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Delinière A, Bessière F, Placide L, Pasquié JL, Haddad C, Tirel S, Mokhtar H, Morel E, Gardey K, Dulac A, Ditac G, Sacher F, Denjoy I, Chevalier P. Wearable electrocardiogram devices in patients with congenital long QT syndrome: The SMART-QT study. Arch Cardiovasc Dis 2024:S1875-2136(24)00054-8. [PMID: 38704288 DOI: 10.1016/j.acvd.2024.02.010] [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: 10/29/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND In patients with congenital long QT syndrome (LQTS), the risk of ventricular arrhythmia is correlated with the duration of the corrected QT interval and the changes in the ST-T wave pattern on the 12-lead surface electrocardiogram (12L-ECG). Remote monitoring of these variables could be useful. AIM To evaluate the abilities of two wearable electrocardiogram devices (Apple Watch and KardiaMobile 6L) to provide reliable electrocardiograms in terms of corrected QT interval and ST-T wave patterns in patients with LQTS. METHODS In a prospective multicentre study (ClinicalTrials.gov identifier: NCT04728100), a 12L-ECG, a 6-lead KardiaMobile 6L electrocardiogram and two single-lead Apple Watch electrocardiograms were recorded in patients with LQTS. The corrected QT interval and ST-T wave patterns were evaluated manually. RESULTS Overall, 98 patients with LQTS were included; 12.2% were children and 92.8% had a pathogenic variant in an LQTS gene. The main genotypes were LQTS type 1 (40.8%), LQTS type 2 (36.7%) and LQTS type 3 (7.1%); rarer genotypes were also represented. When comparing the ST-T wave patterns obtained with the 12L-ECG, the level of agreement was moderate with the Apple Watch (k=0.593) and substantial with the KardiaMobile 6L (k=0.651). Regarding the corrected QT interval, the correlation with 12L-ECG was strong for the Apple Watch (r=0.703 in lead II) and moderate for the KardiaMobile 6L (r=0.593). There was a slight overestimation of corrected QT interval with the Apple Watch and a subtle underestimation with the KardiaMobile 6L. CONCLUSIONS In patients with LQTS, the corrected QT interval and ST-T wave patterns obtained with the Apple Watch and the KardiaMobile 6L correlated with the 12L-ECG. Although wearable electrocardiogram devices cannot replace the 12L-ECG for the follow-up of these patients, they could be interesting additional monitoring tools.
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Affiliation(s)
- Antoine Delinière
- National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, 69008 Lyon, France; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart)
| | - Francis Bessière
- Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Paediatric and Congenital Heart Disease Medico-Surgical Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, LabTau, Inserm, 69003 Lyon, France
| | - Leslie Placide
- Service de Cardiologie, Centre de Compétence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34295 Montpellier, France
| | - Jean-Luc Pasquié
- Service de Cardiologie, Centre de Compétence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 34295 Montpellier, France; CNRS UMR9214, Inserm U1046, PHYMEDEXP, Université de Montpellier, 34295 Montpellier, France
| | - Christelle Haddad
- Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Solenn Tirel
- National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Hajira Mokhtar
- National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Elodie Morel
- National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Kevin Gardey
- Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Arnaud Dulac
- Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Geoffroy Ditac
- Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France
| | - Frédéric Sacher
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart); Institut LIRYC, Centre de référence des MAladies RYthmiques héréditaire (CMARY), Bordeaux University Hospital, 33000 Bordeaux, France; Université de Bordeaux, Inserm, CRCTB, U1045, 33000 Bordeaux, France
| | - Isabelle Denjoy
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart); Service de Cardiologie, Centre de Référence des Troubles du Rythme Cardiaque d'Origine Héréditaire, Hôpital Bichat-Claude-Bernard, AP-HP, 75018 Paris, France
| | - Philippe Chevalier
- National Reference Centre for Inherited Arrhythmia of Lyon (CERA), Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Electrophysiology Unit, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon, 69500 Bron, France; Université Claude-Bernard Lyon-1, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, 69008 Lyon, France; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-Heart).
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Goual L, Bounasri E, Vincenti M, Amédro P, Desprat R, Bernex F, Lemaitre JM, Pasquié JL, Lacampagne A, Thireau J, Meli AC. Generation of patient-specific induced pluripotent stem cell lines with Type 2 Long QT Syndrome and the KCNH2 c.379C > T pathogenic variant. Stem Cell Res 2023; 72:103192. [PMID: 37660555 DOI: 10.1016/j.scr.2023.103192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023] Open
Abstract
Type 2 Long QT Syndrome (LQT2) is a rare genetic heart rhythm disorder causing life-threatening arrhythmias. We derived induced pluripotent stem cell (iPSC) lines from two patients with LQT2, aged 18 and 6, both carrying a heterozygous missense mutation on the 3rd and 11th exons of KCNH2. The iPSC lines exhibited normal genomes, expressed pluripotent markers, and differentiated into trilineage embryonic layers. These patient-specific iPSC lines provide a valuable model to study the molecular and functional impact of the hERG channel gene mutation in LQT2 and to develop personalized therapeutic approaches for this syndrome.
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Affiliation(s)
- Lamia Goual
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Elisa Bounasri
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; MicroBrain Biotech S.A.S., Marly Le-Roi, France
| | - Marie Vincenti
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clinical Investigation Centre, Montpellier University Hospital, Montpellier, France
| | - Pascal Amédro
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Centre, Clinical Investigation Centre, Montpellier University Hospital, Montpellier, France
| | | | - Florence Bernex
- RHEM, Réseau d'Histologie Expérimentale de Montpellier, Univ. Montpellier, BioCampus, CNRS, INSERM, Montpellier, France
| | | | - Jean-Luc Pasquié
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Department of Cardiology, CHU of Montpellier, Montpellier, France
| | - Alain Lacampagne
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Jérôme Thireau
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
| | - Albano C Meli
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
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Sleiman Y, Reiken S, Charrabi A, Jaffré F, Sittenfeld LR, Pasquié JL, Colombani S, Lerman BB, Chen S, Marks AR, Cheung JW, Evans T, Lacampagne A, Meli AC. Personalized medicine in the dish to prevent calcium leak associated with short-coupled polymorphic ventricular tachycardia in patient-derived cardiomyocytes. Stem Cell Res Ther 2023; 14:266. [PMID: 37740238 PMCID: PMC10517551 DOI: 10.1186/s13287-023-03502-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Polymorphic ventricular tachycardia (PMVT) is a rare genetic disease associated with structurally normal hearts which in 8% of cases can lead to sudden cardiac death, typically exercise-induced. We previously showed a link between the RyR2-H29D mutation and a clinical phenotype of short-coupled PMVT at rest using patient-specific hiPSC-derived cardiomyocytes (hiPSC-CMs). In the present study, we evaluated the effects of clinical and experimental anti-arrhythmic drugs on the intracellular Ca2+ handling, contractile and molecular properties in PMVT hiPSC-CMs in order to model a personalized medicine approach in vitro. METHODS Previously, a blood sample from a patient carrying the RyR2-H29D mutation was collected and reprogrammed into several clones of RyR2-H29D hiPSCs, and in addition we generated an isogenic control by reverting the RyR2-H29D mutation using CRIPSR/Cas9 technology. Here, we tested 4 drugs with anti-arrhythmic properties: propranolol, verapamil, flecainide, and the Rycal S107. We performed fluorescence confocal microscopy, video-image-based analyses and biochemical analyses to investigate the impact of these drugs on the functional and molecular features of the PMVT RyR2-H29D hiPSC-CMs. RESULTS The voltage-dependent Ca2+ channel inhibitor verapamil did not prevent the aberrant release of sarcoplasmic reticulum (SR) Ca2+ in the RyR2-H29D hiPSC-CMs, whereas it was prevented by S107, flecainide or propranolol. Cardiac tissue comprised of RyR2-H29D hiPSC-CMs exhibited aberrant contractile properties that were largely prevented by S107, flecainide and propranolol. These 3 drugs also recovered synchronous contraction in RyR2-H29D cardiac tissue, while verapamil did not. At the biochemical level, S107 was the only drug able to restore calstabin2 binding to RyR2 as observed in the isogenic control. CONCLUSIONS By testing 4 drugs on patient-specific PMVT hiPSC-CMs, we concluded that S107 and flecainide are the most potent molecules in terms of preventing the abnormal SR Ca2+ release and contractile properties in RyR2-H29D hiPSC-CMs, whereas the effect of propranolol is partial, and verapamil appears ineffective. In contrast with the 3 other drugs, S107 was able to prevent a major post-translational modification of RyR2-H29D mutant channels, the loss of calstabin2 binding to RyR2. Using patient-specific hiPSC and CRISPR/Cas9 technologies, we showed that S107 is the most efficient in vitro candidate for treating the short-coupled PMVT at rest.
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Affiliation(s)
- Yvonne Sleiman
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France
| | - Steven Reiken
- Department of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Azzouz Charrabi
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France
| | - Fabrice Jaffré
- Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Leah R Sittenfeld
- Department of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jean-Luc Pasquié
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France
- Department of Cardiology, CHRU of Montpellier, Montpellier, France
| | - Sarah Colombani
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France
| | - Bruce B Lerman
- Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
| | - Shuibing Chen
- Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Andrew R Marks
- Department of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Jim W Cheung
- Division of Cardiology, Weill Cornell Medical College, New York, NY, USA
| | - Todd Evans
- Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Alain Lacampagne
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France
| | - Albano C Meli
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier , France.
- CNRS, INSERM, Montpellier Organoid Platform, Biocampus, University of Montpellier, Montpellier, France.
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4
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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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Maire A, Chapet N, Aguilhon S, Laugier ML, Laffont-Lozes P, Rigoni M, Mathieu B, Audurier Y, Breuker C, de Barry G, Jalabert A, Leclercq F, Pasquié JL, Roubille F, Castet-Nicolas A. Evaluation of vaccination coverage in heart failure patients in a tertiary center. Heliyon 2023; 9:e18080. [PMID: 37519644 PMCID: PMC10372228 DOI: 10.1016/j.heliyon.2023.e18080] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023] Open
Abstract
Background Despite current recommendation, vaccination coverage (VC) for patients with heart failure (HF) remains far too limited. Aims To evaluate the VC of HF patients followed in our hospital center and investigate the barriers to vaccination and the ways to address them. Methods This was a cross-sectional monocentric descriptive study conducted between December 2019 and January 2021 at the University Hospital of Montpellier, France. Patients with HF history hospitalized in cardiology unit (CU) and patients in a HF telemonitoring program (TP) were included. An interview was conducted by a pharmacist to find out the patient's vaccination status against influenza and pneumococcus. For non-vaccinated patients, opinion and willingness to be vaccinated were also obtained. Results Data from 335 patients were collected (185 in CU, 150 in TP). The mean age was 69.3 years and the proportion of males was 72%. About 65% were vaccinated against influenza in the last year (60% in CU, 72% in TP, p = 0.022) and 22% were up to date with pneumococcal vaccination (11% in CU, 35% in TP, p < 0.001). Among patients not vaccinated, 17% refused vaccination. Among unvaccinated patients who consider vaccination, 69% wanted to be vaccinated by their general practitioner (GP). Conclusions The VC of HF patients remains insufficient. Patients in TP are more vaccinated than patients in CU, which could involve better management. The low rate of vaccinated patients is mainly explained by a lack of awareness. The medical team, including the clinical pharmacist by his dedicated time during medication reconciliation may play a major role in the management of hospitalized patients as well as GP's as local actors.
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Affiliation(s)
- Adrien Maire
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Chapet
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
| | - Sylvain Aguilhon
- Department of Cardiology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Lucie Laugier
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
| | | | - Mélinda Rigoni
- Department of Pharmacy, University Hospital of Nimes, Nimes, France
| | - Betty Mathieu
- Department of Pharmacy, University Hospital of Nimes, Nimes, France
| | | | - Cyril Breuker
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Gaëlle de Barry
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
| | - Anne Jalabert
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
| | - Florence Leclercq
- Department of Cardiology, University Hospital of Montpellier, Montpellier, France
| | - Jean-Luc Pasquié
- Department of Cardiology, University Hospital of Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - François Roubille
- Department of Cardiology, University Hospital of Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Audrey Castet-Nicolas
- Clinical Pharmacy Department, University Hospital of Montpellier, Montpellier, France
- Cancer Research Institute of Montpellier (IRCM), INSERM U1194, ICM, University of Montpellier, Montpellier, France
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Sleiman Y, Reiken S, Charrabi A, Jaffré F, Sittenfeld LR, Pasquié JL, Lerman BB, Chen S, Marks AR, Cheung JW, Evans T, Lacampagne A, Meli A. Modeling and drug screening of inherited short-coupled polymorphic ventricular tachycardia using patient derived tissue. J Mol Cell Cardiol 2022. [DOI: 10.1016/j.yjmcc.2022.08.160] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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7
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Bernardin AA, Colombani S, Rousselot A, Andry V, Goumon Y, Delanoë-Ayari H, Pasqualin C, Brugg B, Jacotot ED, Pasquié JL, Lacampagne A, Meli AC. Impact of Neurons on Patient-Derived Cardiomyocytes Using Organ-On-A-Chip and iPSC Biotechnologies. Cells 2022; 11:cells11233764. [PMID: 36497024 PMCID: PMC9737466 DOI: 10.3390/cells11233764] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
In the heart, cardiac function is regulated by the autonomic nervous system (ANS) that extends through the myocardium and establishes junctions at the sinus node and ventricular levels. Thus, an increase or decrease in neuronal activity acutely affects myocardial function and chronically affects its structure through remodeling processes. The neuro-cardiac junction (NCJ), which is the major structure of this system, is poorly understood and only a few cell models allow us to study it. Here, we present an innovant neuro-cardiac organ-on-chip model to study this structure to better understand the mechanisms involved in the establishment of NCJ. To create such a system, we used microfluidic devices composed of two separate cell culture compartments interconnected by asymmetric microchannels. Rat PC12 cells were differentiated to recapitulate the characteristics of sympathetic neurons, and cultivated with cardiomyocytes derived from human induced pluripotent stem cells (hiPSC). We confirmed the presence of a specialized structure between the two cell types that allows neuromodulation and observed that the neuronal stimulation impacts the excitation-contraction coupling properties including the intracellular calcium handling. Finally, we also co-cultivated human neurons (hiPSC-NRs) with human cardiomyocytes (hiPSC-CMs), both obtained from the same hiPSC line. Hence, we have developed a neuro-cardiac compartmentalized in vitro model system that allows us to recapitulate the structural and functional properties of the neuro-cardiac junction and that can also be used to better understand the interaction between the heart and brain in humans, as well as to evaluate the impact of drugs on a reconstructed human neuro-cardiac system.
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Affiliation(s)
- Albin A. Bernardin
- PhyMedExp, University of Montpellier, Inserm, CNRS, 371 Avenue du Doyen G. Giraud, CEDEX 5, 34295 Montpellier, France
- MicroBrain Biotech S.A.S., 78160 Marly Le-Roi, France
| | - Sarah Colombani
- PhyMedExp, University of Montpellier, Inserm, CNRS, 371 Avenue du Doyen G. Giraud, CEDEX 5, 34295 Montpellier, France
| | - Antoine Rousselot
- MicroBrain Biotech S.A.S., 78160 Marly Le-Roi, France
- Université Paris-Saclay, CEA, CNRS, NIMBE, 91191 Gif-sur-Yvette, France
| | - Virginie Andry
- SMPMS-INCI, Mass Spectrometry Facilities of the CNRS UPR3212, CNRS UPR3212, Institut des Neu-Rosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique and University of Strasbourg, 68009 Strasbourg, France
| | - Yannick Goumon
- SMPMS-INCI, Mass Spectrometry Facilities of the CNRS UPR3212, CNRS UPR3212, Institut des Neu-Rosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique and University of Strasbourg, 68009 Strasbourg, France
| | - Hélène Delanoë-Ayari
- Claude Bernard University, Université de Lyon, Institut lumière matière, 69000 Lyon, France
| | - Côme Pasqualin
- Groupe Physiologie des Cellules Cardiaques et Vasculaires, Université de Tours, EA4245 Transplantation, Immunologie, Inflammation, 37000 Tours, France
| | - Bernard Brugg
- Sorbonne Université, Campus Pierre et Marie Curie, Institut de Biologie Paris-Seine, CNRS UMR 8256, INSERM U1164, F-75005 Paris, France
| | - Etienne D. Jacotot
- Sorbonne Université, Campus Pierre et Marie Curie, Institut de Biologie Paris-Seine, CNRS UMR 8256, INSERM U1164, F-75005 Paris, France
- The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
- Department of Pathology and Cell Biology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Jean-Luc Pasquié
- PhyMedExp, University of Montpellier, Inserm, CNRS, 371 Avenue du Doyen G. Giraud, CEDEX 5, 34295 Montpellier, France
- Department of Cardiology, Montpellier University Hospital, 34295 Montpellier, France
| | - Alain Lacampagne
- PhyMedExp, University of Montpellier, Inserm, CNRS, 371 Avenue du Doyen G. Giraud, CEDEX 5, 34295 Montpellier, France
- Correspondence: (A.L.); (A.C.M.)
| | - Albano C. Meli
- PhyMedExp, University of Montpellier, Inserm, CNRS, 371 Avenue du Doyen G. Giraud, CEDEX 5, 34295 Montpellier, France
- Correspondence: (A.L.); (A.C.M.)
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8
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Waldmann V, Marquié C, Bouzeman A, Duthoit G, Thambo JB, Koutbi L, Maltret A, Pasquié JL, Combes N, Marijon E. Subcutaneous vs Transvenous Implantable Cardioverter-Defibrillator Therapy in Patients With Tetralogy of Fallot. J Am Coll Cardiol 2022; 80:1701-1703. [DOI: 10.1016/j.jacc.2022.08.761] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
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9
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Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessière F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Al Arnaout A, Anselme F, Audinet C, Bernard Y, Boveda S, Bun SS, Chassignolle M, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators. JACC Clin Electrophysiol 2022; 8:1304-1314. [DOI: 10.1016/j.jacep.2022.06.024] [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] [Received: 02/22/2022] [Revised: 05/24/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
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10
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Goudal A, Karakachoff M, Lindenbaum P, Baron E, Bonnaud S, Kyndt F, Arnaud M, Minois D, Bourcereau E, Thollet A, Deleuze JF, Genin E, Wiart F, Pasquié JL, Galand V, Sacher F, Dina C, Redon R, Bezieau S, Schott JJ, Probst V, Barc J. Burden of rare variants in arrhythmogenic cardiomyopathy with right dominant form associated genes provides new insights for molecular diagnosis and clinical management. Hum Mutat 2022; 43:1333-1342. [PMID: 35819174 PMCID: PMC9544292 DOI: 10.1002/humu.24436] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 11/05/2022]
Abstract
Arrhythmogenic cardiomyopathy with right dominant form (ACR) is a rare heritable cardiac cardiomyopathy disorder associated with sudden cardiac death. Pathogenic variants in desmosomal genes have been causally related to ACR in 40% of cases. Other genes encoding non desmosomal proteins have been described in ACR but their contribution in this pathology is still debated. A panel of 71 genes associated with inherited cardiopathies was screened in an ACR population of 172 probands and 856 individuals from the general population. Pathogenic variants (PV) and variants of uncertain significance (VUS) have been identified in 36% and 18.6% of patients respectively. Among the cardiopathy associated genes, burden tests show a significant enrichment in PV and VUS only for desmosomal genes PKP2, DSP, DSC2 and DSG2. Importantly, VUS may account for 15% of ACR cases and should then be considered for molecular diagnosis. Among the other genes, no evidence of enrichment was detected, suggesting an extreme caution in the interpretation of these genetic variations without associated functional or segregation data. Genotype-phenotype correlation points to 1) a more severe and earlier onset of the disease in PV and VUS carriers, underlying the importance to carry out presymptomatic diagnosis in relatives and 2) to a more prevalent left ventricular dysfunction in DSP variant carriers. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Adeline Goudal
- Service de Génétique Médicale, CHU NANTES, Nantes, F-44000, France.,Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Matilde Karakachoff
- Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France.,Clinique des données, INSERM, CIC 1413, CHU NANTES, Nantes, F-44000, France
| | - Pierre Lindenbaum
- Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Estelle Baron
- Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Stéphanie Bonnaud
- Université de Nantes, CHU Nantes, Inserm, CNRS, SFR Santé, Inserm UMS 016, CNRS UMS 3556, Nantes, F-44000, France
| | - Florence Kyndt
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Marine Arnaud
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Damien Minois
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Emmanuelle Bourcereau
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Aurélie Thollet
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Génomique, CEA, Evry, France
| | | | - François Wiart
- Service de cardiologie, CHU de la Réunion, site sud, 97410 St Pierre, Réunion, France
| | - Jean-Luc Pasquié
- Department of Cardiology, CHU Montpellier, 191 av. du Doyen Giraud, Montpellier, 34295, France
| | | | - Frédéric Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Bordeaux University Hospital (CHU), Univ. Bordeaux, Centre de recherche Cardio-Thoracique de Bordeaux
| | - Christian Dina
- Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Richard Redon
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Stéphane Bezieau
- Service de Génétique Médicale, CHU NANTES, Nantes, F-44000, France.,Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Jean-Jacques Schott
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Vincent Probst
- Université de Nantes, CHU Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
| | - Julien Barc
- Université de Nantes, CNRS, INSERM, l'institut du thorax, Nantes, F-44000, France
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11
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Coulibaly I, Cardelli LS, Duflos C, Moulis L, Mandoorah B, Nicoleau J, Placide L, Massin F, Pasquié JL, Granier M. Virtual Reality Hypnosis in the Electrophysiology Lab: When Human Treatments Are Better than Virtual Ones. J Clin Med 2022; 11:jcm11133913. [PMID: 35807198 PMCID: PMC9267480 DOI: 10.3390/jcm11133913] [Citation(s) in RCA: 2] [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: 05/08/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
Aims: Virtual reality hypnosis (VRH) has been used successfully in various clinical settings to decrease anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and pacing procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed and accepted by 25 patients undergoing electrophysiological procedures. Data were compared with a control group (n = 61) enrolled during the following three-month period. Both groups underwent the measurement of the duration of intervention, the consumption of analgesics and hypnotics, and their pain and comfort using a validated visual analogue scale (VAS 0−10). Results: The baseline characteristics were comparable in both groups, including age. There were no differences in procedure duration (46 (±29) vs. 56 (±32) min, p = 0.18) or in hypnotic/antalgic consumption (midazolam 1.95 (±1.44) vs. 2.00 (±1.22) mg, p = 0.83; sufentanyl 3.78 (±2.87) vs. 3.58 (±2.48) μg, p = 0.9) between the control and VRH groups. In a multivariate analysis, the use of VRH was independently associated with lower comfort during the procedure assessed by postoperative visual analogue scale (OR 15.00 [95% CI 4.77−47.16], p < 0.01). There was no influence of VRH use on pain or drug consumption. Conclusions: In our experience, compared with VRH, human care is preferable during procedures in electrophysiology lab to improve the comfort of the patient. VRH has no influence on pain or drug consumption.
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Affiliation(s)
- Iklo Coulibaly
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
| | | | - Claire Duflos
- Clinical Research and Epidemiology Unit, CHU Montpellier, 34090 Montpellier, France; (C.D.); (L.M.)
- National Institute of Health and Medical Research, Unit 1046, Montpellier University, 34090 Montpellier, France
| | - Lionel Moulis
- Clinical Research and Epidemiology Unit, CHU Montpellier, 34090 Montpellier, France; (C.D.); (L.M.)
- National Institute of Health and Medical Research, Unit 1046, Montpellier University, 34090 Montpellier, France
| | - Bara Mandoorah
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
| | - Jean Nicoleau
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
| | - Leslie Placide
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
| | - François Massin
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
| | - Jean-Luc Pasquié
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
- National Institute of Health and Medical Research, Unit 1046, Montpellier University, 34090 Montpellier, France
| | - Mathieu Granier
- Cardiology Department, CHU Montpellier, 34090 Montpellier, France; (I.C.); (B.M.); (J.N.); (L.P.); (F.M.); (J.-L.P.)
- National Institute of Health and Medical Research, Unit 1046, Montpellier University, 34090 Montpellier, France
- Correspondence:
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12
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Klein C, Finat L, Abbey S, Eschalier R, Fossati F, Lazarus A, Marijon E, Pasquié JL, Ploux S, Salerno F, Williatte L, Gras D, Sacher F, Taieb J, Boveda S, Guédon-Moreau L. Remote monitoring for cardiac implantable electronic devices: A practical guide. Arch Cardiovasc Dis 2022; 115:406-407. [DOI: 10.1016/j.acvd.2022.03.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
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13
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Emeriaud H, Huet F, Roubille F, Pasquié JL. Acute myocarditis induced by Hepatitis E: an uncommon association. CJC Open 2022; 4:729-731. [PMID: 36035732 PMCID: PMC9402964 DOI: 10.1016/j.cjco.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Acute myocarditis is often caused by viral infections. Hepatitis E infection inflicts over 20 million people worldwide each year. Common extra-hepatic manifestations of hepatitis E infection include neurologic, hematologic, and renal sequelae.1 Acute myocarditis, defined by the presence of myocardial inflammatory infiltrates associated with nonischemic myocytic necrosis, is uncommon. Published reports of such cases are limited, and here we present the case of a 45-year-old man with acute myocarditis from hepatitis E infection. This case is the first described in Europe of acute myocarditis associated with hepatitis E infection.
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Affiliation(s)
- Héloïse Emeriaud
- Department of Cardiology, Montpellier University Hospital, Montpellier, France
- Corresponding author: Héloïse Emeriaud, Cardiology Department, Hôpital Arnaud de Villeneuve, CHU de Montpellier, 191 avenue du Doyen Gaston Giraud, Montpellier, France.
| | - Fabien Huet
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France
- Department of Cardiology, Vannes Regional Hospital, Vannes, France
| | - François Roubille
- Department of Cardiology, Montpellier University Hospital, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France
| | - Jean-Luc Pasquié
- Department of Cardiology, Montpellier University Hospital, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, CHU de Montpellier, Montpellier, France
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14
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Colombani S, Bernardin AA, Vincenti M, Amédro P, Desprat R, Bernex F, Lemaitre JM, Pasquié JL, Lacampagne A, Meli AC. Generation of catecholaminergic polymorphic ventricular tachycardia patient-specific induced pluripotent stem cell line. Stem Cell Res 2022; 60:102727. [PMID: 35245853 DOI: 10.1016/j.scr.2022.102727] [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] [Received: 09/15/2021] [Revised: 01/24/2022] [Accepted: 02/23/2022] [Indexed: 11/24/2022] Open
Abstract
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) is a genetic disorder characterized by ventricular tachycardia, that can cause the heart to stop beating leading to death. The prevalence is 1/10.000 and in approximately 60% of cases, the syndrome can be due to a mutation of the cardiac ryanodine receptor gene (RyR2). We derived an induced pluripotent stem cell (iPSC) line from an 11-year-old patient blood-cells, carrying a heterozygous missense mutation on the 8th exon of the RyR2 N-terminal part. This reprogramed CPVT line displayed normal karyotype, expressed pluripotent markers and had a capacity to differentiate in trilineage embryonic layers.
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Affiliation(s)
- Sarah Colombani
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Albin A Bernardin
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Marie Vincenti
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Pediatric and Adult Congenital Cardiology Department, M3C Regional Reference CHD Center, CHU Montpellier, France
| | - Pascal Amédro
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Pediatric and Adult Congenital Cardiology Department, M3C Regional Reference CHD Center, CHU Montpellier, France
| | - Romain Desprat
- SAFE-iPSC Facility INGESTEM, CHU de Montpellier, Montpellier, France
| | - Florence Bernex
- IRCM, Institut de Recherche en Cancérologie de Montpellier, Univ. Montpellier, INSERM, ICM, Montpellier, France; RHEM, Réseau d'Histologie Expérimentale de Montpellier, Univ. Montpellier, BioCampus, CNRS, INSERM, Montpellier, France
| | - Jean-Marc Lemaitre
- SAFE-iPSC Facility INGESTEM, CHU de Montpellier, Montpellier, France; Laboratory of Genome and Stem Cell Plasticity in Development and Aging, INSERM, Montpellier, France
| | - Jean-Luc Pasquié
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Department of Cardiology, CHU of Montpellier, Montpellier, France
| | - Alain Lacampagne
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Albano C Meli
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
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15
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Guichard JB, Anselme F, Defaye P, Mansourati J, Pavin D, Pasquié JL, Saludas Y, Barthélémy JC, Roche F, Laporte S, Chapelle C, Garcin A, Romeyer C, Isaaz K, Da Costa A. Prevention of Atrial Fibrillation After Atrial Flutter Ablation With Ramipril (from the PREFACE Study). Am J Cardiol 2022; 162:73-79. [PMID: 34728062 DOI: 10.1016/j.amjcard.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 11/01/2022]
Abstract
The clinical efficacy of the inhibitors of the renin-angiotensin-aldosterone system (RAAS) as an upstream therapy for atrial fibrillation (AF) prevention is controversial. No study has itemized so far the role of RAAS inhibitors in AF prevention after atrial flutter (AFL) ablation. This trial aims to investigate the effect of ramipril compared with placebo on AF occurrence in patients hospitalized for AFL ablation without structural heart disease. The Prevention of Atrial Fibrillation by Inhibition Conversion Enzyme (ICE) After Radiofrequency Ablation of Atrial Flutter (PREFACE) trial was a prospective, multicenter, randomized, double-blind, double-dummy trial depicting the AF occurrence during a 12-month follow-up as the primary end point. A total of 198 patients hospitalized for AFL ablation were enrolled in the trial and randomized to placebo or ramipril 5 mg/day. Patients were followed up during 1 year after AFL ablation using 1-week Holter electrocardiogram at 3, 6, 9, and 12 months. The intention-to-treat population encompassed 97 patients in the ramipril group and 101 patients in the placebo group. The primary end point, such as AF occurrence during the 1-year follow-up, was not different between the 2 groups (p = 0.96). Secondary end points, including the occurrence of supraventricular arrhythmia (p = 0.50), heart failure, stroke, and death, were not different between the 2 groups. Safety outcome parameters, including serious adverse events leading to treatment disruption (p = 0.10), hypotension, impairment of renal function, and elevated serum potassium level, also were not different between the 2 groups. In conclusion, RAAS inhibition using ramipril does not reduce AF occurrence in patients facing AFL ablation during the 1-year follow-up.
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16
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Jacquemart E, Combes N, Duthoit G, Bessière F, Ladouceur M, Iserin L, Laredo M, Bredy C, Maltret A, Di Filippo S, Hascoët S, Pasquié JL, Marijon E, Waldmann V. Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle. Heart Rhythm 2021; 19:658-666. [PMID: 34863963 DOI: 10.1016/j.hrthm.2021.11.032] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although patients with systemic right ventricle (SRV) represent a significant proportion of patients with congenital heart disease (CHD) implanted with cardiac resynchronization therapy (CRT), there are limited and conflicting data in this specific patient group. OBJECTIVE We aimed to analyze outcomes of patients with SRV implanted with a CRT device. METHODS Data were analyzed from an observational, retrospective, multicenter cohort study including all patients with CHD implanted with a CRT device from 6 French centers from 2004 to 2020. Response to CRT was defined as an increase in systemic ventricular ejection fraction of ≥10% and/or an improvement in New York Heart Association functional class by at least 1 grade. RESULTS A total of 85 patients with CHD were enrolled (mean age 39.8 ± 20.0 years; 55 [64.7%] males; 25 defibrillators [29.4%]), including 31 patients with SRV (36.5%) (mean age 43.9 ± 19.8 years; 16 [51.6%] males). The mean change in QRS duration after implantation was similar as compared with patients with systemic left ventricle (-46 ± 26 ms vs -35 ± 32 ms; P = .16). During a mean follow-up of 5.1 ± 3.5 years, late complications included 2 lead dysfunctions (6.5%), 3 CRT-related infections (9.7%), and 1 inappropriate implantable cardioverter-defibrillator shock (3.2%). The proportion of CRT responders at 6, 12, and 24 months were 82.6%, 80.0%, and 77.8% in patients with SRV vs 66.7%, 64.3%, and 69.6% in patients with systemic left ventricle (P = NS). CONCLUSION In this multicenter cohort, one-third of patients with CHD implanted with a CRT device had SRV. CRT in patients with SRV was associated with a high rate of responders, comparable to that of patients with systemic left ventricle.
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Affiliation(s)
| | - Nicolas Combes
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France; Pasteur Clinic, Toulouse, France
| | | | | | - Magalie Ladouceur
- Université de Paris, PARCC, INSERM, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Mikael Laredo
- La Pitié-Salpêtrière University Hospital, Paris, France
| | | | - Alice Maltret
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Sébastien Hascoët
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Eloi Marijon
- Université de Paris, PARCC, INSERM, Paris, France; Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France
| | - Victor Waldmann
- Université de Paris, PARCC, INSERM, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France.
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17
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Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessiere F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Anselme F, Asselin A, Audinet C, Bernard Y, Bru P, Sithikun Bun S, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Long-term follow-up of patients with tetralogy of fallot and implantable cardioverter defibrillator–The DAI-T4F nationwide registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.006] [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: 11/16/2022]
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18
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Garcia R, Combes N, Defaye P, Narayanan K, Guedon-Moreau L, Boveda S, Blangy H, Bouet J, Briand F, Chevalier P, Cottin Y, Da Costa A, Degand B, Deharo JC, Eschalier R, Extramiana F, Goralski M, Guy-Moyat B, Guyomar Y, Hermida JS, Jourda F, Lellouche N, Mahfoud M, Manenti V, Mansourati J, Martin A, Pasquié JL, Ritter P, Rollin A, Tibi T, Yalioua A, Gras D, Sadoul N, Piot O, Leclercq C, Marijon E. Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study. Europace 2021; 23:73-81. [PMID: 33257972 PMCID: PMC7842091 DOI: 10.1093/europace/euaa268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 03/31/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
Aims We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability. Methods and results Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services. Overall, 1157 patients were included (mean age 60 ± 12 years, 16% women; 46% prospectively): 82.1% with ischaemic cardiomyopathy, 10.3% after implantable cardioverter-defibrillator explant, and 7.6% before heart transplantation. Median WCD usage period was 62 (37–97) days. Median daily wear time of WCD was 23.4 (22.2–23.8) h. In multivariate analysis, younger age was associated with lower compliance [adjusted odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95–0.99, P < 0.01]. A total of 18 participants (1.6%) received at least one appropriate shock, giving an incidence of appropriate therapy of 7.2 per 100 patient-years. Patient-response button allowed the shock to be aborted in 35.7% of well-tolerated sustained ventricular arrhythmias and in 95.4% of inappropriate ventricular arrhythmia detection, finally resulting in an inappropriate therapy in eight patients (0.7%). Conclusion Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients. Moreover, they emphasize the fact that when prescribed appropriately, in concert with adequate patient education and dedicated follow-up using specific remote monitoring system, compliance with WCD is high and the device well-tolerated by the patient.
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Affiliation(s)
- Rodrigue Garcia
- Department of Cardiology, Poitiers University Hospital, 86021 Poitiers, France.,Univ Poitiers, 86000 Poitiers, France
| | - Nicolas Combes
- Department of Cardiology, Pasteur Clinic, 33000 Toulouse, France
| | - Pascal Defaye
- Department of Cardiology, Grenoble University Hospital, 38043 Grenoble, France
| | - Kumar Narayanan
- Department of Cardiology, European Georges Pompidou Hospital, 75015 Paris, France.,University of Paris, PARCC, INSERM, F-75015 Paris, France.,Cardiology Department, Medicover Hospitals, Hyderabad, India
| | | | - Serge Boveda
- Department of Cardiology, Pasteur Clinic, 33000 Toulouse, France
| | - Hugues Blangy
- Department of Cardiology, Nancy University Hospital, 54500 Vandoeuvre-Lès-Nancy, France
| | - Jérôme Bouet
- Department of Cardiology, Hospital Center of Aix, 13080 Aix En Provence, France
| | - Florent Briand
- Department of Cardiology, Besançon University Hospital, 25000 Besançon, France
| | | | - Yves Cottin
- Department of Cardiology, Dijon University Hospital, 28000 Dijon, France
| | - Antoine Da Costa
- Department of Cardiology, Saint-Etienne University Hospital, 42000 Saint-Étienne, France
| | - Bruno Degand
- Department of Cardiology, Poitiers University Hospital, 86021 Poitiers, France
| | - Jean-Claude Deharo
- Department of Cardiology, University Hospital La Timone, 13000 Marseille, France
| | - Romain Eschalier
- Department of Cardiology Clermont-Ferrand University Hospital, 63000 Clermont Ferrand, France
| | - Fabrice Extramiana
- Department of Cardiology, Bichat Hospital - Claude Bernard, 75877 Paris, France
| | - Marc Goralski
- Department of Cardiology, General Hospital of Oréans, 45000 Orléans, France
| | - Benoit Guy-Moyat
- Department of Cardiology, Limoges University Hospital, 87000 Limoges, France
| | - Yves Guyomar
- Department of Cardiology, Hospital Center Saint Philibert, 59160 Lomme, France
| | | | - François Jourda
- Department of Cardiology, General Hospital of Auxerre, 89000 Auxerre, France
| | - Nicolas Lellouche
- Department of Cardiology, University Hospital Henri Mondor, 94000 Creteil, France
| | - Mohanad Mahfoud
- Department of Cardiology, Hospital Center Sud Francilien, 91100 Corbeil Essonnes, France
| | - Vladimir Manenti
- Department of Cardiology, Jacques Cartier Institute, 91300 Massy, France
| | - Jacques Mansourati
- Department of Cardiology, Brest University Hospital, 29200 Brest, France
| | - Angéline Martin
- Department of Cardiology, Fontaine Clinic, 21121 Fontaine-Lès-Dijon, France
| | - Jean-Luc Pasquié
- Department of Cardiology, Montpellier University Hospital, 34000 Montpellier, France
| | - Philippe Ritter
- Department of Cardiology, Bordeaux University Hospital, 33600 Pessac, France
| | - Anne Rollin
- Department of Cardiology, Toulouse University Hospital, 31000 Toulouse, France
| | - Thierry Tibi
- Department of Cardiology, General Hospital of Cannes, 06150 Cannes, France
| | - Arab Yalioua
- Department of Cardiology, General Hospital of Angoulême, 16000 Angoulême, France
| | - Daniel Gras
- Department of Cardiology, Hopital privé du Confluent, 44000 Nantes, France
| | - Nicolas Sadoul
- Department of Cardiology, Nancy University Hospital, 54500 Vandoeuvre-Lès-Nancy, France
| | - Olivier Piot
- Department of Cardiology, Cardiology Center of Nord, 93200 Saint Denis, France
| | | | - Eloi Marijon
- Department of Cardiology, European Georges Pompidou Hospital, 75015 Paris, France.,University of Paris, PARCC, INSERM, F-75015 Paris, France
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19
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Dupuy AM, Kuster N, Bargnoux AS, Aguilhon S, Huet F, Leclercq F, Pasquié JL, Roubille F, Cristol JP. Long term pronostic value of suPAR in chronic heart failure: reclassification of patients with low MAGGIC score. Clin Chem Lab Med 2021; 59:1299-1306. [PMID: 33544524 DOI: 10.1515/cclm-2020-0903] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/22/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Inflammation is a hallmark of heart failure (HF) and among inflammatory biomarkers, the most studied remains the C-reactive protein (CRP). In recent years several biomarkers have emerged, such as sST2 and soluble urokinase-type plasminogen activator receptor (suPAR). This study set out to examine the relative importance of long-time prognostic strength of suPAR and the potential additive information on patient risk with chronic HF in comparison with pronostic value of CRP and sST2. METHODS Demographics, clinical and biological variables were assessed in a total of 182 patients with chronic HF over median follow-up period of 80 months. Inflammatory biomarkers (i.e., CRP, sST2, and suPAR) were performed. RESULTS In univariate Cox regression analysis age, NYHA class, MAGGIC score and the five biomarkers (N-terminal pro brain natriuretic peptide [NT-proBNP], high-sensitive cardiac troponin T [hs-cTnT], CRP, sST2, and suPAR) were associated with both all-cause and cardiovascular mortality. In the multivariate model, only NT-proBNP, suPAR, and MAGGIC score remained independent predictors of all-cause mortality as well as of cardiovascular mortality. Risk classification analysis was significantly improved with the addition of suPAR particularly for all-cause short- and long-term mortality. Using a classification tree approach, the same three variables could be considered as significant classifier variables to predict all-cause or cardiovascular mortality and an algorithm were reported. We demonstrated the favorable outcome associated with patients with a low MAGGIC score and a low suPAR level by comparison to patients with low MAGGIC score but high suPAR values. CONCLUSIONS The main findings of our study are (1) that among the three inflammatory biomarkers, only suPAR levels were independently associated with 96-month mortality for patients with chronic HF and (2) that an algorithm based on clinical score, a cardiomyocyte stress biomarker and an inflammatory biomarker could help to a more reliable long term risk stratification in heart failure.
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Affiliation(s)
- Anne Marie Dupuy
- Department of Biochemistry, Centre Ressources Biologiques de Montpellier, University Hospital of Montpellier, Montpellier, France
| | - Nils Kuster
- Department of Biochemistry, Centre Ressources Biologiques de Montpellier, University Hospital of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Anne Sophie Bargnoux
- Department of Biochemistry, Centre Ressources Biologiques de Montpellier, University Hospital of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
| | - Sylvain Aguilhon
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - Fabien Huet
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - Florence Leclercq
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - Jean-Luc Pasquié
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - François Roubille
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France.,Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - Jean Paul Cristol
- Department of Biochemistry, Centre Ressources Biologiques de Montpellier, University Hospital of Montpellier, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France
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20
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Sleiman Y, Souidi M, Kumar R, Yang E, Jaffré F, Zhou T, Bernardin A, Reiken S, Cazorla O, Kajava AV, Moreau A, Pasquié JL, Marks AR, Lerman BB, Chen S, Cheung JW, Evans T, Lacampagne A, Meli AC. Modeling polymorphic ventricular tachycardia at rest using patient-specific induced pluripotent stem cell-derived cardiomyocytes. EBioMedicine 2020; 60:103024. [PMID: 32980690 PMCID: PMC7519379 DOI: 10.1016/j.ebiom.2020.103024] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/27/2020] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
Background While mutations in the cardiac type 2 ryanodine receptor (RyR2) have been linked to exercise-induced or catecholaminergic polymorphic ventricular tachycardia (CPVT), its association with polymorphic ventricular tachycardia (PMVT) occurring at rest is unclear. We aimed at constructing a patient-specific human-induced pluripotent stem cell (hiPSC) model of PMVT occurring at rest linked to a single point mutation in RyR2. Methods Blood samples were obtained from a patient with PMVT at rest due to a heterozygous RyR2-H29D mutation. Patient-specific hiPSCs were generated from the blood samples, and the hiPSC-derived cardiomyocytes (CMs) were generated via directed differentiation. Using CRIPSR/Cas9 technology, isogenic controls were generated by correcting the RyR2-H29D mutation. Using patch-clamp, fluorescent confocal microscopy and video-image-based analysis, the molecular and functional properties of RyR2-H29D hiPSC—CMs and control hiPSC—CMs were compared. Findings RyR2-H29D hiPSC—CMs exhibit intracellular sarcoplasmic reticulum (SR) Ca2+ leak through RyR2 under physiological pacing. RyR2-H29D enhances the contribution of inositol 1,4,5-trisphosphate receptors to excitation-contraction coupling (ECC) that exacerbates abnormal Ca2+ release in RyR2-H29D hiPSC—CMs. RyR2-H29D hiPSC—CMs exhibit shorter action potentials, delayed afterdepolarizations, arrhythmias and aberrant contractile properties compared to isogenic controls. The RyR2-H29D mutation causes post-translational remodeling that is fully reversed with isogenic controls. Interpretation To conclude, in a model based on a RyR2 point mutation that is associated with short-coupled PMVT at rest, RyR2-H29D hiPSC—CMs exhibited aberrant intracellular Ca2+ homeostasis, shortened action potentials, arrhythmias and abnormal contractile properties. Funding French Muscular Dystrophy Association (AFM; project 16,073, MNM2 2012 and 20,225), “Fondation de la Recherche Médicale” (FRM; SPF20130526710), “Institut National pour la Santé et la Recherche Médicale” (INSERM), National Institutes of Health (ARM; R01 HL145473) and New York State Department of Health (NYSTEM C029156).
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Affiliation(s)
- Yvonne Sleiman
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Monia Souidi
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Ritu Kumar
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Ellen Yang
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Fabrice Jaffré
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Ting Zhou
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Albin Bernardin
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Steve Reiken
- Department of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Olivier Cazorla
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | | | - Adrien Moreau
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Jean-Luc Pasquié
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France; Department of Cardiology, CHU of Montpellier, Montpellier, France
| | - Andrew R Marks
- Department of Physiology and Cellular Biophysics, Clyde and Helen Wu Center for Molecular Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, United States
| | - Bruce B Lerman
- Division of Cardiology, Weill Cornell Medical College, New York, NY, United States
| | - Shuibing Chen
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Jim W Cheung
- Division of Cardiology, Weill Cornell Medical College, New York, NY, United States
| | - Todd Evans
- Department of Surgery, Weill Cornell Medical College, New York, NY, United States
| | - Alain Lacampagne
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France
| | - Albano C Meli
- PhyMedExp, Inserm, CNRS, University of Montpellier, Montpellier, France.
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21
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Galand V, Leclercq C, Bourenane H, Boulé S, Vincentelli A, Maury P, Mondoly P, Picard F, Welté N, Kindo M, Cardi T, Pasquié JL, Gaudard P, Gourraud JB, Probst V, Defaye P, Boignard A, Para M, Algalarrondo V, Pelcé E, Gariboldi V, Pozzi M, Obadia JF, Anselme F, Litzler PY, Blanchart K, Babatasi G, Garnier F, Bielefeld M, Hamon D, Lellouche N, Bourguignon T, Pierre B, Eschalier R, D'Ostrevy N, Varlet E, Marijon E, Blangy H, Sadoul N, Flécher E, Martins RP. Implantable cardiac defibrillator leads dysfunction after LVAD implantation. Pacing Clin Electrophysiol 2020; 43:1309-1317. [PMID: 32627211 DOI: 10.1111/pace.14004] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/03/2020] [Accepted: 06/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Implantable cardioverter-defibrillator (ICD) lead dysfunction has been reported after left ventricular assist device (LVAD) implantation in limited single-center studies. We aimed at describing and characterizing the incidence of ICD lead parameters dysfunction after LVAD implantation. METHODS Among the 652 patients enrolled in the ASSIST-ICD study, only patients with an ICD prior to LVAD were included (n = 401). ICD lead parameters dysfunction following LVAD implantation is defined as follows: (a) >50% decrease in sensing threshold, (b) pacing lead impedance increase/decrease by >100Ω, and (c) >50% increase in pacing threshold. RESULTS One hundred twenty-two patients with an ICD prior to LVAD had available ICD interrogation reports prior and after LVAD. A total of 67 (55%) patients exhibited at least one significant lead dysfunction: 17 (15%) exhibited >50% decrease in right ventricular (RV) sensing, 51 (42%) had >100 Ω increase/decrease in RV pacing impedance, and 24 (20%) experienced >50% increase in RV pacing threshold. A total of 52 patients experienced ventricular arrhythmia during follow-up and all were successfully detected and treated by the device. All lead dysfunction could be managed conservatively. CONCLUSION More than 50% of LVAD-recipients may experience >1 significant change in lead parameters but none had severe clinical consequences.
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Affiliation(s)
- Vincent Galand
- CHU Rennes, INSERM, University of Rennes, Rennes, France
| | | | | | - Stéphane Boulé
- Cardiac Intensive Care Unit, Department of Cardiology and Cardiac Surgery, CHU Lille, Institut Coeur-Poumons, Lille, France
| | - André Vincentelli
- Cardiac Intensive Care Unit, Department of Cardiology and Cardiac Surgery, CHU Lille, Institut Coeur-Poumons, Lille, France
| | - Philippe Maury
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre Mondoly
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - François Picard
- Hôpital Cardiologique du Haut-Lévêque, LIRYC institute, Université Bordeaux, Bordeaux, France
| | - Nicolas Welté
- Hôpital Cardiologique du Haut-Lévêque, LIRYC institute, Université Bordeaux, Bordeaux, France
| | - Michel Kindo
- Département de chirurgie cardiovasculaire, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Thomas Cardi
- Département de chirurgie cardiovasculaire, hôpitaux universitaires de Strasbourg, Strasbourg, France
| | | | - Philippe Gaudard
- Department of Anesthesiology and Critical Care Medicine, PhyMedExp, University of Montpellier, INSERM, CNRS, CHU Montpellier, Montpellier, France
| | | | - Vincent Probst
- Department of Cardiology and Heart Transplantation Unit, CHU Nantes, Nantes, France
| | - Pascal Defaye
- Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
| | - Aude Boignard
- Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
| | - Marylou Para
- Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France
| | | | - Edeline Pelcé
- Department of Cardiac Surgery, La Timone Hospital, Marseille, France
| | - Vlad Gariboldi
- Department of Cardiac Surgery, La Timone Hospital, Marseille, France
| | - Matteo Pozzi
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
| | - Jean-François Obadia
- Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, Lyon, France
| | - Frédéric Anselme
- Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, France
| | - Pierre-Yves Litzler
- Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, France
| | - Katrien Blanchart
- Department of Cardiology and Cardiac Surgery, University of Caen and University Hospital of Caen, Caen, France
| | - Gerard Babatasi
- Department of Cardiology and Cardiac Surgery, University of Caen and University Hospital of Caen, Caen, France
| | - Fabien Garnier
- Department of Cardiology and Cardiac Surgery, University Hospital, Dijon, France
| | - Marie Bielefeld
- Department of Cardiology and Cardiac Surgery, University Hospital, Dijon, France
| | - David Hamon
- Department of Cardiology and Cardiac Surgery, AP-HP CHU Henri Mondor, Créteil, France
| | - Nicolas Lellouche
- Department of Cardiology and Cardiac Surgery, AP-HP CHU Henri Mondor, Créteil, France
| | - Thierry Bourguignon
- Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
| | - Bertrand Pierre
- Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
| | - Romain Eschalier
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Nicolas D'Ostrevy
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Emilie Varlet
- Cardiology Department, European Georges Pompidou Hospital, Paris, France
| | - Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital, Paris, France
| | - Hugues Blangy
- Department of Cardiology and Cardiac Surgery, CHU de Nancy, Hopital de Brabois, Nancy, France
| | - Nicolas Sadoul
- Department of Cardiology and Cardiac Surgery, CHU de Nancy, Hopital de Brabois, Nancy, France
| | - Erwan Flécher
- CHU Rennes, INSERM, University of Rennes, Rennes, France
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22
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Gavotto A, Ousselin A, Pidoux O, Cathala P, Costes-Martineau V, Rivière B, Pasquié JL, Amedro P, Rambaud C, Cambonie G. Respiratory syncytial virus-associated mortality in a healthy 3-year-old child: a case report. BMC Pediatr 2019; 19:462. [PMID: 31771554 PMCID: PMC6880595 DOI: 10.1186/s12887-019-1847-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 11/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is the most frequently identified pathogen in children with acute lower respiratory tract infection. Fatal cases have mainly been reported during the first 6 months of life or in the presence of comorbidity. Case presentation A 47-month-old girl was admitted to the pediatric intensive care unit following sudden cardiopulmonary arrest occurring at home. The electrocardiogram showed cardiac asystole, which was refractory to prolonged resuscitation efforts. Postmortem analyses detected RSV by polymerase chain reaction in an abundant, exudative pericardial effusion. Histopathological examination was consistent with viral myoepicarditis, including an inflammatory process affecting cardiac nerves and ganglia. Molecular analysis of sudden unexplained death genes identified a heterozygous mutation in myosin light chain 2, which was also found in two other healthy members of the family. Additional expert interpretation of the cardiac histology confirmed the absence of arrhythmogenic right ventricular dysplasia or hypertrophic cardiomyopathy. Conclusions RSV-related sudden death in a normally developing child of this age is exceptional. This case highlights the risk of extrapulmonary manifestations associated with this infection, particularly arrhythmia induced by inflammatory phenomena affecting the cardiac autonomic nervous system. The role of the mutation in this context is uncertain, and it is therefore necessary to continue to assess how this pathogenic variant contributes to unexpected sudden death in childhood.
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Affiliation(s)
- A Gavotto
- Pediatric and Congenital Cardiology Department, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France.,CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France
| | - A Ousselin
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - O Pidoux
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France
| | - P Cathala
- Department of Forensic Medicine, Lapeyronie Hospital, Montpellier University Hospital Center, Montpellier, France
| | - V Costes-Martineau
- Department of Pathology, Lapeyronie Hospital, Montpellier University Hospital Center, Montpellier, France
| | - B Rivière
- Department of Pathology, Lapeyronie Hospital, Montpellier University Hospital Center, Montpellier, France
| | - J L Pasquié
- Department of Cardiology, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
| | - P Amedro
- Pediatric and Congenital Cardiology Department, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France.,CNRS UMR 9214, INSERM U1046, University of Montpellier, Montpellier, France
| | - C Rambaud
- Department of Pathology and Forensic Medicine, Raymond Poincaré Hospital, Garches University Hospital, Garches, France
| | - G Cambonie
- Department of Neonatal Medicine and Pediatric Intensive Care, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier Cedex 5, France.
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Haïssaguerre M, Hocini M, Cheniti G, Duchateau J, Sacher F, Puyo S, Cochet H, Takigawa M, Denis A, Martin R, Derval N, Bordachar P, Ritter P, Ploux S, Pambrun T, Klotz N, Massoullié G, Pillois X, Dallet C, Schott JJ, Scouarnec S, Ackerman MJ, Tester D, Piot O, Pasquié JL, Leclerc C, Hermida JS, Gandjbakhch E, Maury P, Labrousse L, Coronel R, Jais P, Benoist D, Vigmond E, Potse M, Walton R, Nademanee K, Bernus O, Dubois R. Localized Structural Alterations Underlying a Subset of Unexplained Sudden Cardiac Death. Circ Arrhythm Electrophysiol 2019; 11:e006120. [PMID: 30002064 PMCID: PMC7661047 DOI: 10.1161/circep.117.006120] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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] [Received: 10/04/2017] [Accepted: 05/08/2018] [Indexed: 01/17/2023]
Abstract
Supplemental Digital Content is available in the text. Background: Sudden cardiac death because of ventricular fibrillation (VF) is commonly unexplained in younger victims. Detailed electrophysiological mapping in such patients has not been reported. Methods: We evaluated 24 patients (29±13 years) who survived idiopathic VF. First, we used multielectrode body surface recordings to identify the drivers maintaining VF. Then, we analyzed electrograms in the driver regions using endocardial and epicardial catheter mapping during sinus rhythm. Established electrogram criteria were used to identify the presence of structural alterations. Results: VF occurred spontaneously in 3 patients and was induced in 16, whereas VF was noninducible in 5. VF mapping demonstrated reentrant and focal activities (87% versus 13%, respectively) in all. The activities were dominant in one ventricle in 9 patients, whereas they had biventricular distribution in others. During sinus rhythm areas of abnormal electrograms were identified in 15/24 patients (62.5%) revealing localized structural alterations: in the right ventricle in 11, the left ventricle in 1, and both in 3. They covered a limited surface (13±6 cm2) representing 5±3% of the total surface and were recorded predominantly on the epicardium. Seventy-six percent of these areas were colocated with VF drivers (P<0.001). In the 9 patients without structural alteration, we observed a high incidence of Purkinje triggers (7/9 versus 4/15, P=0.033). Catheter ablation resulted in arrhythmia-free outcome in 15/18 patients at 17±11 months follow-up. Conclusions: This study shows that localized structural alterations underlie a significant subset of previously unexplained sudden cardiac death. In the other subset, Purkinje electrical pathology seems as a dominant mechanism.
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Affiliation(s)
- Michel Haïssaguerre
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.). .,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Mélèze Hocini
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ghassen Cheniti
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Josselin Duchateau
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Frédéric Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Stéphane Puyo
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Masateru Takigawa
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Arnaud Denis
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ruairidh Martin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Nicolas Derval
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Pierre Bordachar
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Philippe Ritter
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Sylvain Ploux
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Thomas Pambrun
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Nicolas Klotz
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Gregoire Massoullié
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Xavier Pillois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Corentin Dallet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Jean-Jacques Schott
- Inserm UMR 915 l'institut du thorax IRT, Nantes Cedex, France (J.-J.S., S.L.S.)
| | | | - Michael J Ackerman
- Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN (M.J.A., D.T.)
| | - David Tester
- Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN (M.J.A., D.T.)
| | | | | | | | | | | | | | - Louis Labrousse
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ruben Coronel
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Pierre Jais
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - David Benoist
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Edward Vigmond
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux, IMB UMR 5251, CNRS (E.V.).,CNRS, IMB, UMR5251, Talence (E.V.)
| | - Mark Potse
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Richard Walton
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Koonlawee Nademanee
- Pacific Rim Electrophysiology Research Institute, White Memorial Medical Center, Los Angeles, CA (K.N.)
| | - Olivier Bernus
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Remi Dubois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
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Bousquet J, Bourret R, Camuzat T, Augé P, Bringer J, Noguès M, Jonquet O, de la Coussaye JE, Ankri J, Cesari M, Guérin O, Vellas B, Blain H, Arnavielhe S, Avignon A, Combe B, Canovas G, Daien C, Dray G, Dupeyron A, Jeandel C, Laffont I, Laune D, Marion C, Pastor E, Pélissier JY, Galan B, Reynes J, Reuzeau JC, Bedbrook A, Granier S, Adnet PA, Amouyal M, Alomène B, Bernard PL, Berr C, Caimmi D, Claret PG, Costa DJ, Cristol JP, Fesler P, Hève D, Millot-Keurinck J, Morquin D, Ninot G, Picot MC, Raffort N, Roubille F, Sultan A, Touchon J, Attalin V, Azevedo C, Badin M, Bakhti K, Bardy B, Battesti MP, Bobia X, Boegner C, Boichot S, Bonnin HY, Bouly S, Boubakri C, Bourrain JL, Bourrel G, Bouix V, Bruguière V, Cade S, Camu W, Carre V, Cavalli G, Cayla G, Chiron R, Coignard P, Coroian F, Costa P, Cottalorda J, Coulet B, Coupet AL, Courrouy-Michel MC, Courtet P, Cros V, Cuisinier F, Danko M, Dauenhauer P, Dauzat M, David M, Davy JM, Delignières D, Demoly P, Desplan J, Dujols P, Dupeyron G, Engberink O, Enjalbert M, Fattal C, Fernandes J, Fouletier M, Fraisse P, Gabrion P, Gellerat-Rogier M, Gelis A, Genis C, Giraudeau N, Goucham AY, Gouzi F, Gressard F, Gris JC, Guillot B, Guiraud D, Handweiler V, Hayot M, Hérisson C, Heroum C, Hoa D, Jacquemin S, Jaber S, Jakovenko D, Jorgensen C, Kouyoudjian P, Lamoureux R, Landreau L, Lapierre M, Larrey D, Laurent C, Léglise MS, Lemaitre JM, Le Quellec A, Leclercq F, Lehmann S, Lognos B, Lussert CM, Makinson A, Mandrick K, Mares P, Martin-Gousset P, Matheron A, Mathieu G, Meissonnier M, Mercier G, Messner P, Meunier C, Mondain M, Morales R, Morel J, Mottet D, Nérin P, Nicolas P, Nouvel F, Paccard D, Pandraud G, Pasdelou MP, Pasquié JL, Patte K, Perrey S, Pers YM, Portejoie F, Pujol JLE, Quantin X, Quéré I, Ramdani S, Ribstein J, Rédini-Martinez I, Richard S, Ritchie K, Riso JP, Rivier F, Robine JM, Rolland C, Royère E, Sablot D, Savy JL, Schifano L, Senesse P, Sicard R, Stephan Y, Strubel D, Tallon G, Tanfin M, Tassery H, Tavares I, Torre K, Tribout V, Uziel A, Van de Perre P, Venail F, Vergne-Richard C, Vergotte G, Vian L, Vialla F, Viart F, Villain M, Viollet E, Ychou M, Mercier J. MACVIA-LR (Fighting Chronic Diseases for Active and Healthy Ageing in Languedoc-Roussillon): A Success Story of the European Innovation Partnership on Active and Healthy Ageing. J Frailty Aging 2017; 5:233-241. [PMID: 27883170 DOI: 10.14283/jfa.2016.105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Région Languedoc Roussillon is the umbrella organisation for an interconnected and integrated project on active and healthy ageing (AHA). It covers the 3 pillars of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA): (A) Prevention and health promotion, (B) Care and cure, (C) and (D) Active and independent living of elderly people. All sub-activities (poly-pharmacy, falls prevention initiative, prevention of frailty, chronic respiratory diseases, chronic diseases with multimorbidities, chronic infectious diseases, active and independent living and disability) have been included in MACVIA-LR which has a strong political commitment and involves all stakeholders (public, private, patients, policy makers) including CARSAT-LR and the Eurobiomed cluster. It is a Reference Site of the EIP on AHA. The framework of MACVIA-LR has the vision that the prevention and management of chronic diseases is essential for the promotion of AHA and for the reduction of handicap. The main objectives of MACVIA-LR are: (i) to develop innovative solutions for a network of Living labs in order to reduce avoidable hospitalisations and loss of autonomy while improving quality of life, (ii) to disseminate the innovation. The three years of MACVIA-LR activities are reported in this paper.
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Affiliation(s)
- J Bousquet
- Professor Jean Bousquet, CHRU, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France, Tel +33 611 42 88 47,
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Fauchier L, Alonso C, Anselme F, Blangy H, Bordachar P, Boveda S, Clementy N, Defaye P, Deharo JC, Friocourt P, Gras D, Halimi F, Klug D, Mansourati J, Obadia B, Pasquié JL, Pavin D, Sadoul N, Taieb J, Piot O, Hanon O. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators: Groupe de Rythmologie et Stimulation Cardiaque de la Société Française de Cardiologie and Société Française de Gériatrie et Gérontologie. Arch Cardiovasc Dis 2016; 109:563-585. [PMID: 27595465 DOI: 10.1016/j.acvd.2016.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 03/14/2016] [Accepted: 04/01/2016] [Indexed: 02/03/2023]
Abstract
Despite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, the general consensus is that DDD pacing with the programming of an algorithm to minimize ventricular pacing is preferred. In very old patients presenting with intermittent or suspected atrioventricular block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is similar in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantageous effect of the device on arrhythmic death may be attenuated by higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live more than 5-7years after implantation. Elderly patients usually experience significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non-responders remains globally the same, while considering a less aggressive approach in terms of reinterventions (revision of left ventricular [LV] lead placement, addition of a right ventricular or LV lead, LV endocardial pacing configuration). Overall, physiological age, general status and comorbidities rather than chronological age per se should be the decisive factors in making a decision about device implantation selection for survival and well-being benefit in elderly patients.
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Affiliation(s)
- Laurent Fauchier
- CHU Trousseau, université François-Rabelais, 37044 Tours, France.
| | | | | | - Hugues Blangy
- Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | | | | | - Nicolas Clementy
- CHU Trousseau, université François-Rabelais, 37044 Tours, France
| | | | | | | | - Daniel Gras
- Nouvelles cliniques nantaises, 44202 Nantes, France
| | | | | | | | | | | | | | - Nicolas Sadoul
- Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500 Vandœuvre-lès-Nancy, France
| | - Jerome Taieb
- Centre hospitalier, 13616 Aix-en-Provence, France
| | - Olivier Piot
- Centre cardiologique du Nord, 93200 Saint-Denis, France
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El Bouazzaoui R, Marquié C, Chauvin M, Bertaux G, Massin F, Bredy C, Klug D, Pasquié JL. 216-54: S-ICDs in adults with complex congenital heart diseases and absence of venous access to the heart. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i155] [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: 11/13/2022] Open
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Laugaudin G, Granier M, Massin F, Cade S, Cransac F, Ricci JE, Cornelia F, Vernhet H, Pasquié JL. 138-02: One-year permeability rate of LAA closure devices : high incidence of peridevice leak and lack of endothelialization. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i178b] [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: 11/13/2022] Open
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Avignon A, Fesler P, Daien C, Costa D, Picot MC, Roubille F, Sultan A, Viarouge-Reunier C, Attalin V, Badin M, Boegner C, Demoly P, Dauzat M, David M, Lognos B, Morel J, Pasquié JL, Ribstein J, Granier S, Combe B, Mercier J, Bourret R, Bousquet J. [Living Lab MACVIA. Chronic diseases]. Presse Med 2015; 44 Suppl 1:S47-54. [PMID: 26476755 DOI: 10.1016/j.lpm.2015.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/26/2022] Open
Affiliation(s)
- Antoine Avignon
- CHRU de Montpellier, départment d'endocrinologie, 34295 Montpellier cedex 5, France.
| | - Pierre Fesler
- CHRU de Montpellier, département de médecine interne, 34295 Montpellier cedex 5, France
| | - Claire Daien
- CHRU de Montpellier, départment de rhumatologie, 34295 Montpellier cedex 5, France
| | - David Costa
- Faculté de médecine de Montpellier-Nîmes, département de médecine générale, 34060 Montpellier cedex 2, France
| | - Marie-Christine Picot
- CHRU de Montpellier, département de santé publique, 34295 Montpellier cedex 5, France
| | - François Roubille
- CHRU de Montpellier, département de cardiologie, 34295 Montpellier cedex 5, France
| | - Ariane Sultan
- CHRU de Montpellier, départment d'endocrinologie, 34295 Montpellier cedex 5, France
| | | | | | - Mélanie Badin
- CHRU de Nîmes, département de médecine générale, 30029 Nîmes, France
| | - Catherine Boegner
- CHRU de Montpellier, départment d'endocrinologie, 34295 Montpellier cedex 5, France
| | - Pascal Demoly
- CHRU de Montpellier, département des maladies respiratoires et addictologie, 34295 Montpellier cedex 5, France
| | - Michel Dauzat
- CHRU de Nîmes, département de physiologie, 30029 Nîmes, France
| | - Michel David
- Faculté de médecine de Montpellier-Nîmes, département de médecine générale, 34060 Montpellier cedex 2, France
| | | | - Jacques Morel
- CHRU de Montpellier, départment de rhumatologie, 34295 Montpellier cedex 5, France
| | - Jean-Luc Pasquié
- CHRU de Montpellier, département de cardiologie, 34295 Montpellier cedex 5, France
| | - Jean Ribstein
- CHRU de Montpellier, département de médecine interne, 34295 Montpellier cedex 5, France
| | | | - Bernard Combe
- CHRU de Montpellier, départment de rhumatologie, 34295 Montpellier cedex 5, France
| | | | | | - Jean Bousquet
- CHRU de Montpellier, MACVIA-LR, contre les maladies chroniques pour un vieillissement actif en Languedoc-Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, 34295 Montpellier cedex 5, France; Inserm U1018, 94807 Villejuif cedex, France
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Affiliation(s)
- Christophe Hédon
- Department of Cardiology, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France; INSERM U1046, 371 Avenue du Doyen G. Giraud, Bât. Crastes de Paulet, Montpellier, France
| | - Ziad Khoueiry
- Department of Cardiology, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France; INSERM U1046, 371 Avenue du Doyen G. Giraud, Bât. Crastes de Paulet, Montpellier, France
| | - Marine Verges
- Department of Cardiology, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France
| | - Jean-Luc Pasquié
- Department of Cardiology, CHU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, Montpellier, France; INSERM U1046, 371 Avenue du Doyen G. Giraud, Bât. Crastes de Paulet, Montpellier, France
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Gueffier M, Granier M, Aimond F, Hedon C, Pasquié JL, Launay P, Brun JF, Richard S, Demion M. 0150 : Endurance training induced functional TRPM4 channel expression in mouse left ventricle. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)30207-x] [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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Mahida S, Derval N, Sacher F, Leenhardt A, Deisenhofer I, Babuty D, Schläpfer J, de Roy L, Frank R, Yli-Mayry S, Mabo P, Rostock T, Nogami A, Pasquié JL, de Chillou C, Kautzner J, Jesel L, Maury P, Berte B, Yamashita S, Roten L, Lim HS, Denis A, Bordachar P, Ritter P, Probst V, Hocini M, Jaïs P, Haïssaguerre M. Role of electrophysiological studies in predicting risk of ventricular arrhythmia in early repolarization syndrome. J Am Coll Cardiol 2015; 65:151-9. [PMID: 25593056 DOI: 10.1016/j.jacc.2014.10.043] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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: 06/05/2014] [Revised: 09/27/2014] [Accepted: 10/21/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND The early repolarization (ER) pattern is associated with an increased risk of arrhythmogenic sudden death. However, strategies for risk stratification of patients with the ER pattern are not fully defined. OBJECTIVES This study sought to determine the role of electrophysiology studies (EPS) in risk stratification of patients with ER syndrome. METHODS In a multicenter study, 81 patients with ER syndrome (age 36 ± 13 years, 60 males) and aborted sudden death due to ventricular fibrillation (VF) were included. EPS were performed following the index VF episode using a standard protocol. Inducibility was defined by the provocation of sustained VF. Patients were followed up by serial implantable cardioverter-defibrillator interrogations. RESULTS Despite a recent history of aborted sudden death, VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF during EPS experienced VF recurrences, whereas 21 of 63 (33%) patients who were noninducible experienced recurrent VF (p = 0.93). VF storm occurred in 3 patients from the inducible VF group and in 4 patients in the noninducible group. VF inducibility was not associated with maximum J-wave amplitude (VF inducible vs. VF noninducible; 0.23 ± 0.11 mV vs. 0.21 ± 0.11 mV; p = 0.42) or J-wave distribution (inferior, odds ratio [OR]: 0.96 [95% confidence interval (CI): 0.33 to 2.81]; p = 0.95; lateral, OR: 1.57 [95% CI: 0.35 to 7.04]; p = 0.56; inferior and lateral, OR: 0.83 [95% CI: 0.27 to 2.55]; p = 0.74), which have previously been demonstrated to predict outcome in patients with an ER pattern. CONCLUSIONS Our findings indicate that current programmed stimulation protocols do not enhance risk stratification in ER syndrome.
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Affiliation(s)
- Saagar Mahida
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France.
| | - Nicolas Derval
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Frederic Sacher
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Antoine Leenhardt
- AP-HP, Hôpital Bichat, Service de Cardiologie et Centre de Référence des Maladies Cardiaques Héréditaires, INSERM, U698, Université Paris Diderot, Paris, France
| | | | | | | | - Luc de Roy
- Clinique Mont Godinne Leuven, Leuven, Belgium
| | - Robert Frank
- Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | | | - Philippe Mabo
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | | | | | - Jean-Luc Pasquié
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Josef Kautzner
- Institute for Clinical and Experimental Medicine, Department of Cardiology, Prague, Czech Republic
| | - Laurence Jesel
- Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Philippe Maury
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Benjamin Berte
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Seigo Yamashita
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Laurent Roten
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Han S Lim
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Arnaud Denis
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Pierre Bordachar
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Philippe Ritter
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Vincent Probst
- Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Mélèze Hocini
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Pierre Jaïs
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
| | - Michel Haïssaguerre
- Hôpital Cardiologique du Haut-Lévêque and Université Victor Segalen Bordeaux II, Bordeaux, France
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El Bouazzaoui R, Thomann S, Massin F, Cransac F, Tri Cung T, Macia JC, Pasquié JL, Davy JM. 0406: Anticoagulation therapy is frequent in patients with silent AF detected in cardiac devices memory, despite an absence of current guidelines: a monocentric registry. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71690-3] [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: 10/24/2022]
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Solecki K, Dupuy AM, Kuster N, Leclercq F, Gervasoni R, Macia JC, Cung TT, Lattuca B, Cransac F, Cade S, Pasquié JL, Cristol JP, Roubille F. Kinetics of high-sensitivity cardiac troponin T or troponin I compared to creatine kinase in patients with revascularized acute myocardial infarction. ACTA ACUST UNITED AC 2015; 53:707-14. [DOI: 10.1515/cclm-2014-0475] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 10/13/2014] [Indexed: 11/15/2022]
Abstract
AbstractCardiac biomarkers are the cornerstone of the biological definition of acute myocardial infarction (AMI). The key role of troponins in diagnosis of AMI is well established. Moreover, kinetics of troponin I (cTnI) and creatine kinase (CK) after AMI are correlated to the prognosis. New technical assessment like high-sensitivity cardiac troponin T (hs-cTnT) raises concerns because of its unclear kinetic following the peak. This study aims to compare kinetics of cTnI and hs-cTnT to CK in patients with large AMI successfully treated by percutaneous coronary intervention (PCI).We prospectively studied 62 patients with anterior AMI successfully reperfused with primary angioplasty. We evaluated two consecutive groups: the first one regularly assessed by both CK and cTnI methods and the second group by CK and hs-cTnT. Modeling of kinetics was realized using mixed effects with cubic splines.Kinetics of markers showed a peak at 7.9 h for CK, at 10.9 h (6.9–12.75) for cTnI and at 12 h for hs-cTnT. This peak was followed by a nearly log linear decrease for cTnI and CK by contrast to hs-cTnT which appeared with a biphasic shape curve marked by a second peak at 82 h. There was no significant difference between the decrease of cTnI and CK (p=0.63). CK fell by 79.5% (76.1–99.9) vs. cTnI by 86.8% (76.6–92.7). In the hs-cTnT group there was a significant difference in the decrease by 26.5% (9–42.9) when compared with CK that fell by 79.5% (64.3–90.7).Kinetic of hs-cTnT and not cTnI differs from CK. The role of hs-cTnT in prognosis has to be investigated.
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Maury P, Rollin A, Sacher F, Gourraud JB, Raczka F, Pasquié JL, Duparc A, Mondoly P, Cardin C, Delay M, Derval N, Chatel S, Bongard V, Sadron M, Denis A, Davy JM, Hocini M, Jaïs P, Jesel L, Haïssaguerre M, Probst V. Prevalence and prognostic role of various conduction disturbances in patients with the Brugada syndrome. Am J Cardiol 2013; 112:1384-9. [PMID: 24011739 DOI: 10.1016/j.amjcard.2013.06.033] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 06/24/2013] [Accepted: 06/24/2013] [Indexed: 11/26/2022]
Abstract
Prevalence and prognostic value of conduction disturbances in patients with the Brugada syndrome (BrS) remains poorly known. Electrocardiograms (ECGs) from 325 patients with BrS (47 ± 13 years, 258 men) with spontaneous (n = 143) or drug-induced (n = 182) type 1 ECG were retrospectively reviewed. Two hundred twenty-six patients (70%) were asymptomatic, 73 patients (22%) presented with unexplained syncope, and 26 patients (8%) presented with sudden death or implantable cardioverter-defibrillator appropriated therapies at diagnosis or during a mean follow-up of 48 ± 34 months. P-wave duration of ≥120 ms was present in 129 patients (40%), first degree atrioventricular block (AVB) in 113 (35%), right bundle branch block (BBB) in 90 (28%), and fascicular block in 52 (16%). Increased P-wave duration, first degree AVB, and right BBB were more often present in patients after drug challenge than in patients with spontaneous type 1 ST elevation. Left BBB was present in 3 patients. SCN5A mutation carriers had longer P-wave duration and longer PR and HV intervals. In multivariate analysis, first degree AVB was independently associated with sudden death or implantable cardioverter-defibrillator appropriated therapies (odds ratio 2.41, 95% confidence interval 1.01 to 5.73, p = 0.046) together with the presence of syncope and spontaneous type 1 ST elevation. In conclusion, conduction disturbances are frequent and sometimes diffuse in patients with BrS. First degree AVB is independently linked to outcome and may be proposed to be used for individual risk stratification.
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Sacher F, Probst V, Maury P, Babuty D, Mansourati J, Komatsu Y, Marquie C, Rosa A, Diallo A, Cassagneau R, Loizeau C, Martins R, Field ME, Derval N, Miyazaki S, Denis A, Nogami A, Ritter P, Gourraud JB, Ploux S, Rollin A, Zemmoura A, Lamaison D, Bordachar P, Pierre B, Jaïs P, Pasquié JL, Hocini M, Legal F, Defaye P, Boveda S, Iesaka Y, Mabo P, Haïssaguerre M. Outcome after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: a multicenter study-part 2. Circulation 2013; 128:1739-47. [PMID: 23995538 DOI: 10.1161/circulationaha.113.001941] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [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] [Indexed: 12/17/2022]
Abstract
BACKGROUND Implantable cardioverter-defibrillator indications in Brugada syndrome remain controversial, especially in asymptomatic patients. Previous outcome data are limited by relatively small numbers of patients or short follow-up durations. We report the outcome of patients with Brugada syndrome implanted with an implantable cardioverter-defibrillator in a large multicenter registry. METHODS AND RESULTS A total of 378 patients (310 male; age, 46±13 years) with a type 1 Brugada ECG pattern implanted with an implantable cardioverter-defibrillator (31 for aborted sudden cardiac arrest, 181 for syncope, and 166 asymptomatic) were included. Fifteen patients (4%) were lost to follow-up. During a mean follow-up of 77±42 months, 7 patients (2%) died (1 as a result of an inappropriate shock), and 46 patients (12%) had appropriate device therapy (5±5 shocks per patient). Appropriate device therapy rates at 10 years were 48% for patients whose implantable cardioverter-defibrillator indication was aborted sudden cardiac arrest, 19% for those whose indication was syncope, and 12% for the patients who were asymptomatic at implantation. At 10 years, rates of inappropriate shock and lead failure were 37% and 29%, respectively. Inappropriate shock occurred in 91 patients (24%; 4±4 shocks per patient) because of lead failure (n=38), supraventricular tachycardia (n=20), T-wave oversensing (n=14), or sinus tachycardia (n=12). Importantly, introduction of remote monitoring, programming a high single ventricular fibrillation zone (>210-220 bpm), and a long detection time were associated with a reduced risk of inappropriate shock. CONCLUSIONS Appropriate therapies are more prevalent in symptomatic Brugada syndrome patients but are not insignificant in asymptomatic patients (1%/y). Optimal implantable cardioverter-defibrillator programming and follow-up dramatically reduce inappropriate shock. However, lead failure remains a major problem in this population.
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Affiliation(s)
- Frédéric Sacher
- Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, L'Institut de Rythmologie et de Modelisation Cardiaque, INSERM 1045, Bordeaux, France (F.S., A.D., C.L., M.E.F., N.D., A.D., P.R., S.P., A.Z., P.B., P.J., M.H., M.H.); Institut du Thorax, CHU de Nantes, Nantes, France (V.P., J.-B.G.); CHU de Toulouse, Toulouse, France (P. Maury, A. Rollin); CHU de Tours, Tours, France (D.B., B.P.); CHU de Brest, Brest, France (J.M., S.M.); Tsuchiura Kyodo Hospital, Tsuchiura, Japan (Y.K., Y.I.); CHU de Lille, Lille, France (C.M.); Clinique Pasteur, Toulouse, France (A. Rosa, S.B.); CHU de Grenoble, Grenoble, France (R.C., P.D.); CHU de Rennes, Rennes, France (R.M., P. Mabo); Yokohama Rosai Hospital, Yokohama, Japan (A.N.); CHU de Clermont-Ferrand, Clermont-Ferrand, France (D.L.); CHU de Montpellier, Montpellier, France (J.-L.P.); and CHU de Poitiers, Poiters, France (F.L.)
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Rollin A, Sacher F, Gourraud JB, Pasquié JL, Raczka F, Duparc A, Mondoly P, Cardin C, Delay M, Chatel S, Derval N, Denis A, Sadron M, Davy JM, Hocini M, Jaïs P, Jesel L, Haïssaguerre M, Probst V, Maury P. Prevalence, characteristics, and prognosis role of type 1 ST elevation in the peripheral ECG leads in patients with Brugada syndrome. Heart Rhythm 2013; 10:1012-8. [PMID: 23499630 DOI: 10.1016/j.hrthm.2013.03.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [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: 12/31/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Despite isolated reports of Brugada syndrome (BrS) in the inferior or lateral leads, the prevalence and prognostic value of ST elevation in the peripheral electrocardiographic (ECG) leads in patients with BrS remain poorly known. OBJECTIVE To study the prevalence, characteristics, and prognostic value of type 1 ST elevation and ST depression in the peripheral ECG leads in a large cohort of patients with BrS. METHODS ECGs from 323 patients with BrS (age 47 ± 13 years; 257 men) with spontaneous (n = 141) or drug-induced (n = 182) type 1 ECG were retrospectively reviewed. Two hundred twenty-five (70%) patients were asymptomatic, 72 (22%) patients presented with unexplained syncope, and 26 (8%) patients presented with sudden death (12 patients) or appropriated implantable cardioverter-defibrillator therapies (14 patients) at diagnosis or over a mean follow-up of 48 ± 34 months. RESULTS Thirty (9%) patients presented with type 1 ST elevation in at least 1 peripheral lead (22 patients in the aVR leads, 2 in the inferior leads, 5 in both aVR and inferior leads, and 1 in the aVR and VL leads). Patients with type 1 ST elevation in the peripheral leads more often had mutations in the SCN5A gene, were more often inducible, had slower heart rate, and higher J-wave amplitude in the right precordial leads. Twenty-seven percent (8 of 30) of the patients with type 1 ST elevation in the peripheral leads experimented sudden death/appropriate implantable cardioverter-defibrillator therapy, whereas it occurred in only 6% (18 of 293) of other patients (P < .0001). In multivariate analysis, type 1 ECG in the peripheral leads was independently associated with malignant arrhythmic events (odds ratio 4.58; 95% confidence interval 1.7-12.32; P = .0025). CONCLUSIONS Type 1 ST elevation in the peripheral ECG leads can be seen in 10% of the patients with BrS and is an independent predictor for a malignant arrhythmic event.
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Affiliation(s)
- A Rollin
- University Hospital Rangueil, Toulouse, France
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Granier M, Massin F, Pasquié JL. Pro- and anti-arrhythmic effects of anti-inflammatory drugs. Antiinflamm Antiallergy Agents Med Chem 2013; 12:83-93. [PMID: 23286288 DOI: 10.2174/1871523011312010010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 11/06/2012] [Accepted: 12/12/2012] [Indexed: 06/01/2023]
Abstract
Inflammatory process is strongly associated with cardiac arrhythmia, either as a cause or a consequence. Antiinflammatory drugs are widely prescribed, and some of them have been associated with an increased cardiovascular risk. Then, the eventual pro- or anti-arrhythmic effect of these drugs is of high interest for clinical practice. This review summarizes pro- and anti-arrhythmic effects of anti-inflammatory drugs, based on the analysis of published clinical trials. Cardiac arrhythmias are divided into atrial fibrillation (AF) and ventricular arrhythmias. Based on the literature and on pathophysiology, post-operative AF and post-ablative AF are analyzed separately. After a brief overview of fundamental mechanisms of arrhythmia and their relationship to inflammation, we thought to examine corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), and colchicine effects on cardiac arrhythmias. All anti-inflammatory drugs have demonstrated anti-arrhythmic properties in post operative AF. Apart from this specific condition, NSAIDs and corticosteroids increase the risk of AF. Regarding ventricular arrhythmias the effects of these drugs are not well established and would require further investigations.
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Affiliation(s)
- Mathieu Granier
- Cardiology department, University Hospital of Montpellier, Hospital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier, France.
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Khoueiry Z, Roubille C, Nagot N, Lattuca B, Piot C, Leclercq F, Delseny D, Busseuil D, Gervasoni R, Davy JM, Pasquié JL, Cransac F, Sportouch-Dukhan C, Macia JC, Cung TT, Massin F, Cade S, Cristol JP, Barrère-Lemaire S, Roubille F. Could heart rate play a role in pericardial inflammation? Med Hypotheses 2012; 79:512-5. [PMID: 22858356 DOI: 10.1016/j.mehy.2012.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/04/2012] [Accepted: 07/08/2012] [Indexed: 10/28/2022]
Abstract
UNLABELLED PURPOSE AND MEDICAL HYPOTHESIS: Rest is usually recommended in acute pericarditis, as it could help to lower heart rate (HR) and contribute to limit "mechanical inflammation". Whether HR on admission could be correlated and perhaps participate to inflammation has not been reported. METHODS Between March 2007 and February 2010, we conducted a retrospective study on all patients admitted to our center for acute pericarditis. Diagnosis criteria included two of the following ones: typical chest pain, friction rub, pericardial effusion on cardiac echography, or typical electrocardiogram (ECG) findings. Primary endpoint was biology: CRP on admission, on days 1, 2, 3, and especially peak. RESULTS We included 73 patients. Median age was 38 years (interquartiles 28-51) and median hospitalization duration was 2.0 days (1.5-3.0). Median heart rate was 88.0 beats per minute (bpm) on admission (interquartiles 76.0-100.0) and 72.0 on discharge (65.0-80.0). Heart rate on admission was significantly correlated with CRP peak (p<0.001), independently of temperature on admission, hospitalization duration and age. Recurrences occurred within 1 month in 32% of patients. Heart rate on hospital discharge was correlated with recurrence, independently of age. CONCLUSION In acute pericarditis, heart rate on admission is independently correlated with CRP levels and heart rate on discharge seems to be independently correlated to recurrence. This could suggest a link between heart rate and pericardial inflammation.
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Affiliation(s)
- Ziad Khoueiry
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
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Thireau J, Pasquié JL, Martel E, Le Guennec JY, Richard S. New drugs vs. old concepts: a fresh look at antiarrhythmics. Pharmacol Ther 2011; 132:125-45. [PMID: 21420430 DOI: 10.1016/j.pharmthera.2011.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/01/2011] [Indexed: 01/10/2023]
Abstract
Common arrhythmias, particularly atrial fibrillation (AF) and ventricular tachycardia/fibrillation (VT/VF) are a major public health concern. Classic antiarrhythmic (AA) drugs for AF are of limited effectiveness, and pose the risk of life-threatening VT/VF. For VT/VF, implantable cardiac defibrillators appear to be the unique, yet unsatisfactory, solution. Very few AA drugs have been successful in the last few decades, due to safety concerns or limited benefits in comparison to existing therapy. The Vaughan-Williams classification (one drug for one molecular target) appears too restrictive in light of current knowledge of molecular and cellular mechanisms. New AA drugs such as atrial-specific and/or multichannel blockers, upstream therapy and anti-remodeling drugs, are emerging. We focus on the cellular mechanisms related to abnormal Na⁺ and Ca²⁺ handling in AF, heart failure, and inherited arrhythmias, and on novel strategies aimed at normalizing ionic homeostasis. Drugs that prevent excessive Na⁺ entry (ranolazine) and aberrant diastolic Ca²⁺ release via the ryanodine receptor RyR2 (rycals, dantrolene, and flecainide) exhibit very interesting antiarrhythmic properties. These drugs act by normalizing, rather than blocking, channel activity. Ranolazine preferentially blocks abnormal persistent (vs. normal peak) Na⁺ currents, with minimal effects on normal channel function (cell excitability, and conduction). A similar "normalization" concept also applies to RyR2 stabilizers, which only prevent aberrant opening and diastolic Ca²⁺ leakage in diseased tissues, with no effect on normal function during systole. The different mechanisms of action of AA drugs may increase the therapeutic options available for the safe treatment of arrhythmias in a wide variety of pathophysiological situations.
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Affiliation(s)
- Jérôme Thireau
- Inserm U1046 Physiologie & Médecine Expérimentale du Cœur et des Muscles, Université Montpellier-1, Université Montpellier-2, 34295 Montpellier Cedex 5, France
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Edvardsson N, Frykman V, van Mechelen R, Mitro P, Mohii-Oskarsson A, Pasquié JL, Ramanna H, Schwertfeger F, Ventura R, Voulgaraki D, Garutti C, Stolt P, Linker NJ. Use of an implantable loop recorder to increase the diagnostic yield in unexplained syncope: results from the PICTURE registry. Europace 2010; 13:262-9. [PMID: 21097478 PMCID: PMC3024039 DOI: 10.1093/europace/euq418] [Citation(s) in RCA: 145] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims To collect information on the use of the Reveal implantable loop recorder (ILR) in the patient care pathway and to investigate its effectiveness in the diagnosis of unexplained recurrent syncope in everyday clinical practice. Methods and results Prospective, multicentre, observational study conducted in 2006–2009 in 10 European countries and Israel. Eligible patients had recurrent unexplained syncope or pre-syncope. Subjects received a Reveal Plus, DX or XT. Follow up was until the first recurrence of a syncopal event leading to a diagnosis or for ≥1 year. In the course of the study, patients were evaluated by an average of three different specialists for management of their syncope and underwent a median of 13 tests (range 9–20). Significant physical trauma had been experienced in association with a syncopal episode by 36% of patients. Average follow-up time after ILR implant was 10 ± 6 months. Follow-up visit data were available for 570 subjects. The percentages of patients with recurrence of syncope were 19, 26, and 36% after 3, 6, and 12 months, respectively. Of 218 events within the study, ILR-guided diagnosis was obtained in 170 cases (78%), of which 128 (75%) were cardiac. Conclusion A large number of diagnostic tests were undertaken in patients with unexplained syncope without providing conclusive data. In contrast, the ILR revealed or contributed to establishing the mechanism of syncope in the vast majority of patients. The findings support the recommendation in current guidelines that an ILR should be implanted early rather than late in the evaluation of unexplained syncope.
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Affiliation(s)
- Nils Edvardsson
- Division of Cardiology, Sahlgrenska Academy at Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden.
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Machado S, Roubille F, Gahide G, Vernhet-Kovacsik H, Cornillet L, Cung TT, Sportouch-Dukhan C, Raczka F, Pasquié JL, Gervasoni R, Macia JC, Cransac F, Davy JM, Piot C, Leclercq F. Can troponin elevation predict worse prognosis in patients with acute pericarditis? Ann Cardiol Angeiol (Paris) 2010; 59:1-7. [PMID: 19963205 DOI: 10.1016/j.ancard.2009.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Accepted: 07/15/2009] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Myopericarditis are common in clinical practice: up to 15% of acute pericarditis have a significant myocardial involvement as assessed by biological markers. This prospective, bicentric study is aimed at describing a myopericarditis population, the clinical and MRI follow-up, and search for prognosis markers. PATIENTS AND METHODS Between May 2005 and September 2007, 103 patients hospitalised for acute pericarditis were prospectively enrolled. Physical examination, ECG, echocardiography, biological screening and cardiac MRI, in case of myopericarditis defined as acute pericarditis with troponin I elevation, were performed. Between December 2007 and July 2008, patients were contacted for new clinical and MRI evaluation. RESULTS Among the initial population of 103 patients admitted for acute pericarditis, 14 myopericarditis and 38 pericarditis were included. Compared with pericarditis, the myopericarditis group was associated with the following features: younger age (34.9 years [95% CI 28.3-41.2]; p=0.01), ST-segment elevation (nine patients between 14; p=0.03), higher troponin I (7.3 microg/L [95% CI 4.4-10.2]; p<10(-4)) and lower systemic inflammation (CRP peak 38.1mg/L [95% CI 7-69.2]; p=0.01). In the case of myopericarditis, infectious etiologies were predominant (12 patients among 14; p=0.002) and patients stayed longer in hospital (5.8 days [95% CI 4.7-6.8]; p=0.01). Follow-up showed no difference in terms of functional status (p=0.3) and global complications (p=0.9) between paired myopericarditis and pericarditis. Nevertheless, cardiac mortality was higher for myopericarditis (p=0.04). MRI follow-up showed myocardial sequelae without clinical impact. CONCLUSION Myopericarditis significantly distinguished from pericarditis. Three years follow-up showed no difference in terms of global complications but a higher cardiac mortality for myopericarditis. MRI myocardial lesions did not develop into symptomatic sequelae.
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Affiliation(s)
- S Machado
- Département de cardiologie, CHU Arnaud-de-Villeneuve, 371 avenue du Doyen-Gaston-Giraud, Montpellier, France
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Fauconnier J, Pasquié JL, Bideaux P, Lacampagne A, Richard S. Cardiomyocytes hypertrophic status after myocardial infarction determines distinct types of arrhythmia: role of the ryanodine receptor. Prog Biophys Mol Biol 2010; 103:71-80. [PMID: 20109482 DOI: 10.1016/j.pbiomolbio.2010.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 01/08/2010] [Indexed: 11/20/2022]
Abstract
The mechanisms responsible for sudden cardiac death in heart failure (HF) are unclear. We investigated early and delayed afterdepolarizations (EADs, DADs) in HF. Cardiomyocytes were enzymatically isolated from the right ventricle (RV) and the septum of rats 8 weeks after myocardial infarction (MI) and sham-operated animals. Membrane capacitance, action potentials (AP) and ionic currents were measured by whole-cell patch-clamp. The [Ca(2+)](i) transients and Ca(2+) sparks were recorded with Fluo-4 during fluorescence measurements. Arrhythmia was triggered in 40% of MI cells (not in sham) using trains of 5 stimulations at 2.0 Hz. EADs and DADs occurred in distinct cell populations both in the RV and the septum. EADs occurred in normal-sized PMI cells (<230 pF), whereas DADs occurred in hypertrophic PMI cells (>230 pF). All cells exhibited prolonged APs due to reduced I(to) current. However, additional modifications in Ca(2+)-dependent ionic currents occurred in hypertrophic cells: a decrease in the inward rectifier K(+) current I(K1), and a slowing of L-type Ca(2+) current inactivation which was responsible for the lack of adaptation of APs to abrupt changes in the pacing rate. The occurrence of spontaneous Ca(2+) sparks, reflecting ryanodine receptor (RyR2) diastolic activity, increased with hypertrophy. The [Ca(2+)](i) transient amplitude, sarcoplasmic reticulum (SR) Ca(2+) load and Ca(2+) sparks amplitude were all inversely correlated with cell size. We conclude that the trophic status of cardiomyocytes determines the type of cellular arrhythmia in MI rats, based on differential electrophysiological remodeling which may reflect early-mild and late-severe or differential modifications in the RyR2 function.
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Affiliation(s)
- Jérémy Fauconnier
- INSERM U637, Université Montpellier1, Department of Cardiovascular Physiopathology, 371 avenue du Doyen Gaston Giraud, F34295 Montpellier Cedex 5, France
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Abstract
We report the case of a 50-year-old man admitted for cardiac tamponade. He was diagnosed with acute pneumonia. He had no previous medical history, but exhibited a body mass index of 41. Two days before admission, he complained of chest pain irradiating to the neck lateral side. Massive cardiac tamponade developed over 48 hours. There was no obvious cause for immunodepression. Pericardial puncture was ineffective, due to obesity and fluid high viscosity. Surgery was undertaken (Marfan intervention). Pericardial fluid was found to be purulent; direct examination revealed nocardia as bacteria with typical filamentous, branching rods. Despite adapted antibiotic treatment the patient died within a few hours. Acute pericarditis due to Nocardia is discussed.
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Affiliation(s)
- Francois Roubille
- Department of Cardiology, Arnaud de Villeneuve University Hospital, Montpellier, France.
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Haïssaguerre M, Sacher F, Nogami A, Komiya N, Bernard A, Probst V, Yli-Mayry S, Defaye P, Aizawa Y, Frank R, Mantovan R, Cappato R, Wolpert C, Leenhardt A, de Roy L, Heidbuchel H, Deisenhofer I, Arentz T, Pasquié JL, Weerasooriya R, Hocini M, Jais P, Derval N, Bordachar P, Clémenty J. Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol 2009; 53:612-619. [PMID: 19215837 DOI: 10.1016/j.jacc.2008.10.044] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.1] [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: 07/22/2008] [Revised: 10/08/2008] [Accepted: 10/26/2008] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Our purpose was to evaluate the efficacy of antiarrhythmic drugs (AADs) in recurrent ventricular fibrillation (VF) associated with inferolateral early repolarization pattern on the electrocardiogram. BACKGROUND Although an implantable cardioverter-defibrillator is the treatment of choice, additional AADs may be necessary to prevent frequent episodes of VF and reduce implantable cardioverter-defibrillator shock burden or as a lifesaving therapy in electrical storms. METHODS From a multicenter cohort of 122 patients (90 male subjects, age 37 +/- 12 years) with idiopathic VF and early repolarization abnormality in the inferolateral leads, we selected all patients with more than 3 episodes of VF (multiple) including those with electrical storms (> or =3 VF in 24 h). The choice of AAD was decided by individual physicians. Follow-up data were obtained for all patients using monitoring with implantable defibrillator. Successful oral AAD was defined as elimination of all recurrences of VF with a minimal follow-up period of 12 months. RESULTS Multiple episodes of VF were observed in 33 (27%) patients. Electrical storms (34 +/- 47 episodes) occurred in 16 and were unresponsive to beta-blockers (11 of 11), lidocaine/mexiletine (9 of 9), and verapamil (3 of 3), while amiodarone was partially effective (3 of 10). In contrast, isoproterenol infusion immediately suppressed electrical storms in 7 of 7 patients. Over a follow-up of 69 +/- 58 months, oral AADs were poorly effective in preventing recurrent VF: beta-blockers (2 of 16), verapamil (0 of 4), mexiletine (0 of 4), amiodarone (1 of 7), and class 1C AADs (2 of 9). Quinidine was successful in 9 of 9 patients, decreasing recurrent VF from 33 +/- 35 episodes to nil for 25 +/- 18 months. In addition, quinidine restored a normal electrocardiogram. CONCLUSIONS Multiple recurrences of VF occurred in 27% of patients with early repolarization abnormality and may be life threatening. Isoproterenol in acute cases and quinidine in chronic cases are effective AADs.
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Affiliation(s)
| | | | | | | | - Anne Bernard
- Centre Hospitalier Universitaire de Tours, Tours, France
| | - Vincent Probst
- Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Pascal Defaye
- Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | | | - Robert Frank
- Centre Hospitalier Universitaire de Paris, Paris, France
| | | | | | | | | | - Luc de Roy
- Clinique MontGodinne, MontGodinne, Belgium
| | | | | | - Thomas Arentz
- University Hospital Bad Krozingen, Bad Krozingen, Germany
| | - Jean-Luc Pasquié
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | | | - Pierre Jais
- Université Bordeaux, CHU Bordeaux, Bordeaux, France
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Fauconnier J, Pasquié JL, Bideaux P, Lacampagne A, Richard S. Differential Hypertrophic Remodeling Of Cardiomyocytes Determines Distinct Types Of Arrhythmias In The Ischemic Failing Heart: Key Role Of The Ryanodine Receptor. Biophys J 2009. [DOI: 10.1016/j.bpj.2008.12.2646] [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: 11/27/2022] Open
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Pasquié JL, Richard S. Prolongation in QT interval is not predictive of Ca2+-dependent arrhythmias: implications for drug safety. Expert Opin Drug Saf 2009; 8:57-72. [DOI: 10.1517/14740330802655454] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O'Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J. Sudden cardiac arrest associated with early repolarization. N Engl J Med 2008; 358:2016-23. [PMID: 18463377 DOI: 10.1056/nejmoa071968] [Citation(s) in RCA: 952] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early repolarization is a common electrocardiographic finding that is generally considered to be benign. Its potential to cause cardiac arrhythmias has been hypothesized from experimental studies, but it is not known whether there is a clinical association with sudden cardiac arrest. METHODS We reviewed data from 206 case subjects at 22 centers who were resuscitated after cardiac arrest due to idiopathic ventricular fibrillation and assessed the prevalence of electrocardiographic early repolarization. The latter was defined as an elevation of the QRS-ST junction of at least 0.1 mV from baseline in the inferior or lateral lead, manifested as QRS slurring or notching. The control group comprised 412 subjects without heart disease who were matched for age, sex, race, and level of physical activity. Follow-up data that included the results of monitoring with an implantable defibrillator were obtained for all case subjects. RESULTS Early repolarization was more frequent in case subjects with idiopathic ventricular fibrillation than in control subjects (31% vs. 5%, P<0.001). Among case subjects, those with early repolarization were more likely to be male and to have a history of syncope or sudden cardiac arrest during sleep than those without early repolarization. In eight subjects, the origin of ectopy that initiated ventricular arrhythmias was mapped to sites concordant with the localization of repolarization abnormalities. During a mean (+/-SD) follow-up of 61+/-50 months, defibrillator monitoring showed a higher incidence of recurrent ventricular fibrillation in case subjects with a repolarization abnormality than in those without such an abnormality (hazard ratio, 2.1; 95% confidence interval, 1.2 to 3.5; P=0.008). CONCLUSIONS Among patients with a history of idiopathic ventricular fibrillation, there is an increased prevalence of early repolarization.
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Pasquié JL, Massin F, Macia JC, Gervasoni R, Bortone A, Cayla G, Grolleau R, Leclercq F. Long-term follow-up of biventricular pacing using a totally endocardial approach in patients with end-stage cardiac failure. Pacing Clin Electrophysiol 2007; 30 Suppl 1:S31-3. [PMID: 17302712 DOI: 10.1111/j.1540-8159.2007.00599.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Besides standard left ventricular (LV) stimulation via the coronary sinus, a transseptal approach allows left ventricular endocardial stimulation. We report our long-term observations with biventricular stimulation, using a strictly endocardial system for patients presenting with severe congestive heart failure. METHODS Six patients with nonischemic cardiomyopathy (mean age = 60 +/- 9.6 years, women) in New York Heart Association (NYHA) functional class III (n = 5) or IV, despite optimal drug therapy, and a mean LV ejection fraction of 24 +/- 3%, underwent implantation of biventricular stimulation systems between April 1998 and March 1999. All presented with left bundle branch block and an increased LV end-diastolic diameter (mean = 66 +/- 5 mm). In all patients, a bipolar pacing lead was implanted in the lateral LV wall using a direct transseptal approach. After implantation, all patients received oral anticoagulation. RESULTS QRS duration decreased from 184 +/- 22 ms to 108 +/- 11 ms. NYHA functional class decreased to II in all patients within 1 month. Over a 85 +/- 5 month follow-up, two patients underwent cardiac transplantation, 2 and 4 years after device implantation, respectively; two patients died of end-stage heart failure 4 years after system implantation; and two patients were alive in functional class II. One patient, who experienced syncope due to fast ventricular, underwent implantation of an ICD. One transient ischemic attack occurred in a patient whose anticoagulation was temporarily interrupted. CONCLUSIONS Long-term endocardial biventricular stimulation via a transseptal approach was safe and effective in this small population. This approach needs to be further compared with conventional epicardial pacing via the coronary sinus.
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Affiliation(s)
- J L Pasquié
- Clinique des Maladies du Coeur et des Vaisseaux, Hôpital Arnaud de Villeneuve, Centre Hospitalo-Universitaire de Montpellier, France.
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Bortone A, Leclercq F, Grolleau-Raoux R, Pasquié JL. Intermittent fasciculoventricular pathway: ECG and electrophysiologic findings, clinical implications. ACTA ACUST UNITED AC 2007; 9:702-5. [PMID: 17449507 DOI: 10.1093/europace/eum049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although fasciculoventricular (FV) pathways never participate into tachycardia circuits, they give rise to ventricular pre-excitation of variable magnitude which can be source of ECG misinterpretation when associated to other supraventricular rhythm disorders. We report an intermittent FV pathway coincidentally unmasked during an electrophysiologic study performed for a symptomatic supraventricular tachycardia (atrial tachycardia). The clinical context, ECG and EP findings, and therapeutic options are described. Fasciculoventricular pathways need no medical or ablative treatment, thus their positive and differential diagnosis must be clearly assessed.
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Affiliation(s)
- Agustín Bortone
- CHU Montpellier, Service de Cardiologie A, Clinique de Maladies du Coeur et des Vaisseaux, Hôpital Arnaud de Villeneuve, Centre Hospitalo-Universitaire, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
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