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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 19th official report of Heart Rhythm Association of the Spanish Society of Cardiology (2022). Rev Esp Cardiol (Engl Ed) 2023; 76:922-935. [PMID: 37774946 DOI: 10.1016/j.rec.2023.06.015] [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] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 10/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents data on implantable cardioverter-defibrillator implants in Spain in 2022. METHODS The data were collected from implantation centers, which voluntarily completed a data collection sheet during the implantation process, either manually or through a web page. RESULTS In 2022, 170 hospitals participated in the registry. A total of 7693 forms were received compared with the 7970 reported by Eucomed (European Confederation of Medical Suppliers Associations), representing 96.5% of the devices. The total rate of registered implants was 162/million inhabitants (168 according to Eucomed), showing a slight increase compared with previous years. Disparities persisted among autonomous communities and Spain continued to have the lowest implantation rate among countries participating in Eucomed. CONCLUSIONS The data from the registry for 2022 reflect the complete recovery of activity after the impact of the COVID-19 pandemic in 2020. Despite a slight improvement, there was no significant change in our position in Europe or in the substantial differences among autonomous communities.
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Castrejón-Castrejón S, Martínez Cossiani M, Jáuregui-Abularach M, Basterra Sola N, Ibáñez Criado JL, Osca Asensi J, Roca Luque I, Moya Mitjans A, Quesada Dorador A, Hidalgo Olivares VM, Pérez Castellano N, Fernández Gómez JM, Macías-Ruiz MR, Bochard Villanueva B, Gonzalo Bada N, Fernández Prieto A, Guido López LE, Martínez Maldonado ME, Merino D, Escobar Cervantes C, Merino JL. Multicenter prospective comparison of conventional and high-power short duration radiofrequency application for pulmonary vein isolation: the high-power short-duration radiofrequency application for faster and safer pulmonary vein ablation (POWER FAST III) trial. J Interv Card Electrophysiol 2023; 66:1889-1899. [PMID: 36807734 DOI: 10.1007/s10840-023-01509-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/06/2023] [Indexed: 02/21/2023]
Abstract
BACKGROUND Electrical isolation of pulmonary veins (PV) with high-power short-duration (HPSD) radiofrequency application (RFa) may reduce the duration of atrial fibrillation (AF) ablation, without compromising the procedural efficacy and safety in comparison with the conventional approach. This hypothesis has been generated in several observational studies; the POWER FAST III will test it in a randomized multicenter clinical trial. METHODS It is a multicenter randomized, open-label and non-inferiority clinical trial with two parallel groups. AF ablation using 70 W and 9-10 s RFa is compared with the conventional technique using 25-40 W RFa guided by numerical lesion indexes. The main efficacy objective is the incidence of atrial arrhythmia recurrences electrocardiographically documented during 1-year follow-up. The main safety objective is the incidence of endoscopically detected esophageal thermal lesions (EDEL). This trial includes a substudy of incidence of asymptomatic cerebral lesions detected by magnetic resonance imaging (MRI) after ablation. RESULTS A randomized clinical trial compares for the first time high-power short-duration and conventional ablation in order to obtain data about the efficacy and safety of the high-power technique in an adequate methodological context. CONCLUSIONS The results of the POWER FAST III could support the use of the high-power short-duration ablation in clinical practice. REGISTRATION ClinicalTrials.gov: NTC04153747.
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Affiliation(s)
- Sergio Castrejón-Castrejón
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Marcel Martínez Cossiani
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Miguel Jáuregui-Abularach
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Nuria Basterra Sola
- Cardiology Department, Complejo Hospitalario de Navarra-IdiSNA (Navarra Institute for Health Research), Pamplona, Spain
| | - José Luis Ibáñez Criado
- Cardiology Department, Hospital General Universitario de Alicante-ISABIAL (Instituto de Investigación Sanitaria Y Biomédica de Alicante), Alicante, Spain
| | | | - Ivo Roca Luque
- Cardiology Department, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | | | | | | | - Nerea Gonzalo Bada
- Acute Care Unit, Department of Gastroenterology, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | | | - Leonardo Elías Guido López
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | | | - Daniel Merino
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - Carlos Escobar Cervantes
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain
| | - José Luis Merino
- Arrhythmia & Robotic EP Unit, Cardiology Department, Hospital Universitario La Paz-IdiPaz, Madrid, Spain.
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish implantable cardioverter-defibrillator registry. 18th official report of the Heart Rhythm Association of the Spanish Society of Cardiology (2021). Rev Esp Cardiol (Engl Ed) 2022; 75:933-945. [PMID: 36155845 DOI: 10.1016/j.rec.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES This article presents the data corresponding to implantable cardioverter-defibrillator (ICD) implantations in Spain in 2021. METHODS The data were drawn from implanting centers, which voluntarily completed a data collection sheet during the procedure. RESULTS In 2021, 7496 implant data sheets were received, compared with 7743 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 96.8% of the devices implanted in Spain. Data completion ranged from 99.9% for "name of implanting hospital" to 8.9% for "implanting hospital". In 2021, 199 hospitals participated in the registry, exceeding the figures of previous years, with around 170 participating hospitals. The total rate of registered implants was 158/million inhabitants (163 according to Eucomed), making 2021 the year with the highest activity. However, the registry continues to show significant differences among the various autonomous communities and the lowest implantation rate of all the European countries participating in Eucomed. CONCLUSIONS The Spanish implantable cardioverter-defibrillator registry for 2021 recorded an increase in the number of ICD implantations, reflecting the recovery of hospital activity after the initial impact of the COVID-19 pandemic in 2020. Although the total number of implants has increased in Spain, figures are still much lower than the European Union average, with differences persisting among Spanish autonomous communities.
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Loughlin G, Pachón M, Martínez-Sande JL, Ibáñez JL, Bastante T, Osca Asensi J, González Melchor L, Martínez-Martínez JG, Cuesta J, Miguel A A. OUTCOMES OF LEADLESS PACEMAKER IMPLANTATION IN PATIENTS WITH MECHANICAL HEART VALVES. J Cardiovasc Electrophysiol 2022; 33:997-1004. [PMID: 35322490 DOI: 10.1111/jce.15462] [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: 09/14/2021] [Revised: 02/14/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Device infections constitute a major complication of transvenous pacemakers. Mechanical heart valves (MHV) increase the risk of infective endocarditis (IE) and pacemaker infection, requiring lifelong vitamin K-antagonists (VKA), which may affect patient management. Leadless pacemakers (LP) are associated with low infection rates, posing an attractive option in MHV patients requiring permanent pacing.This study describes outcomes following LP implantation in patients with MHV. METHODS This is a multicenter, observational, retrospective study including consecutive patients implanted with an LP at 5 centers between June 2015 and January 2020.Procedural outcomes, antithrombotic management, complications, performance during follow-up and episodes of bacteremia and IE were compared between patients with and without an MHV (MHV and non-MHV groups). RESULTS Four hundred fifty-nine patients were included (74 in the MHV group, 16.1%, and 385 in the non-MHV group, 83.9%).Procedural outcomes and acute electrical performance were comparable between groups.Vascular complications and cardiac perforation occurred in 2.7 vs. 2.3% (p=1) and 0% vs. 0.8% (p=1) in the MHV group and non-MHV group.One case of IE occurred in the MHV group and 2 in the non-MHV group.In MHV patients, uninterrupted VKA was used in 83.8 %, whereas 16.2 % were heparin-bridged.Vascular complication or tamponade occurred in 1(8.3 %) MHV heparin-bridged patient vs. 1 (1.6 %) MHV uninterrupted VKA patient (p=0.3). CONCLUSION LP implantation outcomes in MHV patients are comparable to the general LP population.Device-related infections are rare following LP implantation, including in patients with MHV.In the MHV group, periprocedural anticoagulation management was not associated with significantly different rates of tamponade or vascular complication. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Gerard Loughlin
- Arrhythmia Unit, Hospital Universitario de Toledo, Toledo, Spain
| | - Marta Pachón
- Arrhythmia Unit, Hospital Universitario de Toledo, Toledo, Spain
| | - José Luis Martínez-Sande
- Arrhythmia Unit, Cardiology Service, Hospital Clínico Universitario de Santiago de Compostela, CIBERCV, Santiago de Compostela, Spain
| | - José Luis Ibáñez
- Arrhythmia Unit, Cardiology Service, University General Hospital of Alicante, Alicante Institute of Health and Biomedical Research (ISABIAL Foundation), Alicante, Spain
| | - Teresa Bastante
- Cardiology Service, Hospital Universitario de La Princesa, Madrid, Spain
| | - Joaquín Osca Asensi
- Arrhythmia Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Laila González Melchor
- Arrhythmia Unit, Cardiology Service, Hospital Clínico Universitario de Santiago de Compostela, CIBERCV, Santiago de Compostela, Spain
| | - Juan Gabriel Martínez-Martínez
- Arrhythmia Unit, Cardiology Service, University General Hospital of Alicante, Alicante Institute of Health and Biomedical Research (ISABIAL Foundation), Alicante, Spain
| | - Javier Cuesta
- Cardiology Service, Hospital Universitario de La Princesa, Madrid, Spain
| | - Arias Miguel A
- Arrhythmia Unit, Hospital Universitario de Toledo, Toledo, Spain
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 17th Official Report of the Heart Rhythm Association of the Spanish Society of Cardiology (2020). Rev Esp Cardiol (Engl Ed) 2021; 74:971-982. [PMID: 34583912 DOI: 10.1016/j.rec.2021.09.002] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 07/13/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES We present the data corresponding to implantable cardioverter-defibrillator (ICD) implants in Spain in 2020. METHODS The data in this registry were drawn from implantation centers, which voluntarily completed a data collection sheet. RESULTS In 2020, 7056 implant sheets were received compared with 7106 reported by Eucomed (European Confederation of Medical Suppliers Associations), indicating that data were collected from 99% of the devices implanted in Spain. Completion of the implant sheet ranged from 99.8% for the field "name of the implanting hospital" to 2.6% for the variable "referral hospital". A total of 173 hospitals performed ICD implants and participated in the registry, which is a similar figure to that in 2019 (n=172). The total rate of registered implants was 149/million inhabitants (150 according to Eucomed), revealing a slight reduction in implants in Spain in 2020 as a result of the impact of the COVID-19 pandemic. This reduction was uneven among the autonomous communities. CONCLUSIONS The Spanish Implantable Cardioverter Defibrillator Registry for 2020 shows an improvement in the rate of implants reported and a reduction in the number of ICD implants, which likely reflects the decrease in hospital activity not related to the treatment of COVID-19 infection. Similar to previous years, the total number of implants in Spain is still much lower than the average for the European Union, with an increase in the differences between Spanish autonomous communities.
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Osca Asensi J, Izquierdo de Francisco MT, Cano Pérez Ó, Sancho Tello de Carranza MJ, Alberola Rubio J, Planells Palop C, Lozano Vidal JV, Martínez Dolz L. The RITHMI study: diagnostic ability of a heart rhythm monitor for automatic detection of atrial fibrillation. Rev Esp Cardiol (Engl Ed) 2021; 74:602-607. [PMID: 32792313 DOI: 10.1016/j.rec.2020.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/06/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION AND OBJECTIVES Early detection of atrial fibrillation (AF) is a priority to reduce embolic events by initiating oral anticoagulation therapy. The aim of this study was to evaluate the diagnostic ability of a wrist device designed for automatic AF detection. METHODS RITHMI is a prospective, comparative, observational study that included 167 patients referred to a cardiology outpatient clinic for a general consultation or for electrical cardioversion. The study evaluated the ability of a wrist monitor that uses a photoplethysmography (PPG) signal and an electrocardiographic lead to automatically detect AF compared with diagnosis established by 2 cardiologists using the 12-lead electrocardiogram. RESULTS The AF detection algorithm based on the PPG signal had a sensitivity of 91% and a specificity of 96% (diagnostic accuracy: 93%). The automatic algorithm based on the electrocardiographic signal had a sensitivity of 94% and a specificity of 96% (diagnostic accuracy: 95%). The 2 algorithms concurred in the diagnosis in 96% of the cases. Overall, the monitor had a sensitivity and specificity of 95% (diagnostic accuracy: 95% and Kappa index: 0.98). CONCLUSIONS This study shows that automatic AF detection through the use of a heart rhythm monitor incorporating sensors and algorithms that analyze the PPG signal and the electrocardiographic signal corresponding to lead I is feasible and has high diagnostic accuracy.
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Affiliation(s)
- Joaquín Osca Asensi
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | | | - Óscar Cano Pérez
- Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - José Alberola Rubio
- Instituto de Investigación Sanitaria La Fe, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | | | - Luis Martínez Dolz
- Servicio de Cardiología, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Registro Español de Desfibrilador Automático Implantable. XVI Informe Oficial de la Asociación del Ritmo Cardiaco de la Sociedad Española de Cardiología (2019). Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2020.07.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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García-Fernández FJ, Osca Asensi J, Romero R, Fernández Lozano I, Larrazabal JM, Martínez Ferrer J, Ortiz R, Pombo M, Tornés FJ, Moradi Kolbolandi M. Safety and efficiency of a common and simplified protocol for pacemaker and defibrillator surveillance based on remote monitoring only: a long-term randomized trial (RM-ALONE). Eur Heart J 2020; 40:1837-1846. [PMID: 30793735 PMCID: PMC6568206 DOI: 10.1093/eurheartj/ehz067] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/01/2018] [Accepted: 01/26/2019] [Indexed: 11/24/2022] Open
Abstract
Aims This trial aimed to evaluate the safety and efficiency of a common and simplified protocol for the surveillance of cardiac implantable electronic devices based on remote monitoring (RM) in patients with pacemakers (PMs) and implantable cardiac defibrillators (ICDs) for at least 24 months. Methods and results The RM-ALONE is a multicentre prospective trial that randomly assigned 445 patients in two groups, both followed by RM: the home monitoring-only (HMo) based on RM + remote interrogations (RIs) every 6 months and the HM + IO that adds in-office evaluations every 6 months to RM. Four hundred and forty-five patients were enrolled in the study, 294 PMs and 151 ICDs recipients. In the HMo group, 20% of patients experienced ≥1 major adverse cardiac event (MACE) vs. 19.5% in HM + IO group (P = 0.006 for non-inferiority). The proportion of patients with a PM/ICD who experienced ≥1 MACE was 15.2/29.3% in HMo group and 16.1/26.3% in HM + IO group (hazard ratio 0.95/1.15, 95% confidence interval 0.53–1.70/0.62–2.10). There were 789 in-office evaluations (136 in the HMo and 653 in the HM + IO; P < 0.001). There was a 79.2% reduction of in-office evaluations with no significant differences in unscheduled visits between groups: 122 (54.5%) in HMo and 101 (45.3%) in HM + IO; P = 0.15. The time a physician/nurse spent per patient/follow-up was significantly reduced in the HMo group: 4/5 min (0–30)/(1–30) vs. 10/10 min (0–40)/(1–40) in HM + IO (P < 0.0001). Conclusion The RM-ALONE protocol common for ICD and PM surveillance, consisting of RM + RI every 6 months has proven safe and efficient in reducing hospital visits and staff workload. ![]()
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Affiliation(s)
| | - Joaquín Osca Asensi
- Hospital Universitario y Politécnico La Fe, Av de Fernando Abril Martorell 106, Valencia, Spain
| | - Rafael Romero
- Hospital Nuestra Señora de la Candelaria, Ctra. Gral. del Rosario 145, Sta. Cruz de Tenerife, Spain
| | | | | | | | - Raquel Ortiz
- Hospital General de la Palma, Ctra. de la Cumbre 28, Las Palmas de Gran Canaria, Spain
| | - Marta Pombo
- Hospital Costa del Sol, A-7 Km 187, Marbella, Málaga, Spain
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Registro Español de Desfibrilador Automático Implantable. XV Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2018). Rev Esp Cardiol 2019. [DOI: 10.1016/j.recesp.2019.07.029] [Citation(s) in RCA: 3] [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: 10/25/2022]
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Registro Español de Desfibrilador Automático Implantable. XIV Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2017). Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2018.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fernández Lozano I, Osca Asensi J, Alzueta Rodríguez J. Spanish Implantable Cardioverter-defibrillator Registry. 14th Official Report of the Spanish Society of Cardiology Electrophysiology and Arrhythmias Section (2017). ACTA ACUST UNITED AC 2018; 71:1047-1058. [PMID: 30420318 DOI: 10.1016/j.rec.2018.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 07/06/2018] [Accepted: 08/09/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES The Spanish Automatic Defibrillator Registry has provided activity data since 2002. METHODS The data in this registry are submitted by implantation centers that voluntarily complete a data collection sheet. RESULTS During 2017, a total of 6273 implant sheets were received, compared with 6429 reported by Eucomed (European Confederation of Medical Suppliers Associations). Therefore, the registry contains data on 97.6% of the devices implanted in Spain. Compliance ranged from 99.7% for the field "name of the implanting hospital" to 46.1% for the variable "New York Heart Association functional class". A total of 181 hospitals reported data to the registry, representing an increase compared with the number of participating hospitals in 2016 (177) and in previous years (169 in 2015, 162 in 2014, 154 in 2013, and 153 in 2012). CONCLUSIONS The number of implants per million inhabitants in Spain increased for several years but decreased in 2017. As in previous years, the total number of implants in Spain is still much lower than the European Union average, and the gap continues to widen. There are still substantial differences between autonomous communities.
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Andrés Lahuerta A, Osca Asensi J, Donoso Trenado VJ. Respuesta al ECG de agosto de 2018. Rev Esp Cardiol (Engl Ed) 2018. [DOI: 10.1016/j.recesp.2018.01.016] [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: 10/28/2022]
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Andrés Lahuerta A, Osca Asensi J, Donoso Trenado VJ. Response to ECG, August 2018. Rev Esp Cardiol (Engl Ed) 2018; 71:754. [PMID: 30146125 DOI: 10.1016/j.rec.2018.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Ana Andrés Lahuerta
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - Joaquín Osca Asensi
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Víctor José Donoso Trenado
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Andrés Lahuerta A, Osca Asensi J, Donoso Trenado VJ. ECG de agosto de 2018. Rev Esp Cardiol (Engl Ed) 2018. [DOI: 10.1016/j.recesp.2018.01.014] [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]
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Andrés Lahuerta A, Osca Asensi J, Donoso Trenado VJ. ECG, August 2018. Rev Esp Cardiol (Engl Ed) 2018; 71:671. [PMID: 30054055 DOI: 10.1016/j.rec.2018.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/12/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Ana Andrés Lahuerta
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - Joaquín Osca Asensi
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Víctor José Donoso Trenado
- Departamento de Cardiología, Unidad de Arritmias, Hospital Universitario y Politécnico La Fe, Valencia, Spain
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Sancho-Tello de Carranza MJ, Cano Pérez Ó, Osca Asensi J, Lorente Carreño D, Pombo Jiménez M, Fidalgo Andrés ML. Selección de lo mejor del año 2017 en estimulación cardiaca: resonancia magnética en pacientes portadores de marcapasos y desfibriladores. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.10.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sancho-Tello de Carranza MJ, Cano Pérez Ó, Osca Asensi J, Lorente Carreño D, Pombo Jiménez M, Fidalgo Andrés ML. Selection of the Best of 2017 on Cardiac Pacing: Magnetic Resonance in Patients With Pacemaker and Implantable Defibrillator. ACTA ACUST UNITED AC 2018; 71:229-231. [PMID: 29433943 DOI: 10.1016/j.rec.2017.10.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 10/24/2017] [Indexed: 10/18/2022]
Affiliation(s)
| | - Óscar Cano Pérez
- Unidad de Electrofisiología y Arritmias, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Joaquín Osca Asensi
- Unidad de Electrofisiología y Arritmias, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Marta Pombo Jiménez
- Unidad de Estimulación Cardiaca, Hospital Costa del Sol, Marbella, Málaga, Spain
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Cabrera Bueno F, Alzueta Rodríguez J, Olagüe de Ros J, Fernández-Lozano I, García Guerrero JJ, de la Concha JF, Hernández Madrid A, Tolosana Viu JM, Osca Asensi J, Barrera Cordero A, Llorente Hernangómez E. Improvement in hemodynamic response using a quadripolar LV lead. Pacing Clin Electrophysiol 2013; 36:963-9. [PMID: 23692289 DOI: 10.1111/pace.12172] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 02/21/2013] [Accepted: 03/26/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The Quartet quadripolar lead (St. Jude Medical Inc., St. Paul, MN, USA) offers 10 different left ventricle pacing configurations that may further influence hemodynamic parameters compared to traditional bipolar pacing configurations. The purpose of this study was to evaluate whether pacing from additional quadripolar lead vectors could enhance cardiac output (CO). METHODS For each patient, CO was measured in "no-pacing" and in all the 10 configurations available, within 7 days of implantation of the device. Tip-ring, tip-right ventricular coil (RVC), and ring-RVC vectors were considered as traditional vectors. The seven additional configurations available in the quadripolar lead were considered as nontraditional vectors. CO was measured by ECHO. The best configuration was defined as the one presenting the highest CO measurement within configurations, which have a capture threshold <3 V and a safety margin between the capture and the phrenic nerve stimulation thresholds. RESULTS Fifty-one standard cardiac resynchronization therapy patients were enrolled. The mean of each patient's best CO obtained with traditional vectors was higher than the baseline nonpaced CO (4.16 L/min vs 3.64 L/min). The mean of each patient's best CO, including all 10 available configurations, was also higher than the baseline nonpaced CO (4.33 L/min vs 3.64 L/min). In addition, the mean of each patient's best CO obtained with the best configuration available through a quadripolar lead was better than the mean of each patient's best CO obtained with a traditional configuration. In 53% of patients, the best CO was obtained with a nontraditional vector unique to the quadripolar lead. CONCLUSIONS A quadripolar lead offers multiple additional pacing options to increase CO acutely compared to conventional bipolar leads.
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Brignole M, Menozzi C, Botto GL, Mont L, Osca Asensi J, García Medina D, Oddone D, Navazio A, Luzi M, Iacopino S, De Fabrizio G, Proclemer A, Vardas P. Usefulness of echo-guided cardiac resynchronization pacing in patients undergoing "ablate and pace" therapy for permanent atrial fibrillation and effects of heart rate regularization and left ventricular resynchronization. Am J Cardiol 2008; 102:854-60. [PMID: 18805110 DOI: 10.1016/j.amjcard.2008.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 04/07/2008] [Revised: 05/14/2008] [Accepted: 05/14/2008] [Indexed: 11/30/2022]
Abstract
An acute comparative study of right ventricular (RV) pacing and echocardiographically guided cardiac resynchronization pacing (CRP) was performed in patients who underwent "ablate and pace" therapy for permanent atrial fibrillation. It was hypothesized that optimized CRP guided by tissue Doppler echocardiography would exert an additive beneficial hemodynamic effect to that of rate regularization achieved through atrioventricular junction ablation. An acute intrapatient comparison of echocardiographic parameters was performed between baseline preablation values and RV pacing and CRP (performed <24 hours after ablation) in 50 patients. Optimized CRP configuration was defined as the modality of pacing corresponding to that of the shortest intra-left ventricular (LV) delay among simultaneous biventricular pacing, sequential biventricular pacing, and single-chamber pacing. The intra-LV delay was defined as the difference between the longest and the shortest activation time in the six basal segments of the left ventricle. Compared with preablation measures, the ejection fraction increased by 10.8% during RV pacing (19% in patients with intra-LV delays <47.5 ms and 3% in those with intra-LV delays >47.5 ms). Compared with RV pacing, CRP caused a 9.2% increase in the ejection fraction, a 6.8% decrease in LV systolic diameter, and a 17.3% decrease in mitral regurgitation area; LV dyssynchrony was reduced from 52 +/- 27 to 21 +/- 12 ms. Similar results were observed in patients with and without depressed systolic function and in patients with and without left bundle branch block. In conclusion, rate regularization achieved through atrioventricular junction ablation and RV pacing provides a favorable hemodynamic effect that is inversely related to the level of LV dyssynchrony. Minimizing LV dyssynchrony by means of optimized CRP yields an additional important benefit.
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Affiliation(s)
- Michele Brignole
- Department of Cardiology, Ospedali del Tigullio, Lavagna, Italy.
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Arnau Vives MA, Rueda Soriano J, Martínez Dolz LV, Osa Sáez A, Almenar Bonet L, Morillas Blasco P, Osca Asensi J, Quesada Carmona A, Sanjuán Máñez R, Palencia Pérez MA. [Prognostic value of fibrinogen in patients admitted with suspected unstable angina and non-q-wave myocardial infarction]. Rev Esp Cardiol 2002; 55:622-30. [PMID: 12113721 DOI: 10.1016/s0300-8932(02)76670-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION AND OBJECTIVE In recent years, the relation between biological markers of inflammation and prognosis in patients suffering from acute coronary syndromes has been investigated. The aim of this study was to evaluate the association between baseline fibrinogen concentrations and the development of clinical events in patients admitted with suspicion of unstable angina and non-Q-wave myocardial infarction. MATERIAL AND METHOD Levels of fibrinogen at enrollment were analyzed in 325 consecutive patients with acute coronary syndromes. Fibrinogen values were divided into tertiles and the incidence of clinical events was evaluated at each level. The combination of death and/or myocardial infarction was the main endpoint. RESULTS Fibrinogen levels were significantly higher in patients who subsequently had myocardial infarction, cardiac death, or both during follow up. The probabilities of death and/or myocardial infarction were 6%, 13%, and 29% (p < 0.0001), respectively, in patients grouped by fibrinogen tertiles (304, 305-374 and 375 mg/dl). Multivariate predictors of combined events were age, previous angina, ST-segment depression in the admission ECG, and fibrinogen into tertiles. The adjusted hazard ratio (95% CI) for patients in the upper tertile was 4.8 (1.6-14; p = 0.004). CONCLUSIONS High fibrinogen levels were related to a less favorable long-term or short-term outcome in patients admitted for suspicion of unstable angina and non-Q-wave myocardial infarction. This association persists after adjustment for other classical risk factors such as age, prior angina, and ST-segment depression in the ECG.
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