug
- Cardiology Department CHU Lille Lille France
| | | | - Meleze Hocini
- Cardiology Department Institut de Rythmologie-Hopital Cardiologique, CHU Bordeaux Pessac France
| | - Nicolas Mansencal
- Cardiology Department AP-HP Hopital Ambroise Paré Boulogne Bilancourt France
| | | | - Antoine Da Costa
- Cardiology Department CHU Saint Etienne Saint Priez en Jarez France
| | - Philippe Maury
- Cardiology Department Rangueil University Hospital Toulouse France
| | - Jean Ferrières
- Cardiology Department Rangueil University Hospital Toulouse France
| | - François Schiele
- Cardiology Department University Hospital Jean Minjoz Besançon France
| | - Tabassome Simon
- Clinical Research Unit Saint-Antoine Hospital AP-HP Paris France
| | - Nicolas Danchin
- Université Paris Cité Inserm, PARCC, F-75015 Paris France.,Cardiology Department AP-HP, European Georges Pompidou Hospital Paris France
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8
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Ninni S, Layec J, Brigadeau F, Behal H, Labreuche J, Klein C, Schurtz G, Potelle C, Coisne A, Lemesle G, Lamblin N, Klug D, Lacroix D. Incidence and predictors of mortality after an electrical storm in the ICU. Eur Heart J Acute Cardiovasc Care 2022; 11:431-439. [PMID: 35512138 DOI: 10.1093/ehjacc/zuac044] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
AIMS For assessing predictors of early mortality following hospitalization for electrical storm (ES), only limited data are available. The purpose of this study was to assess the incidence and predictors of early mortality following hospitalization in the intensive care unit (ICU) for ES in a large retrospective study. METHODS AND RESULTS In this retrospective study, we included all patients who were hospitalized for ES from July 2015 to May 2020 in our tertiary centre. A total of 253 patients were included. The median age was 66 [56; 73], and 64% had ischemic cardiomyopathy. A total of 37% of patients presented hemodynamic instability requiring catecholamine at admission. A total of 17% of patients presented an acute reversible cause for ES. The one-year mortality was 34% (95% CI, 30-43%), mostly driven by heart failure (HF). The multivariable Cox's regression model identified age, left ventricular ejection fraction, right ventricle dysfunction, haemoglobin level as independent predictors of one-year mortality. The use of catecholamine at admission was identified as the only variable related to the initial management of ES associated with an increased 30-day mortality risk (HR: 7.95 (95%CI, 3.18-19.85). CONCLUSION In patients admitted for ES in ICU, the one-year mortality remains high and mostly driven by HF. The use of catecholamine at admission is associated with a seven-fold risk for mortality within 30 days. In such patients, the potential use of VT ablation can be questioned and a careful action plan regarding invasive HF-related therapy could be considered.
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Affiliation(s)
- Sandro Ninni
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Jeremy Layec
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - François Brigadeau
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Hélène Behal
- Univ. Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, F59000 Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, F59000 Lille, France
| | - Cédric Klein
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Guillaume Schurtz
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Charlotte Potelle
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Augustin Coisne
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Gilles Lemesle
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Nicolas Lamblin
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Didier Klug
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
| | - Dominique Lacroix
- CHU Lille, Institut Coeur-Poumon, service de cardiologie, F-59000 Lille, France
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9
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Ninni S, Gallot Lavallee T, Klein C, Longere B, Brigadeau F, Potelle C, Crop F, Rault E, Lacornerie T, Lals S, Kouakam C, Pontana F, Lacroix D, Klug D, Mirabel X. Stereotactic radiosurgery for ablation of ventricular tachycardia in the setting of electrical storm. Europace 2022. [DOI: 10.1093/europace/euac053.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Stereotactic body radiotherapy (SBRT) has been reported as a safe and efficient therapy to treat refractory VT despite optimal medical treatment and/or catheter ablation (CA). However data in the setting of ES are lacking.
Objectives
The aim of this study was to assess the clinical outcomes associated with SBRT in the setting of ES.
Methods
This retrospective study included patients who underwent SBRT in the setting of ES from March 2019 to March 2021 in one tertiary center (CHU Lille). Target volume was delineated according to a predefined workflow. The efficacy was assessed with the following endpoints: sustained VT recurrence, VT reduced with ATP or ICD shock.
Results
17 patients underwent SBRT to treat refractory VT in the setting of ES (Mean age: 67±12.8, 59% presenting ischemic heart disease, mean LVEF: 33.7± 9.7%). After a median follow-up of 7 [5; 16] months, a reduction in VT burden was observed in all patients after a 6-week blanking period. 6 patients presented an increase of the VT burden from week 2 to week 6 following SBRT despite an initial reduction of VT burden. No patient experienced ICD shocks beyond 6 weeks.
Conclusion
SBRT is efficient in treating recurrent VT in the setting of ES with failure and/or contraindication to CA. One third of patient present a transient increase in VT burden during a 6 weeks blanking period. Therefore, VT tolerance should be integrated as part of an action plan defined upstream to SBRT for each patient.
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Affiliation(s)
- S Ninni
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | | | - C Klein
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - B Longere
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - F Brigadeau
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - C Potelle
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - F Crop
- Centre Oscar Lambret, lille, France
| | - E Rault
- Centre Oscar Lambret, lille, France
| | | | - S Lals
- Centre Oscar Lambret, lille, France
| | - C Kouakam
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - F Pontana
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - D Lacroix
- Chru De Lille - Institut Coeur-Poumons, Lille, France
| | - D Klug
- Chru De Lille - Institut Coeur-Poumons, Lille, France
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10
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Kamakura T, Gourraud JB, Clementy N, Maury P, Mansourati J, Klug D, Da Costa A, Pasquie JL, Mabo P, Chavernac P, Laurent G, Defaye P, Laborderie J, Leenhardt A, Sadoul N, Deharo JC, Giraudeau C, Quentin A, Jesel L, Thollet A, Tixier R, Derval N, Haissaguerre M, Probst V, Sacher F. Outcome of Patients with Early Repolarization Pattern and Syncope. Heart Rhythm 2022; 19:1306-1314. [PMID: 35395407 DOI: 10.1016/j.hrthm.2022.03.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Syncope in patients with an early repolarization (ER) pattern presents a challenge for clinicians as it has been identified as an indicator of a higher risk of life-threatening ventricular arrhythmias (VAs). OBJECTIVE This study aimed to analyze the outcome of patients with an ER pattern and syncope, and to evaluate the factors predictive of VAs. METHODS Over a period of 5 years, we enrolled 143 patients with an ER pattern and syncope in a multicenter prospective registry. RESULTS Following the initial examinations, 97 patients (67.8%) were implanted with a device allowing electrocardiogram monitoring, including 84 with an implantable loop recorder. During a mean follow-up of 68 ± 34 months, we documented 16 arrhythmias presumably responsible for syncope (5 VAs, 10 bradycardias, and 1 supraventricular tachycardia). Additionally, recurrent syncope not associated with electrocardiogram documentation occurred in 16 patients (11.2%). The cause of syncope was identified in 23 of 97 (23.8%) patients with a monitoring device. The 5-year incidence of VAs and arrhythmic events presumably responsible for syncope was 4.9% and 11.0%, respectively. Patients who developed VAs showed no prodromes or specific triggers at the time of syncope. Neither the presence of a family history of sudden cardiac death nor the previously reported high-risk electrocardiographic parameters differed between patients with and without VAs. CONCLUSIONS VAs occurred in 4.9% of patients with an ER pattern and syncope. Device implantation based on detailed history taking seems to be a reasonable strategy. Previously reported high-risk electrocardiographic patterns did not identify patients with VAs.
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Affiliation(s)
- Tsukasa Kamakura
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Univ. Bordeaux, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France
| | - Jean-Baptiste Gourraud
- Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France
| | - Nicolas Clementy
- Department of Cardiology, University Hospital of Tours, Tours, France
| | - Philippe Maury
- Department of Cardiology, University Hospital Rangueil, Toulouse, France
| | | | - Didier Klug
- Department of Electrophysiology, Lille University Hospital, Lille, France
| | - Antoine Da Costa
- Department of Cardiology, Saint-Etienne University Hospital, France
| | - Jean-Luc Pasquie
- Department of Cardiology and PhyMedExp, Université Montpellier, INSERM, CNRS, CHRU Montpellier University Hospital, France
| | - Philippe Mabo
- Department of Cardiology, Rennes University Hospital, France
| | | | | | - Pascal Defaye
- Department of Cardiology, Grenoble University Hospital, France
| | | | | | - Nicolas Sadoul
- Department of Cardiology, Nancy University Hospital, France
| | | | | | - Anne Quentin
- Department of Cardiology, Centre Hospitalier de Saint Brieuc, France
| | - Laurence Jesel
- Department of Cardiology, Strasbourg University Hospital, France
| | - Aurelie Thollet
- Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France
| | - Romain Tixier
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Univ. Bordeaux, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France
| | - Nicolas Derval
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Univ. Bordeaux, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France
| | - Michel Haissaguerre
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Univ. Bordeaux, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France
| | - Vincent Probst
- Department of Cardiology, National Reference Centre for Inherited Cardiac Arrhythmia, L'institut du thorax, INSERM, CNRS, University of Nantes, Nantes University Hospital, Nantes, France
| | - Frederic Sacher
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, Univ. Bordeaux, Bordeaux University Hospital (CHU), F-33600 Pessac-Bordeaux, France.
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11
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Decoin R, Butruille L, Defrancq T, Robert J, Destrait N, Coisne A, Aghezzaf S, Woitrain E, Gouda Z, Schino S, Klein C, Maboudou P, Brigadeau F, Klug D, Vincentelli A, Dombrowicz D, Staels B, Montaigne D, Ninni S. High liver fibrosis scores in metabolic dysfunction-associated fatty liver disease patients are associated with adverse atrial remodeling and atrial fibrillation recurrence following catheter ablation. Front Endocrinol (Lausanne) 2022; 13:957245. [PMID: 36120456 PMCID: PMC9471263 DOI: 10.3389/fendo.2022.957245] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/01/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A number of epidemiological studies have suggested an association between metabolic dysfunction-associated fatty liver disease (MAFLD) and the incidence of atrial fibrillation (AF). However, the pathogenesis leading to AF in the context of MAFLD remains unclear. We therefore aimed at assessing the impact of MAFLD and liver fibrosis status on left atrium (LA) structure and function. METHODS Patients with a Fatty Liver Index (FLI) >60 and the presence of metabolic comorbidities were classified as MAFLD+. In MAFLD+ patients, liver fibrosis severity was defined using the non-alcoholic fatty liver disease (NAFLD) Fibrosis Score (NFS), as follows: MAFLD w/o fibrosis (NFS ≦ -1.455), MAFLD w/indeterminate fibrosis (-1.455 < NFS < 0.675), and MAFLD w/fibrosis (NFS ≧ 0.675). In the first cohort of patients undergoing AF ablation, the structural and functional impact on LA of MAFLD was assessed by LA strain analysis and endocardial voltage mapping. Histopathological assessment of atrial fibrosis was performed in the second cohort of patients undergoing cardiac surgery. Finally, the impact of MAFLD on AF recurrence following catheter ablation was assessed. RESULTS In the AF ablation cohort (NoMAFLD n = 123; MAFLD w/o fibrosis n = 37; MAFLD indeterm. fibrosis n = 75; MAFLD w/severe fibrosis n = 10), MAFLD patients with high risk of F3-F4 liver fibrosis presented more LA low-voltage areas as compared to patients without MAFLD (16.5 [10.25; 28] vs 5.0 [1; 11] low-voltage areas p = 0.0115), impaired LA reservoir function assessed by peak left atrial longitudinal strain (19.7% ± 8% vs 8.9% ± 0.89% p = 0.0268), and increased LA volume (52.9 ± 11.7 vs 43.5 ± 18.0 ml/m2 p = 0.0168). Accordingly, among the MAFLD patients, those with a high risk of F3-F4 liver fibrosis presented a higher rate of AF recurrence during follow-up (p = 0.0179). In the cardiac surgery cohort (NoMAFLD n = 12; MAFLD w/o fibrosis n = 5; MAFLD w/fibrosis n = 3), an increase in histopathological atrial fibrosis was observed in MAFLD patients with a high risk of F3-F4 liver fibrosis (p = 0.0206 vs NoMAFLD; p = 0.0595 vs MAFLD w/o fibrosis). CONCLUSION In conclusion, we found that liver fibrosis scoring in MAFLD patients is associated with adverse atrial remodeling and AF recurrences following catheter ablation. The impact of the management of MAFLD on LA remodeling and AF ablation outcomes should be assessed in dedicated studies.
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Affiliation(s)
- Raphaël Decoin
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | - Laura Butruille
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | | | | | | | - Augustin Coisne
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
- CHU Lille, Institut Coeur-Poumon, Lille, France
| | | | - Eloise Woitrain
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | - Zouriatou Gouda
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | | | | | - Patrice Maboudou
- CHU Lille, Biochemistry Emergency, Lille, France
- CHU Lille, Service de Biochimie Automatisée Protéines, Lille, France
| | | | - Didier Klug
- CHU Lille, Institut Coeur-Poumon, Lille, France
| | - Andre Vincentelli
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
- CHU Lille, Institut Coeur-Poumon, Lille, France
| | - David Dombrowicz
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | - Bart Staels
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
| | - David Montaigne
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
- CHU Lille, Institut Coeur-Poumon, Lille, France
| | - Sandro Ninni
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011 - EGID, Lille, France
- CHU Lille, Institut Coeur-Poumon, Lille, France
- *Correspondence: Sandro Ninni,
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12
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Blancard M, Touat-Hamici Z, Aguilar-Sanchez Y, Yin L, Vaksmann G, Roux-Buisson N, Fressart V, Denjoy I, Klug D, Neyroud N, Ramos-Franco J, Gomez AM, Guicheney P. A Type 2 Ryanodine Receptor Variant in the Helical Domain 2 Associated with an Impairment of the Adrenergic Response. J Pers Med 2021; 11:jpm11060579. [PMID: 34202968 PMCID: PMC8235491 DOI: 10.3390/jpm11060579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is triggered by exercise or acute emotion in patients with normal resting electrocardiogram. The major disease-causing gene is RYR2, encoding the cardiac ryanodine receptor (RyR2). We report a novel RYR2 variant, p.Asp3291Val, outside the four CPVT mutation hotspots, in three CPVT families with numerous sudden deaths. This missense variant was first identified in a four-generation family, where eight sudden cardiac deaths occurred before the age of 30 in the context of adrenergic stress. All affected subjects harbored at least one copy of the RYR2 variant. Three affected sisters were homozygous for the variant. The same variant was found in two additional CPVT families. It is located in the helical domain 2 and changes a negatively charged amino acid widely conserved through evolution. Functional analysis of D3291V channels revealed a normal response to cytosolic Ca2+, a markedly reduced luminal Ca2+ sensitivity and, more importantly, an absence of normal response to 8-bromo-cAMP and forskolin stimulation in both transfected HEK293 and HL-1 cells. Our data support that the D3291V-RyR2 is a loss-of-function RyR2 variant responsible for an atypical form of CPVT inducing a mild dysfunction in basal conditions but leading potentially to fatal events through its unresponsiveness to adrenergic stimulation.
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Affiliation(s)
- Malorie Blancard
- Inserm, UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, 75013 Paris, France; (Z.T.-H.); (N.N.); (P.G.)
- Correspondence:
| | - Zahia Touat-Hamici
- Inserm, UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, 75013 Paris, France; (Z.T.-H.); (N.N.); (P.G.)
| | - Yuriana Aguilar-Sanchez
- Department of Physiology & Biophysics, Rush University Medical Center, Chicago, IL 60612, USA; (Y.A.-S.); (J.R.-F.)
| | - Liheng Yin
- Inserm, UMRS 1180, Université Paris Saclay, 92290 Châtenay-Malabry, France; (L.Y.); (A.M.G.)
| | - Guy Vaksmann
- Service de Cardiologie Pédiatrique, Hôpital Privé de la Louvière, 59042 Lille, France;
| | | | | | - Isabelle Denjoy
- Département de Cardiologie, Centre de Référence des Maladies Cardiaques Héréditaires, Hôpital Bichat, AP-HP, 75018 Paris, France;
| | - Didier Klug
- Hôpital Cardiologique, CHRU de Lille, 59000 Lille, France;
| | - Nathalie Neyroud
- Inserm, UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, 75013 Paris, France; (Z.T.-H.); (N.N.); (P.G.)
| | - Josefina Ramos-Franco
- Department of Physiology & Biophysics, Rush University Medical Center, Chicago, IL 60612, USA; (Y.A.-S.); (J.R.-F.)
| | - Ana Maria Gomez
- Inserm, UMRS 1180, Université Paris Saclay, 92290 Châtenay-Malabry, France; (L.Y.); (A.M.G.)
| | - Pascale Guicheney
- Inserm, UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, 75013 Paris, France; (Z.T.-H.); (N.N.); (P.G.)
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13
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Spaulding C, Armero S, Champagnac D, Bhugaloo H, Ternacle J, Lellouche N, Audureau E, Le Corvoisier P. Left atrial appendage closure for stroke prevention in atrial fibrillation: Final report from the French left atrial appendage closure registry. Catheter Cardiovasc Interv 2021; 98:788-799. [PMID: 34051135 DOI: 10.1002/ccd.29795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The French left atrial appendage (LAA) closure registry (FLAAC) aimed to assess the safety and efficacy of LAA closure in daily practice. BACKGROUND LAA closure has emerged as an alternative for preventing thromboembolic events (TE) in patients with non-valvular atrial fibrillation (NVAF). Clinical data in this field remains limited and few investigator-initiated, real-world registries have been reported. METHODS This nationwide, prospective study was performed in 36 French centers. The primary endpoint was the TE rate after successful LAA closure. RESULTS The FLAAC registry included 816 patients with a mean age of 75.5 ± 0.3 years, mean follow-up of 16.0 ± 0.3 months, high TE (CHA2 DS2 -VASc score: 4.6 ± 0.1) and bleeding risks (HAS-BLED score: 3.2 ± 0.05) and common contraindications to long-term anticoagulation (95.7%). Procedure or device-related serious adverse events occurred in 49 (6.0%) patients. The annual rate of ischemic stroke/systemic embolism was 3.3% (2.4-4.6). This suggests a relative 57% reduction compared to the risk of stroke in historical NVAF populations without antithrombotic therapy. By multivariate analysis, history of TE was the only factor associated with stroke/systemic embolism during follow-up (HR, 3.3 [1.58-6.89], p = 0.001). The annual mortality rate was 10.2% (8.4-12.3). Most of the deaths were due to comorbidities or underlying cardiovascular diseases and unrelated to the device or to TE. CONCLUSIONS Our study suggests that LAA closure can be an option in patients with NVAF. Long-term follow-up mortality was high, mostly due to comorbidities and underlying cardiovascular diseases, highlighting the importance of multidisciplinary management after LAA closure. REGISTRATION NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France
| | - Pascal Defaye
- Department of Rhythmology, University Hospital of Grenoble-Alpes, Grenoble, France
| | | | - Sélim Abbey
- Interventional Cardiology Unit, Hôpital Prive du Confluent, Nantes, France
| | - Didier Klug
- Department of Electrophysiology, Lille University Hospital, Lille, France
| | - Jean-Michel Juliard
- Département de Cardiologie, Hôpital Bichat, Université Paris-Diderot, Inserm U-1148, AP-HP, Paris, France
| | - Christian Spaulding
- Department of Cardiology, European Hospital Georges Pompidou, AP-HP, Paris Descartes University, INSERM U 970, Sudden Cardiac Death Expert Center, Paris, France
| | | | | | - Hamza Bhugaloo
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France
| | - Julien Ternacle
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Nicolas Lellouche
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Etienne Audureau
- Public Health Department, Hôpital Henri Mondor, Créteil, France.,U955-IMRB, Equipe CEpiA, Inserm, UPEC, Créteil, France
| | - Philippe Le Corvoisier
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France.,U955-IMRB, Equipe 03, Inserm, UPEC, Ecole Nationale Vétérinaire d'Alfort, Créteil, France
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14
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Guédon-Moreau L, Finat L, Klein C, Kouakam C, Marquié C, Klug D, Potelle C, Ninni S, Brigadeau F, Mirabel X, Lacroix D. Usefulness of remote monitoring for the early detection of back-up mode in implantable cardioverter defibrillators. Arch Cardiovasc Dis 2021; 114:287-292. [PMID: 33526375 DOI: 10.1016/j.acvd.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/07/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Reversion of an implantable cardioverter defibrillator (ICD) to back-up mode degrades the operating capabilities of the device, puts patients at risk and requires rapid intervention by a manufacturer's technician. AIM To illustrate the usefulness of remote monitoring of ICDs for the early detection of reversion to back-up mode. METHODS In our centre, all patients implanted with an ICD, with or without resynchronisation, were offered remote monitoring as soon as the technology became available. Alerts triggered by the remote monitoring system were included prospectively in a register. During a mean follow-up of 5.7±1.3 years, a total of 1594 patients with an ICD (441 with resynchronisation function) followed with remote monitoring were included in the register. RESULTS Among 15,874 alerts, only 10 were related to a reversion to back-up mode. Among those, seven reversions were caused by radiotherapy, two were fake events and one was caused by magnetic resonance imaging. Except for the two fake events, the eight other patients had an emergency admission for the resetting and reprogramming of their ICD. None of the reversion to back-up mode alerts was followed by a clinical alert (i.e. a shock alert) before the ICD problem was resolved. CONCLUSIONS Reversion to back-up mode is a very rare event, accounting for 0.06% of total alerts; remote monitoring facilitates the early detection of this critical event to resolve the problem faster than the next scheduled follow-up. Remote monitoring can prevent serious damage to the patient and avoids systematic ambulatory control of the ICD after each radiotherapy session.
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Affiliation(s)
- Laurence Guédon-Moreau
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France.
| | - Loïc Finat
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France
| | - Cédric Klein
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France
| | - Claude Kouakam
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Centre Oscar-Lambret, Cancer centre, 59000 Lille, France
| | - Christelle Marquié
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France
| | - Didier Klug
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France
| | - Charlotte Potelle
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France
| | - Sandro Ninni
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France
| | - François Brigadeau
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France
| | - Xavier Mirabel
- Centre Oscar-Lambret, Cancer centre, 59000 Lille, France
| | - Dominique Lacroix
- Department of cardiovascular medicine, heart & lung institute, Lille university hospital, 59037 Lille, France; Faculty of medicine, Lille university, 59045 Lille, France
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15
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Sacher F, Gandjbakhch E, Maury P, Jenny C, Khalifa J, Boveda S, Defaye P, Gras D, Klug D, Laurent G, Lellouche N, Mansourati J, Marijon E, Piot O, Taieb J, Cochet H, Maingon P, Pruvot E, Fauchier L. Focus on stereotactic radiotherapy: A new way to treat severe ventricular arrhythmias? Arch Cardiovasc Dis 2021; 114:140-149. [PMID: 33478860 DOI: 10.1016/j.acvd.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 02/07/2023]
Abstract
Ventricular tachycardia has a significant recurrence rate after ablation for several reasons, including inaccessible substrate. A non-invasive technique to ablate any defined areas of myocardium involved in arrhythmogenesis would be a potentially important therapeutic improvement if shown to be safe and effective. Early feasibility studies of single-fraction stereotactic body radiotherapy have demonstrated encouraging results, but rigorous evaluation and follow-up are required. In this document, the basic concepts of stereotactic body radiotherapy are summarized, before focusing on stereotactic arrhythmia radioablation. We describe the effect of radioablation on cardiac tissue and its interaction with intracardiac devices, depending on the dose. The different clinical studies on ventricular tachycardia radioablation are analysed, with a focus on target identification, which is the key feature of this approach. Our document ends with the indications and requirements for practicing this type of procedure in 2020. Finally, because of the limited number of patients treated so far, we encourage multicentre registries with long-term follow-up.
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Affiliation(s)
- Frédéric Sacher
- Department of cardiology, IHU Liryc, electrophysiology and heart modelling institute, Bordeaux university hospital (CHU), university of Bordeaux, 33600 Pessac, France.
| | - Estelle Gandjbakhch
- Department of cardiology, La Pitié-Salpétrière university hospital, AP-HP, 75013 Paris, France
| | - Philippe Maury
- Department of cardiology, Toulouse university hospital, 31059 Toulouse, France
| | - Catherine Jenny
- Department of radiotherapy, La Pitié-Salpétrière university hospital, AP-HP, 75013 Paris, France
| | - Jonathan Khalifa
- Departments of radiotherapy and cardiology, Toulouse university hospital, 31059 Toulouse, France
| | - Serge Boveda
- Department of cardiology, clinique Pasteur, 31076 Toulouse, France
| | - Pascal Defaye
- Department of cardiology, Grenoble university hospital, 38700 La Tronche, France
| | - Daniel Gras
- Department of cardiology, nouvelles cliniques nantaises, 44277 Nantes, France
| | - Didier Klug
- Department of cardiology, Lille university hospital, 59000 Lille, France
| | - Gabriel Laurent
- Department of cardiology, Dijon university hospital, 21000 Dijon, France
| | - Nicolas Lellouche
- Department of cardiology, hôpital Henri-Mondor, AP-HP, 94010 Créteil, France
| | - Jacques Mansourati
- Department of cardiology, Brest university hospital, 29609 Brest, France
| | - Eloi Marijon
- Department of cardiology, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - Olivier Piot
- Department of cardiology, centre cardiologique du nord, 93200 Saint-Denis, France
| | - Jerome Taieb
- Department of cardiology, Aix-en-Provence hospital, 13616 Aix-en-Provence, France
| | - Hubert Cochet
- Department of radiology, IHU Liryc, electrophysiology and heart modelling institute, Bordeaux university hospital (CHU), university of Bordeaux, 33600 Pessac, France
| | - Philippe Maingon
- Department of radiotherapy, La Pitié-Salpétrière university hospital, AP-HP, 75013 Paris, France
| | - Etienne Pruvot
- Department of cardiology, CHUV, 1011 Lausanne, Switzerland
| | - Laurent Fauchier
- Department of cardiology, Tours university hospital, 37000 Tours, France
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16
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Anys S, Rigade S, Rigade S, Baron E, Baron E, Lecointe S, Lecointe S, Guyomarch B, Guyomarch B, Klug D, Klug D, Babuty D, Babuty D, Mansourati J, Mansourati J, Bordachar P, Bordachar P, Mabo P, Mabo P, Thollet A, Thollet A, Dina C, Dina C, Schott J, Schott J, Barc J, Barc J, Probst V, Probst V. GENECHOC study: genetic markers of arrhythmic risk in heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Ventricular arrhythmic events are responsible for 50% of death in heart failure but no reliable predictive marker is known to discriminate patients at risk of fatal arrhythmia. Interestingly, familial predisposition has been reported suggesting a role of genetic factors.
Purpose
Identify genetic markers increasing the arrhythmic risk in heart failure population.
Method
We prospectively included heart failure patients with left ventricular ejection fraction (LVEF) under 35% and a cardioverter defibrillator in primary prevention in 22 French centres between 2009 and 2017. Patients were followed for 72 months and divided into two groups: cases with an arrhythmic event during follow-up and controls. A Genome Wide Association Study (GWAS) was done. Single Nucleotide Polymorphisms (SNPs) genotyping was performed on Affymetrix Axiom Precision Medicine Research Array plates. To complement the directly genotyped SNPs we performed large-scale imputation based on the Haplotype Reference Consortium European ancestry panel leading to a dataset of 7,5 million of SNPs.
Results
332 cases and 567 controls were included (86% men, mean age at implantation 52±11 years). 78% of patients had ischaemic cardiopathy, 20% had dilated cardiomyopathy. Mean LVEF was 27±5%. No statistical difference was found between cases and controls on clinical parameters, biological results, electrocardiographic measures. No locus shows genome-wide significant association (p<5.10–8) on the GWAS analysis. However, 16 signals with a p-value between 5.10–8 and 5.10–5 were investigated. eQTL and chromatin conformation point to 35 genes with cardiac expression previously associated with heart failure, cardiomyopathies, cardiogenesis, arrhythmias and inflammation. Variants identified point to regulatory regions of the genome and may then propose a molecular mechanism predisposing patients to arrhythmias.
Conclusion
No locus raises genome-wide significance, but several signals with a nominal p-value point to relevant genes and pathways. Replication of the GWAS is ongoing on a cohort of 156 new patients with a less severe cardiopathy implanted with a cardioverter defibrillator in secondary prevention.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Nantes University Hospital
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Affiliation(s)
- S Anys
- University Hospital of Nantes, Nantes, France
| | - S Rigade
- Institute of Thorax, Nantes, France
| | - S Rigade
- Institute of Thorax, Nantes, France
| | - E Baron
- Institute of Thorax, Nantes, France
| | - E Baron
- Institute of Thorax, Nantes, France
| | | | | | - B Guyomarch
- University Hospital of Nantes, Nantes, France
| | - B Guyomarch
- University Hospital of Nantes, Nantes, France
| | - D Klug
- CHRU Lille, Lille, France
| | - D Klug
- CHRU Lille, Lille, France
| | - D Babuty
- University Hospital of Tours, Tours, France
| | - D Babuty
- University Hospital of Tours, Tours, France
| | | | | | - P Bordachar
- University Hospital of Bordeaux, Bordeaux, France
| | - P Bordachar
- University Hospital of Bordeaux, Bordeaux, France
| | - P Mabo
- Hospital Pontchaillou of Rennes, Rennes, France
| | - P Mabo
- Hospital Pontchaillou of Rennes, Rennes, France
| | - A Thollet
- University Hospital of Nantes, Nantes, France
| | - A Thollet
- University Hospital of Nantes, Nantes, France
| | - C Dina
- Institute of Thorax, Nantes, France
| | - C Dina
- Institute of Thorax, Nantes, France
| | | | | | - J Barc
- Institute of Thorax, Nantes, France
| | - J Barc
- Institute of Thorax, Nantes, France
| | - V Probst
- University Hospital of Nantes, Nantes, France
| | - V Probst
- University Hospital of Nantes, Nantes, France
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17
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Perrin T, Boveda S, Defaye P, Rosier A, Sadoul N, Bordachar P, Klug D, Ritter P, Belhameche M, Babuty D, Mansourati J, Lazarus A, Deharo JC. Role of medical reaction in management of inappropriate ventricular arrhythmia diagnosis: the inappropriate Therapy and HOme monitoRiNg (THORN) registry. Europace 2020; 21:607-615. [PMID: 30605510 PMCID: PMC6452297 DOI: 10.1093/europace/euy284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/05/2018] [Indexed: 12/19/2022] Open
Abstract
AIMS Implantable cardioverter-defibrillators (ICDs) reduce sudden cardiac death in selected patients but inappropriate ICD shocks have been associated with increased mortality. The THORN registry aims to describe the rate of inappropriate ventricular arrhythmia diagnoses and therapies in patients followed by remote monitoring, as well as the following delay to next patient contact (DNPC). METHODS AND RESULTS One thousand eight hundred and eighty-two patients issued from a large remote monitoring database first implanted with an ICD for primary or secondary prevention in 110 French hospitals from 2007 to 2014 constitute the THORN population. Among them, 504 patients were additionally followed prospectively for evaluation of the DNPC. Eight hundred and ninety-five out of 1551 (58%) patients had ischaemic heart disease and 358/771 (46%) were implanted for secondary prevention. During 13.7 ± 3.4 months of follow-up, the prevalence of first inappropriate diagnosis in a ventricular arrhythmia zone with enabled therapy was 162/1882 (9%). Among those patients, 122/162 (75%) suffered at least one inappropriate therapy and 58/162 (36%) at least one inappropriate shock. Eighty-three out of 162 (51%) of first inappropriate diagnosis occurred during the first 4 months following implantation. The median DNPC was 8 days (interquartile range 1-26). At least one other day with recording of an inappropriate diagnosis of the same cause occurred in 13/43 (30%) of available DNPC periods, with an inappropriate therapy in 7/13 (54%). CONCLUSION Inappropriate diagnoses occurred in 9% of patients implanted with an ICD during the first 14 months. The DNPC after inadequate ventricular arrhythmia diagnoses remains long in daily practice and should be optimized. CLINICALTRIALS.GOV IDENTIFIER NCT01594112.
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Affiliation(s)
- Tilman Perrin
- Department of Cardiology, Centre Hospitalier Universitaire La Timone, Marseille, France
| | - Serge Boveda
- Department of Cardiology, Clinique Pasteur, Toulouse, France
| | - Pascal Defaye
- Department of Cardiology, Centre Hospitalier Universitaire Albert Michalon, Grenoble, France
| | - Arnaud Rosier
- Department of Cardiology, Hôpital Privé Jacques Cartier, Massy, France
| | - Nicolas Sadoul
- Department of Cardiology, Centre Hospitalier Universitaire Brabois, Nancy, France
| | - Pierre Bordachar
- Department of Cardiology, Centre Hospitalier Universitaire de Haut-Lévêque, Pessac, France
| | - Didier Klug
- Department of Cardiology, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Philippe Ritter
- Department of Cardiology, Centre Hospitalier Universitaire de Haut-Lévêque, Pessac, France
| | - Mohamed Belhameche
- Department of Cardiology, Centre Hospitalier de Marne-la-Vallée, Jossigny, France
| | - Dominique Babuty
- Department of Cardiology, Centre Hospitalier Régional Universitaire Trousseau, Chambray-lès-Tours, France
| | - Jacques Mansourati
- Department of Cardiology, Centre Régional Hospitalier Universitaire Brest, Hôpital de La Cavale Blanche, Brest, France
| | - Arnaud Lazarus
- Department of Cardiology, Clinique Ambroise Paré, Neuilly-sur-Seine, France
| | - Jean-Claude Deharo
- Department of Cardiology, Centre Hospitalier Universitaire La Timone, Marseille, France
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18
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Anys S, Baron E, Lecointe S, Guyomarch B, Klug D, Babuty D, Jesel L, Dupuis J, Defaye P, Maury P, Pasquie J, Le Franc P, Anselme F, Boveda S, Olivier A, Thollet A, Dina C, Schott J, Barc J, Probst V. Genechoc Study Genetic markers of arrhythmic risk in heart failure. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Dacher JN, Gandjbakhch E, Taieb J, Chauvin M, Anselme F, Bartoli A, Boyer L, Cassagnes L, Cochet H, Dubourg B, Fauchier L, Gras D, Klug D, Laurent G, Mansourati J, Marijon E, Maury P, Piot O, Pontana F, Sacher F, Sadoul N, Boveda S, Jacquier A. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology (SFC) and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) on magnetic resonance imaging in patients with cardiac electronic implantable devices. Diagn Interv Imaging 2020; 101:507-517. [PMID: 32094095 DOI: 10.1016/j.diii.2020.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 11/15/2022]
Abstract
Magnetic resonance imaging (MRI) has become the reference imaging for the management of a large number of diseases. The number of MR examinations increases every year, simultaneously with the number of patients receiving a cardiac electronic implantable device (CEID). A CEID was considered an absolute contraindication for MRI for years. The progressive replacement of conventional pacemakers and defibrillators by MR-conditional CEIDs and recent data on the safety of MRI in patients with "MR-nonconditional" CEIDs have progressively increased the demand for MRI in patients with a CEID. However, some risks are associated with MRI in CEID carriers, even with "MR-conditional" devices because these devices are not "MR-safe". A specific programing of the device in "MR-mode" and monitoring patients during MRI remain mandatory for all patients with a CEID. A standardized patient workflow based on an institutional protocol should be established in each institution performing such examinations. This joint position paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) describes the effect and risks associated with MRI in CEID carriers. We propose recommendations for patient workflow and monitoring and CEID programming in MR-conditional, "MR-conditional nonguaranteed" and MR-nonconditional devices.
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Affiliation(s)
- J-N Dacher
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France.
| | - E Gandjbakhch
- Sorbonne Universités, AP-HP, Heart Institute, La Pitié-Salpêtrière University Hospital, 75013 Paris, France
| | - J Taieb
- Hospital of Aix-en-Provence, Department of Cardiology, 13100 Aix-en-Provence, France
| | - M Chauvin
- Université de Strasbourg, CHU Strasbourg, Department of Cardiology, 67000 Strasbourg, France
| | - F Anselme
- Normandie UNIV, UNIROUEN, CHU Rouen, Department of Cardiology, 76000 Rouen, France
| | - A Bartoli
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
| | - L Boyer
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - L Cassagnes
- Université Clermont Auvergne, CHU Clermont-Ferrand, Department of Radiology, 63000 Clermont-Ferrand, France
| | - H Cochet
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, 33600 Pessac, France
| | - B Dubourg
- Normandie UNIV, UNIROUEN, Inserm U1096, CHU Rouen, Department of Radiology, Cardiac Imaging Unit, 76000 Rouen, France
| | - L Fauchier
- Université de Tours, CHU de Tours, Department of Cardiology, 37000 Tours, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Department of Cardiology, 44200 Nantes, France
| | - D Klug
- Université de Lille, CHRU de Lille, Department of Cardiology, 59000 Lille, France
| | - G Laurent
- Université de Dijon, CHU de Dijon, Department of Cardiology, 21000 Dijon, France
| | - J Mansourati
- Université de Bretagne Occidentale, CHU de Brest, Department of Cardiology, 29200 Brest, France
| | - E Marijon
- Université de Paris, AP-HP, Department of Cardiology, Georges-Pompidou European University Hospital, 75015 Paris, France
| | - P Maury
- Université de Toulouse, Inserm U1048, Department of Cardiology, Hospital Rangueil, 31059 Toulouse, France
| | - O Piot
- Centre Cardiologique du Nord, Department of Cardiology, 93200 Saint-Denis, France
| | - F Pontana
- Université de Lille, Inserm U1011, Department of Cardiovascular Radiology, Institut Cœur-Poumon, 59000 Lille, France
| | - F Sacher
- Université de Bordeaux-Inserm, IHU LIRYC, CHU de Bordeaux, Department of Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France
| | - N Sadoul
- Université de Nancy Lorraine, CHU de Nancy, Department of Cardiology, 54511 Vandœuvre-lès-Nancy, France
| | - S Boveda
- Clinique Pasteur, Department of Cardiology, 31076 Toulouse, France
| | - A Jacquier
- Université Aix-Marseille, Centre Hospitalo-Universitaire Timone, AP-HM, Department of Radiology, CNRS, CRMBM, CEMEREM, 13005 Marseille, France
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20
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Duthoit G, Silvain J, Marijon E, Ducrocq G, Lepillier A, Frere C, Dimby SF, Popovic B, Lellouche N, Martin-Toutain I, Spaulding C, Brochet E, Attias D, Mansourati J, Lorgis L, Klug D, Zannad N, Hauguel-Moreau M, Braik N, Deltour S, Ceccaldi A, Wang H, Hammoudi N, Brugier D, Vicaut E, Juliard JM, Montalescot G. Reduced Rivaroxaban Dose Versus Dual Antiplatelet Therapy After Left Atrial Appendage Closure. Circ Cardiovasc Interv 2020; 13:e008481. [DOI: 10.1161/circinterventions.119.008481] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background:
Percutaneous left atrial appendage closure (LAAC) exposes to the risk of device thrombosis in patients with atrial fibrillation who frequently have a contraindication to full anticoagulation. Thereby, dual antiplatelet therapy (DAPT) is usually preferred. No randomized study has evaluated nonvitamin K antagonist oral anticoagulant after LAAC, and we decided to evaluate the efficacy and safety of reduced doses of rivaroxaban after LAAC.
Methods:
ADRIFT (Assessment of Dual Antiplatelet Therapy Versus Rivaroxaban in Atrial Fibrillation Patients Treated With Left Atrial Appendage Closure) is a multicenter, phase IIb study, which randomized 105 patients after successful LAAC to either rivaroxaban 10 mg (R
10
, n=37), rivaroxaban 15 mg (R
15
, n=35), or DAPT with aspirin 75 mg and clopidogrel 75 mg (n=33). The primary end point was thrombin generation (prothrombin fragments 1+2) measured 2 to 4 hours after drug intake, 10 days after treatment initiation. Thrombin-antithrombin complex, D-dimers, rivaroxaban concentrations were also measured at 10 days and 3 months. Clinical end points were evaluated at 3-month follow-up.
Results:
The primary end point was reduced with R
10
(179 pmol/L [interquartile range (IQR), 129–273],
P
<0.0001) and R
15
(163 pmol/L [IQR, 112–231],
P
<0.0001) as compared with DAPT (322 pmol/L [IQR, 218–528]). We observed no significant reduction of the primary end point between R
10
and R
15
while rivaroxaban concentrations increased significantly from 184 ng/mL (IQR, 127–290) with R
10
to 274 ng/mL (IQR, 192–377) with R
15
,
P
<0.0001. Thrombin-antithrombin complex and D-dimers were numerically lower with both rivaroxaban doses than with DAPT. These findings were all confirmed at 3 months. The clinical end points were not different between groups. A device thrombosis was noted in 2 patients assigned to DAPT.
Conclusions:
Thrombin generation measured after LAAC was lower in patients treated by reduced rivaroxaban doses than DAPT, supporting an alternative to the antithrombotic regimens currently used after LAAC and deserves further evaluation in larger studies.
Registration:
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT03273322.
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Affiliation(s)
- Guillaume Duthoit
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Johanne Silvain
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Eloi Marijon
- European Georges Pompidou Hospital, APHP; Paris Descartes University, INSERM U 970, France (E.M., C.S.)
| | - Grégory Ducrocq
- Département de Cardiologie, Hôpital Bichat, AP-HP, Université Paris-Diderot, Inserm U1148, France (G.D., E.B., J.-M.J.)
| | - Antoine Lepillier
- Department of Cardiology, Centre Cardiologique du Nord, Saint-Denis, France (A.L., D.A.)
| | - Corinne Frere
- Sorbonne Université, Department of Haematology Biologic, APHP Pitié-Salpêtrière Hospital; INSERM UMRS 1166, Institute of Cardiometabolism And Nutrition, Paris, France (C.F., I.M.-T.)
| | - Solohaja-Faniaha Dimby
- Unité de Recherche Clinique, ACTION Study Group, Hôpital Fernand Widal (AP-HP), SAMM - Statistique, Analyse et Modélisation Multidisciplinaire EA 4543, Université Paris 1 Panthéon Sorbonne, France (S.-F.D., E.V.)
| | - Batric Popovic
- Université de Lorraine, Département de Cardiologie, Centre Hospitalier Universitaire Brabois, Nancy, France (B.P.)
| | - Nicolas Lellouche
- Département de Cardiologie, CHU Henri Mondor, Créteil, France (N.L.)
| | - Isabelle Martin-Toutain
- Sorbonne Université, Department of Haematology Biologic, APHP Pitié-Salpêtrière Hospital; INSERM UMRS 1166, Institute of Cardiometabolism And Nutrition, Paris, France (C.F., I.M.-T.)
| | - Christian Spaulding
- European Georges Pompidou Hospital, APHP; Paris Descartes University, INSERM U 970, France (E.M., C.S.)
| | - Eric Brochet
- Département de Cardiologie, Hôpital Bichat, AP-HP, Université Paris-Diderot, Inserm U1148, France (G.D., E.B., J.-M.J.)
| | - David Attias
- Department of Cardiology, Centre Cardiologique du Nord, Saint-Denis, France (A.L., D.A.)
| | - Jacques Mansourati
- Département de Cardiologie, CHRU Brest, Université de Bretagne Occidentale, EA 4324 (J.M.)
| | - Luc Lorgis
- Department of Cardiology, Laboratory of Cerebro-Vascular Pathophysiology and epidemiology (PEC2) EA 7460, University of Burgundy, Dijon, France (L.L.)
| | - Didier Klug
- Univ. Lille CHU Lille, F-59000 Lille, France (D.K.)
| | - Noura Zannad
- Département de Cardiologie, CHR Metz-Thionville, France (N.Z.)
| | - Marie Hauguel-Moreau
- Université de Versailles-Saint Quentin, Department of Cardiology, Ambroise Paré Hospital (AP-HP), INSERM U-1018, Boulogne, France (M.H.-M.)
| | - Nassim Braik
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Sandrine Deltour
- Sorbonne Université, Urgences Cerebro-Vasculaires Pitié-Salpêtrière Hospital (AP-HP), INSERM UMR U-942, Paris, France (S.D.)
| | - Alexandre Ceccaldi
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Hui Wang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China (H.W.)
| | - Nadjib Hammoudi
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Delphine Brugier
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
| | - Eric Vicaut
- Unité de Recherche Clinique, ACTION Study Group, Hôpital Fernand Widal (AP-HP), SAMM - Statistique, Analyse et Modélisation Multidisciplinaire EA 4543, Université Paris 1 Panthéon Sorbonne, France (S.-F.D., E.V.)
| | - Jean-Michel Juliard
- Département de Cardiologie, Hôpital Bichat, AP-HP, Université Paris-Diderot, Inserm U1148, France (G.D., E.B., J.-M.J.)
| | - Gilles Montalescot
- Sorbonne Université, ACTION Study Group (Allies in Cardiovascular Trials, Initiatives and Organized Networks), INSERM UMRS1166, ICAN, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France (G.D., J.S., N.B., A.C., N.H., D.B., G.M.)
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21
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Ninni S, Echivard M, Marquié C, Ortmans S, Labreuche J, Drumez E, Lemaire J, Cuvillier A, Arnaud M, Potelle C, Gouraud JB, Andorin A, Blangy H, Sadoul N, Probst V, Klug D. Predictors of Subcutaneous Implantable Cardioverter-Defibrillator Shocks and Prognostic Impact in Patients With Structural Heart Disease. Can J Cardiol 2020; 37:400-406. [PMID: 32474109 DOI: 10.1016/j.cjca.2020.05.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/30/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses. METHODS In this multicenter registry‒based study, we retrospectively included all patients who underwent S-ICD implantation at 3 tertiary centers. The prognostic impact of S-ICD shock was assessed with a composite outcome that included all-cause death and hospitalisation for heart failure. RESULTS A total of 351 patients with underlying cardiomyopathy were included in the investigation. Using multivariable Fine and Gray regression models, secondary prevention, left ventricular ejection fraction (LVEF), conditional shock threshold, and QRS duration appeared to be independent predictors of appropriate S-ICD shock occurrence. In the multivariate Cox regression model adjusted for age, baseline LVEF, underlying cardiomyopathy subtype, New York Heart Association class, and appropriate shocks were significantly associated with increased composite prognostic outcome risk (hazard ratio [HR], 2.61; 95% confidence interval [CI], 1.21-5.65; P = 0.014), whereas inappropriate shocks were not (HR, 1.35; 95% CI, 0.75-4.48; P = 0.18). The analysis of each component of the composite prognostic outcome highlighted that the occurrence of appropriate shocks was associated with an increased risk of hospitalisation for heart failure (HR, 3.10; 95% CI, 1.26-7.58; P = 0.013) and a trend for mortality (HR, 2.19; 95% CI, 0.78-6.16; P = 0.14). CONCLUSIONS Appropriate S-ICD shocks were associated with a 3-fold increase in acute heart failure admission, whereas inappropriate shocks were not. Conditional shock threshold programming is an independent predictor of S-ICD shock, and its prognostic impact should be investigated further in patients with structural heart disease.
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Affiliation(s)
- Sandro Ninni
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France.
| | | | - Christelle Marquié
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
| | - Staniel Ortmans
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
| | - Julien Labreuche
- Universitaire Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Elodie Drumez
- Universitaire Lille, CHU Lille, ULR 2694-METRICS: évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Juliette Lemaire
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
| | - Antoine Cuvillier
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
| | - Marine Arnaud
- L'Institut du Thorax, Cardiologic Department and Reference Center for Hereditary Arrhythmic Diseases INSERM 1087, Nantes, France
| | - Charlotte Potelle
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
| | - Jean-Baptiste Gouraud
- L'Institut du Thorax, Cardiologic Department and Reference Center for Hereditary Arrhythmic Diseases INSERM 1087, Nantes, France
| | - Antoine Andorin
- L'Institut du Thorax, Cardiologic Department and Reference Center for Hereditary Arrhythmic Diseases INSERM 1087, Nantes, France
| | | | | | - Vincent Probst
- L'Institut du Thorax, Cardiologic Department and Reference Center for Hereditary Arrhythmic Diseases INSERM 1087, Nantes, France
| | - Didier Klug
- CHRU Lille, Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille, F59000-Lille, France
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22
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Gandjbakhch E, Dacher JN, Taieb J, Chauvin M, Anselme F, Bartoli A, Boyer L, Cassagnes L, Cochet H, Defaye P, Deharo JC, Dubourg B, Fauchier L, Gras D, Klug D, Laurent G, Mansourati J, Marijon E, Maury P, Piot O, Pontana F, Sacher F, Sadoul N, Jacquier A, Boveda S. Joint Position Paper of the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the French Society of Diagnostic and Interventional Cardiac and Vascular Imaging on magnetic resonance imaging in patients with cardiac electronic implantable devices. Arch Cardiovasc Dis 2020; 113:473-484. [DOI: 10.1016/j.acvd.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
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23
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Garcia R, Boveda S, Defaye P, Sadoul N, Narayanan K, Perier MC, Klug D, Fauchier L, Leclercq C, Babuty D, Bordachar P, Gras D, Deharo JC, Piot O, Providencia R, Marijon E, Algalarrondo V. Early mortality after implantable cardioverter defibrillator: Incidence and associated factors. Int J Cardiol 2020; 301:114-118. [PMID: 31753583 DOI: 10.1016/j.ijcard.2019.09.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a "reasonable expectation of survival with a good functional status >1 year". Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a ≤1-year survival among patients implanted with ICDs. METHODS The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002-2012 period. Characteristics of patients who survived ≤1 year following the implantation were compared with those who survived >1 year, and predictors of early death determined. RESULTS Out of the 5539 enrolled patients, survival status at 1 year was known for a total of 5,457, and overall 230 (4.2%) survived ≤1 year. Causes of death were similar in the two groups. Patients with ≤1-year survival had lower rates of appropriate (14 vs. 23%; P = 0.004) and inappropriate ICD therapies (2 vs. 7%; P = 0.009) than patients who lived >1 year after ICD implantation. In multivariate analysis, older age, higher NYHA class (≥III), and atrial fibrillation were significantly associated with ≤1-year survival. Presence of all 3 risk factors was associated with a cumulative 22.63% risk of death within 1 year after implantation. CONCLUSIONS This is the largest study determining the factors predicting early mortality after ICD implantation. Patients dying within the first year had low ICD therapy rates. A combination of clinical factors could potentially identify patients at risk for early mortality to help improve selection of ICD candidates.
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Affiliation(s)
| | | | | | | | - Kumar Narayanan
- Maxcure Hospitals, Hyderabad, 500081, Telangana, India; Paris Cardiovascular Research Center (Inserm U970), 75015, Paris, France
| | | | | | | | | | | | | | - Daniel Gras
- Hôpital Privé Du Confluent, 44277, Nantes, France
| | | | - Olivier Piot
- Centre Cardiologique Du Nord, 93200, Saint Denis, France
| | - Rui Providencia
- Clinique Pasteur, 31076, Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, EC1A 7BE, London, UK
| | - Eloi Marijon
- Paris Cardiovascular Research Center (Inserm U970), 75015, Paris, France; Clinique Pasteur, 31076, Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, EC1A 7BE, London, UK; AP-HP, Hôpital Européen Georges Pompidou, 75015 Paris and Université Paris Descartes, 75006, Paris, France
| | - Vincent Algalarrondo
- AP-HP, CHU Bichat Claude Bernard and Université Paris Diderot, 75018, Paris, France.
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24
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Fauchier L, Bisson A, Cinaud A, Brigadeau F, Lepillier A, Jacon P, Gras D, Klug D, Guedeney P, Pierre B, Mansourati J, Piot O, Montalescot G, Deharo JC, Defaye P. P999Major adverse events with percutaneous left atrial appendage closure in patients with atrial fibrillation in real life setting. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Transcatheter left atrial appendage (LAA) closure is an alternative strategy for stroke prevention in atrial fibrillation (AF) patients with an inacceptable risk of bleeding with oral anticoagulation (OAC). A better characterization of major adverse clinical events after LAA closure in daily practice is still needed.
Methods
We analysed data from all AF patients treated with Watchman or Amplatzer LAA closure according to European guidelines in 8 French cardiology departments. Antithrombotic management was decided for each patient on an individual basis. A Cox regression model was used for multivariable analysis of major adverse events. Yearly rate of ischemic stroke during follow-up was calculated and compared to that expected for a same risk score population. Yearly rate of bleeding was extrapolated from that reported with the HASBLED score.
Results
A total of 469 consecutive AF patients (299 males, 74.9±8.9 years old, mean CHA2DS2-VASc score 4.5±1.4, HASBLED score 3.7±1.0) received LAA closure from March 2012 to January 2017. There were 272 Watchman devices (58%) and 197 ACP devices (42%) implanted. At discharge, 36% received a single anti platelet therapy (APT), 23% received dual APT, 29% received OAC and no APT, 5% received OAC plus APT and 8% received no antithrombotic therapy. Mean follow up was 11.4 months (median 7, interquartile 3–22 months) during which 70 major adverse events (19 ischemic strokes, 18 major haemorrhages and 33 deaths) were recorded in 69 patients. The annual rate of ischemic stroke was 3.96%, which translates into a 13% relative risk reduction (95% CI −59 to 52%) as compared with the calculated stroke rate for similar CHA2DS2-VASc score after adjustment for exposure to APT and OAC. The annual rate of major bleeding in the study was 3.75%, which corresponds to a 48% relative risk reduction (95% CI 9 to 70%) as compared with the rate that would have been expected based on a comparable HAS-BLED score. Yearly rate of mortality was 7.4% (2.5 to 3 fold higher than in previous randomized trials) and the rate of non-cardiovascular death was 82%. None of the baseline characteristics was predictive of major adverse events, neither in univariate nor in multivariable analysis, which highlights the difficulty in identifying a risk of unfavourable outcome with simple tools.
Conclusions
AF patients treated with LAA closure may have a lower risk of stroke and bleeding events compared to their theoretical risk. However, our findings indicate that a high rate of major adverse events is observed in these patients during follow-up. This questions the suggested cost-effectiveness of the procedure (with models based on previous trials) for a real-life perspective. A better identification of patients with a relevant benefit of LAA closure is needed among those with long-term anticoagulation contraindication, both for an optimal management of each patient on an individual basis and for a global perspective with limited healthcare resources.
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Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Bisson
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Cinaud
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | | | - A Lepillier
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | - P Jacon
- University Hospital of Grenoble, Grenoble, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | - D Klug
- Hospital of Lille, Lille, France
| | - P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | - B Pierre
- University Hospital of Grenoble, Grenoble, France
| | | | - O Piot
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | | | - J C Deharo
- Hospital La Timone of Marseille, Marseille, France
| | - P Defaye
- University Hospital of Grenoble, Grenoble, France
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25
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Boveda S, Garcia R, Defaye P, Piot O, Narayanan K, Barra S, Gras D, Providencia R, Algalarrondo V, Beganton F, Perier MC, Jacob S, Bordachar P, Babuty D, Klug D, Leclercq C, Fauchier L, Sadoul N, Deharo JC, Marijon E. Implantable cardioverter defibrillator therapy for primary prevention of sudden cardiac death in the real world: Main findings from the French multicentre DAI-PP programme (pilot phase). Arch Cardiovasc Dis 2019; 112:523-531. [PMID: 31471226 DOI: 10.1016/j.acvd.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/21/2019] [Indexed: 11/15/2022]
Abstract
This review summarizes the main findings of the French multicentre DAI-PP pilot programme, and discusses the related clinical and research perspectives. This project included retrospectively (2002-2012 period) more than 5000 subjects with structural heart disease who received an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death, and were followed for a mean period of 3 years. The pilot phase of the DAI-PP programme has provided valuable information on several practical and clinically relevant aspects of primary prevention ICD implantation in the real-world population, which are summarized in this review. This pilot has led to a prospective evaluation that started in May 2018, assessing ICD therapy in primary and secondary prevention in patients with structural and electrical heart diseases, with remote monitoring follow-up using a dedicated platform. This should further enhance our understanding of sudden cardiac death, to eventually optimize the field of preventative actions.
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Affiliation(s)
| | - Rodrigue Garcia
- CHU de Poitiers, 86021 Poitiers, France; Université de Poitiers, 86073 Poitiers, France
| | | | - Olivier Piot
- Centre cardiologique du Nord, 93200 Saint-Denis, France
| | - Kumar Narayanan
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Maxcure Hospitals, 500081 Hyderabad, Telangana, India
| | - Sergio Barra
- Royal Papworth Hospital NHS Foundation Trust, Cambridge University Health Partners, CB2 0AY Cambridge, UK; Hospital da Luz Arrabida, 4400-346 Vila Nova de Gaia, Portugal
| | - Daniel Gras
- Hopital privé du Confluent, 44000 Nantes, France
| | - Rui Providencia
- Clinique Pasteur, 31076 Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, EC1A 7BE London, UK
| | | | - Frankie Beganton
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France
| | | | | | | | | | | | | | | | | | | | - Eloi Marijon
- Paris Cardiovascular Research Centre (Inserm U970), 75015 Paris, France; Unité de Rythmologie, Hôpital européen Georges Pompidou, 20-40, rue Leblanc, 75908 Paris cedex 15, France; Paris Descartes University, 75006 Paris, France.
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26
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Decroocq M, Ninni S, Klein C, Machuron F, Verbrugge E, Klug D, Brigadeau F, Lacroix D. No impact of sports practice before or after atrial fibrillation ablation on procedure efficacy in athletes: a case–control study. Europace 2019; 21:1833-1842. [DOI: 10.1093/europace/euz231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 07/24/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Limited data exist on the efficacy of catheter ablation (CA) for sport-related atrial fibrillation (AF). Impact of sports practice resumption post-CA remains unknown. We aimed to determine AF CA efficacy in athletes vs. non-athletes, and to assess the impact of sport practice resumption.
Methods and results
From 1153 first-time AF CA performed between 2009 and 2017, 73 athletes were matched with 73 sedentary patients based on age, sex, and closest CA procedure date. Athletes were defined as performing ≥6 h/week of vigorous sports to achieve ≥2000 h accumulated lifetime sports activity. They were mostly males (93.2%) with a mean age of 55 ± 9.8 years. Before CA, athletes practiced 10.2 ± 3.9 h/week of vigorous exercise vs. 4.6 ± 3.4 after CA. Within first year after CA, physical activity was stopped in 12 (16.4%) athletes, lowered in 45 (61.9%), and resumed at same intensity in 16 (21.9%). Athletes and non-athletes suffered from same AF recurrence rates during 5-year follow-up after CA: 38 (52.0%) vs. 35 (47.9%), respectively [adjusted hazard ratio (HR) on age, body mass index (BMI), obstructive sleep apnoea (OSA), and reduced left ventricular ejection fraction (LVEF), 1.17 (0.70–1.97, P = 0.54)]. No significant impact of physical activity resumption status was found regarding AF recurrence rates at 1-year and beyond (P = 0.60). Procedure effectiveness was significantly lower in athletes with non-paroxysmal AF [adjusted on age, BMI, reduced LVEF, and OSA HR 2.36 (confidence interval 1.19–4.70), P = 0.01].
Conclusion
Sports practice before and after CA has no significant impact on AF recurrence rates in athletes within 5-year after AF CA.
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Affiliation(s)
- Marie Decroocq
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - Sandro Ninni
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - Cédric Klein
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - François Machuron
- Department of Methodology, Biostatistics and Data Management, Univ. Lille, CHRU de Lille, F-59000 Lille, France
| | - Eric Verbrugge
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - Didier Klug
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - François Brigadeau
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
| | - Dominique Lacroix
- Department of Cardiovascular Medicine, Univ. Lille, CHU Lille, Clinique de Cardiologie, F-59000 Lille, France
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27
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Barra S, Duehmke R, Providência R, Narayanan K, Reitan C, Roubicek T, Polasek R, Chow A, Defaye P, Fauchier L, Piot O, Deharo JC, Sadoul N, Klug D, Garcia R, Dockrill S, Virdee M, Pettit S, Agarwal S, Borgquist R, Marijon E, Boveda S. Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients. Eur Heart J 2019. [PMID: 31046090 DOI: 10.1093/eurheartj/ehz238/5482553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
AIMS The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and with defibrillator (CRT-D). METHODS AND RESULTS A total of 1775 patients, with ischaemic or non-ischaemic dilated cardiomyopathy, who were alive 5 years after CRT implantation, were enrolled in this multicentre European observational cohort study. Overall long-term mortality rates and specific causes of death were assessed, with a focus on late SCD. Over a mean follow-up of 30 months (interquartile range 10-42 months) beyond the first 5 years, we observed 473 deaths. The annual age-standardized mortality rates of CRT-D and CRT-P patients were 40.4 [95% confidence interval (CI) 35.3-45.5] and 97.2 (95% CI 85.5-109.9) per 1000 patient-years, respectively. The adjusted hazard ratio (HR) for all-cause mortality was 0.99 (95% CI 0.79-1.22). Twenty-nine patients in total died of late SCD (14 with CRT-P, 15 with CRT-D), corresponding to 6.1% of all causes of death in both device groups. Specific annual SCD rates were 8.5 and 5.8 per 1000 patient-years in CRT-P and CRT-D patients, respectively, with no significant difference between groups (adjusted HR 1.0, 95% CI 0.45-2.44). Death due to progressive heart failure represented the principal cause of death (42.8% in CRT-P patients and 52.6% among CRT-D recipients), whereas approximately one-third of deaths in both device groups were due to non-cardiovascular death. CONCLUSION In this first description of very long-term outcomes among CRT recipients, progressive heart failure death still represented the most frequent cause of death in patients surviving the first 5 years after CRT implant. In contrast, SCD represents a very low proportion of late mortality irrespective of the presence of a defibrillator.
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Affiliation(s)
- Sérgio Barra
- Cardiology Department, Hospital da Luz Arrabida, V. N. Gaia, Portugal
- Cardiology Department, V. N. Gaia Hospital Center, V. N. Gaia, Portugal
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Rudolf Duehmke
- Cardiology Department, West Suffolk Hospital, West Suffolk, UK
| | - Rui Providência
- Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Kumar Narayanan
- Cardiology Department, MaxCure Hospitals, Hyderabad, India
- Paris Cardiovascular Research Center (Inserm U970), Cardiovascular Epidemiology Unit, Paris, France
| | - Christian Reitan
- Department of Cardiology, Arrhythmia Clinic, Lund University, Skane University Hospital, Lund, Sweden
| | - Tomas Roubicek
- Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic
| | - Rostislav Polasek
- Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic
| | - Antony Chow
- Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Pascal Defaye
- Arrhythmia Department, University Hospital, Grenoble, France
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
- Faculté de Médecine, Université François Rabelais, Tours, France
| | - Olivier Piot
- Cardiology Department, Centre Cardiologique du Nord, Saint Denis, France
| | | | - Nicolas Sadoul
- Cardiology Division, Nancy University Hospital, Nancy, France
| | - Didier Klug
- Cardiology Division, Lille University Hospital and University of Lille, Lille, France
| | - Rodrigue Garcia
- Cardiology Division, Poitiers University Hospital, Poitiers, France
| | - Seth Dockrill
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Munmohan Virdee
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Stephen Pettit
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Sharad Agarwal
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Rasmus Borgquist
- Department of Cardiology, Arrhythmia Clinic, Lund University, Skane University Hospital, Lund, Sweden
| | - Eloi Marijon
- Paris Cardiovascular Research Center (Inserm U970), Cardiovascular Epidemiology Unit, Paris, France
- Cardiology Department, European Georges Pompidou Hospital, Paris, France
- Paris Descartes University, Paris, France
| | - Serge Boveda
- Cardiology Department, Clinique Pasteur, Toulouse, France
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Wahbi K, Ben Yaou R, Gandjbakhch E, Anselme F, Gossios T, Lakdawala NK, Stalens C, Sacher F, Babuty D, Trochu JN, Moubarak G, Savvatis K, Porcher R, Laforêt P, Fayssoil A, Marijon E, Stojkovic T, Béhin A, Leonard-Louis S, Sole G, Labombarda F, Richard P, Metay C, Quijano-Roy S, Dabaj I, Klug D, Vantyghem MC, Chevalier P, Ambrosi P, Salort E, Sadoul N, Waintraub X, Chikhaoui K, Mabo P, Combes N, Maury P, Sellal JM, Tedrow UB, Kalman JM, Vohra J, Androulakis AFA, Zeppenfeld K, Thompson T, Barnerias C, Bécane HM, Bieth E, Boccara F, Bonnet D, Bouhour F, Boulé S, Brehin AC, Chapon F, Cintas P, Cuisset JM, Davy JM, De Sandre-Giovannoli A, Demurger F, Desguerre I, Dieterich K, Durigneux J, Echaniz-Laguna A, Eschalier R, Ferreiro A, Ferrer X, Francannet C, Fradin M, Gaborit B, Gay A, Hagège A, Isapof A, Jeru I, Juntas Morales R, Lagrue E, Lamblin N, Lascols O, Laugel V, Lazarus A, Leturcq F, Levy N, Magot A, Manel V, Martins R, Mayer M, Mercier S, Meune C, Michaud M, Minot-Myhié MC, Muchir A, Nadaj-Pakleza A, Péréon Y, Petiot P, Petit F, Praline J, Rollin A, Sabouraud P, Sarret C, Schaeffer S, Taithe F, Tard C, Tiffreau V, Toutain A, Vatier C, Walther-Louvier U, Eymard B, Charron P, Vigouroux C, Bonne G, Kumar S, Elliott P, Duboc D. Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies. Circulation 2019; 140:293-302. [PMID: 31155932 DOI: 10.1161/circulationaha.118.039410] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND An accurate estimation of the risk of life-threatening (LT) ventricular tachyarrhythmia (VTA) in patients with LMNA mutations is crucial to select candidates for implantable cardioverter-defibrillator implantation. METHODS We included 839 adult patients with LMNA mutations, including 660 from a French nationwide registry in the development sample, and 179 from other countries, referred to 5 tertiary centers for cardiomyopathies, in the validation sample. LTVTA was defined as (1) sudden cardiac death or (2) implantable cardioverter defibrillator-treated or hemodynamically unstable VTA. The prognostic model was derived using the Fine-Gray regression model. The net reclassification was compared with current clinical practice guidelines. The results are presented as means (SD) or medians [interquartile range]. RESULTS We included 444 patients, 40.6 (14.1) years of age, in the derivation sample and 145 patients, 38.2 (15.0) years, in the validation sample, of whom 86 (19.3%) and 34 (23.4%) experienced LTVTA over 3.6 [1.0-7.2] and 5.1 [2.0-9.3] years of follow-up, respectively. Predictors of LTVTA in the derivation sample were: male sex, nonmissense LMNA mutation, first degree and higher atrioventricular block, nonsustained ventricular tachycardia, and left ventricular ejection fraction (https://lmna-risk-vta.fr). In the derivation sample, C-index (95% CI) of the model was 0.776 (0.711-0.842), and the calibration slope 0.827. In the external validation sample, the C-index was 0.800 (0.642-0.959), and the calibration slope was 1.082 (95% CI, 0.643-1.522). A 5-year estimated risk threshold ≥7% predicted 96.2% of LTVTA and net reclassified 28.8% of patients with LTVTA in comparison with the guidelines-based approach. CONCLUSIONS In comparison with the current standard of care, this risk prediction model for LTVTA in laminopathies significantly facilitated the choice of candidates for implantable cardioverter defibrillators. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT03058185.
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Affiliation(s)
- Karim Wahbi
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile de France, Paris-Descartes, Sorbonne Paris Cité University (K.W., D.D.).,INSERM Unit 970, Paris Cardiovascular Research Centre (PARCC), France (K.W., C. Stalens, E.J.)
| | - Rabah Ben Yaou
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.).,Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Center for Research in Myology, Myology Institute,(R.B.Y., G.B.)
| | - Estelle Gandjbakhch
- APHP, Institute of Cardiology (E.G., X.W., P.C.).,Sorbonne Universités, UPMC Univ Paris 06, INSERM 1166, Institute of Cardiometabolism and Nutrition (ICAN), France (E.G., P.C.).,Centre de Référence des Maladies Cardiaques Héréditaires, Paris, France† (E.G., P.C.)
| | - Frédéric Anselme
- Cardiology Department, University Hospital of Rouen, France (F.A.)
| | - Thomas Gossios
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.)
| | - Neal K Lakdawala
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA (N.K.L., U.B.T.).,Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Caroline Stalens
- INSERM Unit 970, Paris Cardiovascular Research Centre (PARCC), France (K.W., C. Stalens, E.J.).,Medical Affairs Department, AFM-Telethon, Evry, France (C. Stalens)
| | - Frédéric Sacher
- Centre de reference des maladies rythmiques héréditaires, Bordeaux University Hospital (CHU), IHU Liryc, Electrophysiology and Heart Modeling Institute, fondation Bordeaux Université, Univ. Bordeaux, INSERM U1045, France (F.S.)
| | - Dominique Babuty
- Université François Rabelais, Cardiology Department, CHU Tours, France (D. Babuty)
| | - Jean-Noel Trochu
- INSERM, UMR1087, Université de Nantes, L'Institut du Thorax, CHU de Nantes, CIC, Centre de référence pour la prise en charge des maladies rythmiques héréditaires de Nantes, France† (J.-N.T.)
| | - Ghassan Moubarak
- Department of Electrophysiology and Pacing, InParys Clinical Research Group, Clinique Ambroise Paré, Neuilly-sur-Seine, France (G.M.)
| | - Kostantinos Savvatis
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.).,William Harvey Research Institute, Queen Mary University London, United Kingdom (K.S.)
| | - Raphaël Porcher
- APHP, Hôtel-Dieu Hospital, Centre d'Epidémiologie Clinique, INSERM U1153, Université Paris Descartes - Sorbonne Paris Cité, France (R.P.)
| | - Pascal Laforêt
- APHP, Hôpital Raymond Poincaré, Centre de Référence des maladies neuromusculaires Nord-Est-Île de France, Garches (P.L., A.F.)
| | - Abdallah Fayssoil
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.).,APHP, Hôpital Raymond Poincaré, Centre de Référence des maladies neuromusculaires Nord-Est-Île de France, Garches (P.L., A.F.)
| | - Eloi Marijon
- Hôpital Européen Georges Pompidou, Département de Cardiologie, Unité de Rythmologie, Paris, France (E.M.)
| | - Tanya Stojkovic
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Anthony Béhin
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Sarah Leonard-Louis
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Guilhem Sole
- Centre de référence des maladies neuromusculaires AOC, Hôpital Pellegrin, CHU Bordeaux, France (G.S., X.F.)
| | | | - Pascale Richard
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | - Corinne Metay
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | - Susana Quijano-Roy
- APHP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neurologie, Réanimation et Réeducation Pediatriques, Hôpital Raymond Poincaré, Garches, France; UMR 1179 INSERM, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux (S.Q.-R., I. Dabaj)
| | - Ivana Dabaj
- APHP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neurologie, Réanimation et Réeducation Pediatriques, Hôpital Raymond Poincaré, Garches, France; UMR 1179 INSERM, Université Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux (S.Q.-R., I. Dabaj)
| | - Didier Klug
- Cardiologie A, University Hospital, Lille, France (D.K.)
| | - Marie-Christine Vantyghem
- CHU Lille, Endocrinology, Diabetology and Metabolism, Univ Lille, Inserm, UMR 1190 -Translational research in diabetes; EGID European Genomic Institute for Diabetes, France (M.-C.V.)
| | - Philippe Chevalier
- Sorbonne Universités, UPMC Univ Paris 06, INSERM 1166, Institute of Cardiometabolism and Nutrition (ICAN), France (E.G., P.C.).,Centre de Référence des Maladies Cardiaques Héréditaires, Paris, France† (E.G., P.C.).,Service de Cardiologie, Hôpital Est, Lyon, France† (P.C.)
| | - Pierre Ambrosi
- Department of Cardiology, La Timone Hospital, Aix-Marseille Université, France (P.A.)
| | - Emmanuelle Salort
- APHM, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Hôpital Timone; Aix Marseille Université, Inserm UMR_S 910, GMGF, France (E.S.)
| | - Nicolas Sadoul
- Department of Cardiology, Institut Lorrain du Coeur et des Vaisseaux, CHU Nancy-Brabois, Vandoeuvre les Nancy Cedex, France (N.S.)
| | | | - Khadija Chikhaoui
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, France (P. Mabo, R.M.)
| | - Nicolas Combes
- Département de Rythmologie, Clinique Pasteur, Toulouse, France (N.C.)
| | - Philippe Maury
- University Hospital Rangueil, Cardiology department; Unité Inserm U1048, Toulouse, France (P. Maury)
| | - Jean-Marc Sellal
- Département de Cardiologie, Centre Hospitalier Universitaire de Nancy; INSERM-IADI U1254, Vandœuvre lès-Nancy, France (J.-M.S.)
| | - Usha B Tedrow
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA (N.K.L., U.B.T.)
| | - Jonathan M Kalman
- Department of Cardiology, Division of Medicine (J.M.K., J.V.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | - Jitendra Vohra
- Department of Cardiology, Division of Medicine (J.M.K., J.V.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | | | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Centre, the Netherlands (A.G.A.A., K.Z.)
| | - Tina Thompson
- Department of Genetic Medicine (T.T.), The Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
| | - Christine Barnerias
- AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, service de neurologie pédiatrique, Hôpital Necker, GH Necker-Enfants malades, Paris, France (C.B., I. Desguerre).,Centre de référence des maladies neuromusculaires AOC, Département de Neurologie, Hôpital Purpan, CHU Toulouse, France (B.C.)
| | - Henri-Marc Bécane
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | - Eric Bieth
- Service de Génétique Médicale, Hôpital Purpan, CHU Toulouse, France (E.B.)
| | - Franck Boccara
- AP-HP, Hôpitaux de l'Est Parisien, Cardiology Unit, Hôpital Saint-Antoine; Sorbonne Universités, INSERM, UMR_S 938, Paris, France (F.B.).,Hospices Civils de Lyon, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Service d'ENMG, Hôpital Neurologique Pierre Wertheimer, Lyon-Bron, France (F.B., P.P.)
| | - Damien Bonnet
- AP-HP, Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence des Malformations Cardiaques Congénitales Complexes-M3C, Hôpital Necker Enfants Malades, Université Paris Descartes, Sorbonne Paris-Cité, France (D. Bonnet)
| | - Françoise Bouhour
- AP-HP, Hôpitaux de l'Est Parisien, Cardiology Unit, Hôpital Saint-Antoine; Sorbonne Universités, INSERM, UMR_S 938, Paris, France (F.B.)
| | - Stéphane Boulé
- Hôpital privé Le Bois, Service de Cardiologie, Lille, France (S.B.)
| | | | - Françoise Chapon
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neurologie, CHU Caen; INSERM U1075, Université de Normandie, Caen, France (F.C., S.S.)
| | | | - Jean-Marie Cuisset
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de Neuropédiatrie, Hôpital Roger Salengro, CHRU Lille (J.-M.C.)
| | - Jean-Marc Davy
- Service de Cardiologie, CHU Montpellier, France (J.-M.D.)
| | - Annachiara De Sandre-Giovannoli
- Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Florence Demurger
- Centre de Référence Maladies Rares CLAD-Ouest, Service de Génétique Clinique, CHU Rennes, Hôpital Sud, France (F.D., M.F.)
| | - Isabelle Desguerre
- AP-HP, Centre de référence des maladies neuromusculaires Nord/Est/Ile de France, service de neurologie pédiatrique, Hôpital Necker, GH Necker-Enfants malades, Paris, France (C.B., I. Desguerre)
| | - Klaus Dieterich
- Unité de Génétique Clinique, Hôpital Couple Enfant, CHU Grenoble, INSERM U1216, Grenoble Institut des Neurosciences Cellular Myology and Pathologies, France (K.D.)
| | - Julien Durigneux
- Centre de référence des maladies neuromusculaires AOC, Service de Neuropédiatrie, CHU Angers, France (J.D.)
| | | | - Romain Eschalier
- Service de cardiologie, CHU Clermont-Ferrand; CNRS équipe thérapies guidées par l'image, Institut-Pascal, France (R.E.)
| | - Ana Ferreiro
- Basic and Translational Myology Laboratory, UMR8251, Université Paris Diderot/CNRS, France (A.F.)
| | - Xavier Ferrer
- Centre de référence des maladies neuromusculaires AOC, Hôpital Pellegrin, CHU Bordeaux, France (G.S., X.F.)
| | | | - Mélanie Fradin
- Unité de Génétique Clinique, Hôpital Couple Enfant, CHU Grenoble, INSERM U1216, Grenoble Institut des Neurosciences Cellular Myology and Pathologies, France (K.D.)
| | - Bénédicte Gaborit
- APHM, pole ENDO, Hôpital la conception; INSERM, INRA, C2VN, Aix Marseille University, France (B.G.)
| | - Arnaud Gay
- Cardio-Thoracic Surgery Unit and Pathology Department, Rouen University Hospital, France (A.G.)
| | - Albert Hagège
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris and INSERM U970, Hôpital Européen Georges Pompidou, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, France (A.H.)
| | - Arnaud Isapof
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, Hôpital Trousseau, Paris, France (A.I., M. Mayer)
| | - Isabelle Jeru
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Raul Juntas Morales
- Centre de référence des maladies neuromusculaires AOC, Department of Neurology, CHU Montpellier, France (R.J.M.)
| | - Emmanuelle Lagrue
- CHRU de Tours, Université François Rabelais de Tours, UMR INSERM U1253, Tours, FILNEMUS, French neuromuscular reference centers, France (E.L.)
| | - Nicolas Lamblin
- Univ. Lille, Inserm U1167, Institut Pasteur; CHRU de Lille, Department of Cardiology, France (N.L.)
| | - Olivier Lascols
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Vincent Laugel
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, CHU Strasbourg, Hôpital Hautepierre, Hôpitaux Universitaires de Strasbourg, France (V.L.)
| | - Arnaud Lazarus
- InParys Clinical Research Group, Clinique Ambroise Paré, Neuilly sur Seine, France (A.L.)
| | - France Leturcq
- Cardiology Department, University Hospital of Caen, France (F.L.).,Service de Génétique, Hopital Cochin, AP-HP, Paris (F.L.)
| | - Nicolas Levy
- Aix Marseille University, INSERM, GMGF; Department of Medical Genetics, Childrens' Hospital La Timone, France (A.D.S.-G., N.L.)
| | - Armelle Magot
- Centre de Référence des Maladies Neuromusculaires AOC, Laboratoire des Explorations Fonctionnelles, CHU de Nantes, France (A. Magot, Y.P.)
| | | | - Raphaël Martins
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, France (P. Mabo, R.M.)
| | - Michèle Mayer
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neuropédiatrie, Hôpital Trousseau, Paris, France (A.I., M. Mayer)
| | | | - Christophe Meune
- APHP, UF Cardiogénétique et Myogénétique, Centre de Génétique, GH Pitié Salpêtrière, Paris, France (P.R., C.M.)
| | | | | | | | | | - Yann Péréon
- Centre de Référence des Maladies Neuromusculaires AOC, Laboratoire des Explorations Fonctionnelles, CHU de Nantes, France (A. Magot, Y.P.)
| | - Philippe Petiot
- Hospices Civils de Lyon, Centre de référence des maladies neuromusculaires PACA-Réunion-Rhône Alpes, Service d'ENMG, Hôpital Neurologique Pierre Wertheimer, Lyon-Bron, France (F.B., P.P.)
| | | | | | | | | | | | - Stéphane Schaeffer
- Centre de Référence des maladies neuromusculaires Nord/Est/Ile de France, Service de neurologie, CHU Caen; INSERM U1075, Université de Normandie, Caen, France (F.C., S.S.)
| | | | | | | | | | - Camille Vatier
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | | | - Bruno Eymard
- APHP, Centre de référence de pathologie neuromusculaire Paris-Est, FILNEMUS, Myology Institute, Neurology Department (R.B.Y., A.F., T.S., A.B., S.L.-L., K.C., H.-M.B., B.E.)
| | | | - Corinne Vigouroux
- APHP, Department of Genetics (I.J., O.L., C. Vatier, C. Vigouroux), Pitié-Salpêtrière University Hospital, Paris, France.,Sorbonne University, Inserm U938, Saint-Antoine Research Centre, Institute of Cardiometabolism and Nutrition, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux).,APHP, Saint-Antoine University Hospital, Department of Molecular Biology and Genetics, Paris, France (I.J., O.L., C. Vatier, C. Vigouroux)
| | - Gisèle Bonne
- Sorbonne Universités, INSERM UMRS 974, CNRS, UMR-7215, Center for Research in Myology, Myology Institute,(R.B.Y., G.B.)
| | | | - Perry Elliott
- Inherited Cardiovascular Diseases Unit, University College London & St. Bartholomew's Hospital, United Kingdom† (T.G., K.S., P.E.)
| | - Denis Duboc
- APHP, Cochin Hospital, Cardiology Department, FILNEMUS, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile de France, Paris-Descartes, Sorbonne Paris Cité University (K.W., D.D.)
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Barra S, Duehmke R, Providência R, Narayanan K, Reitan C, Roubicek T, Polasek R, Chow A, Defaye P, Fauchier L, Piot O, Deharo JC, Sadoul N, Klug D, Garcia R, Dockrill S, Virdee M, Pettit S, Agarwal S, Borgquist R, Marijon E, Boveda S. Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients. Eur Heart J 2019; 40:2121-2127. [PMID: 31046090 DOI: 10.1093/eurheartj/ehz238] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 12/04/2018] [Accepted: 04/03/2019] [Indexed: 01/14/2023] Open
Abstract
Abstract
Aims
The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and with defibrillator (CRT-D).
Methods and results
A total of 1775 patients, with ischaemic or non-ischaemic dilated cardiomyopathy, who were alive 5 years after CRT implantation, were enrolled in this multicentre European observational cohort study. Overall long-term mortality rates and specific causes of death were assessed, with a focus on late SCD. Over a mean follow-up of 30 months (interquartile range 10–42 months) beyond the first 5 years, we observed 473 deaths. The annual age-standardized mortality rates of CRT-D and CRT-P patients were 40.4 [95% confidence interval (CI) 35.3–45.5] and 97.2 (95% CI 85.5–109.9) per 1000 patient-years, respectively. The adjusted hazard ratio (HR) for all-cause mortality was 0.99 (95% CI 0.79–1.22). Twenty-nine patients in total died of late SCD (14 with CRT-P, 15 with CRT-D), corresponding to 6.1% of all causes of death in both device groups. Specific annual SCD rates were 8.5 and 5.8 per 1000 patient-years in CRT-P and CRT-D patients, respectively, with no significant difference between groups (adjusted HR 1.0, 95% CI 0.45–2.44). Death due to progressive heart failure represented the principal cause of death (42.8% in CRT-P patients and 52.6% among CRT-D recipients), whereas approximately one-third of deaths in both device groups were due to non-cardiovascular death.
Conclusion
In this first description of very long-term outcomes among CRT recipients, progressive heart failure death still represented the most frequent cause of death in patients surviving the first 5 years after CRT implant. In contrast, SCD represents a very low proportion of late mortality irrespective of the presence of a defibrillator.
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Affiliation(s)
- Sérgio Barra
- Cardiology Department, Hospital da Luz Arrabida, V. N. Gaia, Portugal
- Cardiology Department, V. N. Gaia Hospital Center, V. N. Gaia, Portugal
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Rudolf Duehmke
- Cardiology Department, West Suffolk Hospital, West Suffolk, UK
| | - Rui Providência
- Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Kumar Narayanan
- Cardiology Department, MaxCure Hospitals, Hyderabad, India
- Paris Cardiovascular Research Center (Inserm U970), Cardiovascular Epidemiology Unit, Paris, France
| | - Christian Reitan
- Department of Cardiology, Arrhythmia Clinic, Lund University, Skane University Hospital, Lund, Sweden
| | - Tomas Roubicek
- Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic
| | - Rostislav Polasek
- Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic
| | - Antony Chow
- Cardiology Department, Barts Heart Centre, Barts Health NHS Trust, London, UK
| | - Pascal Defaye
- Arrhythmia Department, University Hospital, Grenoble, France
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Tours, France
- Faculté de Médecine, Université François Rabelais, Tours, France
| | - Olivier Piot
- Cardiology Department, Centre Cardiologique du Nord, Saint Denis, France
| | | | - Nicolas Sadoul
- Cardiology Division, Nancy University Hospital, Nancy, France
| | - Didier Klug
- Cardiology Division, Lille University Hospital and University of Lille, Lille, France
| | - Rodrigue Garcia
- Cardiology Division, Poitiers University Hospital, Poitiers, France
| | - Seth Dockrill
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Munmohan Virdee
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Stephen Pettit
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Sharad Agarwal
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Rasmus Borgquist
- Department of Cardiology, Arrhythmia Clinic, Lund University, Skane University Hospital, Lund, Sweden
| | - Eloi Marijon
- Paris Cardiovascular Research Center (Inserm U970), Cardiovascular Epidemiology Unit, Paris, France
- Cardiology Department, European Georges Pompidou Hospital, Paris, France
- Paris Descartes University, Paris, France
| | - Serge Boveda
- Cardiology Department, Clinique Pasteur, Toulouse, France
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Bun S, Lațcu DG, Taghji P, Anselme F, Boveda S, Cebron J, Defaye P, Deharo J, Fauchier L, Gandjbakhch E, Gras D, Klug D, Mansourati J, Marijon E, Maury J, Squara F, Saoudi N, Taïeb J. How is Contact Force implemented in routine clinical practice? Results from a French National and Monaco Survey. J Arrhythm 2019; 35:238-243. [PMID: 31007788 PMCID: PMC6457376 DOI: 10.1002/joa3.12165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/19/2018] [Accepted: 01/06/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Combination of elementary parameters (force, time, power, impedance drop) has been proposed to optimize radiofrequency (RF) delivery. They have been partially validated in clinical studies. AIMS The aim of this study was to assess contact-force (CF) implementation into clinical practice. METHODS A 36-question electronic form was sent to 105 electrophysiologists (EP) including some general questions concerning the practice of catheter atrial fibrillation ablation and items concerning the parameters used for CF-guided ablation. RESULTS Answers from 98 EP were collected (93% response rate). The CF-catheters used were Smart Touch, Biosense (52%), Tacticath, Saint-Jude Medical (12%), or both (27%) and no CF (9%). The power applied on the left atrial (LA) anterior (LAAW) and posterior (LAPW) wall was, respectively, 26-34 W (for 73% of the EP) and below 25 W (88% of the EP). Forty percent of the Visitag® users mostly used the nominal parameters. Seventy-five percent of the users did not use automatic display of the impedance drop. For the Tacticath users, 57% used a target value of 400 gs on the LAAW and 300 to 400 gs on the LAPW. Lesion Size Index was exceptionally used. CONCLUSIONS The parameters used for CF-guided ablation are widely variable among the different operators. Further prospective studies are needed to validate the targets for automatic annotation of the RF applications.
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Affiliation(s)
- Sok‐Sithikun Bun
- Department of CardiologyPrincess Grace HospitalMonaco (Principality)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Nadir Saoudi
- Department of CardiologyPrincess Grace HospitalMonaco (Principality)
| | - Jérôme Taïeb
- Centre hospitalier du pays d'AixAix en provenceFrance
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31
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Maury P, Defaye P, Klug D, Alonso C, Anselme F, Fauchier L, Gandjbakhch E, Gras D, Hermida JS, Laurent G, Mansourati J, Marijon E, Sacher F, Taieb J, Boveda S, Piot O, Sadoul N. Reply to the letter about the position paper concerning the competence, performance and environment required in the practice of complex ablation procedures. Arch Cardiovasc Dis 2019; 112:290-291. [PMID: 30898475 DOI: 10.1016/j.acvd.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Philippe Maury
- University hospital Rangueil, 31059 Toulouse, France; Unité Inserm U 1048, 31432 Toulouse, France.
| | - Pascal Defaye
- University hospital of Grenoble-Alpes, 38700 La Tronche, France
| | - Didier Klug
- University hospital of Lille, 59000 Lille, France
| | | | | | | | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, 44200 Nantes, France
| | | | | | | | - Eloi Marijon
- Georges Pompidou European hospital, 75015 Paris, France
| | | | - Jérôme Taieb
- Aix-en-Provence hospital, 13100 Aix-en-Provence, France
| | | | - Olivier Piot
- Centre cardiologique du Nord, 93200 St.-Denis, France
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Zakine C, Garcia R, Narayanan K, Gandjbakhch E, Algalarrondo V, Lellouche N, Perier MC, Fauchier L, Gras D, Bordachar P, Piot O, Babuty D, Sadoul N, Defaye P, Deharo JC, Klug D, Leclercq C, Extramiana F, Boveda S, Marijon E. Prophylactic implantable cardioverter-defibrillator in the very elderly. Europace 2019; 21:1063-1069. [DOI: 10.1093/europace/euz041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 02/22/2019] [Indexed: 12/31/2022] Open
Abstract
Aims
Current guidelines do not propose any age cut-off for the primary prevention implantable cardioverter-defibrillator (ICD). However, the risk/benefit balance in the very elderly population has not been well studied.
Methods and results
In a multicentre French study assessing patients implanted with an ICD for primary prevention, outcomes among patients aged ≥80 years were compared with <80 years old controls matched for sex and underlying heart disease (ischaemic and dilated cardiomyopathy). A total of 300 ICD recipients were enrolled in this specific analysis, including 150 patients ≥80 years (mean age 81.9 ± 2.0 years; 86.7% males) and 150 controls (mean age 61.8 ± 10.8 years). Among older patients, 92 (75.6%) had no more than one associated comorbidity. Most subjects in the elderly group got an ICD as part of a cardiac resynchronization therapy procedure (74% vs. 46%, P < 0.0001). After a mean follow-up of 3.0 ± 2 years, 53 patients (35%) in the elderly group died, including 38.2% from non cardiovascular causes of death. Similar proportion of patients received ≥1 appropriate therapy (19.4% vs. 21.6%; P = 0.65) in the elderly group and controls, respectively. There was a trend towards more early perioperative events (P = 0.10) in the elderly, with no significant increase in late complications (P = 0.73).
Conclusion
Primary prevention ICD recipients ≥80 years in the real world had relatively low associated comorbidity. Rates of appropriate therapies and device-related complications were similar, compared with younger subjects. Nevertheless, the inherent limitations in interpreting observational data on this particular competing risk situation call for randomized controlled trials to provide definitive answers. Meanwhile, a careful multidisciplinary evaluation is needed to guide patient selection for ICD implantation in the elderly population.
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Affiliation(s)
- Cyril Zakine
- Paris Cardiovascular Research Center, Paris, France
| | | | - Kumar Narayanan
- Paris Cardiovascular Research Center, Paris, France
- Maxcure Hospitals, Hyderabad, India
| | | | | | | | - Marie-Cécile Perier
- Paris Cardiovascular Research Center, Paris, France
- European Georges Pompidou Hospital, Cardiology Department, Paris, France
| | | | | | | | - Olivier Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | | | | | | | | | | | | | | | | | - Eloi Marijon
- Paris Cardiovascular Research Center, Paris, France
- European Georges Pompidou Hospital, Cardiology Department, Paris, France
- Paris Descartes University, Paris, France
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33
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Hermida A, Fressart V, Hidden-Lucet F, Donal E, Probst V, Deharo JC, Chevalier P, Klug D, Mansencal N, Delacretaz E, Cosnay P, Scanu P, Extramiana F, Keller DI, Rouanet S, Charron P, Gandjbakhch E. High risk of heart failure associated with desmoglein-2 mutations compared to plakophilin-2 mutations in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Eur J Heart Fail 2019; 21:792-800. [PMID: 30790397 DOI: 10.1002/ejhf.1423] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/21/2018] [Accepted: 12/23/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Previous studies suggested that genetic status affects the clinical course of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) patients. The aim of this study was to compare the outcome of desmoglein-2 (DSG2) mutation carriers to those who carry the plakophilin-2 (PKP2) mutation, the most common ARVC/D-associated gene. METHODS AND RESULTS Consecutive ARVC/D patients carrying a pathogenic mutation in PKP2 or DSG2 were selected from a national ARVC/D registry. The cumulative freedom from sustained ventricular arrhythmia and cardiac transplantation/death from heart failure (HF) during follow-up was assessed, compared between PKP2 and DSG2, and predictors for ventricular arrhythmia and HF events determined. Overall, 118 patients from 78 families were included: 27 (23%) carried a DSG2 mutation and 91 (77%) a PKP2 mutation. There were no significant differences between DSG2 and PKP2 mutation carriers concerning gender, proband status, age at diagnosis, T-wave inversion, or right ventricular dysfunction at baseline. DSG2 patients displayed more frequent epsilon wave (37% vs. 17%, P = 0.048) and left ventricular dysfunction at diagnosis (54% vs. 10%, P < 0.001). During a median follow-up of 5.6 years (2.5-16), DSG2 and PKP2 mutation carriers displayed a similar risk of sustained ventricular arrhythmia (log-rank P = 0.20), but DSG2 mutation carriers were at higher risk of transplantation/HF-related death (log-rank P < 0.001). The presence of a DSG2 mutation vs. PKP2 mutation was a predictor of transplantation/HF-related death in univariate Cox analysis (P = 0.0005). CONCLUSIONS In this multicentre cohort, DSG2 mutation carriers were found to be at high risk of end-stage HF compared to PKP2 mutation carriers, supporting careful haemodynamic monitoring of these patients. The benefit of early HF treatment needs to be assessed in DSG2 carriers.
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Affiliation(s)
- Alexis Hermida
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France.,Service de Rythmologie, Centre Hospitalo-Universitaire, Amiens, France
| | - Véronique Fressart
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
| | - Francoise Hidden-Lucet
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
| | - Erwan Donal
- Département de Cardiologie, Hôpital Pontchaillou, Rennes, France
| | - Vincent Probst
- Institut du Thorax, Centre Hospitalo-Universitaire, Nantes, France
| | - Jean-Claude Deharo
- Département de Cardiologie, Centre Hospitalo-Universitaire, Marseille, France
| | - Philippe Chevalier
- Département de Cardiologie, Centre Hospitalo-Universitaire, Lyon, France
| | - Didier Klug
- Département de Cardiologie, Centre Hospitalo-Universitaire, Lille, France
| | - Nicolas Mansencal
- AP-HP, Groupe Hospitalier Ambroise Paré, UVSQ, INSERM U1018, CESP, Boulogne, France
| | | | - Pierre Cosnay
- Département de Cardiologie, Centre Hospitalo-Universitaire, Tours, France
| | - Patrice Scanu
- Département de Cardiologie, Centre Hospitalo-Universitaire, Caen, France
| | - Fabrice Extramiana
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Département de Cardiologie, Centre Hospitalo-Universitaire Bichat-Claude-Bernard, Paris, France
| | - Dagmar I Keller
- Emergency Department, University Hospital Zurich, Zurich, Switzerland
| | | | - Philippe Charron
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,AP-HP, Groupe Hospitalier Ambroise Paré, UVSQ, INSERM U1018, CESP, Boulogne, France
| | - Estelle Gandjbakhch
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
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Ninni S, Delahaye C, Klein C, Marquie C, Klug D, Lacroix D, Brigadeau F, Potelle C, Kouakam C, Finat L, Guedon-Moreau L. A report on the impact of remote monitoring in patients with S-ICD: Insights from a prospective registry. Pacing Clin Electrophysiol 2019; 42:349-355. [DOI: 10.1111/pace.13598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Sandro Ninni
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
- Institut Pasteur de Lille; UMR1011, F59000-Lille France
| | - Camille Delahaye
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Cédric Klein
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Christelle Marquie
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Didier Klug
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Dominique Lacroix
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - François Brigadeau
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Charlotte Potelle
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Claude Kouakam
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Loïc Finat
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
| | - Laurence Guedon-Moreau
- CHRU Lille; Institut Cœur-Poumon - Bd du Professeur Jules Leclercq - CHU Lille; F59037-Lille France
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35
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Ninni S, Kouakam C, Szurhaj W, Baille G, Klug D, Lacroix D, Derambure P. Usefulness of head-up tilt test combined with video electroencephalogram to investigate recurrent unexplained atypical transient loss of consciousness. Arch Cardiovasc Dis 2019; 112:82-94. [PMID: 30600217 DOI: 10.1016/j.acvd.2018.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 08/17/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Convulsive syncope and epileptic seizure share many similar clinical features. Early diagnosis is critical for choosing the appropriate management strategy. AIM Our aim was to evaluate the diagnostic yield of an innovative diagnostic strategy - combined head-up tilt test (HUT)/video electroencephalogram (EEG) monitoring - in patients with unexplained seizure-like transient loss of consciousness (T-LOC). METHODS Combined HUT/video EEG was performed in patients with unexplained atypical T-LOC with both syncope and seizure characteristics remaining undiagnosed after a first-line investigation. T-LOC diagnosis was achieved in case of reproduction of usual symptoms. Events were classified as vasovagal, psychogenic or epilepsy. The link between EEG abnormalities and T-LOC was determined by an epilepsy specialist. Clinical follow-up was performed to assess T-LOC recurrence. RESULTS Hundred and one consecutive patients were prospectively enrolled (median age 26 [19; 46] years; 72% female) and underwent combined HUT/video EEG between 2007 and 2015. Antiepileptic drugs were being prescribed in 42% of patients. Combined HUT/video EEG was diagnostic in 67% of patients, leading to diagnosis of vasovagal syncope in 59 patients and psychogenic pseudosyncope in nine cases. Antiepileptic drugs were discontinued in 18 patients without epilepsy. Independent predictors of a definitive diagnosis were the presence of prodromal symptoms (odds ratio 5.97, 95% confidence interval 1.37-26; P=0.017) and a history of myoclonic jerks during T-LOC (odds ratio 4.36, 95% confidence interval 1.71-11.15; P=0.002). CONCLUSIONS Combined HUT/video EEG is useful for investigating recurrent unexplained atypical seizure-like T-LOC, especially in patients with a history of myoclonic jerks or with documented interictal non-specific EEG abnormalities.
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Affiliation(s)
- Sandro Ninni
- Clinique cardiologique, Institut Cœur-Poumon, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France.
| | - Claude Kouakam
- Clinique cardiologique, Institut Cœur-Poumon, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France
| | - William Szurhaj
- Service de neurophysiologie clinique, hôpital Roger-Salengro, CHRU de Lille, avenue du Professeur-Emile-Laine, 59037 Lille, France
| | - Guillaume Baille
- Service de neurophysiologie clinique, hôpital Roger-Salengro, CHRU de Lille, avenue du Professeur-Emile-Laine, 59037 Lille, France
| | - Didier Klug
- Clinique cardiologique, Institut Cœur-Poumon, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France
| | - Dominique Lacroix
- Clinique cardiologique, Institut Cœur-Poumon, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France
| | - Philippe Derambure
- Service de neurophysiologie clinique, hôpital Roger-Salengro, CHRU de Lille, avenue du Professeur-Emile-Laine, 59037 Lille, France
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36
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Maury P, Defaye P, Klug D, Alonso C, Anselme F, Fauchier L, Gandjbakhch E, Gras D, Hermida JS, Laurent G, Mansourati J, Marijon E, Sacher F, Taieb J, Boveda S, Piot O, Sadoul N. Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures. Arch Cardiovasc Dis 2019; 112:67-73. [DOI: 10.1016/j.acvd.2018.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/05/2018] [Accepted: 05/14/2018] [Indexed: 10/28/2022]
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37
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Klein C, Brunereau J, Lacroix D, Ninni S, Brigadeau F, Klug D, Longere B, Montaigne D, Pontana F, Coisne A. Left atrial epicardial adipose tissue radiodensity is associated with electrophysiological properties of atrial myocardium in patients with atrial fibrillation. Eur Radiol 2018; 29:3027-3035. [DOI: 10.1007/s00330-018-5793-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/05/2018] [Accepted: 09/21/2018] [Indexed: 01/04/2023]
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38
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Halbach M, Abraham WT, Butter C, Ducharme A, Klug D, Little WC, Reuter H, Schafer JE, Senni M, Swarup V, Wachter R, Weaver FA, Wilks SJ, Zile MR, Müller-Ehmsen J. Baroreflex activation therapy for the treatment of heart failure with reduced ejection fraction in patients with and without coronary artery disease. Int J Cardiol 2018; 266:187-192. [DOI: 10.1016/j.ijcard.2018.04.075] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/01/2018] [Accepted: 04/17/2018] [Indexed: 11/28/2022]
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39
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Algalarrondo V, Perault R, Bories MC, Narayanan K, Garcia R, Combes N, Perier MC, Defaye P, Sadoul N, Gras D, Klug D, Bordachar P, Fauchier L, Deharo JC, Leclercq C, Boveda S, Marijon E, Babuty D. Prophylactic implantable cardioverter defibrillators for primary prevention: From implantation to heart transplantation. Arch Cardiovasc Dis 2018; 111:758-765. [PMID: 30078651 DOI: 10.1016/j.acvd.2018.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/30/2018] [Accepted: 05/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The frequency, characteristics and outcomes of primary prevention implantable cardioverter defibrillator (ICD) recipients who eventually undergo heart transplantation (HT) during follow-up have not been well described. AIMS In a cohort of patients with heart failure implanted with an ICD for primary prevention of sudden cardiac death, to identify those at high risk of subsequent HT and evaluate ICD usefulness. METHODS Between 2002 and 2012, 5539 patients received a primary prevention ICD across 12 centers, and were enrolled in the DAI-PP programme, including 5427 with full HT information available. RESULTS During a median follow-up of 1024 days (interquartile range 484-1702 days), 176 (3.2%) patients underwent HT. Median duration between ICD implantation and HT was 484 days (IQR 169-1117 days). Among those aged≤65 years (theoretical age limit for HT registration in France), the overall incidence per 1000 person-years was 18.03 (95% confidence interval [CI]: 15.32-20.74). Left ventricular ejection fraction<25% (hazard ratio [HR]: 3.43, 95% CI: 2.34-5.04; P<0.0001), younger age (HR: 0.95, 95% CI: 0.93-0.96; P<0.0001), New York Heart Association (NYHA) class III-IV (HR: 2.67, 95% CI: 1.79-4.00; P<0.0001) and no cardiac resynchronization therapy (HR: 2.09, 95% CI: 1.39-3.14; P=0.0004) were independently associated with HT. Patients with these three characteristics (excluding age) had a 1-year HT rate of 15.2%. Incidence of appropriate ICD therapies was 92.7 per 1000 person-years for patients who underwent HT versus 76.1 for those who did not (P=0.64). CONCLUSIONS The overall incidence of HT in this primary prevention population was relatively high, especially among young patients with a very low ejection fraction, an advanced NYHA class and were unsuitable for cardiac resynchronization therapy (up to 15% annually). Patients awaiting HT experienced a significant rate of appropriate ICD therapies, reinforcing the importance of specific cardiac rhythm management in these patients.
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Affiliation(s)
| | - Romain Perault
- Université François-Rabelais, CHU Trousseau, 37170 Tours, France
| | | | - Kumar Narayanan
- Paris Cardiovascular Research Centre, 75015 Paris, France; MaxCure Hospitals, Hyderabad, 500081 Telangana, India
| | | | | | | | | | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, 44202 Nantes, France
| | | | | | - Laurent Fauchier
- Université François-Rabelais, CHU Trousseau, 37170 Tours, France
| | | | | | | | - Eloi Marijon
- Georges-Pompidou European Hospital, 75015 Paris, France; Paris Cardiovascular Research Centre, 75015 Paris, France; Paris Descartes University, 75006 Paris, France
| | - Dominique Babuty
- Université François-Rabelais, CHU Trousseau, 37170 Tours, France.
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- Paris Descartes University, 75006 Paris, France
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40
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Vaksmann G, Klug D. Efficacy of ivabradine to control ventricular arrhythmias in catecholaminergic polymorphic ventricular tachycardia. Pacing Clin Electrophysiol 2018; 41:1378-1380. [DOI: 10.1111/pace.13446] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Guy Vaksmann
- Department of Pediatric Cardiology; Hôpital Privé de La Louvière; Lille France
| | - Didier Klug
- Department of Cardiology, Institut cardio-thoracique; University Hospital of Lille; Lille France
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41
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Fauchier L, Cinaud A, Brigadeau F, Guedeney P, Jacon P, Mansourati J, Deharo JC, Franceschi F, Pierre B, Klug D, Lepillier A, Piot O, Gras D, Montalescot G, Defaye P. P4809Possible benefits of left atrial appendage closure for stroke prevention in patients with atrial fibrillation in real life setting. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Cinaud
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | | | - P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | - P Jacon
- University Hospital of Grenoble, Grenoble, France
| | | | - J C Deharo
- Hospital La Timone of Marseille, Marseille, France
| | - F Franceschi
- Hospital La Timone of Marseille, Marseille, France
| | - B Pierre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - D Klug
- Cardiology Hospital of Lille, Lille, France
| | - A Lepillier
- Centre Cardiologique du Nord, Saint Denis, France
| | - O Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | | | - P Defaye
- University Hospital of Grenoble, Grenoble, France
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42
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Etienne P, Klug D, Babuty D, Jesel L, Dupuis JM, Defaye P, Maury P, Pasquie JL, Le Franc P, Milhem A, Anselme F, Mansourati J, Bordachar P, Mabo P, Probst V. P2865GENECHOC study: a study designed to identify the genetic variants involved in appropriate shock in primary prevention; clinical description of the patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- P Etienne
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec, Nantes, France
| | - D Klug
- Cardiology Hospital of Lille, Lille, France
| | - D Babuty
- University Hospital of Tours, Tours, France
| | - L Jesel
- University Hospital of Strasbourg, Strasbourg, France
| | - J M Dupuis
- University Hospital of Angers, Angers, France
| | - P Defaye
- University Hospital of Grenoble, Grenoble, France
| | - P Maury
- University Hospital of Toulouse, Toulouse, France
| | - J L Pasquie
- University Hospital of Montpellier, Montpellier, France
| | | | - A Milhem
- University Hospital of La Rochelle, La Rochelle, France
| | - F Anselme
- University Hospital of Rouen, Rouen, France
| | | | - P Bordachar
- University Hospital of Bordeaux - Hospital Haut Leveque, Departement of Cardiology, Bordeaux-Pessac, France
| | - P Mabo
- University Hospital of Rennes, Rennes, France
| | - V Probst
- University Hospital of Nantes - Hospital Guillaume & Rene Laennec, Nantes, France
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43
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Etienne P, Klug D, Babuty D, Jesel L, Dupuis J, Defaye P, Maury P, Pasquié J, Le Franc P, Bru P, Anselme F, Bodeva S, Sadoul N, Jean F, Chevalier P, Deharo J, Mansourati J, Bordachar P, Mabo P, Probst V. GENECHOC study: A study designed to identify the genetic variants involved in appropriate shock in primary prevention. Clinical description of the patients. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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44
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Defaye P, Klug D, Anselme F, Sadoul N, Fauchier L, Boveda S. Answer to the letter of Walid Amara et al. Arch Cardiovasc Dis 2018; 111:304-305. [PMID: 29551369 DOI: 10.1016/j.acvd.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/27/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Pascal Defaye
- University Hospital of Grenoble Alpes, 38043 Grenoble, France.
| | - Didier Klug
- University Hospital of Lille, 59037 Lille, France
| | | | - Nicolas Sadoul
- University Hospital of Nancy, 54500 Vandœuvre-lès-Nancy, France
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45
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Bongiorni MG, Burri H, Deharo JC, Starck C, Kennergren C, Saghy L, Rao A, Tascini C, Lever N, Kutarski A, Fernandez Lozano I, Strathmore N, Costa R, Epstein L, Love C, Blomstrom-Lundqvist C, Fauchier L, Defaye P, Arnar DO, Klug D, Boveda S, Nielsen JC, Boriani G, Zhang S, Martin AP, Prutkin JM, de Zuloaga C. 2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS/HRS/LAHRS. Europace 2018; 20:1217. [DOI: 10.1093/europace/euy050] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/01/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Haran Burri
- Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean C Deharo
- Department of Cardiology, CHU la Timone, Marseilles, France
| | - Christoph Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Institute Berlin, Berlin, Germany
| | - Charles Kennergren
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laszlo Saghy
- Electrophysiology Division, 2nd Department of Medicine and Cardiology Center, University of Szeged, Szeged, Hungary
| | | | - Carlo Tascini
- First Division of Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Nigel Lever
- APHRS Reviewer, Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand
| | | | | | - Neil Strathmore
- APHRS Reviewer, Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | - Roberto Costa
- LAHRS Reviewer, Hospital das Clínicas, São Paulo, Brazil
| | - Laurence Epstein
- HRS Reviewer, Clinical Cardiac Electrophysiology, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Charles Love
- HRS Reviewer, Division of Cardiovascular Medicine, the Ohio State University Medical Center Columbus, Ohio, USA
| | | | | | - Pascal Defaye
- CHU Hopital Albert Michallon, Unite de Rythmologie Service De Cardiologie, Grenoble, France
| | - David O Arnar
- Landspitali University Hospital, Cardiology Department, Reykjavik, Iceland
| | - Didier Klug
- Hopital Cardiologique, Chru Lille, Service De Cardiologie A, Lille, France
| | - Serge Boveda
- Clinique Pasteur, Cardiology Department, Toulouse, France
| | - Jens Cosedis Nielsen
- Department of Cardiology, Aarhus University Hospital, Skejby Sygehus, Aaehus, Denmark
| | | | - Shu Zhang
- Beijing Fuwai Hospital, Cardiology Department, Beijing, China
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46
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Barra S, Providência R, Boveda S, Duehmke R, Narayanan K, Chow AW, Piot O, Klug D, Defaye P, Gras D, Deharo JC, Milliez P, Da Costa A, Mondoly P, Gonzalez-Panizo J, Leclercq C, Heck P, Virdee M, Sadoul N, Le Heuzey JY, Marijon E. Device complications with addition of defibrillation to cardiac resynchronisation therapy for primary prevention. Heart 2018. [PMID: 29540431 DOI: 10.1136/heartjnl-2017-312546] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE In patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection. METHODS Observational multicentre European cohort study of 3008 consecutive patients with ischaemic or non-ischaemic dilated cardiomyopathy and no history of sustained ventricular arrhythmias, undergoing CRT implantation with (CRT-D, n=1785) or without (CRT-P, n=1223) defibrillator. Using propensity score and competing risk analyses, we assessed the risk of significant device-related complications requiring surgical reintervention. Inappropriate shocks were not considered except those due to lead malfunction requiring lead revision. RESULTS Acute complications occurred in 148 patients (4.9%), without significant difference between groups, even after considering potential confounders (OR=1.20, 95% CI 0.72 to 2.00, p=0.47). During a mean follow-up of 41.4±29 months, late complications occurred in 475 patients, giving an annual incidence rate of 26 (95% CI 9 to 43) and 15 (95% CI 6 to 24) per 1000 patient-years in CRT-D and CRT-P patients, respectively. CRT-D was independently associated with increased occurrence of late complications (HR=1.68, 95% CI 1.27 to 2.23, p=0.001). In particular, when compared with CRT-P, CRT-D was associated with an increased risk of device-related infection (HR 2.10, 95% CI 1.18 to 3.45, p=0.004). Acute complications did not predict overall late complications, but predicted device-related infection (HR 2.85, 95% CI 1.71 to 4.56, p<0.001). CONCLUSIONS Compared with CRT-P, CRT-D is associated with a similar risk of periprocedural complications but increased risk of long-term complications, mainly infection. This needs to be considered in the decision of implanting CRT with or without a defibrillator.
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Affiliation(s)
- Sérgio Barra
- Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | | | - Serge Boveda
- Cardiology Department, Clinique Pasteur, Toulouse, France
| | - Rudolf Duehmke
- Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Kumar Narayanan
- Cardiovascular Epidemiology, Paris Cardiovascular Research Center, Paris, France.,Cardiology Department, MaxCure Hospitals, Hyderabad, India
| | | | - Olivier Piot
- Cardiology Department, Centre Cardiologique du Nord, St Denis, France
| | - Didier Klug
- Cardiology Department, Lille University Hospital, Lille, France
| | - Pascal Defaye
- Cardiology Department, Grenoble University Hospital, Grenoble, France
| | - Daniel Gras
- Cardiology Department, Nouvelles Cliniques Nantaises, Nantes, France
| | | | - Paul Milliez
- Cardiology Department, Caen University Hospital, Caen, France
| | - Antoine Da Costa
- Cardiology Department, St Etienne University Hospital, St Etienne, France
| | - Pierre Mondoly
- Cardiology Department, Toulouse University Hospital, Toulouse, France
| | | | | | - Patrick Heck
- Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Munmohan Virdee
- Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Nicolas Sadoul
- Cardiology Department, Nancy University Hospital, Nancy, France
| | - Jean-Yves Le Heuzey
- Paris Descartes University, Paris, France.,Cardiology Department, European Georges Pompidou Hospital, Paris, France
| | - Eloi Marijon
- Cardiovascular Epidemiology, Paris Cardiovascular Research Center, Paris, France.,Paris Descartes University, Paris, France.,Cardiology Department, European Georges Pompidou Hospital, Paris, France
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47
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Pasquie JL, Rioufol G, Lepillier A, Elbaz M, Horvilleur J, Brenot P, Pierre B, Le Corvoisier P, Amabile N, Andronache M, Anselme F, Armero S, Aubry P, Audureau E, Babuty D, Bakouboula B, Bars C, Baruteau AE, Bille J, Bonnet JL, Brigadeau F, Brochet E, Bun SS, Cailla G, Cesari O, Champagnac D, Chevalier P, Combes N, Comet B, Commeau P, Dearo JC, Dompnier A, Farah B, Garot P, Gras D, Giraudeau C, Granier M, Guerin P, Iriart X, Jalal Z, Jesel-Morel L, Jeu A, Kamtchueng P, Lellouche N, Meneveau N, Nighoghossian N, Otmani A, Pelliere R, Pillière R, Pons M, Popovic B, Pujadas P, Rossi R, Roux A, Saludas Y, Spaulding C, Statiev V, Ternacle J, Traulle S, Winum PF. Percutaneous Left Atrial Appendage Closure Is a Reasonable Option for Patients With Atrial Fibrillation at High Risk for Cerebrovascular Events. Circ Cardiovasc Interv 2018. [DOI: 10.1161/circinterventions.117.005841] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background—
Percutaneous left atrial appendage (LAA) closure is an emerging option for patients with atrial fibrillation at high risk for cerebrovascular events. The multicenter FLAAC registry (French Nationwide Observational LAA Closure Registry) was established to assess LAA closure outcomes in everyday practice.
Methods and Results—
Four hundred thirty-six patients referred from April 2013 to September 2015 to 33 French interventional cardiology centers for percutaneous LAA closure were included prospectively in the FLAAC registry. Mean age was 75.4±0.4 years. The stroke risk was high (mean CHA
2
DS
2
–VASc score, 4.5±0.1) and most patients had experienced clinically significant bleeding (HAS-BLED score, 3.1±0.05). The device used was Amplatzer LAA occluder in 58% and the Watchman device in 42% of the patients. The procedural success rate was 98.4%. Median postprocedure follow-up was 12.0 (11.8–12.0) months and a single patient was lost to follow-up. During the periprocedural and subsequent follow-up period, procedure-related severe adverse events occurred in 21 (4.9%) and 10 (2.3%) patients, respectively. One-year cumulative incidences of ischemic stroke and cerebral hemorrhage were 2.9% (1.6–5.0) and 1.5% (0.7–3.2), respectively. Overall, 1-year mortality was 9.3% (6.9–12.5) with 7 of the 39 deaths related or possibly related to the device or procedure.
Conclusions—
This nationwide prospective registry shows that, in the French population, LAA closure is mainly used in patients with high comorbidity rates and a poor prognosis. LAA closure in such patients seems reasonable to decrease the stroke rate. The overall health status of these patients should be taken into account during the preprocedural evaluation process.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Benoit Thambo
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Pascal Defaye
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Sylvain Hermida
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Sélim Abbey
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Didier Klug
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Michel Juliard
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Luc Pasquie
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Gilles Rioufol
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Antoine Lepillier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Meyer Elbaz
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jerome Horvilleur
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Brenot
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Bertrand Pierre
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Le Corvoisier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
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48
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Perrin T, Boveda S, Defaye P, Rosier A, Sadoul N, Bordachar P, Klug D, Ritter P, Belhameche M, Babuty D, Mansourati J, Lazarus A, Deharo JC. 1079Role of ICD monitoring in the management of inappropriate ventricular arrhythmia diagnosis: the THORN trial. Europace 2018. [DOI: 10.1093/europace/euy015.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Perrin
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - S Boveda
- Clinic Pasteur of Toulouse, Cardiology, Toulouse, France
| | - P Defaye
- University Hospital of Grenoble, Cardiology, Grenoble, France
| | - A Rosier
- Institut Hospitalier Jacques Cartier, Massy, France
| | - N Sadoul
- University Hospital of Brabois , Cardiology, Nancy, France
| | - P Bordachar
- Hospital Haut Leveque, Cardiology, Bordeaux-Pessac, France
| | - D Klug
- Lille University Hospital, Cardiology, Lille, France
| | - P Ritter
- Hospital Haut Leveque, Cardiology, Bordeaux-Pessac, France
| | - M Belhameche
- Grand Hôpital de l'Est Francilien, Cardiology, Jossigny, France
| | - D Babuty
- University Hospital Trousseau, Cardiology, Chambray-lès-Tours, France
| | - J Mansourati
- Hospital Cavale Blanche, Cardiology, Brest, France
| | - A Lazarus
- Clinique Medico-Chirurgicale Ambroise Pare, Cardiology, Neuilly sur Seine, France
| | - J C Deharo
- Hospital La Timone of Marseille, Cardiology, Marseille, France
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49
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Fauchier L, Cinaud A, Lepillier A, Brigadeau F, Jacon P, Pierre B, Paziaud O, Franceschi F, Mansourati J, Klug D, Piot O, Gras D, Montalescot G, Deharo JC, Defaye P. 201Left atrial appendage closure for stroke prevention in patients with atrial fibrillation: the difficult task of estimating the possible benefit in real life setting. Europace 2018. [DOI: 10.1093/europace/euy015.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Fauchier
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Cinaud
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - A Lepillier
- Centre Cardiologique du Nord, Saint Denis, France
| | | | - P Jacon
- University Hospital of Grenoble, Grenoble, France
| | - B Pierre
- Tours Regional University Hospital, Hospital Trousseau, Tours, France
| | - O Paziaud
- Centre Cardiologique du Nord, Saint Denis, France
| | - F Franceschi
- Hospital La Timone of Marseille, Marseille, France
| | | | - D Klug
- Cardiology Hospital of Lille, Lille, France
| | - O Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | - D Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | | | - J C Deharo
- Hospital La Timone of Marseille, Marseille, France
| | - P Defaye
- University Hospital of Grenoble, Grenoble, France
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Defaye P, Klug D, Anselme F, Gras D, Hermida JS, Piot O, Alonso C, Fauchier L, Gandjbakhch E, Marijon E, Maury P, Taieb J, Boveda S, Sadoul N. Recommendations for the implantation of leadless pacemakers from the French Working Group on Cardiac Pacing and Electrophysiology of the French Society of Cardiology. Arch Cardiovasc Dis 2018; 111:53-58. [DOI: 10.1016/j.acvd.2017.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
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