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Rubio Campal JM, Del Castillo H, Arroyo Rivera B, de Juan Bitriá C, Taibo Urquia M, Sánchez Borque P, Miracle Blanco Á, Bravo Calero L, Martí Sánchez D, Tuñón Fernández J. Improvement in quality of life with sacubitril/ /valsartan in cardiac resynchronization non-responders: The RESINA (RESynchronization plus an Inhibitor of Neprilysin/Angiotensin) registry. Cardiol J 2021; 28:402-410. [PMID: 33634846 DOI: 10.5603/cj.a2021.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/20/2021] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Clinical management of cardiac resynchronization therapy (CRT) non-responders is difficult, and their prognosis is poor. The aim of the present study was to evaluate whether treatment with sacubitril/valsartan can improve quality of life (QoL) parameters in these patients. METHODS Thirty five non-responders to CRT were included (75 ± 7 years, 28% females, mean left ventricular ejection fraction 28 ± 8%, 54% non-ischemic cardiomyopathy) with maximally optimized drug therapy and New York Heart Association class II-III. They were all on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and were switched to sacubitril/valsartan. One week before and 6 months after initiation of the therapy they completed both the Minnesota Living with Heart Failure (MLWHF) and the 12-item Kansas City Cardiomyopathy Questionnaires (KCCQ-12). The primary outcome was the effect of sacubitril/valsartan on the physical, clinical, social and emotional QoL parameters and number of hospitalizations. RESULTS The mean total scores of both questionnaires improved from baseline to the follow-up visit at 6-months (KCCQ-12 40 ± 10 to 47 ± 10; p < 0.001; MLWHF 40 ± 15 to 29 ± 15; p < 0.001). The best results were seen in the KCCQ-12 total symptom domains (77% improvement), the MLWHF physical domain (81% improvement), and the MLWHF emotional domain (71% improvement). Two patients died during follow-up. The mean number of hospitalizations reduced significantly (1 ± 0.6 vs. 0.5 ± 0.8; p = 0.003) CONCLUSIONS: In CRT non-responders, sacubitril/valsartan significantly improved overall QoL, physical limitations and emotional domains and reduced the number of hospitalizations.
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Borque PS, Campal JMR, Blanco ÁM, Calero LB. Manifest preexcitation with a prolonged PR interval: What is the mechanism? J Electrocardiol 2020; 62:26-29. [PMID: 32771754 DOI: 10.1016/j.jelectrocard.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
A 44-year-old woman with a past history of surgical ablation of an accessory pathway presented to our facility with episodes of palpitations and dizziness. An ECG showed sinus rhythm with a prolonged PR interval and a preexcited QRS complex. An EP study revealed AV conduction through a postero-septal accessory pathway and a prolonged PR interval due to severe intra-atrial conduction delay.
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Campal JR, Borque PS, Blanco AM, Calero LB. Stored EGMs in cardiac devices: Clinical value. J Electrocardiol 2020; 61:133-136. [DOI: 10.1016/j.jelectrocard.2020.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/16/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
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Rubio Campal JM, García Torres MA, Sánchez Borque P, Navas Vinagre I, Zamarbide Capdepón I, Miracle Blanco Á, Bravo Calero L, Sáez Pinel R, Tuñón Fernández J, Serratosa Fernández JM. Detecting Atrial Fibrillation in Patients With an Embolic Stroke of Undetermined Source (from the DAF-ESUS registry). Am J Cardiol 2020; 125:409-414. [PMID: 31780074 DOI: 10.1016/j.amjcard.2019.10.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 08/14/2019] [Revised: 10/18/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022]
Abstract
Atrial fibrillation (AF) causes a substantial proportion of embolic strokes of undeterminded source (ESUS). Effective detection of subclinical AF (SCAF) has important therapeutic implications. We conducted a prospective study to determine the prevalence of SCAF in patients with ESUS through of a 21-day Holter monitoring. In an early-monitoring group, Holter was initiated immediately after hospital discharge. The results were compared with a previous cohort of patients in whom the Holter was initiated at least 1 week after hospital discharge (late-monitoring group). We included 100 patients (50 each group; 69 ± 13 years, 56% male). Mean time from ESUS to Holter was 1.2 ± 1 day in the early-monitoring group and 30 ± 15 days in the late-monitoring group. SCAF was detected in 22% of patients in the early-monitoring and 6% in the late-monitoring group (p <0.05). Patients with SCAF were older (77 ± 9 vs 67 ± 11 years, p <0.05), with a higher rate of left atrial enlargement (50% vs 20%, p<0.05), renal impairment (28% vs 5%; p<0.01), and a slower mean heart rate (55 ± 6 vs 70 ± 6 beats/min; p<0.001). On multivariate analysis, the presence of persistent bradycardia (≤60 beats/min) in the 21-day Holter was a powerful and significant risk factor for SCAF. In conclusion, the sooner 21-day Holter electrocardiogram monitoring is initiated after ESUS, the more likely SCAF can be detected. Sinus bradycardia is a powerful predictor of SCAF in patients with ESUS.
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Rubio Campal JM, Sánchez Borque P, Miracle Blanco Á, Bravo Calero L, Crosa J, Tuñón Fernández J. A novel simple, fast, and safe approach for effective superior vena cava isolation using the third‐generation cryoballoon. Pacing Clin Electrophysiol 2019; 43:62-67. [DOI: 10.1111/pace.13848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/19/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022]
Affiliation(s)
| | | | | | | | - Julián Crosa
- Fundación Jiménez Díaz‐ Quirónsalud Madrid Spain
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Rubio Campal JM, Benezet-Mazuecos J, Iglesias Bravo JA, Sánchez Borque P, Miracle Blanco Á, de la Vieja Alarcón JJ, Martínez Mariscal J, Baranchuk AM, Farré Muncharaz J. P-wave and interatrial block: New predictor for atrial high rate episodes in patients with cardiac implantable electronic devices. Pacing Clin Electrophysiol 2018; 41:223-228. [PMID: 29327362 DOI: 10.1111/pace.13268] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/03/2017] [Accepted: 12/13/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The presence of interatrial block (IAB) is associated with the development of atrial fibrillation (AF). The aim of this study was to determine whether P-wave duration and presence of IAB before the implantation of a cardiac implantable electronic device (CIED) are associated with the presence of atrial high rate episodes (AHRE), during long-term follow-up. METHODS 380 patients (57% men; 75 ± 10 years) were included. IAB was defined according to the International Consensus Criteria. AHRE was defined as an episode of atrial rate ≥225 beats/min with a minimum duration of 5 minutes. RESULTS Documented paroxysmal AF before the implantation was present in 24% of the patients; 80% had hypertension and 32% structural heart disease. Mean P-wave duration was 123 ± 23 ms, and 39% of the patients had IAB (32% partial, 7% advanced). After a mean follow-up of 18 ± 12 months, 33% of the patients presented AHRE. Patients with AHRE had a P-wave duration significantly longer (130 ± 24 ms vs 119 ± 21 ms; P < 0.001) and a greater prevalence of IAB (53% vs 32%; P < 0.001). In a multivariate analysis, predictors of AHRE were: IAB (odds ratio [OR] 2.1; 95% confidence interval [CI] [1.3-3.4], P < 0.001) and previous paroxysmal AF (OR 2.6; 95% CI [1.5-4.3], P < 0.001). In patients without previous AF, the presence of IAB was also a significant predictor of AHRE (OR 3.1; 95% CI [1.8-5.5], P < 0.001). CONCLUSIONS IAB is a strong predictor of AHRE in patients with CIED. This finding is independent of the presence of prior paroxysmal AF.
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Affiliation(s)
- José M Rubio Campal
- Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain
| | - Juan Benezet-Mazuecos
- Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain
| | | | - Pepa Sánchez Borque
- Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain
| | - Ángel Miracle Blanco
- Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain
| | | | - Jaime Martínez Mariscal
- Arrhythmia Unit, Cardiology Department, Fundación Jiménez Díaz - Quirón Salud, Madrid, Spain
| | - Adrian M Baranchuk
- Department of Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
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Rubio JM, Sánchez Borque P, Benezet-Mazuecos J, Miracle Á, del Río A, Farré J. Conversion from wide to narrow QRS complex ventricular tachycardia: What is the mechanism? Pacing Clin Electrophysiol 2017. [DOI: 10.1111/pace.13143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- José M Rubio
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Pepa Sánchez Borque
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Juan Benezet-Mazuecos
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Ángel Miracle
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Ana del Río
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
| | - Jerónimo Farré
- Arrhythmia Unit, Cardiology Department; Fundación Jiménez Díaz - Quirón Salud; Madrid Spain
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