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Garcia R, Mansourati J, Gras D, Probst V, Khattar P, Himbert C, Gandjbakhch E, Saulnier PJ, Constantin V, Lequeux B, Gueffet JP, Combes S, Minois D, Gras M, Bisson A, Pierre B, Defaye P, Marijon E, Boveda S, Degand B. Rationale and design of the HeartLogic French Cohort Study: Remote monitoring of heart failure patients implanted with a cardiac defibrillator enabled with the HeartLogic algorithm. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.186] [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: 12/31/2022]
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Garcia R, Mansourati J, Gras D, Probst V, Khattar P, Himbert C, Saulnier PJ, Constantin-Jacquot V, Gueffet JP, Minois D, Pierre B, Defaye P, Marijon E, Boveda S, Degand B. Evaluation of a multisensory algorithm to prevent acute decompensation of heart failure in patients implanted with a cardioverter defibrillator: rationale and design. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is a chronic disease affecting 64 million people worldwide and places a severe burden on society because of its mortality, numerous re-hospitalizations and associated costs [1–4]. HeartLogic is an algorithm incorporating several biometric parameters which aims to predict HF episodes. It provides an index which can be monitored remotely, allowing preemptive treatment of congestion to prevent acute decompensation [5–7].
Objectives
We aim to provide real-world data on the impact of pre-emptive HF management, guided by the HeartLogic index on unscheduled HF hospitalizations in a substantial cohort of patients.
Methods
The HeartLogic French Study is an investigator-initiated, prospective, multi-centre, non-randomized study. All in all, 310 patients with a history of HF (left ventricular ejection fraction ≤40%; or at least one episode of clinical HF with elevated NT-proBNP ≥450 ng/L) and implanted with a cardioverter defibrillator enabling HeartLogic index calculation will be included across 10 French centers. The HeartLogic index will be monitored remotely on a weekly basis for 12 months and in case of HeartLogic index ≥16, the local investigator will contact the patient for assessment and adjust HF treatment as necessary. The primary endpoint is unscheduled hospitalization for HF. Secondary endpoints are all-cause mortality, cardiovascular death, HF-related death, and unscheduled hospitalizations for ventricular or atrial arrhythmia. Blood samples will be collected for biobanking, and quality of life will be assessed. A blind and independent committee will adjudicate the events.
Conclusions
The HeartLogic French Cohort Study will provide robust real-world data on HF hospitalization in a cohort of patients managed with the HeartLogic algorithm allowing preemptive treatment of congestion.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific
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Affiliation(s)
- R Garcia
- University Hospital of Poitiers, Department of cardiology , Poitiers , France
| | - J Mansourati
- University Hospital of Brest, Cardiology , Brest , France
| | - D Gras
- Hôpital Privé du Confluent, Cardiology , Nantes , France
| | - V Probst
- University Hospital of Nantes, Cardiology , Nantes , France
| | - P Khattar
- Centre Hospitalier de Bretagne Sud, Cardiology , Lorient , France
| | - C Himbert
- Hospital Pitie-Salpetriere, Cardiology , Paris , France
| | - P J Saulnier
- University Hospital of Poitiers, Centre d'Investigation Clinique 1402 , Poitiers , France
| | | | - J P Gueffet
- Hôpital Privé du Confluent, Cardiology , Nantes , France
| | - D Minois
- University Hospital of Nantes, Cardiology , Nantes , France
| | - B Pierre
- University Hospital of Tours, Cardiology , Tours , France
| | - P Defaye
- University Hospital of Grenoble, Cardiology , Grenoble , France
| | - E Marijon
- European Hospital Georges Pompidou, Cardiology , Paris , France
| | - S Boveda
- Clinic Pasteur, Cardiology , Toulouse , France
| | - B Degand
- University Hospital of Poitiers, Department of cardiology , Poitiers , France
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Ben Kilani M, Jacon P, Badenco N, Marquie C, Ollitrault P, Behar N, Khattar P, Carabelli A, Venier S, Defaye P. How to better identify patients at high risk of inappropriate shocks before S-ICD implantation: Results from a multicenter experience. Europace 2022. [DOI: 10.1093/europace/euac053.464] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Despite the recent improvements, inappropriate shocks (IAS) in patients implanted with subcutaneous implantable cardioverter-defibrillator (S-ICD) remain a challenge in "real-life" practice. The purpose of this study was to assess the preoperative predictive factors of IAS with the latest generation of S-ICD, with a particular focus on data obtained during the screening procedure.
Methods
Between January 2017 and March 2020, 300 patients implanted with Generation 3 S-ICD system for primary and secondary prevention were included in this multicentric study. Follow-up (FU) of at least 6 months and preoperative screening procedure data were mandatory for all patients.
Results
After a mean follow-up of 22.8 (±11.4) months, appropriate therapies occurred in 12.3% patients; while 26 patients (8.7%) experienced inappropriate therapies (incidence 4.9 per 100 patient-years). The total number of inappropriate shock episodes was 48; 9 patients experienced multiple episodes. Causes of IAS were: supraventricular arrhythmias (34.6%), cardiac (30.7%) and extra-cardiac noise oversensing (38.4%). In univariate analysis, availability of all 3 sensing vectors during preoperative screening significantly reduced inappropriate therapies occurrence (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.12-0.89, P=0.028). Clinical preoperative S-ICD inappropriate shocks predictors were: history of Supraventricular Tachycardia (SVT)(HR, 4.42; 95% CI, 1.45-13.47; P=0.009); overweight (BMI>25: HR, 1.93; 95% CI, 0.83-0.4.48; P=0.13); QRS duration (HR, 1.01; 95% CI, 0.1-1.03; P=0.14) and lower QRS/T wave ratio in lead I (for a threshold < 3: HR, 4.44; 95% CI, 1.88-10.48; P=0.001). By multivariate analysis, independent factors associated with IAS were: the availability of less than 3 sensing vectors during preoperative screening (p<0.05), a low QRS/T wave ratio in lead I (for a threshold <3; p<0.001), history of SVT (p<0.001) and overweight (BMI> 25; p<0.05).
Conclusion
Automatic preoperative screening data is of high interest as a predictor of IAS with a quantitative value. ECG specificities in association with other clinical factors should be taken into consideration to identify patients at high risk for IAS.
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Affiliation(s)
- M Ben Kilani
- Grenoble Alpes University Hospital, Grenoble, France
| | - P Jacon
- Grenoble Alpes University Hospital, Grenoble, France
| | - N Badenco
- Pitie Salpetriere APHP University Hospital, Paris, France
| | - C Marquie
- Lille University Hospital, Lille, France
| | | | - N Behar
- Rennes University Hospital, Rennes, France
| | - P Khattar
- Scorff Hospital - Hospital Centre of Bretagne Sud, Lorient, France
| | - A Carabelli
- Grenoble Alpes University Hospital, Grenoble, France
| | - S Venier
- Grenoble Alpes University Hospital, Grenoble, France
| | - P Defaye
- Grenoble Alpes University Hospital, Grenoble, France
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Moreau JB, Noel A, Rohel G, Fofana A, Khattar P, Mansourati J. P970Is the SonRTip atrial lead reliable for a long term? Europace 2017. [DOI: 10.1093/ehjci/eux151.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shemshedini T, Regard M, Focseneanu M, Pua T, David-West G, Tedjarati S, Yoon E, Khattar P, Pradhan T. Pediatric and adolescent pelvic masses: What is the role of the gynecologic oncologist? Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.366] [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: 11/30/2022]
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Singh L, Pua T, Khattar P, Han L, Tedjarati S, Pradhan T. THE SIGNIFICANCE OF PRE-OPERATIVE ENDOMETRIAL SAMPLING IN GRADE 1, LOW RISK ENDOMETRIAL CANCERS: IGCS-0088 Uterine Cancer, including Sarcoma. Int J Gynecol Cancer 2015. [DOI: 10.1136/00009577-201505001-00057] [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: 11/03/2022] Open
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Vauchez K, Marolleau J, Schmid M, Khattar P, Chapel A, Catelain C, Lecourt S, Larghéro J, Fiszman M, Vilquin J. T.P.6.02 Aldehyde dehydrogenase activity identifies distinct populations of progenitors within human skeletal muscle. Neuromuscul Disord 2009. [DOI: 10.1016/j.nmd.2009.06.277] [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: 11/17/2022]
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Pal DK, Toppo M, Gupta S, Nair KS, Khattar P, Nandan D. A rapid appraisal of functioning of district programme management units under NRHM in Madhya Pradesh. Indian J Public Health 2009; 53:151-156. [PMID: 20108879] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES To study the functioning of District Programme Management Units in the delivery of health services in various districts of Madhya Pradesh. METHODOLOGY A cross-sectional descriptive study was conducted in seven districts of Madhya Pradesh selected randomly. The study subjects were Chief Medical and Health Officers, programme managers, assistant managers and data officers at state and district levels. Datawas collected from the respondents in a pre-designed, pre-tested in-depth interview schedule. RESULTS Around 70% of districts submitted their Programme Implementation Plan (PIP) on time, 30% were unable to do so because of inadequate staff and frequent changing of the reporting format. The District Programme Managers (DPMs) were not satisfied with their fixed salary. But they were satisfied with their job. In some districts the space available for the functioning of District Programme Management Unit (DPMU) are rather too small. CONCLUSION Standardized uniform formats and guidelines should be made available to all DPMUs at the beginning of planning process. A comprehensive pre-service training for the DPMU staff including practical sessions, field exposure on district health planning, financial management, technical and administrative issues needs to be ensured.
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Affiliation(s)
- D K Pal
- Community Medicine, Gandhi Medical College, Bhopal
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Kumar A, Khattar P, Tiwari VK, Shivdasani JP, Dhar N, Nandan D. An assessment of functioning of mobile medical units in Jharkhand. Indian J Public Health 2009; 53:157-160. [PMID: 20108880] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND & OBJECTIVE A scheme of Mobile Medical Units (MMUs) has been initiated under NRHM in Jharkhand state from the year 2008 in an effort to take healthcare to doorstep of the public in rural areas, especially in underserved areas. The objective of the study was to assess the functioning of Medical Mobile Units in Jharkhand through rapid assessment mode. METHODS A cross sectional descriptive study was conducted in three selected districts of Jharkhand state during September-December 2008. Data was collected through in-depth interview using semistructured schedules with State Programme Managers, Chief Medical Officers, District programme managers, staff of MMU and beneficiaries. RESULTS The scheme provided curative and diagnostic facilities like X-ray, ultra sound, and blood test to the poor and under-served areas. More than 90% of clients reported availability of medicines in MMUs. However, more than 90% of them had no prior information about the day and time of visits by the MMUs. Some of the operational difficulties being faced by the scheme were reported to be vibrations of generator disturbing the lab investigations, poor condition of the road, unwillingness of doctors to go in far-off areas and heavy workload. CONCLUSION The scheme of MMUs has been successful in providing health services to the poor and under-served areas.
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Affiliation(s)
- A Kumar
- Community Medicine, MGM Medical College, Jamshedpur
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