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Russo S, Lorusso L, D’Onofrio G, Ciccone F, Tritto M, Nocco S, Cardone D, Perpetuini D, Lombardo M, Lombardo D, Sancarlo D, Greco A, Merla A, Giuliani F. Assessing Feasibility of Cognitive Impairment Testing Using Social Robotic Technology Augmented with Affective Computing and Emotional State Detection Systems. Biomimetics (Basel) 2023; 8:475. [PMID: 37887606 PMCID: PMC10604561 DOI: 10.3390/biomimetics8060475] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Social robots represent a valid opportunity to manage the diagnosis, treatment, care, and support of older people with dementia. The aim of this study is to validate the Mini-Mental State Examination (MMSE) test administered by the Pepper robot equipped with systems to detect psychophysical and emotional states in older patients. Our main result is that the Pepper robot is capable of administering the MMSE and that cognitive status is not a determinant in the effective use of a social robot. People with mild cognitive impairment appreciate the robot, as it interacts with them. Acceptability does not relate strictly to the user experience, but the willingness to interact with the robot is an important variable for engagement. We demonstrate the feasibility of a novel approach that, in the future, could lead to more natural human-machine interaction when delivering cognitive tests with the aid of a social robot and a Computational Psychophysiology Module (CPM).
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Affiliation(s)
- Sergio Russo
- Research & Innovation Unit, Foundation IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Letizia Lorusso
- Research & Innovation Unit, Foundation IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
- Interdisciplinary Department of Medicine, School of Medical Statistics and Biometry, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Grazia D’Onofrio
- Clinical Psychology Service, Health Department, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.D.); (F.C.)
| | - Filomena Ciccone
- Clinical Psychology Service, Health Department, IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (G.D.); (F.C.)
| | - Michele Tritto
- Next2U Srl, Via dei Peligni 137, 65127 Pescara, Italy; (M.T.); (S.N.)
| | - Sergio Nocco
- Next2U Srl, Via dei Peligni 137, 65127 Pescara, Italy; (M.T.); (S.N.)
| | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.C.); (D.P.); (A.M.)
| | - David Perpetuini
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.C.); (D.P.); (A.M.)
| | - Marco Lombardo
- Behaviour Labs S.r.l.s. Piazza Gen. di Brigata Luigi Sapienza 22, 95030 Sant’Agata Li Battiati, Italy (D.L.)
| | - Daniele Lombardo
- Behaviour Labs S.r.l.s. Piazza Gen. di Brigata Luigi Sapienza 22, 95030 Sant’Agata Li Battiati, Italy (D.L.)
| | - Daniele Sancarlo
- Geriatrics Unit, Foundation IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (D.S.); (A.G.)
| | - Antonio Greco
- Geriatrics Unit, Foundation IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy; (D.S.); (A.G.)
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy; (D.C.); (D.P.); (A.M.)
| | - Francesco Giuliani
- Research & Innovation Unit, Foundation IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
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Perpetuini D, Russo EF, Cardone D, Palmieri R, Filippini C, Tritto M, Pellicano F, De Santis GP, Pellegrino R, Calabrò RS, Filoni S, Merla A. Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging. Int J Environ Res Public Health 2022; 19:15224. [PMID: 36429941 PMCID: PMC9690262 DOI: 10.3390/ijerph192215224] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children's gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
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Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Child Neuropsychiatry, University of Bari, 70121 Bari, Italy
| | - Chiara Filippini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Grazia Pia De Santis
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- ITAB, Institute for Advanced Biomedical Technologies, 66100 Chieti, Italy
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Cardone D, Perpetuini D, Filippini C, Mancini L, Nocco S, Tritto M, Rinella S, Giacobbe A, Fallica G, Ricci F, Gallina S, Merla A. Classification of Drivers' Mental Workload Levels: Comparison of Machine Learning Methods Based on ECG and Infrared Thermal Signals. Sensors (Basel) 2022; 22:7300. [PMID: 36236399 PMCID: PMC9572767 DOI: 10.3390/s22197300] [Citation(s) in RCA: 9] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Mental workload (MW) represents the amount of brain resources required to perform concurrent tasks. The evaluation of MW is of paramount importance for Advanced Driver-Assistance Systems, given its correlation with traffic accidents risk. In the present research, two cognitive tests (Digit Span Test-DST and Ray Auditory Verbal Learning Test-RAVLT) were administered to participants while driving in a simulated environment. The tests were chosen to investigate the drivers' response to predefined levels of cognitive load to categorize the classes of MW. Infrared (IR) thermal imaging concurrently with heart rate variability (HRV) were used to obtain features related to the psychophysiology of the subjects, in order to feed machine learning (ML) classifiers. Six categories of models have been compared basing on unimodal IR/unimodal HRV/multimodal IR + HRV features. The best classifier performances were reached by the multimodal IR + HRV features-based classifiers (DST: accuracy = 73.1%, sensitivity = 0.71, specificity = 0.69; RAVLT: accuracy = 75.0%, average sensitivity = 0.75, average specificity = 0.87). The unimodal IR features based classifiers revealed high performances as well (DST: accuracy = 73.1%, sensitivity = 0.73, specificity = 0.73; RAVLT: accuracy = 71.1%, average sensitivity = 0.71, average specificity = 0.85). These results demonstrated the possibility to assess drivers' MW levels with high accuracy, also using a completely non-contact and non-invasive technique alone, representing a key advancement with respect to the state of the art in traffic accident prevention.
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Affiliation(s)
- Daniela Cardone
- Department of Engineering and Geology, University G. d’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - David Perpetuini
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Chiara Filippini
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | | | | | - Sergio Rinella
- Physiology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Alberto Giacobbe
- Physiology Section, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Giorgio Fallica
- National Interuniversity Consortium of Science and Technology of Materials (INSTM), University of Messina, 98122 Messina, Italy
| | - Fabrizio Ricci
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Sabina Gallina
- Department of Neurosciences, Imaging and Clinical Sciences, University G. d’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. d’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- Next2U s.r.l., 65127 Pescara, Italy
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Frigerio L, Sanzo A, Cornara S, Chieffo E, La Greca C, Sirico G, Scopinaro A, Solimene F, Fedele L, Augello G, Marrazzo N, Turreni F, Tritto M, Rordorf R. P1020Persistent AF patients with limited areas of low voltage have a similar benefit from pulmonary vein isolation as compared to paroxysmal AF patients: insight from the SMOP study. Europace 2020. [DOI: 10.1093/europace/euaa162.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pulmonary vein isolation (PVI) performed with radio-frequency catheter ablation (CA) is an effective therapy for atrial fibrillation (AF). However previous data have suggested that PVI is less effective in persistent (PER) vs. paroxysmal (PAR) AF. Atrial fibrosis and scar, indeed, are an important substrate involved in persistent AF, and some author correlate them to an increased rate of recurrences after CA. For this reason several adjunctive ablation strategies have been suggested for invasive treatment in PER AF pts. However, there is a lack of evidence on their effectivness in current literature.
Objective
the aim of our study was to assess the rate of AF recurrences in PAR and PER AF patients after a first pulmonary vein isolation (IVP) procedure, and their relationship with low voltage areas of the left atrium assessed by means of high density mapping performed before CA.
Methods
we analyzed 214 patients of the SMOP-AF study (Substrate Mapping as Outcome Predictor in Atrial Fibrillation Ablation), a prospective multi-centric registry enrolling patients with both PAR and PER AF undergoing a first radio-frequency CA procedure aimed to obtain permanent PVI . High-density mapping was performed in sinus rhythm using the CARTO system before PVI. Areas with less than 0,5 mV on mapping were defined as low voltage zone (LVZ); LVZ was indexed on the atrial area. Comparisons were made by cross-tables and Chi-square test or Student T test.
Results
Patients with PER AF (n = 44, 21%) were older (63 ± 9 vs 58 ± 10 yrs, p = 0.01), but notably with no difference in LVEF and atrial dimensions as compared to pts with PAR AF. In addition no statistical difference was observed in procedural variables, except for a greater LVZ area on atrial mapping (8 ± 18 % vs. 5 ± 15 %, p = 0.04) and a longer p wave duration (115 ± 21 msec vs. 103 ± 18 msec, p = 0.01) in pts with PER AF. The incidence of recurrence in the overall population was 15.3% at 3 months and 13.7% from 3 to 12 months: there was no statistical difference in success-rate between PER and PAR pts (respectively 79,5% vs 86% p value = 0.315 in blanking period and 85,3% vs 86,5% p value = 0.8 at 3-12 months follow-up). No statistical difference was observed for ablation variables (number of lesion, contact force, force time integral) in pts with vs. without recurrences.
Conclusion
Our study showed that pulmonary vein isolation alone seems to be as effective in paroxismal and persistent AF patients with low degree of left atrial fibrosis. Our data call into question the idea that PVI alone is not effective in PER AF. High density mapping of the LA could help to identify a subset of PER AF patients with a limited extension of low voltage areas (i.e around 10% of the overall LA surface) that could benefit from PVI without adjunctive ablation strategies. Our data needs to be confirmed in a longer follow-up.
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Affiliation(s)
- L Frigerio
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - S Cornara
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - E Chieffo
- Maggiore Hospital of Crema, Cardiology, Crema, Italy
| | - C La Greca
- Poliambulanza Foundation Hospital Institute of Brescia, Cardiology, Brescia, Italy
| | - G Sirico
- S. Ambrogio Clinic, Cardiology, Milan, Italy
| | - A Scopinaro
- Ospedale SS. Antonio E Biagio E Cesare Arrigo, Cardiology, Alessandria, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Cardiology, Mercogliano, Italy
| | - L Fedele
- Civil Hospital of Legnano, Cardiology, Legnano, Italy
| | - G Augello
- Città Studi Clinic, Cardiology, Milan, Italy
| | - N Marrazzo
- Fatebenefratelli Hospital of Benevento, Cardiology, Benevento, Italy
| | - F Turreni
- S.Pertini Hospital, Cardiology, Roma, Italy
| | - M Tritto
- Mater Domini Clinic, Cardiology, Castellanza, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
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Landi F, Barillaro C, Bellieni A, Brandi V, Carfì A, D'Angelo M, Fusco D, Landi G, Lo Monaco R, Martone AM, Marzetti E, Pagano F, Pais C, Russo A, Salini S, Tosato M, Tummolo A, Benvenuto F, Bramato G, Catalano L, Ciciarello F, Martis I, Rocchi S, Rota E, Salerno A, Tritto M, Sgadari A, Zuccalà G, Bernabei R. The New Challenge of Geriatrics: Saving Frail Older People from the SARS-COV-2 Pandemic Infection. J Nutr Health Aging 2020; 24:466-470. [PMID: 32346682 PMCID: PMC7118362 DOI: 10.1007/s12603-020-1356-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/15/2022]
Affiliation(s)
- F Landi
- Francesco Landi, MD, PhD, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy, Phone: +39 (06) 5190028, e-mail:
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6
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Rordorf R, Cornara S, Frigerio L, Sanzo A, Chieffo E, La Greca C, Sirico G, Scopinaro A, Solimene F, Fedele L, Augello G, Marrazzo N, Turreni F, Tritto M. P1896Single-procedure success-rate of pulmonary vein isolation using point-by-point tagging lesions algorithm based on contact force technology: preliminary results of the multicentric SMOP study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Pulmonary veins isolation (PVI)is an effective therapy for atrial fibrillation (AF), recommended by current guidelines. However, recurrences after first radio-frequency (RF) catheter ablation (CA) are still high. PV reconnection could be due to ineffective transmural lesions; automated ablation lesion tags (the VisiTag algorithm) based on predefined parameters of catheter stability and contact force (CF) have been developed to allow the detection of ineffective ablation lesion, nevertheless there is a lack of multicenter studies exploring this technology.
Objective
the aim of our study was to assess the rate of recurrence after a first PVI procedure in a large, multicentric Italian population and to explore the efficacy of Visitag algorithm (CARTO 3) used to guide RF ablation of AF.
Methods
we analyzed 214 patients of the SMOP-AF study (Substrate Mapping as Outcome Predictor in Atrial Fibrillation Ablation), a prospective multi-centric study enrolling patients with paroxysmal and persistent AF undergoing a first PVI procedure after an high-density mapping during sinus rhythm. During the procedure, ablation was guided by an automated annotation system in which tag based on predefined parameters were displayed real-time in each lesion site on the electroanatomical map. Visitag settings for the catheter position stability were a 2,5 mm distance limit for at least 7 sec and a minimum CF of 5 g over 30% of the ablation and a FTI>400 g*s. Where available (n=106, 49.5%), Ablation Index (AI), which also incorporates information on delivered RF power, was used instead of FTI to guide RF ablation with a threshold range of 400–550 for anterior/roof and 330–420 for posterior/inferior segments. Minimum and mean contact force, time and power values for each RF-lesion were recorded while both FTI and AI values were calculated automatically by the CARTO system. Comparison between groups were made by cross-tables, Mann-Whitney or Student T test as appropriated.
Results
the mean age of the enrolled population was 59±9 years, left ventricular ejection fraction was 59±9%. AF was paroxysmal in 89.7%, persistent in 10.3% of the patients and refractory to at least one anti-arrhythmic drug in 86.4% of the population. At 3 months follow-up 85% of the patients were free from AF recurrences and the success rate increased to 90.8% at 3–6 months, and 86.3% at 3–12 months follow-up. The mean ablation time was shorter in AI-guided vs. FTI-guided procedures (31±9 vs 46±29 min; p<0.001). There was a trend toward a reduction in AF recurrences when AI vs. FTI was used, both at 6 and 12 months (respectively 5,4% vs 13.6%; p 0.06 and 9.6% vs 18.5%; p 0.08).
Conclusion
PVI isolation using dedicated algorithms developed to guide the effectiveness of RFCA leads to a very high success-rate after a single procedure. The use of AI, which integrates contact force information with delivered power, reduces the procedural time and increases the overall success-rate
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Affiliation(s)
- R Rordorf
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - L Frigerio
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Sanzo
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - E Chieffo
- Maggiore Hospital of Crema, Cardiology, Crema, Italy
| | - C La Greca
- Poliambulanza Foundation Hospital Institute of Brescia, Cardiology, Brescia, Italy
| | - G Sirico
- Sant'Ambrogio Clinical Institute, Cardiology, Milan, Italy
| | - A Scopinaro
- Ospedale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Cardiology, Mercogliano, Italy
| | - L Fedele
- Civil Hospital of Legnano, Cardiology, Legnano, Italy
| | - G Augello
- Istituto Clinico Città Studi, Cardiology, Milan, Italy
| | - N Marrazzo
- Fatebenefratelli Hospital of Benevento, Cardiology, Benevento, Italy
| | - F Turreni
- Ospedale S. Pertini, Cardiology, Rome, Italy
| | - M Tritto
- Clinical Institute Humanitas of Castellanza, Cardiology, Castellanza, Italy
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Rordorf R, Cornara S, Frigerio L, Sanzo A, Chieffo E, La Greca C, Sirico G, Scopinaro A, Solimene F, Fedele L, Augello G, Marrazzo N, Turreni F, Tritto M. P1037Relationship between left atrium low voltage areas and atrial fibrillation radiofrequency ablation success-rate: preliminary results of the SMOP study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
radio frequency catheter ablation (CA) is an effective therapy for atrial fibrillation (AF). Some authors have described a potential relationship between the presence of areas of fibrosis in the left atrium (LA) and the success of CA, nevertheless there is a lack of multicenter studies in this field.
Objective
the aim of our study was to assess the relationship between the of presence of low voltage areas of the LA detected during subtrate mapping at the time of the procedure and recurrences of AF after CA.
Methods
we analyzed 214 patients of the SMOP-AF (Substrate Mapping as Outcome Predictor in Atrial Fibrillation Ablation), a prospective multi-centric study enrolling patients with both paroxysmal and persistent AF undergoing a first radio-frequency CA procedure. High-density mapping was performed in sinus rhythm using the CARTO system before performing pulmonary vein isolation. Areas with less than 0,5 mV on mapping were defined as low voltage zone (LVZ), while between 0,5 mV and 1,5 mV intermediate voltage zone (IVZ). IVZ and LVZ were expressed as a percentage of the LA surface. Comparisons were made by Pearson correlation, cross-tables and Chi-square test or Student T test.
Results
the mean age of the enrolled population was 59±9 years, left ventricular ejection fraction was 59±9%, 86.4% of the pts had tested at least one anti-arrhythmic drug. Persistent atrial fibrillation was present in 10.3% of patients. The rate of documented AF recurrence at 3 months was 15,3% (n=29). There was a statistical significant correlation between the presence of IVZ and the rate of recurrences at 3 months (r=0.16, p value 0.03). Patients with IVZ greater than 4% of the left atrium surface showed a higher risk of recurrences (19.5% vs. 8,7%, p value 0.04). No statistical difference was observed in other procedural variables (number of lesions, contact force, force-time integral) among patients with or without recurrences.
Conclusion
Our study showed a relationship between CA short-term success rate and the presence of areas of intermediate voltage zone detected with high-density substrate mapping at the time of the procedure. The presence of areas of intermediate voltage zone greater than 4% of the LA determines a 2.5 folds increased risk of short-term recurrence. Our data needs to be confirmed in a longer follow-up.
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Affiliation(s)
- R Rordorf
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - L Frigerio
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Sanzo
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - E Chieffo
- Maggiore Hospital of Crema, Cardiology, Crema, Italy
| | - C La Greca
- Poliambulanza Foundation Hospital Institute of Brescia, Cardiology, Brescia, Italy
| | - G Sirico
- Sant'Ambrogio Clinical Institute, Cardiology, Milan, Italy
| | - A Scopinaro
- Ospedale SS. Antonio e Biagio e Cesare Arrigo, Cardiology, Alessandria, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Cardiology, Mercogliano, Italy
| | - L Fedele
- Civil Hospital of Legnano, Cardiology, Legnano, Italy
| | - G Augello
- Istituto Clinico Città Studi, Cardiology, Milan, Italy
| | - N Marrazzo
- Fatebenefratelli Hospital of Benevento, Cardiology, Benevento, Italy
| | - F Turreni
- Ospedale S. Pertini, Cardiology, Rome, Italy
| | - M Tritto
- Clinical Institute Humanitas of Castellanza, Cardiology, Castellanza, Italy
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Arbelo E, Brugada J, Hindricks G, Maggioni AP, Tavazzi L, Vardas P, Laroche C, Anselme F, Inama G, Jais P, Kalarus Z, Kautzner J, Lewalter T, Mairesse GH, Perez-Villacastin J, Riahi S, Taborsky M, Theodorakis G, Trines SA, Brugada J, Arbelo E, Hindriks G, Maggioni AP, Morgan J, Tavazzi L, Vardas P, Alonso A, Ferrari R, Komajda M, Tavazzi L, Wood D, Vardas P, Brugada J, Mairesse G, Taborsky M, Kautzner J, Lewalter T, Riahi S, Jais P, Anselme F, Theodorakis G, Inama G, Trines S, Kalarus Z, Villacastin JP, Maggioni AP, Manini M, Gracia G, Laroche C, Missiamenou V, Taylor C, Konte M, Fiorucci E, Lefrancq EF, Glémot M, McNeill PA, Bois T, Heidbüchel H, Nuyens D, Boland J, Dinraths V, Herzet JM, Hoffer E, Malmendier D, Massoz M, Pourbaix S, Ballant E, Blommaert D, Deceuninck O, Dormal F, Xhaet O, De Potter T, Geelen P, Derycker K, Duytschaever M, Tavernier R, Vandekerckhove Y, Vankats D, Bulava A, Hanis J, Sitek D, Blahova M, Cihak R, Hanyasova L, Jansova H, Peichl P, Tanzerova M, Wichterle D, Duda J, Haman L, Parizek P, Coling L, Neuzil P, Petru J, Sediva L, Skoda J, Chovancik J, Fiala M, Neuwirth R, Karlsdottir A, Pehrson S, Gerdes C, Jensen H, Lukac P, Nielsen JC, Hansen J, Johannessen A, Hansen PS, Pedersen A, Heath F, Hjortshoj S, Thogersen A, Da Costa A, Martel I, Romeyer-Bouchard C, Sadki N, Schmid A, Haissaguerre M, Hocini M, Knecht S, Sacher F, Ait Said M, Cauchemez B, Ledoux F, Thomas O, Cebron JP, Decarsin N, Gras D, Hervouet S, Durand C, Durand-Dubief A, Poty H, Babuty D, Pierre B, Albenque JP, Boveda S, Combes N, Mas R, Hermida JS, Kubala M, Godin B, Savouré A, Soublin Y, Defaye P, Jacon P, Brigadeau F, Corbut S, Flament-Balzola F, Kacet S, Klug D, Lacroix D, Copie X, Gilles L, Hocine Z, Paziaud O, Piot O, Crocq C, Kaballu G, Le Moal V, Lotton P, Mabo P, Pavin D, Andronache M, De Chillou C, Magnin-Poull I, Deharo JC, Durand C, Franceschi F, Peyrouse E, Prevot S, Etchegoin M, Extramiana F, Leenhardt A, Messali A, Heine T, Schneider A, Winter N, Brachmann J, Ritscher G, Schertel-Gruenler B, Simon H, Sinha AM, Turschner O, Wystrach A, Stemberg M, Kuck KH, Metzner A, Tilz R, Wissner E, Heitmann K, Willems S, Andresen D, Mueller S, Volkmer M, Schmidt B, Kostopoulou A, Livanis E, Voudris V, Efremidis M, Letsas K, Tsikrikas S, Christoforatou E, Ioannidis P, Katsivas A, Kourouklis S, Andrikopoulos G, Rassias I, Tzeis S, Dakos G, Paraskevaidis S, Stavropoulos G, Theofilogiannakos E, Vassilikos V, Bongiorni M, Zucchelli G, Raviele A, Themistoclakis S, Pratola C, Tritto M, Della Bella P, Mazzone P, Moltrasio M, Tondo C, Calo L, De Luca L, Guarracini F, Lioy E, Dozza L, Frigoli E, Giannelli L, Pappone C, Saviano M, Schiavina G, Vicedomini G, De Ponti R, Doni LA, Marazzi R, Salerno-Uriarte J, Tamborini C, Anselmino M, Ferraris F, Gaita F, Bertaglia E, Brandolino G, Zoppo F, De Groot N, Janse P, Jordaens L, Pison L, Roos C, Van Gelder I, Manusama R, Meijer A, Van der Voort P, Trines S, Compier MG, Kazmierczak J, Kornacewicz-Jach Z, Wielusinski M, Baran J, Kulakowski P, Dzidowski M, Fuglewicz A, Nowak K, Pruszkowska-Skrzep P, Wozniak A, Nowak S, Trusz-Gluza M, Almendral J, Atienza F, Castellanos E, De Diego C, Ortiz M, Moreno Planas J, Perez Castellano N, Benezet J, Farre Muncharaz J, Rubio Campal J, Hernandez Madrid A, Matia R, Arana E, Pedrote A, Cozar R, Peinado R, Valverde I, Arbelo E, Berruezo A, Calvo N, Guiu E, Husseini S, Mont Girbau L. The Atrial Fibrillation Ablation Pilot Study: an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association. Eur Heart J 2014; 35:1466-78. [DOI: 10.1093/eurheartj/ehu001] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [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: 11/14/2022] Open
Affiliation(s)
- Elena Arbelo
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | - Josep Brugada
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | | | - Aldo P. Maggioni
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Cotignola, Italy
| | - Panos Vardas
- Department of Cardiology, Heraklion University Hospital, Crete, Greece
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Frédéric Anselme
- Service De Cardiologie, Hôpital Charles Nicolle, Rouen Cedex, France
| | | | - Pierre Jais
- Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France
| | - Zbigniew Kalarus
- Department of Cardiology, Silesian Academy of Medicine, Zabrze, Poland
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | | | | | - Sam Riahi
- AF Study Group, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Milos Taborsky
- Internal Cardiology Department, Faculty Hospital Olomouc, Olomouc, Czech Republic
| | | | - Serge A. Trines
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
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Bertaglia E, Stabile G, Pappone A, Themistoclakis S, Tondo C, De Sanctis V, Soldati E, Tritto M, Solimene F, Pappone C. Very low incidence of permanent complications: report of a national multicenter registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3536] [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: 11/12/2022] Open
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Bottoni N, Tritto M, Ricci R, Accogli M, Di Biase M, Iacopino S, Iori M, Themistoclakis S, Sitta N, Spadacini G, De Ponti R, Brignole M. Adherence to guidelines for atrial fibrillation management of patients referred to cardiology departments: Studio Italiano multicentrico sul Trattamento della Fibrillazione Atriale (SITAF). Europace 2010; 12:1070-7. [DOI: 10.1093/europace/euq158] [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: 11/12/2022] Open
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11
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Pedretti RFE, Curnis A, Massa R, Morandi F, Tritto M, Manca L, Occhetta E, Molon G, De Ferrari GM, Sarzi Braga S, Raciti G, Klersy C, Salerno-Uriarte JA. Proportion of patients needing an implantable cardioverter defibrillator on the basis of current guidelines: impact on healthcare resources in Italy and the USA. Data from the ALPHA study registry. Europace 2010; 12:1105-11. [DOI: 10.1093/europace/euq106] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Mujovic N, Grujic M, Mrdja S, Kocijancic A, Potpara T, Mujovic NM, Polovina M, Mccann CJ, Gal B, Goethals P, Peytchev P, Geelen P, Gebauer R, Kubus P, Janousek J, De Groot NMS, Lukac P, Blom NA, Van Kuijk JP, Pedersen AK, Hansen PS, Delacretaz E, Schalij MJ, Lyne JC, Kaba R, Babu-Narayan S, Kilner P, Keegan J, Gatzoulis M, Ernst S, Di Biase L, Spadacini G, Moretti P, Tritto M. Abstracts: Ablation therapy of supraventricular arrhythmias. Europace 2009. [DOI: 10.1093/europace/euq247] [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: 11/12/2022] Open
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Styczkiewicz K, Spadacini G, Tritto M, Facchini M, Perego GB, Bilo G, Castiglioni P, Di Rienzo M, Kawecka-Jaszcz K, Salerno-Uriarte JA, Mancia G, Parati G. Spontaneous Baroreflex Sensitivity is Reduced in Patients with Recurrent Symptomatic Atrial Fibrillation. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00084] [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: 11/02/2022] Open
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14
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Styczkiewicz K, Spadacini G, Tritto M, Moretti P, Perego G, Facchini M, Bilo G, Castiglioni P, Di Rienzo M, Kawecka-Jaszcz K, Salerno-Uriate JA, Parati G. Pulmonary Vein Isolation for Atrial Fibrillation and Baroreflex-Mediated Heart Control. High Blood Press Cardiovasc Prev 2007. [DOI: 10.2165/00151642-200714030-00086] [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: 11/02/2022] Open
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15
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Moretti P, Tritto M, Spadacini G, De Ponti R, Marazzi R, Rogiani S, Forzani T, Salerno J. 366 Radiofrequency catheter ablation of atypical atrial flutters unrelated to prior cardiac surgery: characteristics of intracardiac electrograms recorded at the critical isthmus of the reentry circuit. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.76-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- P. Moretti
- Institute Casa di Cura Mater Domini, Cardiology Dept., Castellanza, Italy
| | - M. Tritto
- University of Insubria-Varese, Cardiology Department “Mater Domini”, Castellanza, Italy
| | - G. Spadacini
- University of Insubria-Varese, Cardiology Department “Mater Domini”, Castellanza, Italy
| | - R. De Ponti
- University of Insubria, Cardiology Department “Osp.di Circolo”, Varese, Italy
| | - R. Marazzi
- University of Insubria, Cardiology Department “Osp.di Circolo”, Varese, Italy
| | - S. Rogiani
- University of Insubria, Cardiology Department “Osp.di Circolo”, Varese, Italy
| | - T. Forzani
- University of Insubria-Varese, Cardiology Department “Mater Domini”, Castellanza, Italy
| | - J.A. Salerno
- University of Insubria, Cardiology Department “Osp.di Circolo”, Varese, Italy
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Styczkiewicz K, Spadacini G, Tritto M, Perego G, Facchini M, Maronati A, Salerno-Uriarte J, Parati G. 785 Cardiac autonomic regulation after ablation of pulmonary veins in patients with atrial fibrillation. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.179-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- K. Styczkiewicz
- Jagiellonian Univ.,Ist. Aux. Italiano, I Dept Cardiology, Milan, Italy
| | - G. Spadacini
- Univ.of Insubria, Clin.Ist.Mater Domini, Cardiol Dept, Castellanza, Italy
| | - M. Tritto
- Univ.of Insubria, Clin.Ist.Mater Domini, Cardiol Dept, Castellanza, Italy
| | - G.B. Perego
- Istituto Auxologico Italiano, S.Luca Hospital, Milan, Italy
| | - M. Facchini
- Istituto Auxologico Italiano, S.Luca Hospital, Milan, Italy
| | - A. Maronati
- Univ.of Milano-Bicocca, Ist.Aux.Ital., Cardiology II, S.Luca Hospital, Milan, Italy
| | - J.A. Salerno-Uriarte
- Circolo Hospital and Macchi Foundation, Dept of Cardiovascular Sciences, Varese, Italy
| | - G. Parati
- S. Luca Hospital, Istituto Auxologico Italiano, Milano, Italy
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Marazzi R, Tritto M, De Ponti R, Spadacini G, Moretti P, Caravati F, Dajelli Ermolli N, Salerno-Uriarte J. 36 Paroxysmal atrial fibrillation: long-term results of different ablation strategies according to different arrhythmic patterns. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.3-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - M. Tritto
- “Mater Domini” — Insubria University, Cardiology, Castellanza (VA), Italy
| | - R. De Ponti
- Circolo Hospital & Macchi Foundation, Cardiovasc. Sci.- Insubria University, Varese, Italy
| | - G. Spadacini
- “Mater Domini” — Insubria University, Cardiology, Castellanza (VA), Italy
| | - P. Moretti
- “Mater Domini” — Insubria University, Cardiology, Castellanza (VA), Italy
| | - F. Caravati
- Circolo Hospital & Macchi Foundation, Cardiovasc. Sci.- Insubria University, Varese, Italy
| | - N.C. Dajelli Ermolli
- Circolo Hospital & Macchi Foundation, Cardiovasc. Sci.- Insubria University, Varese, Italy
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Tritto M, Spadacini G, Moretti P, De Ponti R, Marazzi R, Lanzotti M, Podimani N, Derejko P, Salerno-Uriarte J. A17-6 Spontaneous onset of atrial fibrillation from the pulmonary vein musculature: High-resolution activation mapping with a basket catheter. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b26-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
| | | | | | - R. De Ponti
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - R. Marazzi
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - M. Lanzotti
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - N. Podimani
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - P. Derejko
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
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de Ponti R, Marazzi R, Lanzotti M, Tritto M, Spadacini G, Moretti P, Salerno-Uriarte J. P-181 Electroanatomic mapping in re-entrant tachycardias: Setting the window of interest to identify the critical area. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b109-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- R. de Ponti
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo
,
Varese, Italy
| | - R. Marazzi
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo
,
Varese, Italy
| | - M.E. Lanzotti
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo
,
Varese, Italy
| | - M. Tritto
- Dept. Cardiology Mater Domini
,
Castellanza, Italy
| | - G. Spadacini
- Dept. Cardiology Mater Domini
,
Castellanza, Italy
| | - P. Moretti
- Dept. Cardiology Mater Domini
,
Castellanza, Italy
| | - J.A. Salerno-Uriarte
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo
,
Varese, Italy
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De Ponti R, Marazzi R, Lanzotti M, Salerno-Uriarte J, Tritto M, Spadacini G, Moretti P. P-033 Double trans-septal catheterization for ablation in the left atrium: Feasible or problematic? Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b74-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- R. De Ponti
- University of Insuubria, Dept. Cardiovascular Sciences, H Di Circolo, Varese, Italy
| | - R. Marazzi
- University of Insuubria, Dept. Cardiovascular Sciences, H Di Circolo, Varese, Italy
| | - M.E. Lanzotti
- University of Insuubria, Dept. Cardiovascular Sciences, H Di Circolo, Varese, Italy
| | - J.A. Salerno-Uriarte
- University of Insuubria, Dept. Cardiovascular Sciences, H Di Circolo, Varese, Italy
| | - M. Tritto
- Dept. Cardiology Mater Domini, Castellanza, Italy
| | - G. Spadacini
- Dept. Cardiology Mater Domini, Castellanza, Italy
| | - P. Moretti
- Dept. Cardiology Mater Domini, Castellanza, Italy
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21
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Tritto M, Spadacini G, Moretti P, de Ponti R, Marazzi R, Lanzotti M, Molinari B, Derejko P, Salerno-Uriarte J. A35-2 Electrophysiologic effects of adenosine on the pulmonary vein activity and atrio-venous conduction after electrical isolation of the pulmonary veins. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- M. Tritto
- University of Insubria — Varese; Cardiology Dept. “Mater Domini”, Castellanza VA
| | - G. Spadacini
- University of Insubria — Varese; Cardiology Dept. “Mater Domini”, Castellanza VA
| | - P. Moretti
- University of Insubria — Varese; Cardiology Dept. “Mater Domini”, Castellanza VA
| | - R. de Ponti
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - R. Marazzi
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - M. Lanzotti
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - B. Molinari
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
| | - P. Derejko
- Dept. Cardiovasc. Sci., H Circolo and Fond. Macchi, Varese; Italy
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De Ponti R, Lanzotti M, Marazzi R, Salerno-Uriarte J, Tritto M, Spadacini G, Moretti P. A09-6 Cryoablation of tough septal arrhythmogenic substrates: Efficacy and safety of a step-by-step method. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b14-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- R. De Ponti
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo, Varese, Italy
| | - M.E. Lanzotti
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo, Varese, Italy
| | - R. Marazzi
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo, Varese, Italy
| | - J.A. Salerno-Uriarte
- University of Insubria, Dept. Cardiovascular Sciences, H. Di Circolo, Varese, Italy
| | - M. Tritto
- Dept. Cardiology Mater Domini, Castellanza, Italy
| | - G. Spadacini
- Dept. Cardiology Mater Domini, Castellanza, Italy
| | - P. Moretti
- Dept. Cardiology Mater Domini, Castellanza, Italy
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Lanzotti M, De Ponti R, Tritto M, Spadacini G, Marazzi R, Moretti P, Salerno-Uriarte J. 2.5 Efficacy and safety of percutaneous cryoablation of septal arrhythmogenic substrates to treat supraventricular arrhythmias. Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a3-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- M. Lanzotti
- Univ. of Insubria-Varese, Dept. of Cardiovascular Sciences “Ospedale di Circolo e Fondazione Macchi”, Varese
| | - R. De Ponti
- Univ. of Insubria-Varese, Dept. of Cardiovascular Sciences “Ospedale di Circolo e Fondazione Macchi”, Varese
| | - M. Tritto
- Dept. of Cardiology “Mater Domini”, Castellanza, Italy
| | - G. Spadacini
- Dept. of Cardiology “Mater Domini”, Castellanza, Italy
| | - R. Marazzi
- Univ. of Insubria-Varese, Dept. of Cardiovascular Sciences “Ospedale di Circolo e Fondazione Macchi”, Varese
| | - P. Moretti
- Dept. of Cardiology “Mater Domini”, Castellanza, Italy
| | - J.A. Salerno-Uriarte
- Univ. of Insubria-Varese, Dept. of Cardiovascular Sciences “Ospedale di Circolo e Fondazione Macchi”, Varese
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Marazzi R, De Ponti R, Tritto M, Spadacini G, Lanzotti M, Moretti P, Salerno-Uriarte J. 3.4 Different evidences in idiopathic paroxysmal atrial fibrillation: Results of electrophysiological evaluation in 209 cases. Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a5-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- R. Marazzi
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Varese
| | - R. De Ponti
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Varese
| | - M. Tritto
- Cardiology Dept., “Mater Domini” Institute, Castellanza, Italy
| | - G. Spadacini
- Cardiology Dept., “Mater Domini” Institute, Castellanza, Italy
| | - M. Lanzotti
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Varese
| | - P. Moretti
- Cardiology Dept., “Mater Domini” Institute, Castellanza, Italy
| | - J.A. Salerno-Uriarte
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Varese
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Marazzi R, De Ponti R, Tritto M, Spadacini G, Lanzotti M, Moretti P, Salerno Uriarte J. 2.3 Postsurgical atrial tachycardias: Report of four cases not due to macro-reentry. Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a3-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- R. Marazzi
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Italy
| | - R. De Ponti
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Italy
| | - M. Tritto
- Varese and Cardiology Dept., “Mater Domini” Institute — Castellanza, Italy
| | - G. Spadacini
- Varese and Cardiology Dept., “Mater Domini” Institute — Castellanza, Italy
| | - M. Lanzotti
- University of Insubria-Varese, Cardiovasc. Sciences Dept., Circolo H. & Macchi Found., Italy
| | - P. Moretti
- Varese and Cardiology Dept., “Mater Domini” Institute — Castellanza, Italy
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26
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De Ponti R, Tritto M, Marazzi R, Salerno-Uriarte JA. How to approach epicardial ventricular tachycardia: electroanatomical mapping and ablation by transpericardial nonsurgical approach. Europace 2003; 5:55-6. [PMID: 12504641 DOI: 10.1053/eupc.2002.0287] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- R De Ponti
- University of Insubria - Varese, Department of Cardiovascular Sciences, 'Ospedale di Circolo e Fondazione Macchi' Varese, Italy.
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Tritto M, De PR, Zardini M, Spadacini G, Salerno-Uriarte JA. Bystander cavo-tricuspid isthmus activation during post-incisional intra-atrial reentrant tachycardia. Europace 2002; 4:91-7. [PMID: 11846322 DOI: 10.1053/eupc.2001.0206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/11/2022] Open
Abstract
We describe a case of post-incisional atrial tachycardia resembling typical atrial flutter on the surface ECG. Typical atrial flutter reentry was ruled out by the results of activation and entrainment mapping. Nevertheless, overdrive pacing from the lateral edge of the cavo-tricuspid isthmus produced tachycardia entrainment with concealed fusion associated with post-pacing and stimulus-to-P wave onset intervals exactly matching the tachycardia cycle length duration and the electrogram-to-P wave onset interval, respectively. Therefore, that site was firstly severed by sequential radiofrequency pulses. However, a transformation of the tachycardia P wave morphology and endocardial activation sequence, not associated with tachycardia termination or cycle length modification occurred. After additional mapping manoeuvres, a relatively small reentrant circuit was identified in the low and mid aspect of the lateral right atrium with the critical isthmus located between the lower border of a cannulation atriotomy and the crista terminalis, close to the inferior vena cava orifice. A single radiofrequency pulse at that site terminated the tachycardia. Both the electrocardiographic pattern and the endocardial mapping data obtained in our case might be explained by a split of the reentrant wavefront into a secondary wavelet which freely propagated through the cavo-tricuspid isthmus without completing the peritricuspid loop. In conclusion, bystander cavo-tricuspid isthmus activation during atrial tachycardia may simulate a typical atrial flutter pattern on the surface ECG. Further studies should evaluate the prevalence of this propagation pattern in post-incisional atrial reentry and atypical atrial flutters, and identify its implications for ablation strategy.
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Affiliation(s)
- M Tritto
- Cardiology Department Mater Domini, Castellanza (VA), University of Insubria, Varesa-I, Italy.
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28
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Abstract
A case of iterative atrial tachycardia leading to dilated cardiomyopathy is reported. During electrophysiologic study, the tachycardia showed a markedly irregular cycle length associated with changes in atrial activation breakthrough as demonstrated by coronary sinus (CS) recordings and frequently degenerated into self-terminating atrial fibrillation. Left atrial transseptal mapping demonstrated the earliest endocardial atrial activation close to the posterolateral mitral annulus, but this was invariably later than that recorded within the CS, where low-energy radiofrequency applications eliminated the tachycardia. No acute vessel damage was observed at postablation CS angiography. In accordance with previously published experimental data, we hypothesized that the muscular sleeves surrounding the CS might be involved in the genesis of this tachycardia. During 6-month follow-up, the patient remained asymptomatic without tachycardia recurrences and with complete recovery of left ventricular function, confirming the reversible nature of the tachycardia-induced cardiomyopathy.
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Affiliation(s)
- M Tritto
- Cardiology Department Mater Domini, Castellanza, Varese, Italy.
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Tritto M, De Ponti R, Zardini M, Spadacini G, Oliveira M, Salerno-Uriarte JA. Electrical connections between pulmonary veins in humans: evidence after radiofrequency ablation of the venoatrial junction. Circulation 2001; 104:E30-1. [PMID: 11502715 DOI: 10.1161/hc3201.094105] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Tritto
- Cardiology Department "Mater Domini," University of Insubria, Varese, Italy.
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30
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Salerno-Uriarte JA, Tritto M. [Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay]. Ital Heart J Suppl 2001; 2:912-4. [PMID: 11582726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- J A Salerno-Uriarte
- Dipartimento di Scienze Cardiovascolari, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi, Varese
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31
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Avella A, De Ponti R, Tritto M, Spadacini G, Salerno-Uriarte JA. Radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia: selective approach to the slow pathway via the superior vena cava. Ital Heart J 2001; 2:142-6. [PMID: 11256543] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Selective radiofrequency catheter ablation of the slow atrioventricular nodal pathway is currently considered the first-line therapy for patients suffering from recurrent symptomatic atrioventricular nodal reentry tachycardia. In most cases slow pathway conduction may be selectively eliminated or modified by the application of radiofrequency current at the posterior portion of Koch's triangle. The ablation site is usually targeted by careful mapping of this area performed using an ablation catheter advanced via the inferior vena cava approach. In this report we describe 2 cases in which the conventional approach to the target site was either impossible owing to the presence of an atresic inferior vena cava (case 1), or contraindicated in view of a history of common femoral vein thrombosis, subsequently extended up to the inferior vena cava (case 2). In both patients a superior vena cava approach was utilized and the slow pathway was successfully ablated. In case of arrhythmias necessitating slow pathway mapping and ablation, such an approach may be considered as a feasible and safe alternative whenever, owing to the presence of anomalies and/or diseases of the inferior vena cava, the conventional approach cannot be employed.
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Affiliation(s)
- A Avella
- Department of Cardiology Mater Domini, Castellanza (VA), University of Insubria-Varese, Italy
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32
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Zardini M, Tritto M, Spadacini G, De Ponti R, Salerno J. Dual-chamber ICD: Acute evaluation of different detection algorithms performance in the electrophysiology laboratory. Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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33
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De Ponti R, Tritto M, Zardini M, Spadacini G, Caravati F, Bonfanti P, Salamo J. Biatrial mapping on sinus rhythm in patients with idiopathic paroxysmal atrial fibrillation as compared to control patients. Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a51-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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34
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De Ponti R, Spadacini G, Tritto M, Zardini M, Cadario F, Albonico P, Salerno JA. Atrial conduction delay as a possible arrhythmogenic mechanism in paroxysmal idiopathic atrial fibrillation. Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a15-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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35
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De Ponti R, Tritto M, Zardini M, Spadacini G, Lattanzio M, Molinari B, Salemo J. Non-conventional mapping systems to validate conduction block along linear lesions in patients with atrial fibrillation or flutter. Europace 2001. [DOI: 10.1016/eupace/2.supplement_1.a58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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36
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Tritto M, De Ponti R, Zardini M, Fang P, Salerno-Uriarte JA. Preexcited tachycardia: what is the tachycardia mechanism? J Cardiovasc Electrophysiol 2000; 11:1058-60. [PMID: 11021478 DOI: 10.1111/j.1540-8167.2000.tb00180.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Tritto
- Institute of Cardiology, Mater Domini Hospital, University of Insubria, School of Medicine of Varese, Castellanza (VA), Italy.
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37
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Uriarte JA, Tritto M, Spadacini G, Meloni I, Uriarte DS, Caravati F. [Cardiac rhythm disturbances in hypertensive cardiopathy]. Ital Heart J 2000; 1 Suppl 2:37-41. [PMID: 10905127] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Patients with hypertensive heart disease are at a significantly increased risk for cardiovascular morbidity and mortality. Ultrastructural and gross anatomical cardiac changes, combined with hemodynamic and neurovegetative balance fluctuations, are frequently responsible for cardiac arrhythmias of atrial and/or ventricular origin. The prevalence, the pathophysiologic mechanism and the prognostic significance of cardiac rhythm disturbances occurring in hypertensive heart disease are discussed in this review.
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Affiliation(s)
- J A Uriarte
- Dipartimento di Cardiologia Mater Domini, Castellanza (VA), Università degli Studi dell'Insubria, Facoltà di Medicina e Chirurgia, Varese.
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38
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De Ponti R, Zardini M, Tritto M, Fang P, Caravati F, Salerno-Uriarte JA. [Non-fluoroscopic system for the tridimensional electroanatomical heart mapping (CARTO)]. Cardiologia 1999; 44 Suppl 1:387-90. [PMID: 12497940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- R De Ponti
- Dipartimento di Cardiologia Mater Domini Università degli Studi dell'Insubria, Sede di Varese Via Gerenzano 2, 21053 Castellanza, VA.
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Tritto M, Dicandia CD, Calabrese P. Overdrive atrial stimulation during transesophageal electrophysiological study: usefulness of post-pacing VA interval analysis in differentiating supraventricular tachycardias with 1:1 atrio-ventricular relationship. Int J Cardiol 1997; 62:37-45. [PMID: 9363501 DOI: 10.1016/s0167-5273(97)00190-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [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: 02/05/2023]
Abstract
We evaluated the feasibility and usefulness of overdrive atrial pacing to identify the relationship between atrial and ventricular activation in supraventricular tachycardias with a stable 1:1 atrio-ventricular (AV) conduction ratio during a transesophageal electrophysiological investigation. Overdrive atrial stimulation was performed in 42 consecutive patients (11 males and 31 females; mean age 49 +/- 17 years) during AV junctional reentrant tachycardia, orthodromic AV reentrant tachycardia and ectopic atrial tachycardia (22, 13 and seven subjects, respectively). Trains of 12 stimuli at a constant rate were introduced starting at a cycle length 10 ms shorter than the tachycardia cycle length; stimulation was repeated with a 10-ms decrement in pacing cycle length at each step until tachycardia terminated and/or second-degree AV block occurred. The difference between the VA interval duration at baseline and in the first post-pacing tachycardia beat was measured at each step and provided identification of the AV relationship. At least one post-pacing VA interval was evaluable in 90% of the cases and measured 2 +/- 4 and 1 +/- 3 ms in AV junctional and AV reentrant tachycardia groups, respectively, and 83 +/- 42 ms in the ectopic atrial tachycardia group (P < 0.0000001 ectopic atrial tachycardia group vs. others). When three or more post-pacing VA intervals were obtained during the same tachycardia, a curve was constructed by plotting their values against the corresponding pacing cycle lengths. A curve could be constructed in 36% of the cases and was flat in all patients with AV junctional and AV reentry, while it was completely irregular in the ectopic atrial tachycardia group (P < 0.003). The analysis of post-pacing VA interval behaviour in response to overdrive atrial stimulation provides a rapid and reliable differentiation between supraventricular tachycardias with 1:1 AV conduction ratio during a transesophageal electrophysiological study.
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Affiliation(s)
- M Tritto
- Division of Cardiology, Oncology Institute, Bari, Italy.
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40
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Tritto M, Dicandia CD, Calabrese P. Incessant long RP tachycardia: what is the tachycardia mechanism? J Cardiovasc Electrophysiol 1997; 8:843-4. [PMID: 9255692 DOI: 10.1111/j.1540-8167.1997.tb00843.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- M Tritto
- Division of Cardiology, Oncology Institute, Bari, Italy
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41
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Tritto M, Calabrese P. ["Double nodal pathway" as a common electrogenic pathway at the base of first and second degree paroxysmal atrioventricular node and nodal reentrant tachycardia]. Cardiologia 1996; 41:1001-4. [PMID: 8983818] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The combined occurrence of conduction disturbances and reentry in subjects with a dual atrioventricular nodal pathway is extremely rare and poorly documented, only by means of short electrocardiographic strips. This case report deals with a young woman with frequent episodes of paroxysmal first- and second-degree type I atrioventricular block due to a dual atrioventricular nodal pathway at Holter monitoring, and atrioventricular nodal reentrant tachycardia inducible at transesophageal electrophysiologic study. This case confirms that some paroxysmal first- and second-degree atrioventricular block and the atrioventricular nodal reentrant tachycardia may share the same electrogenetic substrate represented by a dual atrioventricular nodal pathway. This finding may be of clinical significance because of its potential therapeutical implications. Further studies are needed in order to explain the rarity of this association.
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Affiliation(s)
- M Tritto
- Unità Operativa di Cardiologia, IRCCS, Istituto Oncologico, Bari
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Abstract
INTRODUCTION Two unusual resetting patterns were observed in two patients with slow-fast AV junctional reentrant tachycardia (AVJRT) submitted to an electrophysiologic study. METHODS AND RESULTS After AVJRT induction, resetting was evaluated by introducing single extrastimuli at progressively shorter coupling intervals from the high right atrium (HRA) and the proximal coronary sinus (CS). An alteration in the return cycle length duration allowed demonstration of resetting. In the first patient, during and AVJRT with a large excitable gap, properly timed extrastimuli delivered both from the HRA and CS simultaneously reset the tachycardia and advanced the H electrogram of the preceding tachycardia beat. In the second patient, both HRA and CS stimulation apparently failed to reset AVJRT (return cycle length unchanged), but, at critical coupling intervals, the cycle length duration of the tachycardia beat following the return cycle was consistently shortened. CONCLUSION During slow-fast AVJRT, single atrial stimulation from sites remote to the reentrant circuit may result in unusual resetting patterns. Further studies are required to evidence the full spectrum of resetting in AVJRT.
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Affiliation(s)
- M Tritto
- Division of Cardiology, Oncology Institute, Bari, Italy
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44
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Tritto M, Calabrese P. Radiation-induced heart disease. Oncol Rep 1996; 3:21-26. [PMID: 21594309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
The recent improvement in radiation techniques and the associated significant prolongation of survival have resulted in a widespread utilization of mediastinal irradiation in patients with various neoplasms. However, a large number of experimental and clinical studies have clearly demonstrated that high-dose therapeutic mediastinal irradiation can produce delayed, severe cardiovascular disease. This review presents the data from the Literature regarding the pathogenesis, pathology, prevalence and clinical manifestation of the radiation-related heart disease.
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Tritto M, Calabrese P. [Cardiovascular changes secondary to therapeutic irradiation of the mediastinum]. Cardiologia 1994; 39:789-96. [PMID: 7736479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- M Tritto
- Unità Operativa di Cardiologia, IRCCS, Ospedale Oncologico, Bari
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46
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Tritto M, Calabrese P, Massari V, Tricarico G. Intra-atrial and atrioventricular nodal reentrant tachycardia in the same subject diagnosed at transesophageal electrophysiologic study. Cardiologia 1994; 39:137-41. [PMID: 8013018] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The case report deals with a young woman with frequent episodes of paroxysmal narrow QRS tachycardia of uncertain etiology at Holter monitoring in whom a transesophageal electrophysiologic study was carried out in order to identify the electrogenetic mechanism of the presenting arrhythmia. During the electrophysiologic study, 2 different types of supraventricular tachycardia were induced and diagnosed as intra-atrial and atrioventricular nodal reentrant tachycardia. This association represents a rare finding and can provide a possible explanation to the intriguing electrocardiographic pattern observed at Holter monitoring. Therefore, transesophageal electrophysiologic study proved to be a valuable method for evaluating subjects with complex supraventricular tachycardias.
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Affiliation(s)
- M Tritto
- Unità Operativa, Divisione di Cardiologia, IRCCS Istituto Oncologico, Bari
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47
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Abstract
This report describes the results of right ventricle endomyocardial biopsies from 26 subjects (mean age 27 +/- 10 years) with premature ventricular beats and normal cardiac anatomy and mechanical function. Light microscopy examination revealed normal myocardium in 10 subjects (38%), acute myocarditis in two (7%), borderline myocarditis in one (3.5%), non-specific histological abnormalities including cellular hypertrophy, fibrosis and degenerative changes in 11 (42%), vasculitis in one (3.5%) and findings compatible with right ventricular dysplasia in the final subject (3.5%). The frequency of ventricular premature beats, as assessed by Holter monitoring, and the results of electrophysiological testing did not correlate with histopathological findings and their severity. These data indicate that some young subjects with premature ventricular beats of unknown origin have abnormal right ventricular biopsy findings. Adequate follow-up will probably demonstrate the clinical utility of these observations.
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Affiliation(s)
- M Di Biase
- Department of Cardiology, University of Bari, Italy
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48
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Abstract
Keloids and hypertrophic scars may complicate elective foot surgery. Differentiation between these two entities is important before treatment is contemplated. The authors review current theories on the etiology of these lesions and outline various treatment options.
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49
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Di Biase M, Tritto M, Pitzalis MV, Favale S, Rizzon P. [Localization of the accessory pathways using surface ECG in Wolff-Parkinson-White syndrome]. Cardiologia 1991; 36:71-4. [PMID: 1817774] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
During recent years criteria for localization of bypass tracts in the Wolff-Parkinson-White syndrome from the conventional ECG have been acquired utilizing epicardial and endocardial mapping data. The polarity of delta wave and QRS in the frontal and horizontal plane and the morphology of retrograde P waves during orthodromic reciprocating tachycardia, are the most indicative elements. An accurate analysis of QRS complexes during atrial fibrillation confirms the site of pre-excitation and could suggest the presence of 2 or more accessory pathways with sufficient spatial separation. Some criteria for identifying multiple accessory pathways are discussed.
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Affiliation(s)
- M Di Biase
- Istituto di Malattie dell'Apparato Cardiovascolare, Università degli Studi, Bari
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50
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Abstract
L-propionylcarnitine, a short-chain acylcarnitine, has been shown in experimental studies to induce, during acidic and hypoxic conditions, some electrophysiological changes such as an increase of duration of the action potential and of the effective refractory period. In this study, the acute electrophysiological effects of intravenous L-propionylcarnitine (30 mg/kg in 3 min) were studied in 12 subjects with estimated normal function of the sinus node and normal parameters for atrioventricular conduction. Statistically significant changes were observed 2 min after infusion. The sinus cycle length shortened (866 +/- 138 vs 818 +/- 124 msec, P less than 0.05) while refractory periods of the atrioventricular node increased (effective by 30-50 msec in four cases; functional from 425 +/- 52 to 436 +/- 55 msec, P less than 0.05). Sinuatrial conduction time, atrial refractory periods, infranodal conduction, bundle branch, His-Purkinje system and ventricular refractoriness were unchanged. Systolic and diastolic blood pressure were also unchanged. Because of the limited effects on electrophysiological parameters, L-propionylcarnitine should be used as a metabolic drug even in patients with mild disturbances of conduction.
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Affiliation(s)
- M Di Biase
- Division of Cardiology, University of Bari, Italy
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