1
|
Laredo M, Landes R, Laporte PL, Waintraub X, Hermida A. Ethanol Infusion into the Vein of Marshall of a Transplanted Heart. Can J Cardiol 2024:S0828-282X(24)00294-0. [PMID: 38579964 DOI: 10.1016/j.cjca.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/18/2024] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Affiliation(s)
- Mikael Laredo
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France.
| | - Rosanna Landes
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France
| | - Pierre-Léo Laporte
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France
| | - Xavier Waintraub
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France
| | - Alexis Hermida
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, Paris, France
| |
Collapse
|
2
|
Beyls C, Hermida A, Nicolas M, Debrigode R, Vialatte A, Peschanski J, Bunelle C, Fournier A, Jarry G, Landemaine T, Malaquin D, Kubala M, Mahjoub Y, Leborgne L. Left atrial strain analysis and new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction: A prospective echocardiography study. Arch Cardiovasc Dis 2024; 117:266-274. [PMID: 38423888 DOI: 10.1016/j.acvd.2024.01.002] [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: 12/04/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND New-onset atrial fibrillation (NOAF) is a well-known complication of ST-segment elevation myocardial infarction (STEMI), probably due to left atrial (LA) remodelling. LA strain (LAS) can predict NOAF in several cardiovascular diseases. OBJECTIVE To assess whether LAS predicts NOAF in sinus rhythm patients with STEMI during hospitalization. METHODS Adults with a STEMI and transthoracic echocardiography performed within 48hours of admission were included. LAS analysis, performed by automated software, recorded LAS during the reservoir phase (LASr), the conduit phase (LAScd) and the contraction phase (LASct). RESULTS From May 2021 to November 2022, 175 patients were included, 21 (12%) of whom developed NOAF. NOAF patients were older (median [Q1-Q3]: 67 [59-80] vs 59 [51-67]years; P=0.006) and had a higher Thrombolysis In Myocardial Infarction scores (4 [2-7] vs 3 [1-4]; P=0.005). All LAS parameters were significantly impaired in NOAF patients, especially LASr (13.0% [10.5-28.4] vs 36.6% [29.0-44.9]; P=0.001). An LASr cut-off of 27% had a sensitivity of 81% and a specificity of 80% to identify patients with NOAF. In a multivariable model, LASr was significantly associated with NOAF (odds ratio 1.18, 95% confidence interval 1.09-1.26; P=0.003). The cumulative risk of NOAF during hospital stay was 30% (18-43 with LASr<27% and 4% [1.5-8.5] with LASr≥27% [P<0.0001]). CONCLUSION NOAF is a frequent complication of STEMI. LASr seems helpful for identifying patients at high risk of NOAF during hospitalization.
Collapse
Affiliation(s)
- Christophe Beyls
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France; UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules-Verne, 80054 Amiens, France.
| | - Alexis Hermida
- Department of Cardiology, Rhythmology unit, Amiens University Hospital, 80054 Amiens, France.
| | - Martin Nicolas
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Romain Debrigode
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Alexis Vialatte
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Julia Peschanski
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France
| | - Camille Bunelle
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France
| | - Alexandre Fournier
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Geneviève Jarry
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Thomas Landemaine
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Dorothée Malaquin
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| | - Maciej Kubala
- Department of Cardiology, Rhythmology unit, Amiens University Hospital, 80054 Amiens, France
| | - Yazine Mahjoub
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France
| | - Laurent Leborgne
- Department of Cardiology, Cardiac intensive care unit, Amiens University Hospital, 80054 Amiens, France
| |
Collapse
|
3
|
Hermida A, Gourraud JB, Denjoy I, Fressart V, Kyndt F, Maltret A, Khraiche D, Klug D, Mabo P, Sacher F, Maury P, Winum P, Defaye P, Clerici G, Babuty D, Elbez Y, Morgat C, Surget E, Messali A, De Jode P, Clédel A, Minois D, Maison-Blanche P, Bloch A, Leenhardt A, Probst V, Extramiana F. Type 3 long QT syndrome: Is the effectiveness of treatment with beta-blockers population-specific? Heart Rhythm 2024; 21:313-320. [PMID: 37956775 DOI: 10.1016/j.hrthm.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND The efficacy of beta-blocker treatment in type 3 long QT syndrome (LQT3) remains debated. OBJECTIVES The purpose of this study was to test the hypothesis that beta-blocker use is associated with cardiac events (CEs) in a French cohort of LQT3 patients. METHODS All patients with a likely pathogenic/pathogenic variant in the SCN5A gene (linked to LQT3) were included and followed-up. Documented ventricular tachycardia/ventricular fibrillation, torsades de pointes, aborted cardiac arrest, sudden death, and appropriate shocks were considered as severe cardiac events (SCEs). CEs also included syncope. RESULTS We included 147 patients from 54 families carrying 23 variants. Six of the patients developed symptoms before the age of 1 year and were analyzed separately. The 141 remaining patients (52.5% male; median age at diagnosis 24.0 years) were followed-up for a median of 11 years. The probabilities of a CE and an SCE from birth to the age of 40 were 20.5% and 9.9%, respectively. QTc prolongation (hazard ratio [HR] 1.12 [1.0-1.2]; P = .005]) and proband status (HR 4.07 [1.9-8.9]; P <.001) were independently associated with the occurrence of CEs. Proband status (HR 8.13 [1.7-38.8]; P = .009) was found to be independently associated with SCEs, whereas QTc prolongation (HR 1.11 [1.0-1.3]; P = .108) did not reach statistical significance. The cumulative probability of the age at first CE/SCE was not lower in patients treated with a beta-blocker. CONCLUSION In agreement with the literature, proband status and lengthened QTc were associated with a higher risk of CEs. Our data do not show a protective effect of beta-blocker treatment.
Collapse
Affiliation(s)
- Alexis Hermida
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Service de Rythmologie, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Jean-Baptiste Gourraud
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Isabelle Denjoy
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Véronique Fressart
- AP-HP, Service de Biochimie Métabolique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Florence Kyndt
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Alice Maltret
- Service de Cardiopathie Congenitale, GHPSJ Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | | | - Didier Klug
- Service de Cardiologie, Centre Hospitalier Universitaire, Lille, France
| | - Philippe Mabo
- Service de Cardiologie, Centre Hospitalier Universitaire, Rennes, France
| | - Frédéric Sacher
- Service de Rythmologie, LIRYC Institute, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - Philippe Maury
- Service de Cardiologie, Centre Hospitalier Universitaire, Toulouse, France
| | - Pierre Winum
- Service de Cardiologie, Centre Hospitalier Universitaire, Nîmes, France
| | - Pascal Defaye
- Service de Cardiologie, Centre Hospitalier Universitaire, Grenoble, France
| | - Gael Clerici
- Service de Cardiologie, Centre Hospitalier Universitaire, Saint Pierre, La Réunion, France
| | - Dominique Babuty
- Service de Cardiologie, Centre Hospitalier Universitaire, Tours, France
| | | | - Charles Morgat
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France
| | - Elodie Surget
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Anne Messali
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Patrick De Jode
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France
| | - Aurélien Clédel
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Damien Minois
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Adrien Bloch
- AP-HP, Service de Biochimie Métabolique, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Antoine Leenhardt
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France
| | - Vincent Probst
- L'institut du Thorax, CNMR Maladies Rythmique Héréditaires ou Rares, Service de Cardiologie et Unité INSERM 1087, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Fabrice Extramiana
- CNMR Maladies Cardiaques Héréditaires Rares, APHP, Hôpital Bichat, Paris, France; Université Paris Cité, Paris, France.
| |
Collapse
|
4
|
Beyls C, Yakoub-Agha M, Hermida A, Martin N, Crombet M, Hanquiez T, Fournier A, Jarry G, Malaquin D, Michaud A, Abou-Arab O, Leborgne L, Mahjoub Y. Prognostic Value of a New Right Ventricular-to-Pulmonary Artery Coupling Parameter Using Right Ventricular Longitudinal Shortening Fraction in Patients Undergoing Transcatheter Aortic Valve Replacement: A Prospective Echocardiography Study. J Clin Med 2024; 13:1006. [PMID: 38398319 PMCID: PMC10889072 DOI: 10.3390/jcm13041006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Introduction: Right-ventricular-to-pulmonary artery (RV-PA) coupling, measured as the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), has emerged as a predictor factor in patients undergoing transcatheter aortic valvular replacement (TAVR). Right ventricular longitudinal shortening fraction (RV-LSF) outperformed TAPSE as a prognostic parameter in several diseases. We aimed to compare the prognostic ability of two RV-PA coupling parameters (TAPSE/PASP and the RV-LSF/PASP ratio) in identifying MACE occurrences. Method: A prospective and single-center study involving 197 patients who underwent TAVR was conducted. MACE (heart failure, myocardial infarction, stroke, and death within six months) constituted the primary outcome. ROC curve analysis determined cutoff values for RV-PA ratios. Multivariable Cox regression analysis explored the association between RV-PA ratios and MACE. Results: Forty-six patients (23%) experienced the primary outcome. No significant difference in ROC curve analysis was found (RV-LSF/PASP with AUC = 0.67, 95%CI = [0.58-0.77] vs. TAPSE/PASP with AUC = 0.62, 95%CI = [0.49-0.69]; p = 0.16). RV-LSF/PASP < 0.30%.mmHg-1 was independently associated with the primary outcome. The 6-month cumulative risk of MACE was 59% (95%CI = [38-74]) for patients with RV-LSF/PASP < 0.30%.mmHg-1 and 17% (95%CI = [12-23]) for those with RV-LSF/PASP ≥ 0.30%.mmHg-1; (p < 0.0001). Conclusions: In a contemporary cohort of patients undergoing TAVR, RV-PA uncoupling defined by an RV-LSF/PASP < 0.30%.mmHg-1 was associated with MACE at 6 months.
Collapse
Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
- UR UPJV 758 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80054 Amiens, France
| | - Mathilde Yakoub-Agha
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Alexis Hermida
- Rythmology Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France;
| | - Nicolas Martin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Maxime Crombet
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Thomas Hanquiez
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Alexandre Fournier
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Geneviève Jarry
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Dorothée Malaquin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Audrey Michaud
- Biostatistics Unit, Clinical Research and Innovation Directorate, Amiens-Picardie University Hospital Centre, F-80054 Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Laurent Leborgne
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
- UR UPJV 758 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80054 Amiens, France
| |
Collapse
|
5
|
Hermida A, Ader F, Jedraszak G, Viboud G, Fressart V, Bréhin AC, Gérard M, Khraiche D, Palmyre A, Paziaud O, Popescu E, Proukhnitzky J, Laredo M, Richard P, Vedrenne G, Vernier A, Charron P, Gandjbakhch E. Prevalence and Significance of Rare Genetic Variants in AKAP9 in Inherited Cardiac Diseases. Circ Genom Precis Med 2024; 17:e004260. [PMID: 38258564 DOI: 10.1161/circgen.123.004260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens, France (A.H., G. Viboud)
- EA4666 Hématopoïèse et Immunologie, University of Picardie Jules Verne, Amiens, France (G.J.)
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institute of Cardiology, Institute for Cardiometabolism and Nutrition, Paris, France (A.H., J.P., M.L., P.C., E.G.)
| | - Flavie Ader
- Unité Pédagogique de Biochimie, Département des Sciences Biologiques et Médicales, Unité de Formation et de Recherche de Pharmacie-Faculté de Santé, Université Paris Cité, France (F.A.)
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale 1166, Paris, France (F.A., J.P., M.L., P.C., E.G.)
| | - Guillaume Jedraszak
- EA4666 Hématopoïèse et Immunologie, University of Picardie Jules Verne, Amiens, France (G.J.)
- Molecular Genetics Laboratory, Amiens-Picardie University Hospital, Amiens, France (G.J.)
| | - Guillaume Viboud
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens, France (A.H., G. Viboud)
| | - Véronique Fressart
- Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, Département Médico-Universitaire Biogem, Service de Biochimie Métabolique, AP-HP-Sorbonne Université, Pitié-Salpêtrière-Charles Foix, Paris, France (V.F., P.R.)
| | - Anne-Claire Bréhin
- Service de génétique, Centre Hospitalier Universitairemn Rouen, France (A.-C.B.)
| | | | - Diala Khraiche
- Service de cardiologie pédiatrique, Hôpital Necker, APHP, Paris, France (D.K.)
| | - Aurélien Palmyre
- APHP, Ambroise Paré Hospital, Department of Genetics, Referral Center for Cardiac Hereditary Cardiac Diseases, Boulogne-Billancourt, Paris, France (A.P., P.C.)
| | - Olivier Paziaud
- Service de rythmologie, Centre Cardiologique du Nord, Saint-Denis, France (O.P.)
| | - Elena Popescu
- Service de cardiologie, Hôpital du Havre, France (E.P.)
| | - Julie Proukhnitzky
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institute of Cardiology, Institute for Cardiometabolism and Nutrition, Paris, France (A.H., J.P., M.L., P.C., E.G.)
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale 1166, Paris, France (F.A., J.P., M.L., P.C., E.G.)
- APHP, Pitié-Salpêtrière Hospital, Department of Genetics, Department of Cardiology, Referral Center for Hereditary Cardiac Diseases (J.P., P.C.)
| | - Mikael Laredo
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institute of Cardiology, Institute for Cardiometabolism and Nutrition, Paris, France (A.H., J.P., M.L., P.C., E.G.)
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale 1166, Paris, France (F.A., J.P., M.L., P.C., E.G.)
| | - Pascale Richard
- Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, Département Médico-Universitaire Biogem, Service de Biochimie Métabolique, AP-HP-Sorbonne Université, Pitié-Salpêtrière-Charles Foix, Paris, France (V.F., P.R.)
| | - Géraldine Vedrenne
- Service de Cardiologie, Hôpital Saint Joseph, Paris, France (G. Vedrenne)
| | - Agathe Vernier
- Cardiology department, Victor Pauchet Clinic, Amiens, 80000, France (A.V.)
| | - Philippe Charron
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institute of Cardiology, Institute for Cardiometabolism and Nutrition, Paris, France (A.H., J.P., M.L., P.C., E.G.)
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale 1166, Paris, France (F.A., J.P., M.L., P.C., E.G.)
- APHP, Ambroise Paré Hospital, Department of Genetics, Referral Center for Cardiac Hereditary Cardiac Diseases, Boulogne-Billancourt, Paris, France (A.P., P.C.)
- APHP, Pitié-Salpêtrière Hospital, Department of Genetics, Department of Cardiology, Referral Center for Hereditary Cardiac Diseases (J.P., P.C.)
| | - Estelle Gandjbakhch
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institute of Cardiology, Institute for Cardiometabolism and Nutrition, Paris, France (A.H., J.P., M.L., P.C., E.G.)
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale 1166, Paris, France (F.A., J.P., M.L., P.C., E.G.)
| |
Collapse
|
6
|
Hermida A, Ader F, Millat G, Jedraszak G, Maury P, Cador R, Catalan PA, Clerici G, Combes N, De Groote P, Dupin-Deguine D, Eschalier R, Faivre L, Garcia P, Guillon B, Janin A, Kugener B, Lackmy M, Laredo M, Le Guillou X, Lesaffre F, Lucron H, Milhem A, Nadeau G, Nguyen K, Palmyre A, Perdreau E, Picard F, Rebotier N, Richard P, Rooryck C, Seitz J, Verloes A, Vernier A, Winum P, Yabeta GAD, Bouchot O, Chevalier P, Charron P, Gandjbakhch E. NEXN Gene in Cardiomyopathies and Sudden Cardiac Deaths: Prevalence, Phenotypic Expression, and Prognosis. Circ Genom Precis Med 2024; 17:e004285. [PMID: 38059363 DOI: 10.1161/circgen.123.004285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Few clinical data are available on NEXN mutation carriers, and the gene's involvement in cardiomyopathies or sudden death has not been fully established. Our objectives were to assess the prevalence of putative pathogenic variants in NEXN and to describe the phenotype and prognosis of patients carrying the variants. METHODS DNA samples from consecutive patients with cardiomyopathy or sudden cardiac death/sudden infant death syndrome/idiopathic ventricular fibrillation were sequenced with a custom panel of genes. Index cases carrying at least one putative pathogenic variant in the NEXN gene were selected. RESULTS Of the 9516 index patients sequenced, 31 were carriers of a putative pathogenic variant in NEXN only, including 2 with double variants and 29 with a single variant. Of the 29 unrelated probands with a single variant (16 males; median age at diagnosis, 32.0 [26.0-49.0] years), 21 presented with dilated cardiomyopathy (prevalence, 0.33%), and 3 presented with hypertrophic cardiomyopathy (prevalence, 0.14%). Three patients had idiopathic ventricular fibrillation, and there were 2 cases of sudden infant death syndrome (prevalence, 0.46%). For patients with dilated cardiomyopathy, the median left ventricle ejection fraction was 37.5% (26.25-50.0) at diagnosis and improved with treatment in 13 (61.9%). Over a median follow-up period of 6.0 years, we recorded 3 severe arrhythmic events and 2 severe hemodynamic events. CONCLUSIONS Putative pathogenic NEXN variants were mainly associated with dilated cardiomyopathy; in these individuals, the prognosis appeared to be relatively good. However, severe and early onset phenotypes were also observed-especially in patients with double NEXN variants. We also detected NEXN variants in patients with hypertrophic cardiomyopathy and sudden infant death syndrome/idiopathic ventricular fibrillation, although a causal link could not be established.
Collapse
Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service (A.H.), Amiens-Picardie University Hospital
- EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens (A.H., G.J.)
- Institute of Cardiology and ICAN Institute for Cardiometabolism and Nutrition (A.H., M. Laredo, P. Charron, E.G.)
- Department of Genetics, Department of Cardiology, and Referral center for hereditary cardiac diseases, APHP, Pitié-Salpêtrière Hospital (A.H., P. Charron, E.G.)
| | - Flavie Ader
- Unité Pédagogique de Biochimie, Département des Sciences Biologiques et Médicales, UFR de Pharmacie-Faculté de Santé, Université Paris Cité (F.A.)
- Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, DMU Biogem, Service de Biochimie Métabolique, AP-HP-Sorbonne Université, Pitié-Salpêtrière -Charles Foix (F.A., P.R.)
- Sorbonne Université, INSERM 1166, Paris (F.A., M. Laredo, P.R., P. Charron, E.G.)
| | - Gilles Millat
- Service de Génétique Moléculaire, Hospices Civils de Lyon (G.M., A.J.)
| | - Guillaume Jedraszak
- Molecular Genetics Laboratory (G.J.), Amiens-Picardie University Hospital
- EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens (A.H., G.J.)
| | | | - Romain Cador
- Service de Cardiologie, Hôpital Saint Joseph, Paris (R.C.)
| | | | - Gaël Clerici
- Service de Cardiologie, Centre hospitalier universitaire, Saint Pierre, La Réunion (G.C.)
| | - Nicolas Combes
- Service de Cardiologie, Clinique Pasteur, Toulouse (N.C.)
| | - Pascal De Groote
- France CHU Lille, Service de Cardiologie & Inserm U1167, Institut Pasteur de Lille (P.D.G.)
| | | | | | | | - Patricia Garcia
- Unité Mort Inattendue du Nourrisson, Hôpital de la Conception, APHM, Marseille (P.G.)
| | | | - Alexandre Janin
- Service de Génétique Moléculaire, Hospices Civils de Lyon (G.M., A.J.)
| | | | - Marylin Lackmy
- Unité de Génétique Clinique, CHU de Guadeloupe, Pointe à Pitre (M. Lackmy)
| | - Mikael Laredo
- Institute of Cardiology and ICAN Institute for Cardiometabolism and Nutrition (A.H., M. Laredo, P. Charron, E.G.)
- Sorbonne Université, INSERM 1166, Paris (F.A., M. Laredo, P.R., P. Charron, E.G.)
| | | | | | - Hugues Lucron
- Service de Cardiologie pédiatrique, CHU Martinique, Fort-de-France (H.L.)
| | | | - Gwenaël Nadeau
- Service de génétique clinique CH Métropole Savoie, Chambéry (G.N.)
| | | | - Aurélien Palmyre
- APHP, Ambroise Paré Hospital, Department of Genetics and Referral center for cardiac hereditary cardiac diseases, Boulogne-Billancourt (A.P., P. Charron)
| | - Elodie Perdreau
- Département médico chirurgical de cardiologie pédiatrique (E.P.), Hôpital Louis Pradel, HCL, Lyon
| | - François Picard
- Service de Cardiologie, Hôpital Cardiologique Haut Leveque, Bordeaux (F.P.)
| | | | - Pascale Richard
- Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, DMU Biogem, Service de Biochimie Métabolique, AP-HP-Sorbonne Université, Pitié-Salpêtrière -Charles Foix (F.A., P.R.)
- Sorbonne Université, INSERM 1166, Paris (F.A., M. Laredo, P.R., P. Charron, E.G.)
| | | | - Julien Seitz
- Service de Cardiologie, Hôpital Saint Joseph, Marseille (J.S.)
| | - Alain Verloes
- Departement de génétique, Hôpital Robert Debré, APHP (A. Verloes)
| | | | | | - Grace-A-Dieu Yabeta
- Service de Cardiologie, CH Ouest Guyane, Saint-Laurent-du-Maroni (G.-A.-D.Y.)
| | - Océane Bouchot
- Service de Cardiologie, CH Annecy Genevois, Annecy, France (O.B.)
| | | | - Philippe Charron
- Institute of Cardiology and ICAN Institute for Cardiometabolism and Nutrition (A.H., M. Laredo, P. Charron, E.G.)
- Department of Genetics, Department of Cardiology, and Referral center for hereditary cardiac diseases, APHP, Pitié-Salpêtrière Hospital (A.H., P. Charron, E.G.)
- Sorbonne Université, INSERM 1166, Paris (F.A., M. Laredo, P.R., P. Charron, E.G.)
- APHP, Ambroise Paré Hospital, Department of Genetics and Referral center for cardiac hereditary cardiac diseases, Boulogne-Billancourt (A.P., P. Charron)
| | - Estelle Gandjbakhch
- Institute of Cardiology and ICAN Institute for Cardiometabolism and Nutrition (A.H., M. Laredo, P. Charron, E.G.)
- Department of Genetics, Department of Cardiology, and Referral center for hereditary cardiac diseases, APHP, Pitié-Salpêtrière Hospital (A.H., P. Charron, E.G.)
- Sorbonne Université, INSERM 1166, Paris (F.A., M. Laredo, P.R., P. Charron, E.G.)
| |
Collapse
|
7
|
Beyls C, Hermida A, Martin N, Peschanski J, Debrigode R, Vialatte A, Hanquiez T, Fournier A, Jarry G, Landemaine T, Malaquin D, Abou-Arab O, Mahjoub Y, Leborgne L. Prognostic Value of Right Ventricular Longitudinal Shortening Fraction in Patients With ST-Elevation Myocardial Infarction: A Prospective Echocardiography Study. Am J Cardiol 2024; 211:79-88. [PMID: 37898222 DOI: 10.1016/j.amjcard.2023.10.049] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/29/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023]
Abstract
Right ventricular systolic dysfunction (RVsD) frequently occurs in patients with ST-elevation myocardial infarction (STEMI). However, the diagnosis depends on the echocardiographic parameters to define RVsD. The right ventricle longitudinal shortening fraction (RV-LSF) is an accurate and reproducible 2-dimensional speckle-tracking parameter associated with clinical events in various pathologies. This study aimed to evaluate the association between RVsD and major adverse cardiovascular event (MACE) occurrence in a cohort of patients with STEMI. Adult patients with STEMI admitted to Amiens University Hospital's cardiovascular intensive care unit between May 2021 and November 2022 who underwent coronary angiography and transthoracic echocardiography within 48 hours of admission were included. RVsD was defined as RV-LSF <20%. The primary outcome was MACE occurrence, including heart failure, myocardial infarction, stroke, and death within 6 months of admission. A multivariable Cox regression analysis with proportional hazard ratio models assessed the association between RVsD and MACEs. In the 164 included patients, 72 (44%) had RVsD and 92 (56%) did not. The RVsD group had a significantly higher proportion of MACEs during the 6-month follow-up (n = 23 of 72, 33%) than the group without RVsD (n = 8 of 92, 9%, p = 0.001). RVsD showed an independent association with MACEs at 6 months (hazard ratio 3.1, 95% confidence interval [CI] 1.35 to 7.30, p = 0.008). Left ventricular ejection fraction <40% and Thrombolysis in Myocardial Infarction score >4 were independently associated with RVsD (odds ratio 2.80, 95% CI 1.34 to 5.98 and odds ratio 2.15, 95% CI 1.18 to 4.39, respectively, p = 0.015). The cumulative risk of MACEs at 6 months was 33% for RV-LSF <20% and 9% for RV-LSF ≥20% (log-rank test p <0.001). RVsD, defined by RV-LSF <20%, is associated with an increased risk of MACEs after STEMI.
Collapse
Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France; UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, Amiens, France.
| | - Alexis Hermida
- Rythmology unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Nicolas Martin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Julia Peschanski
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Romain Debrigode
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Alexis Vialatte
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Thomas Hanquiez
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Alexandre Fournier
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Geneviève Jarry
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Thomas Landemaine
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Dorothée Malaquin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France; UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, Amiens, France
| | - Laurent Leborgne
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, Amiens, France
| |
Collapse
|
8
|
Guedeney P, Farjat-Pasos JI, Asslo G, Roule V, Beygui F, Hermida A, Gabrion P, Leborgne L, Houde C, Huang F, Lattuca B, Leclercq F, Mesnier J, Abtan J, Rouanet S, Hammoudi N, Collet JP, Zeitouni M, Silvain J, Montalescot G, Rodés-Cabau J. Impact of the antiplatelet strategy following patent foramen ovale percutaneous closure. Eur Heart J Cardiovasc Pharmacother 2023; 9:601-607. [PMID: 36963773 DOI: 10.1093/ehjcvp/pvad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Accepted: 03/23/2023] [Indexed: 03/26/2023]
Abstract
AIMS Temporary dual antiplatelet therapy (DAPT) is recommended following patent foramen ovale (PFO) percutaneous closure although its benefit, compared to single antiplatelet therapy (SAPT), has not been demonstrated in this setting. We aimed at assessing outcomes following PFO closure according to the antiplatelet strategy at discharge. METHODS AND RESULTS The ambispective AIR-FORCE cohort included consecutive patients from seven centres in France and Canada undergoing PFO closure and discharged without anticoagulation. Patients treated in French and Canadian centres were mostly discharged with DAPT and SAPT, respectively. The primary endpoint was the composite of death, stroke, transient ischaemic attack, peripheral embolism, myocardial infarction, or BARC type ≥2 bleeding with up to 5 years of follow-up. The impact of the antiplatelet strategy on outcomes was evaluated with a marginal Cox model (cluster analyses per country) with inverse probability weighting according to propensity score. A total of 1532 patients (42.2% female, median age: 49 [40-57] years) were included from 2001 to 2022, of whom 599 (39.1%) were discharged with SAPT and 933 (60.9%) with DAPT, for ≤3 months in 894/923 (96.9%) cases. After a median follow-up of 2.4 [1.1-4.4] years, a total of 58 events were observed. In the weighted analysis, the rate of the primary endpoint up to 5 years was 7.8% in the SAPT strategy and 7.3% in the DAPT strategy (weighted hazard ratio 1.04, 95% confidence interval 0.59-1.83). CONCLUSION The antiplatelet strategy following PFO closure did not seem to impact clinical outcomes, thus challenging the current recommendations of temporary DAPT.
Collapse
Affiliation(s)
- Paul Guedeney
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | | | - Gabriel Asslo
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Vincent Roule
- Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France
| | - Farzin Beygui
- Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France
| | - Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Paul Gabrion
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Laurent Leborgne
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Christine Houde
- Centre Hospitalier Universitaire de Québec, Quebec City, Quebec, Canada
| | - Florent Huang
- Service de Cardiologie, Hôpital Foch, Suresnes, France
| | - Benoit Lattuca
- ACTION Study Group, Cardiology Department, Nîmes University Hospital, Montpellier University, Nîmes, France
| | - Florence Leclercq
- Department of Cardiology, Arnaud de Villeneuve University Hospital, Montpellier, France
| | - Jules Mesnier
- Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
- FACT (French Alliance for Cardiovascular Clinical Trials), Université de Paris, INSERM U-1148, Hôpital Bichat (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Jérémie Abtan
- FACT (French Alliance for Cardiovascular Clinical Trials), Université de Paris, INSERM U-1148, Hôpital Bichat (Assistance Publique-Hôpitaux de Paris), Paris, France
| | - Stéphanie Rouanet
- Statistician Unit, StatEthic, ACTION Study Group, Levallois-Perret, France
| | - Nadjib Hammoudi
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Jean-Philippe Collet
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Michel Zeitouni
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Johanne Silvain
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Gilles Montalescot
- Sorbonne Université, ACTION Study Group, INSERM UMRS_1166 Institut de cardiologie (AP-HP), Paris, France
| | - Josep Rodés-Cabau
- Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada
| |
Collapse
|
9
|
Hermida A, Gabrion P, Beyls C. You can't prove what you believe: Response to a letter entitled "Cardiovascular events in the context of coronavirus disease 2019" from Lee et al. Arch Cardiovasc Dis 2023; 116:427. [PMID: 37419723 PMCID: PMC10306415 DOI: 10.1016/j.acvd.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Alexis Hermida
- Department of Cardiology, Amiens University Hospital, 1, rond point du Pr-Cabrol, 80054 Amiens cedex 1, France.
| | - Paul Gabrion
- Department of Cardiology, Amiens University Hospital, 1, rond point du Pr-Cabrol, 80054 Amiens cedex 1, France
| | - Christophe Beyls
- Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, 80054 Amiens, France; UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, Jules-Verne University of Picardie, 80000 Amiens, France
| |
Collapse
|
10
|
Delinière A, Haddad C, Herrera-Siklody C, Hermida A, Pruvot E, Bressieux-Degueldre S, Millat G, Janin A, Hermida JS, Asatryan B, Chevalier P. Phenotypic Characterization of Timothy Syndrome Caused by the CACNA1C p.Gly402Ser Variant. Circ Genom Precis Med 2023:e004010. [PMID: 37009738 DOI: 10.1161/circgen.122.004010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Antoine Delinière
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
- University of Lyon, Claude Bernard Lyon 1 University, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, Lyon, France (A.D., P.C.)
| | - Christelle Haddad
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
| | - Claudia Herrera-Siklody
- Arrhythmia Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (C.H.-S., P.C.)
| | - Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France (A.H., J.-S.H.)
| | | | - Sabrina Bressieux-Degueldre
- Pediatric Cardiology Unit, Woman-Mother-Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (S.B.-D.)
| | - Gilles Millat
- Cardiogenetic laboratory, Centre de biologie et pathologie Est, Hospices Civils de Lyon (HCL), Lyon, France (G.M., A.J.)
| | - Alexandre Janin
- Cardiogenetic laboratory, Centre de biologie et pathologie Est, Hospices Civils de Lyon (HCL), Lyon, France (G.M., A.J.)
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France (A.H., J.-S.H.)
| | - Babken Asatryan
- Department of Cardiology, Inselspital, Bern University Hospital, Switzerland (B.A.)
| | - Philippe Chevalier
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
- University of Lyon, Claude Bernard Lyon 1 University, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, Lyon, France (A.D., P.C.)
- Arrhythmia Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (C.H.-S., P.C.)
| |
Collapse
|
11
|
Gabrion P, Beyls C, Martin N, Jarry G, Facq A, Fournier A, Malaquin D, Mahjoub Y, Dupont H, Diouf M, Duquenne H, Maizel J, Bohbot Y, Leborgne L, Hermida A. Two-year prognosis of acute coronary syndrome during the first wave of the coronavirus disease 2019 pandemic. Arch Cardiovasc Dis 2023; 116:240-248. [PMID: 37032221 PMCID: PMC10038673 DOI: 10.1016/j.acvd.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND The first wave of the coronavirus disease 2019 pandemic significantly changed behaviour in terms of access to healthcare. AIM To assess the effects of the pandemic and initial lockdown on the incidence of acute coronary syndrome and its long-term prognosis. METHODS Patients admitted for acute coronary syndrome from 17 March to 6 July 2020 and from 17 March to 6 July 2019 were included. The number of admissions for acute coronary syndrome, acute complication rates and 2-year rates of survival free from major adverse cardiovascular events or death from any cause were compared according to the period of hospitalization. RESULTS In total, 289 patients were included. We observed a 30±3% drop in acute coronary syndrome admissions during the first lockdown, which did not recover in the 2months after it was lifted. At 2years, there were no significant differences in the combined endpoint of major adverse cardiovascular events or death from any cause between the different periods (P=0.34). Being hospitalized during lockdown was not predictive of adverse events during follow-up (hazard ratio 0.87, 95% confidence interval 0.45-1.66; P=0.67). CONCLUSIONS We did not observe an increased risk of major cardiovascular events or death at 2years from initial hospitalization for patients hospitalized during the first lockdown, adopted in March 2020 in response to the coronavirus disease 2019 pandemic, potentially as a result of the lack of power of the study.
Collapse
Affiliation(s)
- Paul Gabrion
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Christophe Beyls
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Nicolas Martin
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Genevieve Jarry
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Arthur Facq
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Alexandre Fournier
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Dorothée Malaquin
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Yazine Mahjoub
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Hervé Dupont
- Surgical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Momar Diouf
- Biostatistics Unit, Clinical Research and Innovation Directorate, Amiens-Picardie University Hospital Centre, 80054 Amiens, France
| | - Helene Duquenne
- Cardiology and Arrhythmia Service, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Julien Maizel
- Medical Intensive Care Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Yohann Bohbot
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Laurent Leborgne
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France
| | - Alexis Hermida
- Intensive Cardiac Unit, Amiens-Picardie University Hospital, 80054 Amiens, France; Cardiology and Arrhythmia Service, Amiens-Picardie University Hospital, 80054 Amiens, France.
| |
Collapse
|
12
|
Benali K, Barré V, Hermida A, Galand V, Milhem A, Philibert S, Boveda S, Bars C, Anselme F, Maille B, André C, Behaghel A, Moubarak G, Clémenty N, Da Costa A, Arnaud M, Venier S, Sebag F, Jésel-Morel L, Sagnard A, Champ-Rigot L, Dang D, Guy-Moyat B, Abbey S, Garcia R, Césari O, Badenco N, Lepillier A, Ninni S, Boulé S, Maury P, Algalarrondo V, Bakouboula B, Mansourati J, Lesaffre F, Lagrange P, Bouzeman A, Muresan L, Bacquelin R, Bortone A, Bun SS, Pavin D, Macle L, Martins RP. Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study. Circ Arrhythm Electrophysiol 2023; 16:e011354. [PMID: 36802906 DOI: 10.1161/circep.122.011354] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [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] [Indexed: 02/22/2023]
Abstract
BACKGROUND Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown. We analyzed the impact of current ablation strategies in a large multicenter study. METHODS Patients undergoing a redo ablation for AF and presenting durable PVI were included. The freedom from atrial arrhythmia after pulmonary vein-based, linear-based, electrogram-based, and trigger-based ablation strategies were compared. RESULTS Between 2010 and 2020, 367 patients (67% men, 63±10 years, 44% paroxysmal) underwent a redo ablation for AF recurrences despite durable PVI at 39 centers. After durable PVI was confirmed, linear-based ablation was performed in 219 (60%) patients, electrogram-based ablation in 168 (45%) patients, trigger-based ablation in 101 (27%) patients, and pulmonary vein-based ablation in 56 (15%) patients. Seven patients (2%) did not undergo any additional ablation during the redo procedure. After 22±19 months of follow-up, 122 (33%) and 159 (43%) patients had a recurrence of atrial arrhythmia at 12 and 24 months, respectively. No significant difference in arrhythmia-free survival was observed between the different ablation strategies. Left atrial dilatation was the only independent factor associated with arrhythmia-free survival (HR, 1.59 [95% CI, 1.13-2.23]; P=0.006). CONCLUSIONS In patients with recurrent AF despite durable PVI, no ablation strategy used alone or in combination during the redo procedure appears to be superior in improving arrhythmia-free survival. Left atrial size is a significant predictor of ablation outcome in this population.
Collapse
Affiliation(s)
- Karim Benali
- CHU Saint Etienne, University of Rennes, INSERM, LTSI -UMR 1099, Rennes (K.B.)
| | - Valentin Barré
- University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.)
| | | | - Vincent Galand
- University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.)
| | | | | | - Serge Boveda
- Cardiology-Heart Rhythm Management Department, Clinique Pasteur, Toulouse (S.B.)
| | | | | | | | | | | | | | | | | | | | | | - Frédéric Sebag
- Rythmologie, Institut Mutualiste Montsouris, Paris (F.S.)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Babé Bakouboula
- Institut Cardiovasculaire de Strasbourg, Clinique RHENA (B.B.)
| | | | | | | | | | | | | | | | | | - Dominique Pavin
- University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.)
| | - Laurent Macle
- Department of Medicine, Electrophysiology Service at the Montreal Heart Institute, Canada (L.M.)
| | - Raphaël P Martins
- University of Rennes, CHU Rennes, INSERM, LTSI-UMR 1099, Rennes (V.B., V.G., D.P., R.P.M.)
| |
Collapse
|
13
|
Laredo M, Duthoit G, Sacher F, Anselme F, Audinet C, Bessière F, Bordachar P, Bouzeman A, Boveda S, Bun SS, Chassignolle M, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Extramiana F, Fauchier L, Hermida A, Gandjbakhch E, Garcia R, Gourraud JB, Guenancia C, Guy-Moyat B, Irles D, Iserin L, Jourda F, Koutbi L, Labombarda F, Ladouceur M, Lagrange P, Lellouche N, Mansourati J, Marquié C, Martins R, Massoulié G, Mathiron A, Maury P, Messali A, Milhem A, Mondoly P, Nguyen C, Ninni S, Pasquié JL, Pierre B, Pujadas P, Sellal JM, Thambo JB, Walton C, Winum P, Zakine C, Zhao A, Jouven X, Combes N, Marijon E, Waldmann V. Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator: Insights from the DAI-T4F nationwide registry. Heart Rhythm 2023; 20:252-260. [PMID: 36309156 DOI: 10.1016/j.hrthm.2022.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 08/29/2022] [Revised: 09/28/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND In repaired tetralogy of Fallot (TOF), little is known about characteristics of patients with rapid ventricular tachycardia (VT). Also, whether patients with a first episode of nonrapid VT may subsequently develop rapid VT or ventricular fibrillation (VF) has not been addressed. OBJECTIVES The objectives of this study were to compare patients with rapid VT/VF with those with nonrapid VT and to assess the evolution of VT cycle lengths (VTCLs) overtime. METHODS Data were analyzed from a nationwide registry including all patients with TOF and implantable cardioverter-defibrillator (ICD) since 2000. Patients with ≥1 VT episode with VTCL ≤250 ms (240 beats/min) formed the rapid VT/VF group. RESULTS Of 144 patients (mean age 42.0 ± 12.7 years; 104 [72%] men), 61 (42%) had at least 1 VT/VF episode, including 28 patients with rapid VT/VF (46%), during a median follow-up of 6.3 years (interquartile range 2.2-10.3 years). Compared with patients in the nonrapid VT group, those in the rapid VT/VF group were significantly younger at ICD implantation (35.2 ± 12.6 years vs 41.5 ± 11.2 years; P = .04), had more frequently a history of cardiac arrest (8 [29%] vs 2 [6%]; P = .02), less frequently a history of atrial arrhythmia (11 [42%] vs 22 [69%]; P = .004), and higher right ventricular ejection fraction (43.3% ± 10.3% vs 36.6% ± 11.2%; P = .04). The median VTCL of VT/VF episodes was 325 ms (interquartile range 235-429 ms). None of the patients with a first documented nonrapid VT episode had rapid VT/VF during follow-up. CONCLUSION Patients with TOF and rapid VT/VF had distinct clinical characteristics. The relatively low variation of VTCL over time suggests a room for catheter ablation without a backup ICD in selected patients with well-tolerated VT.
Collapse
Affiliation(s)
- Mikael Laredo
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Guillaume Duthoit
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Frédéric Sacher
- LIRYC Institute, Bordeaux University Hospital, Bordeaux, France
| | | | | | | | | | | | | | | | - Morgane Chassignolle
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France
| | - Gaël Clerici
- Saint Pierre University Hospital, La Réunion, France
| | | | | | | | | | | | | | | | | | - Estelle Gandjbakhch
- Unité de Rythmologie, Cardiology institute, Sorbonne University, AP-HP, La Pitié-Salpêtrière University Hospital, Paris, France
| | | | | | | | | | | | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | - Magalie Ladouceur
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xavier Jouven
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France
| | | | - Eloi Marijon
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France
| | - Victor Waldmann
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Cardiac Electrophysiology Section, European Georges Pompidou Hospital, Paris, France.
| | | |
Collapse
|
14
|
Benali K, Barre V, Hermida A, Milhem A, Philibert S, Boveda S, Bars C, Anselme F, Maille B, André C, Behaghel A, Moubarak G, Clémenty N, Da Costa A, Arnaud M, Venier S, Sebag F, Jesel L, Macle L, Martins R. Atrial fibrillation recurrences despite durable pulmonary vein isolation: Characteristics, management and outcomes, the PARTY-PVI study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.177] [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]
|
15
|
Kubala M, Bohbot Y, Dromzee PH, Hermida A, Rusinaru D, Tribouilloy C. Effect of frailty on survival after cardiac resynchronization therapy. Arch Cardiovasc Dis 2022; 115:610-611. [DOI: 10.1016/j.acvd.2022.08.002] [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] [Received: 01/23/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/15/2022]
|
16
|
Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessière F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Al Arnaout A, Anselme F, Audinet C, Bernard Y, Boveda S, Bun SS, Chassignolle M, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators. JACC Clin Electrophysiol 2022; 8:1304-1314. [DOI: 10.1016/j.jacep.2022.06.024] [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: 02/22/2022] [Revised: 05/24/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
|
17
|
Beyls C, Ghesquières T, Hermida A, Booz T, Crombet M, Martin N, Huette P, Jounieaux V, Dupont H, Abou-Arab O, Mahjoub Y. Feasibility, Prediction and Association of Right Ventricular Free Wall Longitudinal Strain with 30-Day Mortality in Severe COVID-19 Pneumonia: A Prospective Study. J Clin Med 2022; 11:jcm11133629. [PMID: 35806914 PMCID: PMC9267479 DOI: 10.3390/jcm11133629] [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: 05/24/2022] [Revised: 06/13/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Right ventricular (RV) systolic dysfunction (RVsD) is a common complication of coronavirus infection 2019 disease (COVID-19). The right ventricular free wall longitudinal strain parameter (RV-FWLS) is a powerful predictor of mortality. We explored the performance of RVsD parameters for predicting 30-day mortality and the association between RV-FWLS and 30-day mortality. Methods: COVID-19 patients hospitalized at Amiens University Hospital in the critical care unit with transthoracic echocardiography were included. We measured tricuspid annular plane systolic excursion (TAPSE), the RV S’ wave, RV fractional area change (RV-FAC), and RV-FWLS. The diagnostic performance of RVsD parameters as predictors for 30-day mortality was evaluated by the area under the receiver operating characteristic (ROC) curve (AUC). RVsD was defined by an RV-FWLS < 21% to explore the association between RVsD and 30-day mortality. Results: Of the 116 patients included, 20% (n = 23/116) died and 47 had a RVsD. ROC curve analysis showed that RV-FWLS failed to predict 30-day mortality, as did conventional RV parameters (all p > 0.05). TAPSE (21 (19−26) mm vs. 24 (21−27) mm; p = 0.024) and RV-FAC (40 (35−47)% vs. 47 (41−55)%; p = 0.006) were lowered in the RVsD group. In Cox analysis, RVsD was not associated with 30-day mortality (hazard ratio = 1.12, CI 95% (0.49−2.55), p = 0.78). Conclusion: In severe COVID-19 pneumonia, RV-FWLS was not associated with 30-day mortality.
Collapse
Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
- Correspondence:
| | - Tristan Ghesquières
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Alexis Hermida
- Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (A.H.); (N.M.)
| | - Thomas Booz
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Maxime Crombet
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Nicolas Martin
- Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (A.H.); (N.M.)
| | - Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
| | - Vincent Jounieaux
- Respiratory Department, Amiens University Hospital, F-80054 Amiens, France;
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (T.G.); (T.B.); (M.C.); (P.H.); (H.D.); (O.A.-A.); (Y.M.)
- UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80000 Amiens, France
| |
Collapse
|
18
|
Hermida A, Burtin J, Kubala M, Fay F, Lallemand PM, Buiciuc O, Lieu A, Zaitouni M, Beyls C, Hermida JS. Sex Differences in the Outcomes of Cryoablation for Atrial Fibrillation. Front Cardiovasc Med 2022; 9:893553. [PMID: 35665259 PMCID: PMC9157614 DOI: 10.3389/fcvm.2022.893553] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background The literature data on the outcomes of radiofrequency catheter ablation for atrial fibrillation (AF) in women are contradictory. Aim To determine and compare the outcomes and complications of cryoballoon pulmonary vein isolation (cryo-PVI) in men vs. women, and to identify predictors of atrial tachyarrhythmia (ATa) recurrence. Methods We included all consecutive patients having undergone cryo-PVI for the treatment of symptomatic AF in our center since 2012. Peri-operative complications were documented. All patients were prospectively monitored for the recurrence of ATa, and predictors were assessed. Results A total of 733 patients were included (550 men (75%) and 183 (25%) women). Paroxysmal AF was recorded in 112 (61%) female patients and 252 male patients (46%; p < 0.001). Female patients were older (p < 0.001) and had a greater symptom burden (p = 0.04). Female patients were more likely to experience complications (p = 0.02). After cryo-PVI for paroxysmal AF, 66% of the female patients and 79% of the male patients were free of ATa at 24 months (p = 0.001). Female sex was the only independent predictive factor for ATa recurrence (hazard ratio [95% confidence interval] = 1.87 [1.28; 2.73]; p = 0.001). After cryo-PVI for non-paroxysmal AF, 37% of the male patients and 39% of the female patients were free of ATa at 36 months (p = 0.73). Female patients were less likely than male patients to undergo repeat ablation after an index cryo-PVI for non-paroxysmal AF (p = 0.019). Conclusion A single cryo-PVI procedure for paroxysmal AF was significantly less successful in female patients than in male patients. Overall, the complication rate was higher in women than in men.
Collapse
Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Jacqueline Burtin
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Floriane Fay
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | | | - Otilia Buiciuc
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Audrey Lieu
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Mustafa Zaitouni
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Christophe Beyls
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | | |
Collapse
|
19
|
Waintraub X, Sauve R, Vedrenne G, Amet D, Gras M, Degand B, Moini C, Duthoit G, Laredo M, Badenco N, Lesaffre F, Lepillier A, Hidden Lucet F, Hermida A, Gandjbakhch E. Endocardial ablation of ventricular tachycardia ablation in arrhythmogenic right ventricular cardiomyopathy aiming epicardial late potential abolition. Europace 2022. [DOI: 10.1093/europace/euac053.382] [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.
Background
Catheter ablation is frequently needed to treat ventricular tachycardia (VT) in ARVC patients. Ablation aiming non-inducibility (NI) and late potential (LP) abolition has been shown to be effective1. Simultaneous endo-epicardial mapping demonstrate epicardial involvement in most VT2. However epicardial fat and vicinity of coronary artery may prevent effective epicardial ablation.
Aims
(a) evaluate endocardial-only ablation guided by epicardial late-potential recording (EA-ELP) to achieve LP abolition (LPA) and NI; (b) measure ablation-index(AI) values allowing epicardial LP suppression by endocardial ablation, as a surrogate for transmurality.
Methods
From 2019 to 2021 the authors (XW, EG) evaluated EA-ELP in ARVC patients patient referred for ablation. Our ablation protocol was previously described3. Endo and epicardial voltage mapping of the right ventricle (RV) were performed in sinus rhythm using 0.5-1.5 mV threshlods for endocardial scar and 0.5-1 mV for the epicardial. All LP were manually tagged. Programmed ventricular stimulation (PVS) was performed till S4 from the RV apex and other sites, all inducible tolerated VT were mapped. Endocardial ablation was performed with an irrigated tip catheter positioned in front of epi-LP recorded by a multi-electrode catheter aiming to eliminate or delay epi-LP as a surrogate for transmurality. For each lesion fulfilling the «transmurality criteria», the AI values were recorded. Remap was performed to validate LPA and NI was tested. Patient follow-up (FU) rely on telemonitoring in ICD-carriers and holter/exercise test for the others.
Results
11 patients were enrolled (9M/2F, mean age 45 years), 9 for VT recurrence (3 redo) and 2 for de novo VT. The median ICD therapy before ablation was 5/patient (mean 1.7). The clinical VT originated from the RV outflow tract (RVOT) in 5 patients, peritricuspid (PT) in 2, RV free wall (RFW) in 4. Substrate were more extended in the epicardium compared to the endocardium: epi-LP and scar surfaces were 42.5 cm2/118 cm2 versus 24.5 cm2/25.5 cm2 for the endocardium. In one patient, additional epicardial lesion was necessary to achieve LPA. The mean ablation duration was 3377 s. Remap showed LPA in all patients and PVS was negative in all (not tested in one due to hemodynamic instability). One patient presented retrosternal hematoma after ablation with spontaneous favorable outcome. Endocardial AI values allowing epi-LP abolition were 595 for the inferior wall, 625 in the RVOT, 604 for PT and 639 for RFW. During a mean FU of 12 months (median 16.5 mths), only one patient had VT recurrence.
Conclusion
Based on this case-series, EA-ELP appeared as a safe and effective method to treat VT in ARVC. EA-ELP ablation allowed VT suppression in 91 % of patients after an mean FU of 12 mths. The RV endocardial AI needed to suppress epi-LP ranged was between 595-639 and could be used as surrogate for transmurality in ARVC.
Collapse
Affiliation(s)
- X Waintraub
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - R Sauve
- Biosense Webster, Paris, France
| | - G Vedrenne
- Saint Joseph Hospital, Arrhythmia Unit, Paris, France
| | - D Amet
- European Hospital Georges Pompidou, Paris, France
| | - M Gras
- La Miletrie University Hospital Centre, Poitiers, France
| | - B Degand
- La Miletrie University Hospital Centre, Poitiers, France
| | - C Moini
- JACQUES CARTIER PRIVATE HOSPITAL, Massy, France
| | - G Duthoit
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - M Laredo
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - N Badenco
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - F Lesaffre
- HOSPITAL ROBERT DEBRE - UNIVERSITY HOSPITAL CENTRE OF REIMS, Reims, France
| | - A Lepillier
- Centre Cardiologique du Nord (CCN), Saint Denis, France
| | - F Hidden Lucet
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - A Hermida
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| | - E Gandjbakhch
- AP-HP - Hospital Pitie-Salpetriere - Institute of Cardiology, Rhythmology Department, Paris, France
| |
Collapse
|
20
|
Hermida A, Jedraszak G, Kubala M, Bourgain M, Bodeau S, Hermida JS. Use of ranolazine as rescue therapy in a patient with Timothy syndrome type 2. Rev Esp Cardiol (Engl Ed) 2022; 75:447-448. [PMID: 34844894 DOI: 10.1016/j.rec.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France; EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France.
| | - Guillaume Jedraszak
- EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France; Molecular Genetics Laboratory, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| | - Marion Bourgain
- Pediatric Cardiology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Sandra Bodeau
- Laboratory of Pharmacology and Toxicology, Amiens-Picardie University Hospital, Amiens, France
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| |
Collapse
|
21
|
Hermida A, Jedraszak G, Kubala M, Bourgain M, Bodeau S, Hermida JS. Uso de ranolazina en paciente con síndrome de Timothy tipo 2. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.10.023] [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: 11/29/2022]
|
22
|
Hermida A, Hermida JS. Should cryoballoon ablation of paroxysmal atrial fibrillation be proposed as a first-line treatment? J Interv Card Electrophysiol 2022; 65:267-270. [PMID: 35119585 DOI: 10.1007/s10840-022-01140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Alexis Hermida
- Service de Cardiologie, Rythmologie Et Stimulation Cardiaque CHU Amiens-Picardie, 1, rond-point du Professeur Christian Cabrol, 80054, Amiens Cedex, France.
| | | |
Collapse
|
23
|
Beyls C, Hermida A, Bohbot Y, Martin N, Viart C, Boisgard S, Daumin C, Huette P, Dupont H, Abou-Arab O, Mahjoub Y. Automated left atrial strain analysis for predicting atrial fibrillation in severe COVID-19 pneumonia: a prospective study. Ann Intensive Care 2021; 11:168. [PMID: 34874509 PMCID: PMC8649321 DOI: 10.1186/s13613-021-00955-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background Atrial fibrillation (AF) is the most documented arrhythmia in COVID-19 pneumonia. Left atrial (LA) strain (LAS) analysis, a marker of LA contractility, have been associated with the development of AF in several clinical situations. We aimed to assess the diagnostic ability of LA strain parameters to predict AF in patients with severe hypoxemic COVID-19 pneumonia. We conducted a prospective single center study in Amiens University Hospital intensive care unit (ICU) (France). Adult patients with severe or critical COVID-19 pneumonia according to the World Health Organization definition and in sinus rhythm were included. Transthoracic echocardiography was performed within 48 h of ICU admission. LA strain analysis was performed by an automated software. The following LA strain parameters were recorded: LA strain during reservoir phase (LASr), LA strain during conduit phase (LAScd) and LA strain during contraction phase (LASct). The primary endpoint was the occurrence of AF during ICU stay. Results From March 2020 to February of 2021, 79 patients were included. Sixteen patients (20%) developed AF in ICU. Patients of the AF group were significantly older with a higher SAPS II score than those without AF. LAScd and LASr were significantly more impaired in the AF group compared to the other group (− 8.1 [− 6.3; − 10.9] vs. − 17.2 [− 5.0; − 10.2] %; P < 0.001 and 20.2 [12.3;27.3] % vs. 30.5 [23.8;36.2] %; P = 0.002, respectively), while LASct did not significantly differ between groups (p = 0.31). In a multivariate model, LAScd and SOFA cv were significantly associated with the occurrence of AF. A LAScd cutoff value of − 11% had a sensitivity of 76% and a specificity of 75% to identify patients with AF. The 30-day cumulative risk of AF was 42 ± 9% with LAScd > − 11% and 8 ± 4% with LAScd ≤ − 11% (log rank test P value < 0.0001). Conclusion For patients with severe COVID-19 pneumonia, development of AF during ICU stay is common (20%). LAS parameters seem useful in predicting AF within the first 48 h of ICU admission. Trial registration: NCT04354558.
Collapse
Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France. .,UR UPJV 7518 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, Amiens, France.
| | - Alexis Hermida
- Department of Rythmology, Amiens University Hospital, 80054, Amiens, France
| | - Yohann Bohbot
- Department of Cardiology, Amiens University Hospital, 80054, Amiens, France
| | - Nicolas Martin
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Christophe Viart
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Solenne Boisgard
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Camille Daumin
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Pierre Huette
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Hervé Dupont
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, 1, Rond-point du Pr Cabrol, 80054, Amiens, Cedex 1, France
| |
Collapse
|
24
|
Mernissi T, Hermida A, André C, Bennis Y, Masmoudi K, Bodeau S, Lemaire-Hurtel AS. Consommation de cannabis et infarctus du myocarde : à propos d’un cas fatal. Toxicologie Analytique et Clinique 2021. [DOI: 10.1016/j.toxac.2021.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
Waldmann V, Bouzeman A, Duthoit G, Koutbi L, Bessiere F, Labombarda F, Marquié C, Gourraud JB, Mondoly P, Sellal JM, Bordachar P, Hermida A, Anselme F, Asselin A, Audinet C, Bernard Y, Bru P, Sithikun Bun S, Clerici G, Da Costa A, de Guillebon M, Defaye P, Elbaz N, Eschalier R, Garcia R, Guenancia C, Guy-Moyat B, Halimi F, Irles D, Iserin L, Jourda F, Ladouceur M, Lagrange P, Laredo M, Mansourati J, Massoulié G, Mathiron A, Maury P, Messali A, Narayanan K, Nguyen C, Ninni S, Perier MC, Pierre B, Pujadas P, Sacher F, Sagnol P, Sharifzadehgan A, Walton C, Winum P, Zakine C, Fauchier L, Martins R, Pasquié JL, Thambo JB, Jouven X, Combes N, Marijon E. Long-term follow-up of patients with tetralogy of fallot and implantable cardioverter defibrillator–The DAI-T4F nationwide registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.06.006] [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: 11/16/2022]
|
26
|
Hermida A, Kubala M, Hermida JS. Air Bubble Trapped in the Left Atrial Appendage After Occluder Delivery. CJC Open 2021; 3:693-694. [PMID: 34027376 PMCID: PMC8134932 DOI: 10.1016/j.cjco.2021.01.002] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | | |
Collapse
|
27
|
Hermida A, Jedraszak G, Kubala M, Mathiron A, Berna P, Bennis Y, Hermida JS. Long-term follow-up of a patient with type 2 Timothy syndrome and the partial efficacy of mexiletine. Gene 2021; 777:145465. [PMID: 33524520 DOI: 10.1016/j.gene.2021.145465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/23/2020] [Accepted: 01/22/2021] [Indexed: 11/15/2022]
Abstract
We report a detailed case of type 2 TS due to a p.(Gly402Ser) mutation in exon 8 of the CACNA1C gene. The patient shows a marked prolongation of repolarization with a mean QTc of 540 ms. He shows no structural heart disease, syndactyly, or cranio-facial abnormalities. However, he shows developmental delays, without autism, and dental abnormalities. The cardiac phenotype is very severe, with a resuscitated cardiac arrest at 2.5 years of age, followed by 26 appropriate shocks during nine years of follow-up. Adding mexiletine to nadolol resulted in a reduction of the QTc and a slight decrease in the number of appropriate shocks.
Collapse
Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France.
| | - Guillaume Jedraszak
- Molecular Genetics Laboratory, Amiens-Picardie University Hospital, Amiens, France; EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France
| | - Maciej Kubala
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| | - Amel Mathiron
- Pediatric Cardiology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Pascal Berna
- Department of Thoracic Surgery Service, Amiens-Picardie University Hospital, Amiens, France
| | - Youssef Bennis
- Laboratory of Pharmacology and Toxicology, Amiens-Picardie University Hospital, Amiens, France
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| |
Collapse
|
28
|
Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine (C.B., O.A.-A., Y.M.), Amiens University Hospital, France
| | - Nicolas Martin
- Department of Rythmology (N.M., A.H.), Amiens University Hospital, France
| | - Alexis Hermida
- Department of Rythmology (N.M., A.H.), Amiens University Hospital, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine (C.B., O.A.-A., Y.M.), Amiens University Hospital, France
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine (C.B., O.A.-A., Y.M.), Amiens University Hospital, France
| |
Collapse
|
29
|
Ader F, Surget E, Charron P, Redheuil A, Zouaghi A, Maltret A, Marijon E, Denjoy I, Hermida A, Fressart V, Gandjbakhch E. Inherited Cardiomyopathies Revealed by Clinically Suspected Myocarditis: Highlights From Genetic Testing. Circ Genom Precis Med 2020; 13:e002744. [PMID: 32522011 DOI: 10.1161/circgen.119.002744] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Flavie Ader
- Sorbonne Universités, APHP, UF Cargiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpital Universitaire Pitié-Salpêtrière (F.A., V.F.)
| | - Elodie Surget
- Sorbonne Universités, APHP, Institut de Cardiologie, ICAN, Hôpital universitaire Pitié-Salpêtrière (E.S., A.R., A.Z., E.G.)
| | - Philippe Charron
- Centre de Références des Maladies Cardiaques Héréditaires, Paris, France (F.A., P.C., A.M., E.M., I.D., V.F., E.G.).,Sorbonne Universités, APHP, Département de Génétique, Hôpital Universitaire Pitié-Salpêtrière (P.C.)
| | - Alban Redheuil
- Sorbonne Universités, APHP, Institut de Cardiologie, ICAN, Hôpital universitaire Pitié-Salpêtrière (E.S., A.R., A.Z., E.G.)
| | - Amir Zouaghi
- Sorbonne Universités, APHP, Institut de Cardiologie, ICAN, Hôpital universitaire Pitié-Salpêtrière (E.S., A.R., A.Z., E.G.)
| | - Alice Maltret
- Centre de Références des Maladies Cardiaques Héréditaires, Paris, France (F.A., P.C., A.M., E.M., I.D., V.F., E.G.)
| | - Eloi Marijon
- Centre de Références des Maladies Cardiaques Héréditaires, Paris, France (F.A., P.C., A.M., E.M., I.D., V.F., E.G.)
| | - Isabelle Denjoy
- APHP, Département de Cardiologie, Hôpital Universitaire Bichat, Paris (I.D.)
| | - Alexis Hermida
- Département de Cardiologie, Hôpital Universitaire, Amiens, France (A.H.)
| | - Véronique Fressart
- Sorbonne Universités, APHP, UF Cargiogénétique et Myogénétique, Service de Biochimie Métabolique, Hôpital Universitaire Pitié-Salpêtrière (F.A., V.F.).,Centre de Références des Maladies Cardiaques Héréditaires, Paris, France (F.A., P.C., A.M., E.M., I.D., V.F., E.G.)
| | - Estelle Gandjbakhch
- Sorbonne Universités, APHP, Institut de Cardiologie, ICAN, Hôpital universitaire Pitié-Salpêtrière (E.S., A.R., A.Z., E.G.).,Centre de Références des Maladies Cardiaques Héréditaires, Paris, France (F.A., P.C., A.M., E.M., I.D., V.F., E.G.)
| |
Collapse
|
30
|
Waldmann V, Bouzeman A, Duthoit G, Koutbi R, Bessiere F, Hermida A, Elbaz N, Messali A, Garcia R, Pujadas P, Halimi F, Bun S, Lagrange P, De Guillebon M, Mansourati J, Da Costa A, Martins R, Gourraud J, Combes N, Marijon E. Electrocardiographic predictors of appropriate implantable cardioverter defibrillator therapies in patients with tetralogy of Fallot. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
31
|
Hermida A, Zaitouni M, Kubala M, Lallemand P, Buiciuc O, Fay F, Tournevache F, Hermida J. Long-term incidence of cardioembolic events after cryoballoon pulmonary vein isolation. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
32
|
Waldmann V, Bouzeman A, Koutbi R, Bessiere F, Hermida A, Duthoit G, Elbaz N, Messali A, De Guillebon M, Mansourati J, Da Costa A, Martins R, Gourraud JB, Combes N, Marijon E. 5205Electrocardiographic predictors of appropriate implantable cardioverter defibrillator therapies in patients with tetralogy of Fallot. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0063] [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: 11/14/2022] Open
Abstract
Abstract
Background
The electrocardiogram (ECG) is widely available and may contribute to a better risk stratification for sudden cardiac death in patients with tetralogy of Fallot. QRS duration has been consistently associated with outcomes, with a lack of specificity for sudden mortality and a relatively low predictive value. New markers such as QRS fragmentation and vectocardiographic parameters have been recently suggested.
Purpose
To identify ECG predictors of appropriate therapies in patients with tetralogy of Fallot and implantable cardioverter defibrillator (ICD).
Methods
The DAI-T4F study is a large ongoing national French registry including all patients with tetralogy of Fallot and ICD (NCT03837574). Information have been collected prospectively since 2010 with annual update. Baseline patient characteristics and clinical events during the follow-up were analyzed with central adjudication. Cox proportional hazard models were used to identify factors associated with appropriate ICD therapies.
Results
A total of 134 patients (median age 41.7 years, 70.7% males) were enrolled. During a median (IQR) follow-up of 6.1 (2.7–10.2) years, 59 (44.0%) patients received at least one appropriate ICD therapy, giving annual incidence of 5.5% and 7.1% in primary and secondary prevention, respectively (p=0.058). Overall, QRSd ≥180ms (p=0.073), QRS fragmentation (p=0.052), and QRS vector magnitude (vm, p=0.327) were not significantly associated with appropriate ICD therapies, whereas QRS fragmentation in right leads (HR=1.7, 95% CI: 1.1–2.9, p=0.039) and the association of QRSd ≥180ms and overall QRS fragmentation (HR=1.9, 95% CI: 1.1–3.4, p=0.036) were associated with an increased risk of appropriates ICD therapies. In patients with ICD for primary prevention (47 patients, 35.1%), 53.8% had QRS fragmentation, 48.6% had decreased QRS vm, and 41.0% had QRSd ≥180ms. In this group, while non-sustained ventricular tachycardia (NSVT) considered isolated was not associated with ventricular events during follow-up (p=0.069), respective combinations with QRSd ≥180 ms (HR=7.2, 95% CI: 1.6–32.7, p=0.011), QRS fragmentation (HR=3.8, 95% CI: 1.2–12.4, p=0.025), or decreased QRS vm (HR=3.6, 95% CI: 1.1–12.1, p=0.042) were all associated with a higher incidence of appropriate ICD therapies. Positive predictive value and negative predictive value were 0.33 and 0.85, 0.58 and 0.74, and 0.36 and 0.84 in patients with NSVT and QRS ≥180ms, NSVT and QRS fragmentation, and NSVT and decreased QRS vm, respectively.
Conclusions
Our findings highlight that cumulative risk score derived from ECG may contribute to improve risk stratification in patients with tetralogy of Fallot, in particular QRS fragmentation and QRS vm in association with QRS duration and other traditional risk factors.
Collapse
Affiliation(s)
- V Waldmann
- European Hospital Georges Pompidou, Paris, France
| | - A Bouzeman
- Private Hopital of Parly II, Le Chesnay, France
| | - R Koutbi
- Hospital La Timone of Marseille, Marseille, France
| | - F Bessiere
- Hospital Louis Pradel of Bron, Lyon, France
| | - A Hermida
- University Hospital of Amiens, Amiens, France
| | - G Duthoit
- Hospital Pitie-Salpetriere, Paris, France
| | - N Elbaz
- University Hospital Henri Mondor, Creteil, France
| | - A Messali
- Hospital Bichat-Claude Bernard, Paris, France
| | | | | | - A Da Costa
- CHU Saint Etienne Hopital Nord, Saint-Etienne, France
| | - R Martins
- University Hospital of Rennes, Rennes, France
| | | | - N Combes
- Clinic Pasteur, Toulouse, France
| | - E Marijon
- European Hospital Georges Pompidou, Paris, France
| |
Collapse
|
33
|
Beyls C, Hermida A, Duchateau J, Maury P, Taieb J, Laurent G, Kubala M, Ben Amar A, Sacher F, Jais P, Hermida J. Management of acute cardiac tamponade by direct autologous blood transfusion in interventional electrophysiology. J Cardiovasc Electrophysiol 2019; 30:1287-1293. [DOI: 10.1111/jce.14050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/19/2019] [Accepted: 05/29/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Christophe Beyls
- Pôle Cardio‐Thoracique VasculaireAmiens‐Picardie University Hospital Amiens France
| | - Alexis Hermida
- Pôle Cardio‐Thoracique VasculaireAmiens‐Picardie University Hospital Amiens France
| | - Josselin Duchateau
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F‐/ Bordeaux University Hospital (CHU)Electrophysiology and Ablation Unit/Univ. Bordeaux, Centre de recherche Cardio‐Thoracique de Bordeaux Bordeaux France
| | - Philippe Maury
- Pôle Cardiologie et MétaboliqueToulouse University Hospital. Hôpital Rangueil Toulouse France
| | - Jérôme Taieb
- Service de Cardiologie et Maladies VasculairesAix en Provence Hospital Aix‐en‐Provence France
| | - Gabriel Laurent
- Service de Rythmologie et Insuffisance CardiaqueDijon‐Bourgogne University Hospital Dijon France
| | - Maciej Kubala
- Pôle Cardio‐Thoracique VasculaireAmiens‐Picardie University Hospital Amiens France
| | - Amar Ben Amar
- Pôle Cardio‐Thoracique VasculaireAmiens‐Picardie University Hospital Amiens France
| | - Frederic Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F‐/ Bordeaux University Hospital (CHU)Electrophysiology and Ablation Unit/Univ. Bordeaux, Centre de recherche Cardio‐Thoracique de Bordeaux Bordeaux France
| | - Pierre Jais
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, F‐/ Bordeaux University Hospital (CHU)Electrophysiology and Ablation Unit/Univ. Bordeaux, Centre de recherche Cardio‐Thoracique de Bordeaux Bordeaux France
| | - Jean‐Sylvain Hermida
- Pôle Cardio‐Thoracique VasculaireAmiens‐Picardie University Hospital Amiens France
| |
Collapse
|
34
|
Hermida A, Fressart V, Hidden-Lucet F, Donal E, Probst V, Deharo JC, Chevalier P, Klug D, Mansencal N, Delacretaz E, Cosnay P, Scanu P, Extramiana F, Keller DI, Rouanet S, Charron P, Gandjbakhch E. High risk of heart failure associated with desmoglein-2 mutations compared to plakophilin-2 mutations in arrhythmogenic right ventricular cardiomyopathy/dysplasia. Eur J Heart Fail 2019; 21:792-800. [PMID: 30790397 DOI: 10.1002/ejhf.1423] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [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: 03/21/2018] [Revised: 06/21/2018] [Accepted: 12/23/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Previous studies suggested that genetic status affects the clinical course of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) patients. The aim of this study was to compare the outcome of desmoglein-2 (DSG2) mutation carriers to those who carry the plakophilin-2 (PKP2) mutation, the most common ARVC/D-associated gene. METHODS AND RESULTS Consecutive ARVC/D patients carrying a pathogenic mutation in PKP2 or DSG2 were selected from a national ARVC/D registry. The cumulative freedom from sustained ventricular arrhythmia and cardiac transplantation/death from heart failure (HF) during follow-up was assessed, compared between PKP2 and DSG2, and predictors for ventricular arrhythmia and HF events determined. Overall, 118 patients from 78 families were included: 27 (23%) carried a DSG2 mutation and 91 (77%) a PKP2 mutation. There were no significant differences between DSG2 and PKP2 mutation carriers concerning gender, proband status, age at diagnosis, T-wave inversion, or right ventricular dysfunction at baseline. DSG2 patients displayed more frequent epsilon wave (37% vs. 17%, P = 0.048) and left ventricular dysfunction at diagnosis (54% vs. 10%, P < 0.001). During a median follow-up of 5.6 years (2.5-16), DSG2 and PKP2 mutation carriers displayed a similar risk of sustained ventricular arrhythmia (log-rank P = 0.20), but DSG2 mutation carriers were at higher risk of transplantation/HF-related death (log-rank P < 0.001). The presence of a DSG2 mutation vs. PKP2 mutation was a predictor of transplantation/HF-related death in univariate Cox analysis (P = 0.0005). CONCLUSIONS In this multicentre cohort, DSG2 mutation carriers were found to be at high risk of end-stage HF compared to PKP2 mutation carriers, supporting careful haemodynamic monitoring of these patients. The benefit of early HF treatment needs to be assessed in DSG2 carriers.
Collapse
Affiliation(s)
- Alexis Hermida
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France.,Service de Rythmologie, Centre Hospitalo-Universitaire, Amiens, France
| | - Véronique Fressart
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
| | - Francoise Hidden-Lucet
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
| | - Erwan Donal
- Département de Cardiologie, Hôpital Pontchaillou, Rennes, France
| | - Vincent Probst
- Institut du Thorax, Centre Hospitalo-Universitaire, Nantes, France
| | - Jean-Claude Deharo
- Département de Cardiologie, Centre Hospitalo-Universitaire, Marseille, France
| | - Philippe Chevalier
- Département de Cardiologie, Centre Hospitalo-Universitaire, Lyon, France
| | - Didier Klug
- Département de Cardiologie, Centre Hospitalo-Universitaire, Lille, France
| | - Nicolas Mansencal
- AP-HP, Groupe Hospitalier Ambroise Paré, UVSQ, INSERM U1018, CESP, Boulogne, France
| | | | - Pierre Cosnay
- Département de Cardiologie, Centre Hospitalo-Universitaire, Tours, France
| | - Patrice Scanu
- Département de Cardiologie, Centre Hospitalo-Universitaire, Caen, France
| | - Fabrice Extramiana
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Département de Cardiologie, Centre Hospitalo-Universitaire Bichat-Claude-Bernard, Paris, France
| | - Dagmar I Keller
- Emergency Department, University Hospital Zurich, Zurich, Switzerland
| | | | - Philippe Charron
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,AP-HP, Groupe Hospitalier Ambroise Paré, UVSQ, INSERM U1018, CESP, Boulogne, France
| | - Estelle Gandjbakhch
- Centre de Référence Pour les Maladies Cardiaques Héréditaires, APHP, Hôpital de la Pitié Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Université Paris 6, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, ICAN, Département de Cardiologie, Paris, France
| |
Collapse
|
35
|
Hermida A, Lallemand PM, Kubala M, Tournevache F, Buiciuc O, Quenum S, Hermida JS. P757Half of recurrences occurs after 1-year follow-up after cryoablation of persistent atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Hermida
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - P M Lallemand
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - M Kubala
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - F Tournevache
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - O Buiciuc
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - S Quenum
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - J S Hermida
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| |
Collapse
|
36
|
Hermida A, Kubala M, Traullé S, Buiciuc O, Quenum S, Hermida JS. Prevalence and predictive factors of left atrial tachycardia occurring after second-generation cryoballoon ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2017; 29:46-54. [PMID: 29024212 DOI: 10.1111/jce.13364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Assess the prevalence and predictors of left atrial tachycardia (LAT) after cryoballoon ablation of pulmonary veins. METHODS AND RESULTS Patients who underwent catheter ablation of pulmonary veins with a second-generation cryoballoon for symptomatic paroxysmal (151 of 270, 56%) or persistent (119 of 270, 44%) atrial fibrillation were entered in a single-center prospective registry. Patients who experienced postcryoballoon LAT (pcryo-LAT) were selected on the basis of 12-lead ECG characteristics. Left atrial origin was confirmed during conventional EP study and electroanatomical activation mapping, and patients were treated by RF catheter ablation. Pcryo-LAT was observed in 15 (5.6%) of 270 patients and was attributed to a reentrant mechanism in 11 patients (73%). The other four cases of pcryo-LAT were due to focal atrial tachycardia associated with reconnection of one pulmonary vein. In comparison with patients who remained in sinus rhythm, LA area (HR = 1.09; CI 1.01, 1.2; P = 0.02), LVEF (HR = 0.94; CI 0.90, 0.97; P < 0.001), and LVEF <50% (HR = 8.5; CI 3.1, 23.6; P < 0.001) were predictors of pcryo-LAT. After multivariate Cox analysis, only left ventricular ejection fraction < 50% remained predictive of pcryo-LAT, (HR = 7.8, CI 2.3 26.7, P = 0.002). With a mean survival of 23 months, 73% of patients who experienced pcryo-LAT were in sinus rhythm versus 78% of patients without pcryo-LAT (log rank P = 0.85). CONCLUSION The prevalence of pcryo-LAT in patients with atrial fibrillation is low. Left ventricular ejection fraction < 50% is associated with an increased risk of pcryo-LAT. When treated by RF catheter ablation, the presence of pcryo-LAT is not a predictive factor of subsequent recurrence of atrial fibrillation during follow-up.
Collapse
Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Sarah Traullé
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Otilia Buiciuc
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Serge Quenum
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | | |
Collapse
|
37
|
Hermida A, Fressart V, Hidden-Lucet F, Donal E, Probst V, Deharo JC, Chevalier P, Klug D, Mansencal N, Delacretaz E, Cosnay P, Scanu P, Extramiana F, Charron P, Gandjbakhch E. 745High risk of heart failure in desmoglein-2 mutation carriers in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Europace 2017. [DOI: 10.1093/ehjci/eux146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
38
|
Novo J, Hermida A, Ortega M, Barreira N, Penedo MG, López JE, Calvo C. Hydra: A web-based system for cardiovascular analysis, diagnosis and treatment. Comput Methods Programs Biomed 2017; 139:61-81. [PMID: 28187896 DOI: 10.1016/j.cmpb.2016.10.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 10/13/2016] [Accepted: 10/19/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Cardiovascular (CV) risk stratification is a highly complex process involving an extensive set of clinical trials to support the clinical decision-making process. There are many clinical conditions (e.g. diabetes, obesity, stress, etc.) that can lead to the early diagnosis or establishment of cardiovascular disease. In order to determine all these clinical conditions, a complete set of clinical patient analyses is typically performed, including a physical examination, blood analysis, electrocardiogram, blood pressure (BP) analysis, etc. This article presents a web-based system, called Hydra, which integrates a full and detailed set of services and functionalities for clinical decision support in order to help and improve the work of clinicians in cardiovascular patient diagnosis, risk assessment, treatment and monitoring over time. METHODS Hydra integrates a number of different services: a service for inputting all the information gathered by specialists (physical examination, habits, BP, blood analysis, electrocardiogram, etc.); a tool to automatically determine the CV risk stratification, including well-known standard risk stratification tables; and, finally, various tools to incorporate, analyze and graphically present the records of the ambulatory BP monitoring that provides BP analysis over a given period of time (24 or 48 hours). In addition, the platform presents a set of reports derived from all the information gathered from the patient in order to support physicians in their clinical decisions. RESULTS Hydra was tested and validated in a real domain. In particular, internal medicine specialists at the Hypertension Unit of the Santiago de Compostela University Hospital (CHUS) validated the platform and used it in different clinical studies to demonstrate its utility. It was observed that the platform increased productivity and accuracy in the assessment of patient data yielding a cost reduction in clinical practice. CONCLUSIONS This paper proposes a complete platform that includes different services for cardiovascular clinical decision support. It was also run as a web-based application to facilitate its use by clinicians, who can access the platform from any remote computer with Internet access. Hydra also includes different automated methods to facilitate the physicians' work and avoid potential errors in the analysis of patient data.
Collapse
Affiliation(s)
- J Novo
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain.
| | - A Hermida
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - M Ortega
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - N Barreira
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - M G Penedo
- Dep. Computación, Universidade da Coruña, 15781 A Coruña, Spain
| | - J E López
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - C Calvo
- Complexo Hospitalario Universitario de Santiago de Compostela, Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| |
Collapse
|
39
|
Hermida A, Fressart V, Hidden-Lucet F, Donal E, Probst V, Deharo J, Chevalier P, Klug D, Mansencal N, Delacretaz E, Cosnay P, Scanu P, Extramiana F, Keller D, Charron P, Gandjbakhch E. High risk of heart failure in desmoglein -2 mutation carriers in arrhythmogenic right ventricular dysplasia/cardiomyopathy. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30272-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
40
|
Hermida JS, Arnalsteen-Dassonvalle É, Kubala M, Mathiron A, Traulle S, Anbazhagan K, Hermida A, Rochette J. Dual phenotypic transmission in Brugada syndrome. Arch Cardiovasc Dis 2013; 106:366-72. [DOI: 10.1016/j.acvd.2013.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 02/24/2013] [Accepted: 04/10/2013] [Indexed: 11/24/2022]
|
41
|
Hermida JS, Dassonvalle E, Six I, Amant C, Coviaux F, Clerc J, Herent D, Hermida A, Rochette J, Jarry G. Prospective evaluation of the familial prevalence of the brugada syndrome. Am J Cardiol 2010; 106:1758-62. [PMID: 21126620 DOI: 10.1016/j.amjcard.2010.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 05/01/2010] [Revised: 07/28/2010] [Accepted: 07/28/2010] [Indexed: 11/30/2022]
Abstract
The familial prevalence of Brugada syndrome (BrS) in a consecutive series of patients was prospectively determined. BrS is genetically determined with autosomal dominant transmission. The familial prevalence of the BrS is unknown. A detailed pedigree of each family of patients with BrS was assembled and permission was obtained to invite relatives for electrocardiography and an ajmaline challenge. Sixty-two of 98 patients participated in the study and were included over a 6-year period. SCN5A genotyping was performed in 56 of these 62 patients (90%). Electrocardiograms (ECGs) of 488 relatives (mean age 38 ± 20 years, 45% men) were recorded and 270 of these relatives agreed to undergo an ajmaline challenge. Spontaneous type 1 BrS ECG was found in 4 of 488 relatives (0.8%). In the group of relatives in whom ajmaline challenge was performed (n = 270), the finding was positive in 79 subjects (29%). SCN5A genotyping identified 5 other affected relatives. As a result, the total number of affected relatives was 88. Standard 12-lead ECG was normal in 64 of the 88 affected relatives (73%). Mean percentage of affected relatives per family was 27 ± 32% (95% confidence interval 19 to 35). Familial forms of BrS were observed in 41 of the 62 families (66%) and no SCN5A mutations were found in sporadic forms. In conclusion, after active family screening affected relatives were found in almost 1/3 of subjects. BrS appeared to be a familial disease in 2/3 of subjects.
Collapse
Affiliation(s)
- Jean-Sylvain Hermida
- Centre d'Activité de Rythmologie, Hôpital Sud, Centre Hospitalier Universitaire d'Amiens-Picardie, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Montes J, Fernández Peña C, Hermida A. [Bronchiolitis obliterans organizing pneumonia, biochemical cholestasis and late development of rheumatoid arthritis]. An Med Interna 1998; 15:287. [PMID: 9629783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
43
|
Hermida A, Eirís J, Alvarez-Moreno A, Alonso-Martín A, Barreiro J, Castro-Gago M. [Hypomelanosis of Ito: autism, segmental dilatation of colon and unusual neuroimaging findings]. Rev Neurol 1997; 25:71-4. [PMID: 9091225] [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: 02/04/2023]
Abstract
INTRODUCTION Hipomelanosis of Ito (HI) also called Incontinentia pigmenti achromians, is the third most frequent neurocutaneous disorder. The abnormal skin lesions are more evident under Wood's lamp and consist of hypopigmented areas with irregular borders, streaks, whorls or patches which are usually distributed on the trunk or on the limbs. Non-cutaneous abnormalities, particularly of the central nervous system, eye, teeth and skeleton, have been reported in 76-94% of patients. CLINICAL CASES AND CONCLUSIONS In the present paper, we report two cases of Hipomelanosis of Ito in two female girls with facial coarse features. In the first case the psychomotor development was normal. Segmental dilatation of the colon, precocious pubarchy, abnormal periventricular white matter hipersignal on MRI and nodular mass on left caudate nuclei were also present. In the second case a severe developmental delay and autistic behaviour were the prominent features. To our knowledge, findings described in case 1 were not previously reported in association with HI.
Collapse
Affiliation(s)
- A Hermida
- Departamento de Pediatria, Complejo Hospitalario Universitario de Santiago, La Coruña, España
| | | | | | | | | | | |
Collapse
|