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Salihu A, Lu H, Maurizi N, Tzimas G, Herrera Siklody C, Le Bloa M, Domenichini G, Teres C, Hugelshofer S, Monney P, Pruvot E, Muller O, Antiochos P, Pascale P. Prevention of esophageal lesions during atrial fibrillation catheter ablation using esophageal temperature monitoring: A systematic review and meta-analysis. Pacing Clin Electrophysiol 2024; 47:614-625. [PMID: 38558218 DOI: 10.1111/pace.14972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION The use of esophageal temperature monitoring (ETM) for the prevention of esophageal injury during atrial fibrillation (AF) ablation is often advocated. However, evidence supporting its use is scarce and controversial. We therefore aimed to review the evidence assessing the efficacy of ETM for the prevention of esophageal injury. METHODS We performed a meta-analysis and systematic review of the available literature from inception to December 31, 2022. All studies comparing the use of ETM, versus no ETM, during radiofrequency (RF) AF ablation and which reported the incidence of endoscopically detected esophageal lesions (EDELs) were included. RESULTS Eleven studies with a total of 1112 patients undergoing RF AF ablation were identified. Of those patients, 627 were assigned to ETM (56%). The overall incidence of EDELs was 9.8%. The use of ETM during AF ablation was associated with a non significant increase in the incidence of EDELs (12.3% with ETM, vs. 6.6 % without ETM, odds ratio, 1.44, 95%CI, 0.49, 4.22, p = .51, I2 = 72%). The use of ETM was associated with a significant increase in the energy delivered specifically on the posterior wall compared to patients without ETM (mean power difference: 5.13 Watts, 95% CI, 1.52, 8.74, p = .005). CONCLUSIONS The use of ETM does not reduce the incidence of EDELs during RF AF ablation. The higher energy delivered on the posterior wall is likely attributable to a false sense of safety that may explain the lack of benefit of ETM. Further randomized controlled trials are needed to provide conclusive results.
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Affiliation(s)
- Adil Salihu
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Henri Lu
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Niccolo Maurizi
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Georgios Tzimas
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Claudia Herrera Siklody
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giulia Domenichini
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl Teres
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Sarah Hugelshofer
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre Monney
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Etienne Pruvot
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Muller
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Panagiotis Antiochos
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrizio Pascale
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Jeanningros L, Le Bloa M, Teres C, Herrera Siklody C, Porretta A, Pascale P, Luca A, Solana Muñoz J, Domenichini G, Meister TA, Soria Maldonado R, Tanner H, Vesin JM, Thiran JP, Lemay M, Rexhaj E, Pruvot E, Braun F. The influence of cardiac arrhythmias on the detection of heartbeats in the photoplethysmogram: benchmarking open-source algorithms. Physiol Meas 2024; 45:025005. [PMID: 38266291 DOI: 10.1088/1361-6579/ad2216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/24/2024] [Indexed: 01/26/2024]
Abstract
Objective.Cardiac arrhythmias are a leading cause of mortality worldwide. Wearable devices based on photoplethysmography give the opportunity to screen large populations, hence allowing for an earlier detection of pathological rhythms that might reduce the risks of complications and medical costs. While most of beat detection algorithms have been evaluated on normal sinus rhythm or atrial fibrillation recordings, the performance of these algorithms in patients with other cardiac arrhythmias, such as ventricular tachycardia or bigeminy, remain unknown to date.Approach. ThePPG-beatsopen-source framework, developed by Charlton and colleagues, evaluates the performance of the beat detectors namedQPPG,MSPTDandABDamong others. We applied thePPG-beatsframework on two newly acquired datasets, one containing seven different types of cardiac arrhythmia in hospital settings, and another dataset including two cardiac arrhythmias in ambulatory settings.Main Results. In a clinical setting, theQPPGbeat detector performed best on atrial fibrillation (with a medianF1score of 94.4%), atrial flutter (95.2%), atrial tachycardia (87.0%), sinus rhythm (97.7%), ventricular tachycardia (83.9%) and was ranked 2nd for bigeminy (75.7%) behindABDdetector (76.1%). In an ambulatory setting, theMSPTDbeat detector performed best on normal sinus rhythm (94.6%), and theQPPGdetector on atrial fibrillation (91.6%) and bigeminy (80.0%).Significance. Overall, the PPG beat detectorsQPPG,MSPTDandABDconsistently achieved higher performances than other detectors. However, the detection of beats from wrist-PPG signals is compromised in presence of bigeminy or ventricular tachycardia.
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Affiliation(s)
- Loïc Jeanningros
- Swiss Center for Electronics and Microtechnology, Neuchâtel, Switzerland
- Swiss Federal Institute of Technology Lausanne, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Cheryl Teres
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Patrizio Pascale
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Adrian Luca
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Jorge Solana Muñoz
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Giulia Domenichini
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Théo A Meister
- Department of Cardiology and Biomedical Research, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Rodrigo Soria Maldonado
- Department of Cardiology and Biomedical Research, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Hildegard Tanner
- Department of Cardiology and Biomedical Research, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Jean-Marc Vesin
- Swiss Federal Institute of Technology Lausanne, Lausanne, Switzerland
| | | | - Mathieu Lemay
- Swiss Center for Electronics and Microtechnology, Neuchâtel, Switzerland
| | - Emrush Rexhaj
- Department of Cardiology and Biomedical Research, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Etienne Pruvot
- Service of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Fabian Braun
- Swiss Center for Electronics and Microtechnology, Neuchâtel, Switzerland
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Domenichini G, Le Bloa M, Teres Castillo C, Graf D, Carroz P, Ascione C, Porretta AP, Pascale P, Pruvot E. Conduction System Pacing versus Conventional Biventricular Pacing for Cardiac Resynchronization Therapy: Where Are We Heading? J Clin Med 2023; 12:6288. [PMID: 37834932 PMCID: PMC10573781 DOI: 10.3390/jcm12196288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Over the last few years, pacing of the conduction system (CSP) has emerged as the new standard pacing modality for bradycardia indications, allowing a more physiological ventricular activation compared to conventional right ventricular pacing. CSP has also emerged as an alternative modality to conventional biventricular pacing for the delivery of cardiac resynchronization therapy (CRT) in heart failure patients. However, if the initial clinical data seem to support this new physiological-based approach to CRT, the lack of large randomized studies confirming these preliminary results prevents CSP from being used routinely in clinical practice. Furthermore, concerns are still present regarding the long-term performance of pacing leads when employed for CSP, as well as their extractability. In this review article, we provide the state-of-the-art of CSP as an alternative to biventricular pacing for CRT delivery in heart failure patients. In particular, we describe the physiological concepts supporting this approach and we discuss the future perspectives of CSP in this context according to the implant techniques (His bundle pacing and left bundle branch area pacing) and the clinical data published so far.
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Affiliation(s)
- Giulia Domenichini
- Cardiology Service, University Hospital of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
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van der Ree MH, Herrera Siklody C, Le Bloa M, Pascale P, Porretta AP, Teres CC, Solana Munoz J, Luca A, Domenichini G, Ozasahin M, Jumeau R, Postema PG, Ribi C, Bourhis J, Schiappacasse L, Pruvot E. Case report: First-in-human combined low-dose whole-heart irradiation and high-dose stereotactic arrhythmia radioablation for immunosuppressive refractory cardiac sarcoidosis and ventricular tachycardia. Front Cardiovasc Med 2023; 10:1213165. [PMID: 37547255 PMCID: PMC10401040 DOI: 10.3389/fcvm.2023.1213165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Background Cardiac sarcoidosis is associated with heart failure, conduction abnormalities, and life-threatening arrhythmias including ventricular tachycardia (VT). Radiotherapy has been suggested as a treatment for extra-cardiac sarcoidosis in patients refractory to immunomodulatory treatment. Methods The effectiveness and safety of low-dose whole-heart radiotherapy for therapy refractory cardiac sarcoidosis were evaluated in a pre- and post-intervention case report comparing the 54 months before and after treatment. Immunomodulatory low-dose whole-heart irradiation as sarcoidosis treatment consisted of a 2 × 2 Gy scheme. Additionally, high-dose single-fraction stereotactic arrhythmia radioablation of 1 × 20 Gy was applied to the pro-arrhythmic region to manage the ventricular tachycardia episodes. Cardiac sarcoidosis disease activity was measured by hypermetabolic areas on repeated fluorodeoxyglucose ([18F]FDG)-PET/computed tomography (CT) scans and by evaluating changes in ventricular tachycardia episodes before and after treatment. Results One patient with therapy refractory progressive cardiac sarcoidosis and recurrent ventricular tachycardia was treated. The cardiac sarcoidosis disease activity showed a durable regression of inflammatory disease activity from 3 months onwards. The [18F]FDG-PET/CT scan at 54 months did not show any signs of active cardiac sarcoidosis, and a state of remission was achieved. The number of sustained VT episodes was reduced by 95%. We observed that the development of moderate aortic valve regurgitation was likely irradiation-related. No other irradiation-related adverse events occurred, and the left ventricular ejection fraction remained stable. Conclusion We report here for the first time on the beneficial and lasting effects of combined immunomodulatory low-dose whole-heart radiotherapy and high-dose stereotactic arrhythmia radioablation in a patient with therapy refractory cardiac sarcoidosis and recurrent VT.
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Affiliation(s)
- Martijn H. van der Ree
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | | | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | | | - Cheryl C. Teres
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Jorge Solana Munoz
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Adrian Luca
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Giulia Domenichini
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Mahmut Ozasahin
- Department of Radiation Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Raphael Jumeau
- Department of Radiation Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Pieter G. Postema
- Department of Cardiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Heart Failure and Arrhythmias, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Camillo Ribi
- Division of Immunology and Allergy, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Jean Bourhis
- Department of Radiation Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Luis Schiappacasse
- Department of Radiation Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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van der Ree MH, Luca A, Siklody CH, Le Bloa M, Pascale P, Porretta AP, Teres CC, Munoz JS, Hoeksema WF, Domenichini G, Jumeau R, Postema PG, Bourhis J, Schiappacasse L, Pruvot E. Effects of Stereotactic Arrhythmia Radioablation on left ventricular ejection fraction and valve function over time. Heart Rhythm 2023:S1547-5271(23)02252-X. [PMID: 37225114 DOI: 10.1016/j.hrthm.2023.05.022] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 05/26/2023]
Abstract
Twenty patients (80% male) were included, 15 (75%) with a non-ischemic cardiomyopathy. The radiotherapy dose was 20Gy (20;25) prescribed to a planning target volume (PTV) of 25cc (18;39) resulting in a median whole-heart dose of 6.1Gy. The follow-up duration before and after STAR was 2.1 (0.6;4.5) and 1.7 (0.9;3.9) years respectively. The number of echocardiograms was 5 (3;7) before and 4 (2;7) after STAR.
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Affiliation(s)
- Martijn H van der Ree
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland; Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands.
| | - Adrian Luca
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Claudia Herrera Siklody
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Patrizio Pascale
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Alessandra P Porretta
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Cheryl C Teres
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Jorge Solana Munoz
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Wiert F Hoeksema
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands
| | - Giulia Domenichini
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Raphael Jumeau
- Lausanne University Hospital (CHUV), Department of Radiation Oncology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Pieter G Postema
- Amsterdam UMC location University of Amsterdam, Department of Cardiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences, Heart Failure and arrhythmias, Amsterdam, the Netherlands
| | - Jean Bourhis
- Lausanne University Hospital (CHUV), Department of Radiation Oncology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Luis Schiappacasse
- Lausanne University Hospital (CHUV), Department of Radiation Oncology, Rue du Bugnon 46, Lausanne, Switzerland
| | - Etienne Pruvot
- Lausanne University Hospital (CHUV), Department of Cardiology, Rue du Bugnon 46, Lausanne, Switzerland
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Pagnoni M, Meier D, Luca A, Fournier S, Aminfar F, Gentil P, Haddad C, Domenichini G, Le Bloa M, Herrera-Siklody C, Cook S, Goy JJ, Roguelov C, Girod G, Rubimbura V, Dupré M, Eeckhout E, Pruvot E, Muller O, Pascale P. Corrigendum: Yield of the electrophysiological study in patients with new-onset left bundle branch block after transcathether aortic valve replacement: The PR interval matters. Front Cardiovasc Med 2022; 9:1065221. [PMID: 36330011 PMCID: PMC9623285 DOI: 10.3389/fcvm.2022.1065221] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mattia Pagnoni
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Adrian Luca
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Farhang Aminfar
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascale Gentil
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Christelle Haddad
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Arrhythmias Unit, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Giulia Domenichini
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Stephane Cook
- Department of Cardiology, Clinique Cecil Hirslanden Group, Lausanne, Switzerland
- Department of Cardiology, University Hospital Fribourg, Fribourg, Switzerland
| | - Jean-Jacques Goy
- Department of Cardiology, Clinique Cecil Hirslanden Group, Lausanne, Switzerland
- Department of Cardiology, University Hospital Fribourg, Fribourg, Switzerland
| | - Christan Roguelov
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Grégoire Girod
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Vladimir Rubimbura
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Marion Dupré
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Patrizio Pascale
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7
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Pagnoni M, Meier D, Luca A, Fournier S, Aminfar F, Gentil P, Haddad C, Domenichini G, Le Bloa M, Herrera-Siklody C, Cook S, Goy JJ, Roguelov C, Girod G, Rubimbura V, Dupré M, Eeckhout E, Pruvot E, Muller O, Pascale P. Yield of the electrophysiological study in patients with new-onset left bundle branch block after transcathether aortic valve replacement: The PR interval matters. Front Cardiovasc Med 2022; 9:910693. [PMID: 36148076 PMCID: PMC9485718 DOI: 10.3389/fcvm.2022.910693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Studies suggest that performing an electrophysiological study (EPS) may be useful to identify patients with new-onset left bundle branch block (LBBB) post-TAVR at risk of atrioventricular block. However, tools to optimize the yield of such strategy are needed. We therefore aimed to investigate whether 12-lead ECG changes post-TAVR may help identify patients with abnormal EPS findings. Materials and methods Consecutive patients with new-onset LBBB post-TAVR who underwent EPS were included. PR and QRS intervals were measured on 12-lead ECG pre-TAVR and during EPS. Abnormal EPS was defined as an HV interval > 55 ms. Results Among 61 patients, 28 (46%) had an HV interval > 55 ms after TAVR. Post-TAVR PR interval and ΔPR (PR-post–pre-TAVR) were significantly longer in patients with prolonged HV (PR: 188 ± 38 vs. 228 ± 34 ms, p < 0.001, ΔPR: 10 ± 30 vs. 34 ± 23 ms, p = 0.001), while no difference was found in QRS duration. PR and ΔPR intervals both effectively discriminated patients with HV > 55 ms (AUC = 0.804 and 0.769, respectively; p < 0.001). A PR > 200 ms identified patients with abnormal EPS results with a sensitivity of 89% and a negative predictive value (NPV) of 88%. ΔPR ≥ 20 ms alone provided a somewhat lower sensitivity (64%) but combining both criteria (i.e., PR > 200 ms or ΔPR ≥ 20 ms) identified almost every patients with abnormal HV (sensitivity = 96%, NPV = 95%). Selecting EPS candidate based on both criteria would avoid 1/3 of exams. Conclusion PR interval assessment may be useful to select patients with new-onset LBBB after TAVR who may benefit most from an EPS. In patients with PR ≤ 200 ms and ΔPR < 20 ms the likelihood of abnormal EPS is very low independently of QRS changes.
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Affiliation(s)
- Mattia Pagnoni
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - David Meier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Adrian Luca
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Farhang Aminfar
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Pascale Gentil
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Christelle Haddad
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Arrhythmias Unit, Louis Pradel Cardiovascular Hospital, Hospices Civils de Lyon, Lyon, France
| | - Giulia Domenichini
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Stephane Cook
- Department of Cardiology, Clinique Cecil Hirslanden Group, Lausanne, Switzerland
- Department of Cardiology, University Hospital Fribourg, Fribourg, Switzerland
| | - Jean-Jacques Goy
- Department of Cardiology, Clinique Cecil Hirslanden Group, Lausanne, Switzerland
- Department of Cardiology, University Hospital Fribourg, Fribourg, Switzerland
| | - Christan Roguelov
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Grégoire Girod
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Vladimir Rubimbura
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Marion Dupré
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- *Correspondence: Patrizio Pascale,
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Tortigue M, Nield LE, Karakachoff M, McLeod CJ, Belli E, Babu-Narayan SV, Prigent S, Boet A, Conway M, Elder RW, Ladouceur M, Khairy P, Kowalik E, Kalfa DM, Barron DJ, Mussa S, Hiippala A, Temple J, Abadir S, Le Gloan L, Lachaud M, Sanatani S, Thambo JB, Gronier CG, Amedro P, Vaksmann G, Charbonneau A, Koutbi L, Ovaert C, Houeijeh A, Combes N, Maury P, Duthoit G, Hiel B, Erickson CC, Bonnet C, Van Hare GF, Dina C, Karsenty C, Fournier E, Le Bloa M, Pass RH, Liberman L, Happonen JM, Perry JC, Romefort B, Benbrik N, Hauet Q, Fraisse A, Gatzoulis MA, Abrams DJ, Dubin AM, Ho SY, Redon R, Bacha EA, Schott JJ, Baruteau AE. Familial Recurrence Patterns in Congenitally Corrected Transposition of the Great Arteries: An International Study. Circ Genom Precis Med 2022; 15:e003464. [PMID: 35549293 DOI: 10.1161/circgen.121.003464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Congenitally corrected transposition of the great arteries (ccTGA) is a rare disease of unknown cause. We aimed to better understand familial recurrence patterns. METHODS An international, multicentre, retrospective cohort study was conducted in 29 tertiary hospitals in 6 countries between 1990 and 2018, entailing investigation of 1043 unrelated ccTGA probands. RESULTS Laterality defects and atrioventricular block at diagnosis were observed in 29.9% and 9.3%, respectively. ccTGA was associated with primary ciliary dyskinesia in 11 patients. Parental consanguinity was noted in 3.4% cases. A congenital heart defect was diagnosed in 81 relatives from 69 families, 58% of them being first-degree relatives, including 28 siblings. The most prevalent defects in relatives were dextro-transposition of the great arteries (28.4%), laterality defects (13.6%), and ccTGA (11.1%); 36 new familial clusters were described, including 8 pedigrees with concordant familial aggregation of ccTGA, 19 pedigrees with familial co-segregation of ccTGA and dextro-transposition of the great arteries, and 9 familial co-segregation of ccTGA and laterality defects. In one family co-segregation of ccTGA, dextro-transposition of the great arteries and heterotaxy syndrome in 3 distinct relatives was found. In another family, twins both displayed ccTGA and primary ciliary dyskinesia. CONCLUSIONS ccTGA is not always a sporadic congenital heart defect. Familial clusters as well as evidence of an association between ccTGA, dextro-transposition of the great arteries, laterality defects and in some cases primary ciliary dyskinesia, strongly suggest a common pathogenetic pathway involving laterality genes in the pathophysiology of ccTGA.
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Affiliation(s)
- Marine Tortigue
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Lynne E Nield
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | | | | | - Emre Belli
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Sonya V Babu-Narayan
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Solène Prigent
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Angèle Boet
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Miriam Conway
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Robert W Elder
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT (R.W.E.)
| | - Magalie Ladouceur
- Department of Adult Congenital Heart Diseases, M3C Hôpital Européen Georges Pompidou, Paris, France (M.L.)
| | - Paul Khairy
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
| | - Ewa Kowalik
- Department of Congenital Heart Diseases, National Institute of Cardiology, Warsaw, Poland (E.K.)
| | - David M Kalfa
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - David J Barron
- Division of Pediatric Cardiology, Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Canada (L.E.N., D.J.B.)
| | - Shafi Mussa
- Department of Congenital Cardiac Surgery, University Hospitals Bristol NHS Foundation Trust, United Kingdom (S.M.)
| | - Anita Hiippala
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - Joel Temple
- Department of Pediatrics, Nemours Cardiac Center, Alfred I. duPont Hospital for Children, Wilmington, DE (J.T.)
| | - Sylvia Abadir
- Electrophysiology Service and Adult Congenital Heart Center, Montreal Heart Institute, University of Montreal, Quebec, Canada (P.K., S.A.)
- Division of Cardiology, CHU Mère-Enfant Sainte-Justine, University of Montreal, Quebec, Canada (S.A.)
| | - Laurianne Le Gloan
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Department of Cardiology, CHU Nantes, Nantes, France (L.L.G.)
| | | | - Shubhayan Sanatani
- Division of Cardiology, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada (S.S.)
| | | | - Céline Grunenwald Gronier
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
| | - Pascal Amedro
- Department of Cardiology, CHU Bordeaux, France (J.-B.T., P.A.)
- PhyMedExp, CNRS, INSERM, University of Montpellier, France (P.A.)
| | - Guy Vaksmann
- Department of Pediatric Cardiology, Hôpital Privé de La Louvière, Lille, France (G.V.)
| | - Anne Charbonneau
- Department of Pediatric and Congenital Cardiology, American Memorial Hospital, CHU Reims, France (A.C.)
| | - Linda Koutbi
- Department of Cardiology (L.K.), La Timone Hospital, CHU Marseille, France
| | - Caroline Ovaert
- Department of Pediatric Cardiology (C.O.), La Timone Hospital, CHU Marseille, France
- Marseille Medical Genetics, Inserm UMR 1251, Aix-Marseille University, France (C.O.)
| | - Ali Houeijeh
- Department of Pediatric Cardiology, CHRU Lille, France (A.H.)
| | - Nicolas Combes
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
- Department of Cardiology, Pasteur Clinic, Toulouse, France (N.C.)
| | | | - Guillaume Duthoit
- Department of Cardiology, Groupe Hospitalier Pitié Salpétrière, Sorbonne Université, Paris, France (G.D.)
| | - Bérengère Hiel
- Department of Pediatric Cardiology, CHU Amiens, France (B.H.)
| | - Christopher C Erickson
- UDivision of Pediatric Cardiology, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE (C.C.E.)
| | | | - George F Van Hare
- Division of Pediatric Cardiology, St Louis Children's Hospital, Washington University School of Medicine (G.F.V.H.)
| | - Christian Dina
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
| | - Clément Karsenty
- Department of Pediatric and Congenital Cardiology, Children's Hospital (C.K.), CHU Toulouse, France
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR 1048, Université de Toulouse, France (C.K.)
| | - Emmanuelle Fournier
- Department of Pediatric and Adult Congenital Heart Disase, M3C Marie Lannelongue Hospital, Groupe Hospitalier Saint Joseph, Paris, France (E.B., A.B., N.C., E.F.)
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital, University of Lausanne, Switzerland (M.L.B.)
| | - Robert H Pass
- Department of Pediatric Cardiology, Mount Sinai Kravis Children's Hospital, NY (R.H.P.)
| | - Leonardo Liberman
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Juha-Matti Happonen
- Department of Pediatric Cardiology, New Children's Hospital, Helsinki University Hospital, Finland (A.H., J.-M.H.)
| | - James C Perry
- Department of Pediatrics, Rady Children's Hospital, University of California San Diego (J.C.P.)
| | - Bénédicte Romefort
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Nadir Benbrik
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Quentin Hauet
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
| | - Alain Fraisse
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Michael A Gatzoulis
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Dominic J Abrams
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, MA (D.J.A.)
| | - Anne M Dubin
- Division of Pediatric Cardiology, Stanford University, Palo Alto, CA (A.M.D.)
| | - Siew Yen Ho
- National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield Hospitals, United Kingdom (S.V.B.-N., M.C., A.F., M.A.G., S.Y.H.)
| | - Richard Redon
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Emile A Bacha
- Department of Pediatric and Congenital Cardiac Surgery, Morgan Stanley Children's Hospital - New York Presbyterian, Columbia University Medical Center, NY (D.M.K., L.L., E.A.B.)
| | - Jean-Jacques Schott
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
| | - Alban-Elouen Baruteau
- Nantes Université, CHU Nantes, CNRS, INSERM, l'institut du thorax, France (M.T., L.L.G., C.D., R.R., J.-J.S., A.-E.B.)
- Nantes Université, CHU Nantes, Department of Pediatric Cardiology and Pediatric Cardiac Surgery, France (M.T., S.P., C.G.G., B.R., N.B., Q.H., A.-E.B.)
- Nantes Université, CHU Nantes, INSERM, CIC FEA 1413, France (M.T., S.P., C.G.G., A.-E.B.)
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart-ERN GUARD-Heart (R.R., J.-J.S., A.-E.B.)
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9
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Iten L, Carroz P, Domenichini G, Graf D, Herrera C, Le Bloa M, Monney P, Porretta A, Pascale P, Pruvot É, Teres C. [Epicardial adipose tissue and atrial fibrillation]. Rev Med Suisse 2022; 18:1048-1051. [PMID: 35612477 DOI: 10.53738/revmed.2022.18.783.1048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Atrial fibrillation (AF) is the most common arrhythmia encountered in adults; it is associated with a significant morbidity and mortality. Obesity is a risk factor contributing to AF occurrence. Recently, interest has focused on epicardial adipose tissue (EAT), defined as a fatty deposit located between the epicardium and the visceral pericardium. Its characteristics are distinct from classic adipose deposits: it infiltrates the epicardial myocardium and secretes cytokines, which modulate cardiomyocyte electrophysiology and cardiac remodeling. Different studies show that EAT can be an independent risk factor for AF and that EAT thickness, as measured by CT or MRI, could predict the presence, severity and recurrence of AF.
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Affiliation(s)
- Léa Iten
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Patrice Carroz
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Denis Graf
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Claudia Herrera
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Alessandra Porretta
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Étienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Cheryl Teres
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
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10
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Salihu A, Roux O, Tzimas G, Antiochos P, Le Bloa M, Fournier S, Carron PN, Muller O, Lu H. [An update on some atypical electrocardiographic forms of acute coronary syndrome The "STEMI equivalents"]. Rev Med Suisse 2022; 18:1030-1037. [PMID: 35612475 DOI: 10.53738/revmed.2022.18.783.1030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The diagnosis of acute coronary syndrome with ST segment elevation (STEMI) is based on clinical symptoms suggestive of acute myocardial ischemia and precise ECG criteria. STEMI is due to an acute occlusion or subocclusion of a coronary artery, generating a transmural ischaemia, requiring coronary angiography with urgent coronary revascularization. However, some authors consider the current STEMI ECG criteria to be too restrictive: up to 30 % of patients who do not meet these criteria present with critical coronary artery stenosis or acute coronary occlusion. Atypical electrocardiographic patterns, known as "STEMI equivalents", can be found in some cases and justify a rapid cardiological evaluation. We present a pragmatic review of five STEMI equivalents.
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Affiliation(s)
- Adil Salihu
- Service de médecine interne, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Olivier Roux
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Georgios Tzimas
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Pierre-Nicolas Carron
- Service des urgences, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Henri Lu
- Service de cardiologie, Faculté de biologie et de médecine, Université de Lausanne et Centre hospitalier universitaire vaudois, 1011 Lausanne
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11
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Oestreicher S, Bouchardy J, Rutz T, Monney P, Pruvot É, Le Bloa M. [Prevention of thromboembolic complications in adult congenital heart disease]. Rev Med Suisse 2022; 18:1057-1063. [PMID: 35612479 DOI: 10.53738/revmed.2022.18.783.1057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Thromboembolic complications in adults with congenital heart disease are frequent and responsible for significant morbidity and mortality. Their prevention frequently requires long-term thromboprophylaxis. In this article, we discuss the specificities that must be considered when stratifying the thromboembolic risk in these patients, the different therapeutic strategies, particularly the place of direct oral anticoagulants.
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Affiliation(s)
- Simon Oestreicher
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Étienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
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12
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Domenichini G, Le Bloa M, Carroz P, Graf D, Herrera-Siklody C, Teres C, Porretta AP, Pascale P, Pruvot E. New Insights in Central Venous Disorders. The Role of Transvenous Lead Extractions. Front Cardiovasc Med 2022; 9:783576. [PMID: 35282352 PMCID: PMC8904723 DOI: 10.3389/fcvm.2022.783576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Over the last decades, the implementation of new technology in cardiac pacemakers and defibrillators as well as the increasing life expectancy have been associated with a higher incidence of transvenous lead complications over time. Variable degrees of venous stenosis at the level of the subclavian vein, the innominate trunk and the superior vena cava are reported in up to 50% of implanted patients. Importantly, the number of implanted leads seems to be the main risk factor for such complications. Extraction of abandoned or dysfunctional leads is a potential solution to overcome venous stenosis in case of device upgrades requiring additional leads, but also, in addition to venous angioplasty and stenting, to reduce symptoms related to the venous stenosis itself, i.e., the superior vena cava syndrome. This review explores the role of transvenous lead extraction procedures as therapeutical option in case of central venous disorders related to transvenous cardiac leads. We also describe the different extraction techniques available and other clinical indications for lead extractions such as lead infections. Finally, we discuss the alternative therapeutic options for cardiac stimulation or defibrillation in case of chronic venous occlusions that preclude the implant of conventional transvenous cardiac devices.
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13
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Lu H, Roux O, Fournier S, Aur S, Hullin R, Antiochos P, Pucci L, Monney P, Schwitter J, Le Bloa M, Domenichini G, Pascale P, Pruvot E, Mahendiran T, Bouchardy J, Rutz T, Duchini M, Muller O. [Cardiology]. Rev Med Suisse 2022; 18:144-151. [PMID: 35107886 DOI: 10.53738/revmed.2022.18.767.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Significant advances have been made in 2021 in the areas of interventional cardiology, heart failure, cardiac imaging, electrophysiology and congenital heart disease. In addition to improving the screening, diagnosis and management of many heart diseases, these advances will change our daily practice. Moreover, the European Society of Cardiology has updated its guidelines on heart failure, valve disease, cardiac pacing and cardiovascular disease prevention. As in previous years, members of the Cardiology division of Lausanne University Hospital (CHUV) came together to select and present to you the papers that they considered to be the most important of the past year.
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Affiliation(s)
- Henri Lu
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Roux
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stephane Fournier
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Stefania Aur
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Roger Hullin
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Panagiotis Antiochos
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Lorenzo Pucci
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Pierre Monney
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Juerg Schwitter
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mathieu Le Bloa
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Giulia Domenichini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Patrizio Pascale
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Etienne Pruvot
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Thabo Mahendiran
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Judith Bouchardy
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Tobias Rutz
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mattia Duchini
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Muller
- Service de cardiologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
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14
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Pithon A, McCann A, Buttu A, Vesin JM, Pascale P, Le Bloa M, Herrera C, Park CI, Roten L, Kühne M, Spies F, Knecht S, Sticherling C, Pruvot E, Luca A. Dynamics of Intraprocedural Dominant Frequency Identifies Ablation Outcome in Persistent Atrial Fibrillation. Front Physiol 2021; 12:731917. [PMID: 34712148 PMCID: PMC8546232 DOI: 10.3389/fphys.2021.731917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The role of dominant frequency (DF) in tracking the efficiency of a stepwise catheter ablation (step-CA) in persistent atrial fibrillation (peAF) remains poorly studied. We hypothesized that the DF time-course during step-CA displays divergent patterns between patients in whom a step-CA successfully restores long-term sinus rhythm (SR) and those with recurrence. Methods: This study involved 40 consecutive patients who underwent a step-CA for peAF (sustained duration 19 ± 11 months). Dominant frequency was computed on electrograms recorded from the right and left atrial appendages (RAA; LAA) and the coronary sinus before and during the step-CA synchronously to the 12-lead ECG. Dominant frequency was defined as the highest peak within the power spectrum. Results: Persistent atrial fibrillation was terminated by a step-CA in 28 patients [left-terminated (LT)], whereas 12 patients remaining in AF after ablation [not left-terminated (NLT)] were cardioverted. Over a mean follow-up of 34 ± 14 months, all NLT patients had a recurrence. Among the 28 LT patients, 20 had a recurrence, while 8 remained in SR throughout follow-up. The RAA and V1 DF had the best predictive values of the procedural failure to terminate AF (area under the curve; AUC 0.84, p < 0.05). A decision tree model including a decrease in LAA DF ≥ 6.61% during the first 20 min following pulmonary vein isolation (PVI) and a baseline RAA DF <5.6 Hz predicted long-term SR restoration with a sensitivity of 83% and a specificity of 93% (p < 0.05). Conclusion: This study found that high baseline DF values are predictive of unfavorable ablation outcomes. The reduction of the LAA DF at early ablation steps following PVI is associated with procedural AF termination and long-term SR maintenance.
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Affiliation(s)
- Alain Pithon
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Anna McCann
- Applied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland
| | - Andréa Buttu
- Applied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland
| | - Jean-Marc Vesin
- Applied Signal Processing Group, Swiss Federal Institute of Technology, Lausanne, Switzerland
| | - Patrizio Pascale
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Mathieu Le Bloa
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Claudia Herrera
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Chan-Il Park
- Department of Cardiology, Hôpital de La Tour, Geneva, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Michael Kühne
- Department of Cardiology, University Hospital of Basel, Basel, Switzerland
| | - Florian Spies
- Department of Cardiology, University Hospital of Basel, Basel, Switzerland
| | - Sven Knecht
- Department of Cardiology, University Hospital of Basel, Basel, Switzerland
| | | | - Etienne Pruvot
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Adrian Luca
- Service of Cardiology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Pavon AG, Arangalage D, Pascale P, Hugelshofer S, Rutz T, Porretta AP, Le Bloa M, Muller O, Pruvot E, Schwitter J, Monney P. Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse. J Cardiovasc Magn Reson 2021; 23:102. [PMID: 34517908 PMCID: PMC8438990 DOI: 10.1186/s12968-021-00797-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 07/20/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events. BACKGROUND In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. METHODS In this retrospective study, 30 patients with MVP and MAD (MVP-MAD) underwent cardiovascular magnetic resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECVsyn). The control group included 14 patients with mitral regurgitation (MR) but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24 h-Holter monitoring. RESULTS LGE was observed in 47% of MVP-MAD patients and was absent in all controls. ECVsyn was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p < 0.001 and vs 24 ± 2% NoMR-NoMAD, p < 0.001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p < 0.001 and vs 24 ± 2%, p < 0.001, respectively). MAD length correlated with ECVsyn (rho = 0.61, p < 0.001), but not with LGE extent. Four patients had history of out-of-hospital cardiac arrest; LGE and ECVsyn were equally performant to identify those high-risk patients, area under the receiver operating characteristic (ROC) curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECVsyn was above the cut-off value in all while only 53% had LGE. CONCLUSION Increase in ECVsyn, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and increased risk of out-of-hospital cardiac arrest. ECV should be includedin the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification.
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Affiliation(s)
- Anna Giulia Pavon
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, CH-6900 Lugano, Switzerland
| | - Dimitri Arangalage
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Sarah Hugelshofer
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
| | - Tobias Rutz
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Alessandra Pia Porretta
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Mathieu Le Bloa
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Juerg Schwitter
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
| | - Pierre Monney
- Department of Cardiology, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
- Center for Cardiac Magnetic Resonance of the CHUV (CRMC), Lausanne University Hospital, Lausanne, Switzerland
- University of Lausanne (UniL), Lausanne, Switzerland
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McCann A, Luca A, Fenwick J, Buttu A, Vesin JM, Pascale P, Bloa ML, Herrera C, Park CI, Roten L, Kühne M, Spies F, Knecht S, Sticherling C, Pruvot E. B-PO04-091 INTRACARDIAC DOMINANT FREQUENCY, BUT NOT BIPOLAR ELECTROGRAM VOLTAGE, CORRELATES WITH ABLATION OUTCOMES IN PERSISTENT ATRIAL FIBRILLATION. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.786] [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: 10/20/2022]
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Abstract
Introduction: There are numerous challenges to catheter ablation in patients with congenital heart disease (CHD), including access to cardiac chambers, distorted anatomies, displaced conduction systems, multiple and/or complex arrhythmia substrates, and excessively thickened walls, or interposed material. Areas covered: Herein, we review recent developments in catheter ablation strategies for patients with CHD that are helpful in addressing these challenges. Expert opinion: Remote magnetic navigation overcomes many challenges associated with vascular obstructions, chamber access, and catheter contact. Patients with CHD may benefit from a range of ablation catheter technologies, including irrigated-tip and contact-force radiofrequency ablation and focal and balloon cryoablation. High-density mapping, along with advances in multipolar catheters and interpolation algorithms, is contributing to new mechanistic insights into complex arrhythmias. Ripple mapping allows the activation wave front to be tracked visually without prior assignment of local activation times or window of interest, and without interpolations of unmapped regions. There is growing interest in measuring conduction velocities to identify arrhythmogenic substrates. Noninvasive mapping with a multielectrode-embedded vest allows prolonged bedside monitoring, which is of particular interest in those with non-sustained or multiple arrhythmias. Further studies are required to assess the role of radiofrequency needle catheters and stereotactic radiotherapy in patients with CHD.
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Affiliation(s)
- Mathieu Le Bloa
- Montreal Heart Institute, Université De Montréal , Montreal, Canada.,Electrophysiology Service, Centre Hospitalier Universitaire Vaudois , Lausanne, Switzerland
| | - Sylvia Abadir
- Montreal Heart Institute, Université De Montréal , Montreal, Canada
| | - Krishnakumar Nair
- University Health Network, Toronto General Hospital , Toronto, Canada
| | | | - Paul Khairy
- Montreal Heart Institute, Université De Montréal , Montreal, Canada
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Lemesre C, Graf D, Bisch L, Carroz P, Cherbuin N, Damet J, Desorgher L, Siklody CH, Le Bloa M, Pascale P, Pruvot E. Efficiency of the RADPAD Surgical Cap in Reducing Brain Exposure During Pacemaker and Defibrillator Implantation. JACC Clin Electrophysiol 2020; 7:161-170. [PMID: 33602396 DOI: 10.1016/j.jacep.2020.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 07/15/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to investigate the RADPAD No Brainer (Worldwide Innovation and Technologies, Overland Park, Kansas) efficiency in reducing brain exposure to scattered radiation. BACKGROUND Cranial radioprotective caps such as the RADPAD No Brainer are being marketed as devices that significantly reduce operator's brain exposure to scattered radiation. However, the efficiency of the RADPAD No Brainer in reducing brain exposure in clinical practice remains unknown to date. METHODS Five electrophysiologists performing device implantations over a 2-month period wore the RADPAD cap with 2 strips of 11 thermoluminescent dosimeter pellets covering the front head above and under the shielded cap. Phantom measurements and Monte Carlo simulations were performed to further investigate brain dose distribution. RESULTS Our study showed that the right half of the operators' front head was the most exposed region during left subpectoral device implantation; the RADPAD cap attenuated the skin front-head exposure but provided no protection to the brain. The exposure of the anterior part of the brain was decreased by a factor of 4.5 compared with the front-head skin value thanks to the skull. The RADPAD cap worn as a protruding horizontal plane, however, reduced brain exposure by a factor of 1.7 (interquartile range: 1.3 to 1.9). CONCLUSIONS During device implantation, the RADPAD No Brainer decreased the skin front head exposure but had no impact on brain dose distribution. The RADPAD No Brainer worn as a horizontal plane worn around the neck reduces brain exposure and confirms that the exposure comes from upward scattered radiation.
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Affiliation(s)
- Camille Lemesre
- Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland
| | - Denis Graf
- Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland
| | | | - Patrice Carroz
- Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland
| | - Nicolas Cherbuin
- Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland
| | - Jérôme Damet
- Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland; Department of Radiology, University of Otago, Christchurch, New Zealand
| | - Laurent Desorgher
- Institute for Radiation Physics, University Hospital Centre Vaudois, Lausanne, Switzerland
| | | | - Mathieu Le Bloa
- Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland
| | - Patrizio Pascale
- Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland
| | - Etienne Pruvot
- Department of Cardiology, University Hospital Centre Vaudois, Lausanne, Switzerland.
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Le Bloa M, Pham M, Mongeon FP, Mondésert B, Khairy P. Right Ventricular Basal Aneurysm as a Substrate for Ventricular Tachycardia in Tetralogy of Fallot. JACC Clin Electrophysiol 2020; 6:743-744. [PMID: 32553228 DOI: 10.1016/j.jacep.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/19/2020] [Accepted: 03/20/2020] [Indexed: 11/17/2022]
Affiliation(s)
| | - Magali Pham
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | | | - Paul Khairy
- Montreal Heart Institute, Montreal, Quebec, Canada.
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Antiochos P, Barras N, Regamey J, Bisch L, Le Bloa M, Hullin R, Monney P, Schwitter J, Pascale P, Pruvot É, Eeckhout É, Muller O, Fournier S. [The year in cardiology : 2018]. Rev Med Suisse 2019; 15:27-30. [PMID: 30629363] [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: 06/09/2023]
Abstract
This review article provides a broad overview of the novelties in cardiology in 2018. Advances in interventional cardiology and cardiovascular prevention, heart failure, electrophysiology and non-invasive cardiovascular imaging have provided important new insights in the pathophysiology, diagnosis and treatment of ischemic and valvular heart disease, heart failure, rhythm disorders and cardiomyopathies. This article provides an overview of the most relevant articles published in 2018.
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Pambrun T, El Bouazzaoui R, Combes N, Combes S, Sousa P, Le Bloa M, Massoullié G, Cheniti G, Martin R, Pillois X, Duchateau J, Sacher F, Hocini M, Jaïs P, Derval N, Bortone A, Boveda S, Denis A, Haïssaguerre M, Albenque JP. Maximal Pre-Excitation Based Algorithm for Localization of Manifest Accessory Pathways in Adults. JACC Clin Electrophysiol 2018; 4:1052-1061. [DOI: 10.1016/j.jacep.2018.03.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/06/2018] [Accepted: 03/29/2018] [Indexed: 11/17/2022]
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Combes N, Derval N, Hascoët S, Zhao A, Amet D, Le Bloa M, Maltret A, Heitz F, Thambo JB, Marijon E. Ablation of supraventricular arrhythmias in adult congenital heart disease: A contemporary review. Arch Cardiovasc Dis 2017; 110:334-345. [DOI: 10.1016/j.acvd.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 10/19/2022]
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Pambrun T, Combes S, Sousa P, Bloa ML, El Bouazzaoui R, Grand-Larrieu D, Thompson N, Martin R, Combes N, Boveda S, Haïssaguerre M, Albenque JP. Contact-force guided single-catheter approach for pulmonary vein isolation: Feasibility, outcomes, and cost-effectiveness. Heart Rhythm 2017; 14:331-338. [DOI: 10.1016/j.hrthm.2016.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Indexed: 12/31/2022]
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Pambrun T, Sousa P, Bloa ML, Nader K, Grand-Larrieu D, Combes N, Boveda S, Combes S, Albenque JP. 16-17: Contact-force guided single catheter approach for pulmonary vein antrum isolation: procedural feasibility. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i5] [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: 11/14/2022] Open
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