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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.
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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.
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Menè R, Sousonis V, Combes S, Maltret A, Albenque JP, Combes N. Pulsed field ablation of a persistent left superior vena cava in recurrent paroxysmal atrial fibrillation and its effect on the mitral isthmus: A case report. HeartRhythm Case Rep 2024; 10:6-10. [PMID: 38264100 PMCID: PMC10800993 DOI: 10.1016/j.hrcr.2023.10.009] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Affiliation(s)
- Roberto Menè
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
- Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | | | - Stéphane Combes
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
| | - Alice Maltret
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Nicolas Combes
- Heart Rhythm Management Department, Clinique Pasteur, Toulouse, France
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
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Waldmann V, Marquié C, Bessière F, Perrot D, Anselme F, Badenco N, Barra S, Bertaux G, Blangy H, Bordachar P, Boveda S, Chauvin M, Clémenty N, Clerici G, Combes N, Defaye P, Deharo JC, Durand P, Duthoit G, Eschalier R, Fauchier L, Garcia R, Geoffroy O, Gitenay E, Gourraud JB, Guenancia C, Iserin L, Jacon P, Jesel-Morel L, Kerkouri F, Klug D, Koutbi L, Labombarda F, Ladouceur M, Laurent G, Leclercq C, Maille B, Maltret A, Massoulié G, Mondoly P, Ninni S, Ollitrault P, Pasquié JL, Pierre B, Pujadas P, Champ-Rigot L, Sacher F, Sadoul N, Schatz A, Winum P, Milliez PU, Probst V, Marijon E. Subcutaneous Implantable Cardioverter-Defibrillators in Patients With Congenital Heart Disease. J Am Coll Cardiol 2023; 82:590-599. [PMID: 37558371 DOI: 10.1016/j.jacc.2023.05.057] [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: 04/11/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Very few data have been published on the use of subcutaneous implantable cardioverter-defibrillators (S-ICDs) in patients with congenital heart disease (CHD). OBJECTIVES The aim of this study was to analyze outcomes associated with S-ICDs in patients with CHD. METHODS This nationwide French cohort including all patients with an S-ICD was initiated in 2020 by the French Institute of Health and Medical Research. Characteristics at implantation and outcomes were analyzed in patients with CHD. RESULTS From October 12, 2012, to December 31, 2019, among 4,924 patients receiving an S-ICD implant in 150 centers, 101 (2.1%) had CHD. Tetralogy of Fallot, univentricular heart, and dextro-transposition of the great arteries represented almost one-half of the population. Patients with CHD were significantly younger (age 37.1 ± 15.4 years vs 50.1 ± 14.9 years; P < 0.001), more frequently female (37.6% vs 23.0%; P < 0.001), more likely to receive an S-ICD for secondary prevention (72.3% vs 35.9%; P < 0.001), and less likely to have severe systolic dysfunction of the systemic ventricle (28.1% vs 53.1%; P < 0.001). Over a mean follow-up period of 1.9 years, 16 (15.8%) patients with CHD received at least 1 appropriate shock, with all shocks successfully terminating the ventricular arrhythmia. The crude risk of appropriate S-ICD shock was twice as high in patients with CHD compared with non-CHD patients (annual incidences of 9.0% vs 4.4%; HR: 2.1; 95% CI: 1.3-3.4); however, this association was no longer significant after propensity matching (especially considering S-ICD indication, P = 0.12). The burden of all complications (HR: 1.2; 95% CI: 0.7-2.1; P = 0.4) and inappropriate shocks (HR: 0.9; 95% CI: 0.4-2.0; P = 0.9) was comparable in both groups. CONCLUSIONS In this nationwide study, patients with CHD represented 2% of all S-ICD implantations. Our findings emphasize the effectiveness and safety of S-ICD in this particularly high-risk population. (S-ICD French Cohort Study [HONEST]; NCT05302115).
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Affiliation(s)
- 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; Pediatric and Congenital Medico-Surgical Unit, Necker Hospital, Paris, France; Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France.
| | | | - Francis Bessière
- Université de Lyon, INSERM LabTau, Lyon, France; Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France
| | - David Perrot
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | - Sergio Barra
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Cardiology Department, Hospital da Luz Arrábida, Vila Nova de Gaia, Portugal
| | | | | | | | | | - Michel Chauvin
- ICS HENA Strasbourg, Strasbourg, France; Clinique de l'Orangerie, Strasbourg, France
| | | | | | | | | | - Jean-Claude Deharo
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, France
| | - Philippe Durand
- Centre Médico-Chirurgical Arnault Tzanck, St Laurent du Var, France
| | | | - Romain Eschalier
- Cardiology Department, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France, and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, F-63000 Clermont-Ferrand, France
| | | | - Rodrigue Garcia
- Cardiology Department, University Hospital of Poitiers, Poitiers, France; Centre d'Investigations Cliniques 1402, University Hospital of Poitiers, Poitiers, France
| | | | | | | | | | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | - Fawzi Kerkouri
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; University Hospital of Brest, Brest, France
| | | | - Linda Koutbi
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, 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
| | | | | | - Baptiste Maille
- Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Service de Cardiologie, Marseille, France and Aix Marseille Université, C2VN, Marseille, France
| | - Alice Maltret
- Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Grégoire Massoulié
- Cardiology Department, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France, and Université Clermont Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, Institut Pascal, F-63000 Clermont-Ferrand, France
| | | | | | | | - Jean-Luc Pasquié
- PhyMedExp, Université de Montpellier, INSERM, CNRS, CHRU de Montpellier, France
| | | | | | | | | | | | | | | | | | | | - Eloi Marijon
- Université de Paris, INSERM, Paris Cardiovascular Research Centre, Paris, France; Pediatric and Congenital Medico-Surgical Unit, Necker Hospital, Paris, France
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Waldmann V, Bessière F, Gardey K, Hascoët S, Henaine R, Iserin L, Ladouceur M, Bonnet D, Marijon E, Maltret A, Combes N, de Groot N. Catheter ablation of atrial tachyarrhythmias in patients with atrioventricular septal defect. Europace 2023; 25:euad275. [PMID: 37695311 PMCID: PMC10516589 DOI: 10.1093/europace/euad275] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/22/2023] [Indexed: 09/12/2023] Open
Abstract
AIMS The incidence of atrial tachyarrhythmias is high in patients with atrioventricular septal defect (AVSD). No specific data on catheter ablation have been reported so far in this population. We aimed to describe the main mechanisms of atrial tachyarrhythmias in patients with AVSD and to analyse outcomes after catheter ablation. METHODS AND RESULTS This observational multi-centric cohort study enrolled all patients with AVSD referred for catheter ablation of an atrial tachyarrhythmia at six tertiary centres from 2004 to 2022. The mechanisms of the different tachyarrhythmias targeted were described and outcomes were analysed. Overall, 56 patients (38.1 ± 17.4 years, 55.4% females) were included. A total of 87 atrial tachyarrhythmias were targeted (mean number of 1.6 per patient). Regarding main circuits involved, a cavo-annular isthmus-dependent intra-atrial re-entrant tachycardia (IART) was observed in 41 (73.2%) patients and an IART involving the right lateral atriotomy in 10 (17.9%) patients. Other tachyarrhythmias with heterogeneous circuits were observed in 13 (23.2%) patients including 11 left-sided and 4 right-sided tachyarrhythmias. Overall, an acute success was achieved in 54 (96.4%) patients, and no complication was reported. During a mean follow-up of 2.8 ± 3.8 years, 22 (39.3%) patients had at least one recurrence. Freedom from atrial tachyarrhythmia recurrences was 77.5% at 1 year. Among 15 (26.8%) patients who underwent repeated ablation procedures, heterogeneous circuits including bi-atrial and left-sided tachyarrhythmias were more frequent. CONCLUSION In patients with AVSD, most circuits involve the cavo-annular isthmus, but complex mechanisms are frequently encountered in patients with repeated procedures. The acute success rate is excellent, although recurrences remain common during follow-up.
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Affiliation(s)
- Victor Waldmann
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, 149 rue de Sèvres, 75015 Paris, France
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Francis Bessière
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Kevin Gardey
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Sébastien Hascoët
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
| | - Roland Henaine
- Cardiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, 50 boulevard Pinel, 69500 Bron, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Magalie Ladouceur
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Damien Bonnet
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, 149 rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Alice Maltret
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
| | - Nicolas Combes
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France
- Electrophysiology Unit, Pasteur Clinic, 45 avenue de Lombez, 31300 Toulouse, France
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Waldmann V, Bessière F, Gardey K, Bakloul M, Belli E, Bonnet D, Chaussade AS, Cohen S, Delasnerie H, Dib N, Di Filippo S, Dulac A, Hascoët S, Henaine R, Iserin L, Karsenty C, Ladouceur M, Legendre A, Malekzadeh-Milani S, Mostefa Kara M, Radojevic J, Ratsimandresy M, Marijon E, Maltret A, Khairy P, Combes N. Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study. Circ Arrhythm Electrophysiol 2023:e011745. [PMID: 37170812 DOI: 10.1161/circep.122.011745] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Ventricular arrhythmias and sudden death are recognized complications in tetralogy of Fallot. Electrophysiological studies (EPS) before pulmonary valve replacement (PVR), the most common reintervention in tetralogy of Fallot, could potentially inform therapy to improve arrhythmic outcomes. METHODS A prospective multicenter study was conducted to systematically assess EPS with programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR from January 2020 to December 2021. A standardized stimulation protocol was used across all centers. RESULTS A total of 120 patients were enrolled, mean age 39.2±14.5 years, 53.3% males. Sustained ventricular tachycardia was induced in 27 (22.5%) patients. When identifiable, the critical isthmus most commonly implicated (ie, in 90.0%) was between the ventricular septal defect patch and pulmonary annulus. Factors independently associated with inducible ventricular tachycardia were history of atrial arrhythmia (OR, 8.56 [95% CI, 2.43-34.73]) and pulmonary annulus diameter >26 mm (OR, 5.05 [95% CI, 1.47-21.69]). The EPS led to a substantial change in management in 23 (19.2%) cases: 18 (15.0%) had catheter ablation, 3 (2.5%) surgical cryoablation during PVR, and 9 (7.5%) defibrillator implantation. Repeat EPS 5.1 (4.8-6.2) months after PVR was negative in 8 of 9 (88.9%) patients. No patient experienced a sustained ventricular arrhythmia during 13 (6.1-20.1) months of follow-up. CONCLUSIONS Systematically performing programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR yields a high rate of inducible ventricular tachycardia and carries the potential to alter management. It remains to be determined whether a standardized treatment approach based on the results of EPS will translate into improved outcomes. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04205461.
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Affiliation(s)
- Victor Waldmann
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France (V.W., E.M.)
| | - Francis Bessière
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Kevin Gardey
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Mohamed Bakloul
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Emre Belli
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Anne-Solène Chaussade
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Sarah Cohen
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Hubert Delasnerie
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
| | - Nabil Dib
- Pasteur Clinic, Toulouse, France (H.D., C.K., M.R., N.C.)
| | - Sylvie Di Filippo
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Arnaud Dulac
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Sébastien Hascoët
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Roland Henaine
- Louis Pradel Hospital, Hospices Civils de Lyon, Université Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Clément Karsenty
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
| | - Magalie Ladouceur
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Antoine Legendre
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Sophie Malekzadeh-Milani
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)
| | - Mansour Mostefa Kara
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)
| | - Jelena Radojevic
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | | | - Eloi Marijon
- Université Paris Cité, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)
- Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France (V.W., E.M.)
| | - Alice Maltret
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
| | - Paul Khairy
- Pasteur Clinic, Toulouse, France (H.D., C.K., M.R., N.C.)
| | - Nicolas Combes
- Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)
- Université Paris-Saclay, UVSQ, Inserm, CESP U1018, Le Kremlin-Bicêtre, France (S.C.)
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6
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Le Bos PA, Pontailler M, Maltret A, Kraiche D, Gaudin R, Barbanti C, Marijon E, Raisky O, Bonnet D, Waldmann V. Epicardial vs. transvenous implantable cardioverter defibrillators in children. Europace 2023; 25:961-968. [PMID: 36735263 PMCID: PMC10062323 DOI: 10.1093/europace/euad015] [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: 08/30/2022] [Accepted: 10/23/2022] [Indexed: 02/04/2023] Open
Abstract
AIMS The implantable cardioverter defibrillator (ICD) has been increasingly used in children. Both epicardial and transvenous approaches are used, with controversy regarding the best option with no specific recommendations. We aimed to compare outcomes associated with epicardial vs. transvenous ICDs in children. METHODS AND RESULTS Data were analysed from a retrospective study including all patients <18-year-old implanted with an ICD in a tertiary centre from 2003 to 2021. Outcomes were compared between epicardial and transvenous ICDs. A total of 122 children with an ICD (mean age 11.5 ± 3.8 years, 57.4% males) were enrolled, with 84 (64.1%) epicardial ICDs and 38 (29.0%) transvenous ICDs. Early (<30 days) ICD-related complications were reported in 17 (20.2%) patients with an epicardial ICD vs. 0 (0.0%) with a transvenous ICD (P = 0.002). Over a mean follow-up of 4.8 ± 4.0 years, 25 (29.8%) patients with an epicardial ICD and 9 (23.7%) patients with a transvenous ICD experienced at least one late ICD-related complication [hazard ratio (HR) 1.8, 95% confidence interval (CI) 0.8-4.0]. Implantable cardioverter defibrillator lead dysfunction occurred in 19 (22.6%) patients with an epicardial ICD vs. 3 (7.9%) with a transvenous ICD (HR 5.7, 95% CI 1.3-24.5) and was associated with a higher incidence of ICD-related reintervention (HR 3.0, 95% CI 1.3-7.0). After considering potential confounders, especially age and weight at implantation, this association was no longer significant (P = 0.112). The freedom from ICD lead dysfunction was greater in patients with pleural coils than in those with epicardial coils (HR 0.38, 95% CI 0.15-0.96). CONCLUSION In children, after a consideration of patient characteristics at implantation, the burden of complications and ICD lead dysfunction appears to be similar in patients with epicardial and transvenous devices. Pleural coils seem to be associated with better outcomes than epicardial coils in this population. CLINICAL TRIAL REGISTRATION NCT05349162.
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Affiliation(s)
- Pierre Antoine Le Bos
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France
| | - Margaux Pontailler
- Department of Pediatric Cardiac Surgery, Necker Hospital, 149 rue de Sèvres, 75015 Paris, France
| | - Alice Maltret
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France
| | - Diala Kraiche
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France
| | - Regis Gaudin
- Department of Pediatric Cardiac Surgery, Necker Hospital, 149 rue de Sèvres, 75015 Paris, France
| | - Claudio Barbanti
- Pediatric Cardiac Anesthesia and Cardiopulmonary Unit, Necker Hospital, 149 rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Université de Paris Cité, INSERM, Paris Cardiovascular Research Centre, 56 rue Leblanc, 75015 Paris, France.,Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Olivier Raisky
- Department of Pediatric Cardiac Surgery, Necker Hospital, 149 rue de Sèvres, 75015 Paris, France.,Université de Paris Cité, INSERM, Paris Cardiovascular Research Centre, 56 rue Leblanc, 75015 Paris, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.,Université de Paris Cité, INSERM, Paris Cardiovascular Research Centre, 56 rue Leblanc, 75015 Paris, France.,Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
| | - Victor Waldmann
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.,Université de Paris Cité, INSERM, Paris Cardiovascular Research Centre, 56 rue Leblanc, 75015 Paris, France.,Electrophysiology Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France.,Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, 20 rue Leblanc, 75015 Paris, France
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7
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Fournier E, Batteux C, Mostefa-Kara M, Valdeolmillos E, Maltret A, Cohen S, Van Aerschot I, Guirgis L, Azarine A, Sigal-Cinqualbre A, Provost B, Radojevic-Liegeois J, Roussin R, Zoghbi J, Belli E, Hascoët S. Cardiac tomography-echocardiography imaging fusion: a new approach to congenital heart disease. Rev Esp Cardiol (Engl Ed) 2023; 76:10-18. [PMID: 35570123 DOI: 10.1016/j.rec.2022.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 03/17/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION AND OBJECTIVES Diagnosis, management, and surgical decision-making in children and adults with congenital heart disease are largely based on echocardiography findings. A recent development in cardiac imaging is fusion of different imaging modalities. Our objective was to evaluate the feasibility of computed tomography (CT) and 3-dimensional (3D) transthoracic echocardiography (TTE) fusion in children and adults with congenital heart disease. METHODS We prospectively included 14 patients, 13 of whom had congenital heart disease, and who underwent both CT and 3D TTE as part of their usual follow-up. We described the steps required to complete the fusion process (alignment, landmarks, and superimposition), navigation, and image evaluation. RESULTS Median age was 9.5 [2.7-15.7] years, 57% were male, and median body surface area was 0.9 m2 [0.6-1.7]. Congenital heart disease was classified as simple (n=4, 29%), moderate (n=4, 29%), or complex (n=6, 42%). 3D TTE-CT fusion was successful in all patients. Median total time to complete the fusion process was 735 [628-1163] seconds, with no significant difference according to the degree of complexity of the defects. Landmarks were significantly modified in complex congenital heart disease. CONCLUSIONS We established the feasibility and accuracy of 3D TTE-CT fusion in a population of children and adults with a variety of congenital heart diseases. The simultaneous visualization of many intracardiac structures may help to understand the anatomical features of congenital heart disease without limitations regarding age, weight, or complexity of the congenital defects.
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Affiliation(s)
- Emmanuelle Fournier
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Clément Batteux
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France; UMRS 999, INSERM, Hôpital Marie Lannelongue, Université Paris-Saclay, Le Plessis Robinson, France
| | - Meriem Mostefa-Kara
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Estibaliz Valdeolmillos
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France; UMRS 999, INSERM, Hôpital Marie Lannelongue, Université Paris-Saclay, Le Plessis Robinson, France
| | - Alice Maltret
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Sarah Cohen
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Isabelle Van Aerschot
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Lisa Guirgis
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Arshid Azarine
- UMRS 999, INSERM, Hôpital Marie Lannelongue, Université Paris-Saclay, Le Plessis Robinson, France; Département de Radiologie, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Anne Sigal-Cinqualbre
- Département de Radiologie, Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Bastien Provost
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Jelena Radojevic-Liegeois
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Régine Roussin
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Joy Zoghbi
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Emre Belli
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France
| | - Sebastien Hascoët
- Pôle des Cardiopathies Congénitales de l'Enfant et de l'Adulte, Centre de Référence Malformations Cardiaques Congénitales Complexes (M3C), Hôpital Marie Lannelongue, Groupe hospitalier Paris Saint Joseph, Université Paris-Saclay, Le Plessis Robinson, France; UMRS 999, INSERM, Hôpital Marie Lannelongue, Université Paris-Saclay, Le Plessis Robinson, France.
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8
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Waldmann V, Marquié C, Bouzeman A, Duthoit G, Thambo JB, Koutbi L, Maltret A, Pasquié JL, Combes N, Marijon E. Subcutaneous vs Transvenous Implantable Cardioverter-Defibrillator Therapy in Patients With Tetralogy of Fallot. J Am Coll Cardiol 2022; 80:1701-1703. [DOI: 10.1016/j.jacc.2022.08.761] [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: 06/06/2022] [Revised: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
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9
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Silvetti MS, Bruyndonckx L, Maltret A, Gebauer R, Kwiatkowska J, Környei L, Albanese S, Raimondo C, Paech C, Kempa M, Fésüs G, Knops RE, Blom NA, Drago F. The SIDECAR project: S-IcD registry in European paediatriC and young Adult patients with congenital heaRt defects. Europace 2022; 25:460-468. [PMID: 36107451 PMCID: PMC9935000 DOI: 10.1093/europace/euac162] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Subcutaneous-implantable cardiac defibrillators (S-ICDs) are used increasingly to prevent sudden cardiac death in young patients. This study was set up to gain insight in the indications for S-ICD, possible complications, and their predictors and follow-up results. METHODS AND RESULTS A multicentre, observational, retrospective, non-randomized, standard-of-care registry on S-ICD outcome in young patients with congenital heart diseases (CHDs), inherited arrhythmias (IAs), idiopathic ventricular fibrillation (IVF), and cardiomyopathies (CMPs). Anthropometry was registered as well as implantation technique, mid-term device-related complications, and incidence of appropriate/inappropriate shocks (IASs). Data are reported as median (interquartile range) or mean ± standard deviation. Eighty-one patients (47% CMPs, 20% CHD, 21% IVF, and 12% IA), aged 15 (14-17) years, with body mass index (BMI) 21.8 ± 3.8 kg/m2, underwent S-ICD implantation (primary prevention in 59%). This was performed with two-incision technique in 81% and with a subcutaneous pocket in 59%. Shock and conditional zones were programmed at 250 (200-250) and 210 (180-240) b.p.m., respectively. No intraoperative complications occurred. Follow up was 19 (6-35) months: no defibrillation failure occurred, 17% of patients received appropriate shocks, 13% of patients received IAS (supraventricular tachycardias 40%, T-wave oversensing 40%, and non-cardiac oversensing 20%). Reprogramming, proper drug therapy, and surgical revision avoided further IAS. Complications requiring surgical revision occurred in 9% of patients, with higher risks in patients with three-incision procedures [hazard ratio (HR) 4.3, 95% confidence interval (95% CI) 0.5-34, P = 0.038] and BMI < 20 (HR 5.1, 95% CI 1-24, P = 0.031). CONCLUSION This multicentre European paediatric registry showed good S-ICD efficacy and safety in young patients. Newer implantation techniques and BMI > 20 showed better outcome.
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Affiliation(s)
| | - Luc Bruyndonckx
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Antwerp, Belgium
| | - Alice Maltret
- Department of Paediatric Cardiology Hopital Necker-Enfants Malades, Paris, France,Hopital Marie Lannelongue-M3C, GHPSJ, Université Paris Descartes, Paris, France
| | - Roman Gebauer
- Department of Paediatric Cardiology, Heart Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Joanna Kwiatkowska
- Department of Paediatric Cardiology and Congenital Heart Defects, Medical University of Gdansk, Gdansk, Poland
| | - László Környei
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - Sonia Albanese
- Heart Surgery Team, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Cristina Raimondo
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy,Department of Paediatric Cardiology Hopital Necker-Enfants Malades, Paris, France
| | - Christian Paech
- Department of Paediatric Cardiology, Heart Centre Leipzig, University of Leipzig, Leipzig, Germany
| | - Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Gábor Fésüs
- Gottsegen National Cardiovascular Center, Budapest, Hungary
| | - Reinoud E Knops
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Paediatrics, Antwerp University Hospital, Edegem, Belgium
| | - Nico Andreas Blom
- Department of Paediatric Cardiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands,Department of Paediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmia/Syncope Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
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10
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Miniaoui I, Morel N, Lévesque K, Maltret A, Driessen M, Masseau A, Orquevaux P, Piette JC, Barriere F, Le Bidois J, Georgin-Lavialle S, Guettrot-Imbert G, Le Guern V, Mouthon L, Jallouli M, Deligny C, Hachulla E, Romefort B, Bonnet D, Costedoat-Chalumeau N. Health Outcome of 215 Mothers of Children with Autoimmune Congenital Heart Block: Analysis of the French Neonatal Lupus Syndrome Registry. J Rheumatol 2022; 49:1124-1130. [DOI: 10.3899/jrheum.210703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/22/2022]
Abstract
Objective Transplacental passage of maternal anti-SSA and -SSB antibodies, potentially associated with maternal autoimmune diseases, can cause neonatal lupus syndrome. Given the paucity of data in this setting, we report short- and long-term outcomes of mothers of offspring with congenital heart block (CHB). Methods This retrospective study included anti-SSA/SSB antibody-positive mothers of fetuses with high-degree CHB and focused on their health status before pregnancy, at CHB diagnosis, and thereafter. Results We analyzed 215 women with at least one pregnancy with CHB. Before this diagnosis, only 52 (24%) mothers had been diagnosed with an autoimmune disease, mainly systemic lupus erythematosus (SLE) (n=26, 12%) and Sjögren's syndrome (SS) (n=16, 7%). Six more were diagnosed with an autoimmune disease during the index pregnancy. Of the 157 mothers (73%) with no such diagnosis at childbirth, 77 (49%) developed one after a median follow-up of 11 years (range: 21 days to 54 years). By the end of follow-up, 135 women (63%) had an autoimmune disease diagnosis: mainly SLE (n=54, 25%) and SS (n=72, 33%). Three SLE patients had renal involvement, and only 6 (3%) had required an immunosuppressive drug at any point. The symptoms best predicting autoimmune disease development were arthralgia and myalgia (p<0.0001), dry syndrome (p=0.01), and parotid swelling (p=0.05). Conclusion One quarter of the patients had an autoimmune disease diagnosis at the fetal CHB diagnosis. Nearly half those without an initial diagnosis progressed during follow-up, most without severe manifestations. Severe diseases such as lupus nephritis were rarely seen, and immunosuppressive drugs rarely required.
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Jacquemart E, Bessière F, Combes N, Ladouceur M, Iserin L, Gardey K, Henaine R, Dulac A, Cohen S, Belli E, Jannot AS, Chevalier P, Ly R, Clavier S, Legendre A, Petit J, Maltret A, Di Filippo S, Hascoët S, Marijon E, Waldmann V. Incidence, Risk Factors, and Outcomes of Atrial Arrhythmias in Adult Patients With Atrioventricular Septal Defect. JACC Clin Electrophysiol 2022; 8:331-340. [PMID: 35331427 DOI: 10.1016/j.jacep.2021.09.004] [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: 07/02/2021] [Revised: 08/06/2021] [Accepted: 09/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to assess the incidence, associated factors, and outcomes of atrial arrhythmias in adults with atrioventricular septal defect (AVSD). BACKGROUND Data regarding atrial arrhythmias in adults with AVSD are particularly scarce. METHODS Data were analyzed from a multicentric cohort of adult patients with AVSD. Lifetime cumulative incidences of atrial arrhythmias were studied. Multiple logistic regression models were used to identify risk factors. RESULTS A total of 391 patients (61.6% women) were enrolled with a mean age of 36.3 ± 16.3 years and a mean follow-up of 17.3 ± 14.2 years after initial surgical repair. Overall, 98 patients (25.1%) developed at least 1 episode of atrial arrhythmia at a mean age of 39.2 ± 17.2 years. The mean ages of patients at first episode of intra-atrial re-entrant tachycardia (IART)/ focal atrial tachycardia (FAT) and atrial fibrillation were 33.7 ± 15.3 and 44.3 ± 16.5 years, respectively. The lifetime risks for developing atrial arrhythmia to ages 20, 40, and 60 years were 3.7%, 17.8%, and 55.3%, respectively. IART/FAT was the leading arrhythmia until the age of 45, then atrial fibrillation surpassed IART/FAT. Age (odds ratio [OR]: 1.4; 95% confidence interval [CI]: 1.2-1.6), number of cardiac surgeries (OR: 4.1; 95% CI: 2.5-6.9), left atrial dilatation (OR: 3.1; 95% CI: 1.4-6.8), right atrial dilatation (OR: 4.1; 95% CI: 1.7-10.3), and moderate or severe left atrioventricular valve regurgitation (OR: 3.7; 95% CI: 1.2-11.7) were independently associated with a higher risk of atrial arrhythmias, whereas the type of AVSD and the age at repair were not. The occurrence of atrial arrhythmias was associated with pacemaker implantation (41.8% vs. 8.5%; P < 0.001), heart failure (24.5% vs. 1.0%; P < 0.001), and cerebrovascular accidents (11.2% vs. 3.4%; P = 0.007). CONCLUSIONS The lifetime risk of atrial arrhythmias in patients with AVSD is considerable with more than half of patients developing ≥1 atrial arrhythmia by the age of 60 and is associated with a significant morbidity. The risk in partial/intermediate AVSD is as high as in complete AVSD and is not impacted by age at repair.
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Affiliation(s)
- Etienne Jacquemart
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | | | - Nicolas Combes
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France; Pasteur Clinic, Toulouse, France
| | - Magalie Ladouceur
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | | | | | | | - Sarah Cohen
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Emre Belli
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Anne-Sophie Jannot
- Department of Medical Informatics and Public Health, European Georges Pompidou Hospital, Paris, France
| | | | - Reaksmei Ly
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Sandra Clavier
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Antoine Legendre
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Jérôme Petit
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Alice Maltret
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | | | - Sébastien Hascoët
- Marie Lannelongue Hospital, Department of Pediatric Cardiology and Congenital Heart Diseases, Centre de Référence Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint Joseph, Paris-Saclay University, Inserm UMR999, Le Plessis-Robinson, France
| | - Eloi Marijon
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France
| | - Victor Waldmann
- Electrophysiology Section, European Georges Pompidou Hospital, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Université de Paris, Inserm, Paris Cardiovascular Research Centre, Paris, France.
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Surget E, Maltret A, Raimondi F, Fressart V, Bonnet D, Gandjbakhch E, Khraiche D. Clinical Presentation and Heart Failure in Children With Arrhythmogenic Cardiomyopathy. Circ Arrhythm Electrophysiol 2022; 15:e010346. [PMID: 35089053 DOI: 10.1161/circep.121.010346] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Elodie Surget
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Foundation Bordeaux Université, France (E.S.)
| | - Alice Maltret
- M3C-Necker Enfants Malades, AP-HP, Paris, France (A.M., F.R., D.B., D.K.)
| | - Francesca Raimondi
- M3C-Necker Enfants Malades, AP-HP, Paris, France (A.M., F.R., D.B., D.K.)
| | - Veronique Fressart
- Département de Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de, Paris, France (V.F., E.G.)
| | - Damien Bonnet
- M3C-Necker Enfants Malades, AP-HP, Paris, France (A.M., F.R., D.B., D.K.)
| | - Estelle Gandjbakhch
- Département de Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de, Paris, France (V.F., E.G.)
| | - Diala Khraiche
- M3C-Necker Enfants Malades, AP-HP, Paris, France (A.M., F.R., D.B., D.K.)
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Djeddai C, Karsenty C, Maltret A, Dulac Y, Acar P, Hascoët S, Albenque J, Maury P, Combes N. Wolff Parkinson White syndrome: Validation of an algorithm for identifying accessory pathway in children. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.251] [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]
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Peltenburg PJ, Kallas D, Bos JM, Lieve KVV, Franciosi S, Roston TM, Denjoy I, Sorensen KB, Ohno S, Roses-Noguer F, Aiba T, Maltret A, LaPage MJ, Atallah J, Giudicessi JR, Clur SAB, Blom NA, Tanck M, Extramiana F, Kato K, Barc J, Borggrefe M, Behr ER, Sarquella-Brugada G, Tfelt-Hansen J, Zorio E, Swan H, Kammeraad JAE, Krahn AD, Davis A, Sacher F, Schwartz PJ, Roberts JD, Skinner JR, van den Berg MP, Kannankeril PJ, Drago F, Robyns T, Haugaa KH, Tavacova T, Semsarian C, Till J, Probst V, Brugada R, Shimizu W, Horie M, Leenhardt A, Ackerman MJ, Sanatani S, van der Werf C, Wilde AAM. An International Multi-Center Cohort Study on β-blockers for the Treatment of Symptomatic Children with Catecholaminergic Polymorphic Ventricular Tachycardia. Circulation 2021; 145:333-344. [PMID: 34874747 DOI: 10.1161/circulationaha.121.056018] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [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: 11/16/2022]
Abstract
Background: Symptomatic children with catecholaminergic polymorphic ventricular tachycardia (CPVT) are at risk for recurrent arrhythmic events. Beta-blockers (BBs) decrease this risk, but studies comparing individual BBs in sizeable cohorts are lacking. We aimed to assess the association between risk for arrhythmic events and type of BB in a large cohort of symptomatic children with CPVT. Methods: From two international registries of patients with CPVT, RYR2 variant-carrying symptomatic children (defined as syncope or sudden cardiac arrest prior to BB initiation and age at start of BB therapy <18 years), treated with a BB were included. Cox-regression analyses with time-dependent covariates for BB and potential confounders were used to assess the hazard ratio (HR). The primary outcome was the first occurrence of sudden cardiac death, sudden cardiac arrest, appropriate implantable cardioverter-defibrillator shock, or syncope. The secondary outcome was the first occurrence of any of the primary outcomes except syncope. Results: We included 329 patients (median age at diagnosis 12 [interquartile range, 7-15] years, 35% females). Ninety-nine (30.1%) patients experienced the primary and 74 (22.5%) experienced the secondary outcome during a median follow-up of 6.7 [interquartile range, 2.8-12.5] years. Two-hundred sixteen patients (66.0%) used a non-selective BB (predominantly nadolol [n=140] or propranolol [n=70]) and 111 (33.7%) used a β1-selective BB (predominantly atenolol [n=51], metoprolol [n=33], or bisoprolol [n=19]) as initial BB. Baseline characteristics did not differ. The HR for both the primary and secondary outcomes were higher for β1-selective compared with non-selective BBs (HR, 2.04 95% CI, 1.31-3.17; and HR, 1.99; 95% CI, 1.20-3.30, respectively). When assessed separately, the HR for the primary outcome was higher for atenolol (HR, 2.68; 95% CI, 1.44-4.99), bisoprolol (HR, 3.24; 95% CI, 1.47-7.18), and metoprolol (HR, 2.18; 95% CI, 1.08-4.40) compared with nadolol, but did not differ from propranolol. The HR of the secondary outcome was only higher in atenolol compared with nadolol (HR, 2.68; 95% CI, 1.30-5.55). Conclusions: B1-selective BBs were associated with a significantly higher risk for arrhythmic events in symptomatic children with CPVT compared with non-selective BBs, specifically nadolol. Nadolol, or propranolol if nadolol is unavailable, should be the preferred BB for treating symptomatic children with CPVT.
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Affiliation(s)
- Puck J Peltenburg
- Amsterdam UMC, University of Amsterdam, Heart Centre; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | | | - Johan M Bos
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics; Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN
| | - Krystien V V Lieve
- Amsterdam UMC, University of Amsterdam, Heart Centre; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Sonia Franciosi
- BC Childrenâs Hospital, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Thomas M Roston
- BC Childrenâs Hospital, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada; Center for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - Isabelle Denjoy
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Université de Paris, Paris, France; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Katrina B Sorensen
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics; Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN
| | - Seiko Ohno
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan; Department of Bioscience and Genetics, National Cerebral and Cardiovascular Centre, National Cerebral and Cardiovascular Centre, Suita, Japan
| | | | - Takeshi Aiba
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan
| | - Alice Maltret
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Université de Paris, Paris, France
| | - Martin J LaPage
- Department of Pediatrics, Division of Cardiology, University of Michigan, Ann Arbor, MI
| | - Joseph Atallah
- Cardiology, Faculty of Medicine and Dentistry - Pediatrics Dept., Stollery Children's Hospital, Edmonton, Canada
| | - John R Giudicessi
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics; Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN
| | - Sally-Ann B Clur
- Department of Pediatric Cardiology, Emma Childrenâs Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands;Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Nico A Blom
- Department of Pediatric Cardiology, Emma Childrenâs Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands;Department of Pediatric Cardiology, Willem-Alexander Childrenâs Hospital, Leiden University Medical Centre, Leiden, The Netherlands; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Michael Tanck
- Amsterdam UMC, University of Amsterdam, Heart Centre; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Fabrice Extramiana
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Université de Paris, Paris, France; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Koichi Kato
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Julien Barc
- Université de Nantes, CNRS, INSERM, lâinstitut du thorax, Nantes, France; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Martin Borggrefe
- Department of Medicine, University Medical Center Mannheim, Mannheim, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim
| | - Elijah R Behr
- Cardiovascular Clinical Academic Group and Cardiology Research Centre, Molecular and Clinical Sciences Research Institute, St. Georgeâs, University of London, London, UK; St. Georgeâs University Hospitals NHS Foundation Trust, Cranmer Terrace, London, UK
| | - Georgia Sarquella-Brugada
- Pediatric Arrhythmias, Inherited Cardiac Diseases and Sudden Death Unit, Hospital Sant Joan de Déu, Spain; Medical Science Department, School of Medicine, Universitat de Girona, Spain; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Rigshospitalet, Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Esther Zorio
- Department of Cardiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Center for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | - Heikki Swan
- Heart and Lung Centre, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | | | - Andrew D Krahn
- Center for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - Andrew Davis
- The Royal Children's Hospital, Melbourne, Australia; Murdoch Childrenâs Research Institute and Department of Paediatrics, Melbourne University, Melbourne, Australia
| | - Frederic Sacher
- LIRYC Institute, Bordeaux University Hospital, Bordeaux University, Bordeaux, France
| | - Peter J Schwartz
- Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Jason D Roberts
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, and McMaster University, Hamilton, Ontario, Canada
| | - Jonathan R Skinner
- Cardiac Inherited Disease Group New Zealand, Green Lane Paediatric and Congenital Cardiac Services, Starship Childrenâs Hospital, Auckland, New Zealand; Department of Paediatrics Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Maarten P van den Berg
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Prince J Kannankeril
- Department of Pediatrics, Monroe Carell Jr Childrenâs Hospital at Vanderbilt, Vanderbilt University Medical Centre, Nashville, TN
| | - Fabrizio Drago
- Pediatric Cardiology and Cardiac Arrhythmias Unit, Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Palidoro-Rome, Italy; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Tomas Robyns
- Department of Cardiovascular Diseases, University Hospitals Leuven, Belgium; Department of Cardiovascular Sciences, University of Leuven, Belgium; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Kristina H Haugaa
- Department of Cardiology, ProCardio Center for Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway; University of Oslo, Oslo, Norway
| | - Terezia Tavacova
- Department of Pediatric Cardiology, Childrenâs Heart Centre, Second Faculty of Medicine, Charles University in Prague; Motol University Hospital, Prague, Czech Republic
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jan Till
- Department of Cardiology, Royal Brompton Hospital, London, UK
| | - Vincent Probst
- Université de Nantes, CHU Nantes, CNRS, INSERM, lâinstitut du thorax, Nantes, France; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Ramon Brugada
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Cardiovascular Genetics Center, Institut d'Investigació Biomèdica Girona (IDIBGI), University of Girona, Girona, Spain; Medical Science Department, School of Medicine, University of Girona, Girona, Spain; Cardiology Service, Hospital Josep Trueta, Girona, Spain
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Suita, Japan; Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Antoine Leenhardt
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, Université de Paris, Paris, France; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Michael J Ackerman
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics; Division of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN
| | - Shubhayan Sanatani
- BC Childrenâs Hospital, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Christian van der Werf
- Amsterdam UMC, University of Amsterdam, Heart Centre; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
| | - Arthur A M Wilde
- Amsterdam UMC, University of Amsterdam, Heart Centre; Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands; Member of the European Reference Network for rare, low prevalence and complex diseases of the heart: ERN GUARD-Heart
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Jacquemart E, Combes N, Duthoit G, Bessière F, Ladouceur M, Iserin L, Laredo M, Bredy C, Maltret A, Di Filippo S, Hascoët S, Pasquié JL, Marijon E, Waldmann V. Cardiac resynchronization therapy in patients with congenital heart disease and systemic right ventricle. Heart Rhythm 2021; 19:658-666. [PMID: 34863963 DOI: 10.1016/j.hrthm.2021.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/24/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although patients with systemic right ventricle (SRV) represent a significant proportion of patients with congenital heart disease (CHD) implanted with cardiac resynchronization therapy (CRT), there are limited and conflicting data in this specific patient group. OBJECTIVE We aimed to analyze outcomes of patients with SRV implanted with a CRT device. METHODS Data were analyzed from an observational, retrospective, multicenter cohort study including all patients with CHD implanted with a CRT device from 6 French centers from 2004 to 2020. Response to CRT was defined as an increase in systemic ventricular ejection fraction of ≥10% and/or an improvement in New York Heart Association functional class by at least 1 grade. RESULTS A total of 85 patients with CHD were enrolled (mean age 39.8 ± 20.0 years; 55 [64.7%] males; 25 defibrillators [29.4%]), including 31 patients with SRV (36.5%) (mean age 43.9 ± 19.8 years; 16 [51.6%] males). The mean change in QRS duration after implantation was similar as compared with patients with systemic left ventricle (-46 ± 26 ms vs -35 ± 32 ms; P = .16). During a mean follow-up of 5.1 ± 3.5 years, late complications included 2 lead dysfunctions (6.5%), 3 CRT-related infections (9.7%), and 1 inappropriate implantable cardioverter-defibrillator shock (3.2%). The proportion of CRT responders at 6, 12, and 24 months were 82.6%, 80.0%, and 77.8% in patients with SRV vs 66.7%, 64.3%, and 69.6% in patients with systemic left ventricle (P = NS). CONCLUSION In this multicenter cohort, one-third of patients with CHD implanted with a CRT device had SRV. CRT in patients with SRV was associated with a high rate of responders, comparable to that of patients with systemic left ventricle.
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Affiliation(s)
| | - Nicolas Combes
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France; Pasteur Clinic, Toulouse, France
| | | | | | - Magalie Ladouceur
- Université de Paris, PARCC, INSERM, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France
| | - Mikael Laredo
- La Pitié-Salpêtrière University Hospital, Paris, France
| | | | - Alice Maltret
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Sébastien Hascoët
- Department of Pediatric Cardiology and Congenital Heart Diseases, Marie Lannelongue Hospital, Groupe Hospitalier Paris Saint Joseph, Le Plessis-Robinson, France
| | | | - Eloi Marijon
- Université de Paris, PARCC, INSERM, Paris, France; Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France
| | - Victor Waldmann
- Université de Paris, PARCC, INSERM, Paris, France; Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, Paris, France; Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France.
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Maltret A, Benaich FA, Rendu J, Fressart V, Roux-Buisson N, Bonnet D, Denjoy I. Challenging indication of cardioverter defibrillator implantation after sudden cardiac arrest in the very young: a case series of catecholaminergic polymorphic ventricular tachycardia secondary to de novo calmodulin p.Asn98Ser. Eur Heart J Case Rep 2021; 5:ytab393. [PMID: 34729453 PMCID: PMC8557678 DOI: 10.1093/ehjcr/ytab393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/07/2021] [Accepted: 09/20/2021] [Indexed: 11/14/2022]
Abstract
Background Calmodulinopathy is an emerging group of primary electrical disease with various, severe, and early onset phenotype. Sudden cardiac arrest (SCA)/death can be the first symptom and current medical management seems insufficient to prevent recurrences. Implantable cardioverter-defibrillator (ICD) in the young is challenging and can be harmful. Case summary We report the management of two very young boys (aged 3.5 and 5.5 years old) who survived an SCA due to calmodulin mutation responsible of a catecholaminergic polymorphic ventricular tachycardia phenotype. In both case, SCA had an adrenergic trigger. Despite SCA, ICD implantation was denied by the parents. After thorough discussion with the family, the patients were managed with solely betablocker treatment and loop recorder implantation. At last follow-up of 30 and 23 months, respectively, there were no recurrence of any cardiac event. Discussion The benefits of ICD implantation at a very young age must be weighed against the risk complication. In the youngest, whom recreative activities are under constant supervision, the decision, jointly made with the parents, could be to postpone ICD.
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Affiliation(s)
- Alice Maltret
- Hôpital Marie Lannelongue-M3C, GHPSJ, Université Paris Saclay, service de cardiologie congénitale, Le Plessis-Robinson, France
- Corresponding author. Tel: +33 140 942 303,
| | | | - John Rendu
- Centre Hospitalier Universitaire Grenoble Alpes, Laboratoire de Biochimie et Génétique Moléculaire, Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut Neurosciences, Grenoble, France
| | - Véronique Fressart
- Groupe Hospitalier Pitié-Salpêtrière, Service de Biochimie Métabolique, Unité de Cardiogénétique et Myogénétique, APHP, Paris, France
| | - Nathalie Roux-Buisson
- Centre Hospitalier Universitaire Grenoble Alpes, Laboratoire de Biochimie et Génétique Moléculaire, Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut Neurosciences, Grenoble, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - Isabelle Denjoy
- CNMR, Maladies Cardiaques Héréditaires Rares, Service de cardiologie, Hôpital Bichat, APHP, Paris, France
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Peltenburg P, Kallas D, van der Werf C, Lieve KV, Franciosi S, Roston TM, Denjoy I, Martijn Bos J, Sorensen KB, Perez G, Wada Y, Noguer FR, Almaas VM, Yap SC, Khan H, Maltret A, LaPage MJ, Giudicessi JR, Barker Clur SA, Blom NA, Tanck M, Davis AM, Behr E, Rudic B, Brugada GS, Kannankeril PJ, Sacher F, Skinner J, Tfelt-Hansen J, Tavacova T, Baban A, Robyns T, Semsarian C, Schwartz PJ, Van Den Berg MP, Roberts JD, Grima EZ, Swan H, Kammeraad JA, Krahn AD, Haugaa KH, Shimizu W, Till J, Horie M, Probst V, Brugada R, Ackerman MJ, Sanatani S, Leenhardt A, Wilde AA. B-PO04-026 NON-SELECTIVE VERSUS Β1-SELECTIVE BETA-BLOCKERS IN THE TREATMENT OF SYMPTOMATIC CHILDREN WITH CATECHOLAMINERGIC POLYMORPHIC VENTRICULAR TACHYCARDIA. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Waldmann V, Amet D, Zhao A, Ladouceur M, Otmani A, Karsenty C, Maltret A, Ollitrault J, Pontnau F, Legendre A, Florens E, Munte L, Soulat G, Mousseaux E, Du Puy-Montbrun L, Lavergne T, Bonnet D, Vouhé P, Jouven X, Marijon E, Iserin L. Catheter ablation in adults with congenital heart disease: A 15-year perspective from a tertiary centre. Arch Cardiovasc Dis 2021; 114:455-464. [PMID: 33846095 DOI: 10.1016/j.acvd.2020.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/08/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND With the growing adult congenital heart disease (ACHD) population, the number of catheter ablation procedures is expected to dramatically increase. Data reporting experience and evolution of catheter ablation in patients with ACHD, over a significant period of time, remain scarce. AIM We aimed to describe temporal trends in volume and outcomes of catheter ablation in patients with ACHD. METHODS This was a retrospective observational study including all consecutive patients with ACHD undergoing attempted catheter ablation in a large tertiary referral centre over a 15-year period. Acute procedural success rate and freedom from recurrence at 12 and 24 months were analysed. RESULTS From November 2004 to November 2019, 302 catheter ablations were performed in 221 patients with ACHD (mean age 43.6±15.0 years; 58.9% male sex). The annual number of catheter ablations increased progressively from four to 60 cases per year (P<0.001). Intra-atrial reentrant tachycardia/focal atrial tachycardia was the most common arrhythmia (n=217, 71.9%). Over the study period, acute procedural success rate increased from 45.0% to 93.4% (P<0.001). Use of irrigated catheters (odds ratio [OR] 4.03, 95% confidence interval [CI] 1.86-8.55), a three-dimensional mapping system (OR 3.70, 95% CI 1.72-7.74), contact force catheters (OR 3.60, 95% CI 1.81-7.38) and high-density mapping (OR 3.69, 95% CI 1.82-8.14) were associated with acute procedural success. The rate of freedom from any recurrence at 12 months increased from 29.4% to 66.2% (P=0.001). Seven (2.3%) non-fatal complications occurred. CONCLUSIONS The number of catheter ablation procedures in patients with ACHD has increased considerably over the past 15 years. Growing experience and advances in ablative technologies appear to be associated with a significant improvement in acute and mid-term outcomes.
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Affiliation(s)
- Victor Waldmann
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France; Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France.
| | - Denis Amet
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Alexandre Zhao
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Magalie Ladouceur
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Akli Otmani
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Clement Karsenty
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Alice Maltret
- Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France
| | - Jacky Ollitrault
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Florence Pontnau
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Antoine Legendre
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France; Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France
| | - Emmanuelle Florens
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Laura Munte
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Gilles Soulat
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Elie Mousseaux
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Leonarda Du Puy-Montbrun
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Thomas Lavergne
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Damien Bonnet
- Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France
| | - Pascal Vouhé
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Xavier Jouven
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Eloi Marijon
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France
| | - Laurence Iserin
- Adult Congenital Heart Disease Medico-Surgical Unit, Georges Pompidou European Hospital, 75015 Paris, France; Paediatric and Congenital Heart Disease Department, Necker Hospital, 75015 Paris, France
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19
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Combes N, Maltret A, Waldmann V. Unusual Wide QRS Complex Rhythm in a Teenager. JAMA Cardiol 2021; 6:475-476. [PMID: 33502429 DOI: 10.1001/jamacardio.2020.7091] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nicolas Combes
- Electrophysiology Unit, Clinique Pasteur, Toulouse, France.,Pediatric and Adult Congenital Heart Disease Department, Clinique Pasteur, Toulouse, France.,Pediatric and Adult Congenital Heart Disease Department, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Alice Maltret
- Pediatric and Adult Congenital Heart Disease Department, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Victor Waldmann
- Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France.,Adult Congenital Heart Disease Unit, European Georges Pompidou Hospital, Paris, France.,Pediatric and Congenital Heart Disease Department, Necker Hospital, Paris, France
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20
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Abstract
Background Fetal tachyarrhythmia is a condition that may lead to cardiac dysfunction, hydrops, and death. Despite a transplacental treatment, failure to obtain or maintain sinus rhythm may occur. Objective We aimed to analyze the perinatal outcomes of sustained fetal tachyarrhythmias after in utero treatment. Methods We performed a retrospective evaluation of 69 cases with sustained fetal tachyarrhythmia. We compared the perinatal and long-term outcomes of prenatally converted and drug-resistant fetuses. Tachyarrhythmia subtypes were also evaluated. Results Conversion to sinus rhythm was obtained in 74% of cases; 26% of cases were drug-resistant and delivered arrhythmic. Three perinatal deaths occurred in both groups (6.7% vs 17%, P = .34). Neonates delivered arrhythmic were more frequently admitted to neonatal intensive care units (75% vs 31%, P < .01), and their hospital stay was longer (20.9 vs 6.64 days, P < .001). Multiple neonatal recurrences (81% vs 11%, P < .001), temporary hemodynamic dysfunction or heart failure (50% vs 6.7%, P < .001), and postnatal use of a combination treatment (44% vs 13%, P = .028) were also more frequent in this population. Beyond the neonatal period, rates of recurrences within the first 16 months were higher in drug-resistant fetuses (HR = 16.14, CI 95% [4.485; 193.8], P < .001). In this population, postnatal electrocardiogram revealed an overrepresentation of rare mechanisms, especially permanent junctional reciprocating tachycardia (PJRT) (31%). Conclusion Prenatal conversion to stable sinus rhythm is a major determinant of perinatal and long-term outcomes in fetal tachyarrhythmias. The underlying electrophysiological mechanisms have a major role in predicting these differential outcomes with an overrepresentation of PJRT in the drug-resistant population.
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Affiliation(s)
- Raphael Bartin
- Obstetric and Maternal Fetal Medicine and EA7328.,Hôpital universitaire Necker-Enfants malades, AP-HP
| | - Alice Maltret
- M3C-Necker, Pediatric and Congenital Cardiology Unit.,Hôpital universitaire Necker-Enfants malades, AP-HP
| | - Muriel Nicloux
- Neonatology and Neonatal Intensive Care Unit.,Hôpital universitaire Necker-Enfants malades, AP-HP
| | - Yves Ville
- Obstetric and Maternal Fetal Medicine and EA7328.,Hôpital universitaire Necker-Enfants malades, AP-HP.,Université de Paris, Paris, France
| | - Damien Bonnet
- M3C-Necker, Pediatric and Congenital Cardiology Unit.,Hôpital universitaire Necker-Enfants malades, AP-HP.,Université de Paris, Paris, France
| | - Julien Stirnemann
- Obstetric and Maternal Fetal Medicine and EA7328.,Hôpital universitaire Necker-Enfants malades, AP-HP.,Université de Paris, Paris, France
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21
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Bérat CM, Montealegre S, Wiedemann A, Nuzum MLC, Blondel A, Debruge H, Cano A, Chabrol B, Hoebeke C, Polak M, Stoupa A, Feillet F, Torre S, Boddaert N, Bruel H, Barth M, Damaj L, Abi-Wardé MT, Afenjar A, Benoist JF, Madrange M, Caccavelli L, Renard P, Hubas A, Nusbaum P, Pontoizeau C, Gobin S, van Endert P, Ottolenghi C, Maltret A, de Lonlay P. Clinical and biological characterization of 20 patients with TANGO2 deficiency indicates novel triggers of metabolic crises and no primary energetic defect. J Inherit Metab Dis 2021; 44:415-425. [PMID: 32929747 DOI: 10.1002/jimd.12314] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 06/24/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022]
Abstract
TANGO2 disease is a severe inherited disorder associating multiple symptoms such as metabolic crises, encephalopathy, cardiac arrhythmias, and hypothyroidism. The mechanism of action of TANGO2 is currently unknown. Here, we describe a cohort of 20 French patients bearing mutations in the TANGO2 gene. We found that the main clinical presentation was the association of neurodevelopmental delay (n = 17), acute metabolic crises (n = 17) and hypothyroidism (n = 12), with a large intrafamilial clinical variability. Metabolic crises included rhabdomyolysis (15/17), neurological symptoms (14/17), and cardiac features (12/17; long QT (n = 10), Brugada pattern (n = 2), cardiac arrhythmia (n = 6)) that required intensive care. We show previously uncharacterized triggers of metabolic crises in TANGO2 patients, such as some anesthetics and possibly l-carnitine. Unexpectedly, plasma acylcarnitines, plasma FGF-21, muscle histology, and mitochondrial spectrometry were mostly normal. Moreover, in patients' primary myoblasts, palmitate and glutamine oxidation rates, and the mitochondrial network were also normal. Finally, we found variable mitochondrial respiration and defective clearance of oxidized DNA upon cycles of starvation and refeeding. We conclude that TANGO2 disease is a life-threatening disease that needs specific cardiac management and anesthesia protocol. Mechanistically, TANGO2 disease is unlikely to originate from a primary mitochondrial defect. Rather, we suggest that mitochondrial defects are secondary to strong extrinsic triggers in TANGO2 deficient patients.
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Affiliation(s)
- Claire-Marine Bérat
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Université de Paris, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Imagine Institute, Filière G2M, Paris, France
| | - Sebastian Montealegre
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Imagine Institute, Filière G2M, Paris, France
| | - Arnaud Wiedemann
- Department of Pediatric Intensive Care, Reference Center of Inherited Metabolic Disorders, INSERM U1256, Nancy Hospital, Nancy, France
| | | | - Amélie Blondel
- Department of Biochemistry, Necker-Enfants-Malades University Hospital, APHP, Filière G2M, Paris, France
| | - Hugo Debruge
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
| | - Aline Cano
- Reference Center of Inherited Metabolic Disorders, La Timone Hospital, Filière G2M, Marseille, France
| | - Brigitte Chabrol
- Reference Center of Inherited Metabolic Disorders, La Timone Hospital, Filière G2M, Marseille, France
| | - Célia Hoebeke
- Reference Center of Inherited Metabolic Disorders, La Timone Hospital, Filière G2M, Marseille, France
| | - Michel Polak
- Université de Paris, Paris, France
- Endocrinology Unit, Reference Center of Rare Endocrine Diseases of Growth and Development, Necker-Enfants-Malades, University hospital, APHP, Imagine Institute, Paris, France
| | - Athanasia Stoupa
- Université de Paris, Paris, France
- Endocrinology Unit, Reference Center of Rare Endocrine Diseases of Growth and Development, Necker-Enfants-Malades, University hospital, APHP, Imagine Institute, Paris, France
| | - François Feillet
- Department of Pediatric Intensive Care, Reference Center of Inherited Metabolic Disorders, INSERM U1256, Nancy Hospital, Nancy, France
| | - Stéphanie Torre
- Competence Center of Inherited Metabolic Disorders, Rouen Hospital, Filière G2M, Rouen, France
| | - Nathalie Boddaert
- Université de Paris, Paris, France
- Paediatric Radiology Department, Necker-Enfants-Malades University hospital, APHP and INSERM U1163, Imagine Institute, Paris, France
| | - Henri Bruel
- Pediatrics Department, Le Havre Hospital, Le Havre, France
| | - Magalie Barth
- Pediatrics Department, Angers Hospital, Angers, France
| | - Lena Damaj
- Pediatrics Department, Rennes Hospital, Rennes, France
| | | | - Alexandra Afenjar
- Reference Center of Cerebellar Malformations and Congenital Diseases, Trousseau Hospital, APHP, Paris, France
| | - Jean-François Benoist
- Department of Biochemistry, Necker-Enfants-Malades University Hospital, APHP, Filière G2M, Paris, France
| | - Marine Madrange
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Imagine Institute, Filière G2M, Paris, France
| | - Laure Caccavelli
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Imagine Institute, Filière G2M, Paris, France
| | - Perrine Renard
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
| | - Arnaud Hubas
- Genetics and Molecular Biology, Laboratoire de culture cellulaire, Hôpital Cochin, Paris, France
| | - Patrick Nusbaum
- Genetics and Molecular Biology, Laboratoire de culture cellulaire, Hôpital Cochin, Paris, France
| | - Clément Pontoizeau
- Department of Biochemistry, Necker-Enfants-Malades University Hospital, APHP, Filière G2M, Paris, France
| | - Stéphanie Gobin
- Genetics Department, Necker-Enfants-Malades University Hospital, APHP, Paris, France
| | - Peter van Endert
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Université de Paris, Paris, France
| | - Chris Ottolenghi
- Department of Biochemistry, Necker-Enfants-Malades University Hospital, APHP, Filière G2M, Paris, France
| | - Alice Maltret
- Cardiology Unit, Necker-Enfants-Malades University Hospital, APHP, Paris, France
| | - Pascale de Lonlay
- Inserm U1151, Institut Necker Enfants-Malades, Paris, France
- Université de Paris, Paris, France
- Reference Center of inherited Metabolic Diseases, Necker-Enfants-Malades University hospital, APHP, Imagine Institute, Filière G2M, Paris, France
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22
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Waldmann V, Amet D, Zhao A, Ladouceur M, Otmani A, Karsenty C, Maltret A, Soulat G, Mousseaux E, Lavergne T, Jouven X, Marijon E, Iserin L. Catheter ablation of intra-atrial re-entrant tachycardia in adult congenital heart disease: Value of final programmed atrial stimulation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.207] [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: 10/22/2022]
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23
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Shokrzadeh A, Maltret A, Morel N, Costedoat-Chalumeau N, Driessen M, Raisky O, Ville Y, Bonnet D, Stirnemann J. Longitudinal Analysis of Fetal Ventricular Rate for Risk Stratification in Immune Congenital Heart Block. Fetal Diagn Ther 2020; 48:1-8. [PMID: 33296896 DOI: 10.1159/000507811] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/25/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the perinatal risks of immune complete congenital heart block (iCCHB) based on the longitudinal analysis of fetal heart rate. METHODS Retrospective analysis of a cohort of grade III congenital heart block diagnosed in utero, in the absence of associated cardiac defect, with positive maternal serum antibodies. Longitudinal measurements of the fetal heart rate were used to estimate the average slope of ventricular rate as a function of gestational age. We then defined the following prognostic stratification based on longitudinal follow-up observations: the high-rate (HR) group included cases for which all prenatal ventricular rate measurements were above the age-specific mean of our population of iCCHB and the low-rate (LR) group included those with at least one observation below the mean during follow-up. The 2 groups were compared to analyze the potential relationship between prenatal ventricular rate and adverse neonatal outcome defined by in utero or perinatal death, neonatal heart rate <50 bpm, or hemodynamic failure requiring emergency pacing. RESULTS Forty-four cases were studied. Overall, the average heart rate significantly decreased during gestation from 65 bpm at 20 weeks to 55 bpm at 38 weeks. The HR and LR groups included 18 (41%) and 26 (59%) cases, respectively. Adverse perinatal outcome occurred in 1/18 (6%) and 22/26 (85%) cases in the HR and LR groups, respectively (p < 0.001). In the HR group, 33% of cases remained nonpaced at >6 months. The positive predictive values and negative predictive values for adverse perinatal outcome in the LR group were 85% (22/26) and 94% (17/18), respectively (100 and 80% <30 weeks and 88 and 78% at ≥30 weeks). CONCLUSIONS The prognostic classification we developed based on longitudinal heart rate assessment may be used in the late 2nd or early 3rd trimester to identify iCCHB cases at high risk of adverse perinatal outcome. This prognostic stratification should help refine counseling and perinatal management earlier in pregnancy instead of waiting for late gestation or predelivery assessment.
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Affiliation(s)
- Ayla Shokrzadeh
- Obstetrics, Fetal Medicine and Surgery, Hôpital Necker Enfants Malades, Paris, France
| | - Alice Maltret
- M3C-Necker, Pediatric cardiology and cardiac surgery, Hôpital Necker-Enfants Malades, Paris, France
| | - Nathalie Morel
- Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, Paris, France
| | - Nathalie Costedoat-Chalumeau
- Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne, Hôpital Cochin, Paris, France
| | - Marine Driessen
- Obstetrics, Fetal Medicine and Surgery, Hôpital Necker Enfants Malades, Paris, France
| | - Olivier Raisky
- M3C-Necker, Pediatric cardiology and cardiac surgery, Hôpital Necker-Enfants Malades, Paris, France
| | - Yves Ville
- Obstetrics, Fetal Medicine and Surgery, Hôpital Necker Enfants Malades, Paris, France.,EA7328 - PACT, Institut IMAGINE, Université de Paris, Paris, France
| | - Damien Bonnet
- M3C-Necker, Pediatric cardiology and cardiac surgery, Hôpital Necker-Enfants Malades, Paris, France
| | - Julien Stirnemann
- Obstetrics, Fetal Medicine and Surgery, Hôpital Necker Enfants Malades, Paris, France, .,EA7328 - PACT, Institut IMAGINE, Université de Paris, Paris, France,
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24
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Maltret A, Morel N, Levy M, Evangelista M, Malekzadeh-Milani S, Barbet P, Costedoat-Chalumeau N, Bonnet D. Pulmonary hypertension associated with congenital heart block and neonatal lupus syndrome: A series of four cases. Lupus 2020; 30:307-314. [PMID: 33198562 DOI: 10.1177/0961203320973073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Neonatal lupus syndrome has multisystemic manifestations among which pulmonary involvement has been rarely reported. We describe the clinical presentation, management, and outcome of a series of four neonates who developed reversible pulmonary hypertension associated with auto-immune congenital complete heart block. METHOD Data from the French registry of neonatal lupus syndrome were retrospectively reviewed. RESULTS Between 2000 and March 2020, 231 children were included in the French registry, four/73 followed in our institution developed pulmonary hypertension. Diagnosis was suspected on transthoracic echocardiography at a median age of 42 days [range 10-58], and confirmed by right heart catheterization in all; 2 of them where paced at time of diagnosis and 2 were not. All had some degree of hypoxemia and respiratory distress. Hypoxemia was always reversible under O2 et NO. Lung CT demonstrated ground glass anomalies in all. One patient had a lung biopsy consistent with pulmonary hypertension secondary to lung disease. Management included immunosuppressive therapy in 3 associated with sildenafil in 2. Pulmonary hypertension resolved in all at a median age of 4 weeks [range 3-6] after treatment initiation and after one year for the one child who did not receive specific treatment. CONCLUSION Clinical, hemodynamical, imaging and histological findings advocate for pulmonary hypertension associated with respiratory disease as a rare manifestation of neonatal lupus syndrome.
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Affiliation(s)
- Alice Maltret
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France
| | - Nathalie Morel
- AP-HP, Hôpital Cochin, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Paris, France
| | - Marilyne Levy
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France.,Université de Paris, Paris, France
| | | | | | - Patrick Barbet
- Université de Paris, Paris, France.,Service d'Anatomo-Pathologie, APHP, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Nathalie Costedoat-Chalumeau
- AP-HP, Hôpital Cochin, Centre de Référence Maladies Auto-immunes et Systémiques Rares, Paris, France.,Université de Paris, Paris, France
| | - Damien Bonnet
- M3C-Necker, Hôpital Universitaire Necker-Enfants malades, Paris, France.,Université de Paris, Paris, France
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25
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van der Werf C, Lieve KV, Bos JM, Lane CM, Denjoy I, Roses-Noguer F, Aiba T, Wada Y, Ingles J, Leren IS, Rudic B, Schwartz PJ, Maltret A, Sacher F, Skinner JR, Krahn AD, Roston TM, Tfelt-Hansen J, Swan H, Robyns T, Ohno S, Roberts JD, van den Berg MP, Kammeraad JA, Probst V, Kannankeril PJ, Blom NA, Behr ER, Borggrefe M, Haugaa KH, Semsarian C, Horie M, Shimizu W, Till JA, Leenhardt A, Ackerman MJ, Wilde AA. Implantable cardioverter-defibrillators in previously undiagnosed patients with catecholaminergic polymorphic ventricular tachycardia resuscitated from sudden cardiac arrest. Eur Heart J 2020; 40:2953-2961. [PMID: 31145795 DOI: 10.1093/eurheartj/ehz309] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [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: 01/05/2019] [Revised: 03/28/2019] [Accepted: 04/26/2019] [Indexed: 11/12/2022] Open
Abstract
AIMS In patients with catecholaminergic polymorphic ventricular tachycardia (CPVT), implantable cardioverter-defibrillator (ICD) shocks are sometimes ineffective and may even trigger fatal electrical storms. We assessed the efficacy and complications of ICDs placed in patients with CPVT who presented with a sentinel event of sudden cardiac arrest (SCA) while undiagnosed and therefore untreated. METHODS AND RESULTS We analysed 136 patients who presented with SCA and in whom CPVT was diagnosed subsequently, leading to the initiation of guideline-directed therapy, including β-blockers, flecainide, and/or left cardiac sympathetic denervation. An ICD was implanted in 79 patients (58.1%). The primary outcome of the study was sudden cardiac death (SCD). The secondary outcomes were composite outcomes of SCD, SCA, appropriate ICD shocks, and syncope. After a median follow-up of 4.8 years, SCD had occurred in three patients (3.8%) with an ICD and none of the patients without an ICD (P = 0.1). SCD, SCA, or appropriate ICD shocks occurred in 37 patients (46.8%) with an ICD and 9 patients (15.8%) without an ICD (P < 0.0001). Inappropriate ICD shocks occurred in 19 patients (24.7%) and other device-related complications in 22 patients (28.9%). CONCLUSION In previously undiagnosed patients with CPVT who presented with SCA, an ICD was not associated with improved survival. Instead, the ICD was associated with both a high rate of appropriate ICD shocks and inappropriate ICD shocks along with other device-related complications. Strict adherence to guideline-directed therapy without an ICD may provide adequate protection in these patients without all the potential disadvantages of an ICD.
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Affiliation(s)
- Christian van der Werf
- Amsterdam UMC, University of Amsterdam, Heart Centre, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Krystien V Lieve
- Amsterdam UMC, University of Amsterdam, Heart Centre, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - J Martijn Bos
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Conor M Lane
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Isabelle Denjoy
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, 46 Rue Henri Huchard, Paris, France
| | - Ferran Roses-Noguer
- Department of Cardiology, Royal Brompton Hospital, Sydney St, Chelsea, London, UK
| | - Takeshi Aiba
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, 5 Chome-7-1 Fujishirodai, Suita, Osaka, Japan
| | - Yuko Wada
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Japan
| | - Jodie Ingles
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Locked Bag 6, Newtown, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Locked Bag 6, Newtown, Sydney, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Locked Bag 6, Newtown, Sydney, Australia
| | - Ida S Leren
- Department of Cardiology, Centre for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
| | - Boris Rudic
- Department of Cardiology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1 - 3, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Peter J Schwartz
- Istituto Auxologico Italiano, IRCCS, Center for Cardiac Arrhythmias of Genetic Origin, Via Pier Lombardo 22, Milan, Italy
| | - Alice Maltret
- Hôpital Necker-Enfants-Malades, Cardiologie Pédiatrique, 149 Rue de Sèvres, Paris, France
| | - Frederic Sacher
- LIRYC Institute, Bordeaux University Hospital, Bordeaux University, Avenue du Haut Lévêque, Pessac- Bordeaux, France
| | - Jonathan R Skinner
- Cardiac Inherited Disease Group New Zealand, Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, 2 Park Rd, Grafton, Auckland 1023 New Zealand.,Department of Paediatrics Child and Youth Health, The University of Auckland, Auckland, New Zealand
| | - Andrew D Krahn
- Division of Cardiology, Heart Rhythm Services, University of British Columbia, 1033 Davie Street, Vancouver, BC, Canada
| | - Thomas M Roston
- Division of Cardiology, Heart Rhythm Services, University of British Columbia, 1033 Davie Street, Vancouver, BC, Canada.,BC Children's Hospital, 4480 Oak St, Vancouver, BC, Canada.,Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, Canada
| | - Jacob Tfelt-Hansen
- Department of Cardiology, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark
| | - Heikki Swan
- Heart and Lung Centre, Helsinki University Hospital and Helsinki University, Tukholmankatu 8 A Helsinki, Finland
| | - Tomas Robyns
- Department of Cardiovascular Diseases, University Hospitals Leuven, Herestraat 49, Leuven, Belgium
| | - Seiko Ohno
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Japan.,Department of Bioscience and Genetics, National Cerebral and Cardiovascular Centre, 5 Chome-7-1 Fujishirodai, Suita, Osaka, Japan
| | - Jason D Roberts
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, 339 Windermere Road, B6-129B, London, ON, Canada
| | - Maarten P van den Berg
- Department of Cardiology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, GZ Groningen, The Netherlands
| | - Janneke A Kammeraad
- Department of Pediatric Cardiology, Sophia Children's Hospital, Erasmus University Medical Centre, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Vincent Probst
- L'Institut du Thorax, Cardiologic Department and Reference Center for Hereditary Arrhythmic Diseases INSERM 1087, Boulevard Monod, Nantes, France
| | - Prince J Kannankeril
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University Medical Centre, 2200 Children's Way, Nashville, TN, USA
| | - Nico A Blom
- Department of Pediatric Cardiology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, AZ Amsterdam, The Netherlands.,Department of Pediatric Cardiology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Albinusdreef 2, ZA Leiden, The Netherlands
| | - Elijah R Behr
- Molecular and Clinical Sciences Research Institute, St. George's, University of London, Cranmer Terrace, London, UK.,Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, Cranmer Terrace, London, UK
| | - Martin Borggrefe
- Department of Cardiology, University Medical Centre Mannheim, Theodor-Kutzer-Ufer 1 - 3, Mannheim, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Kristina H Haugaa
- Department of Cardiology, Centre for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, Oslo, Norway
| | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Locked Bag 6, Newtown, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Locked Bag 6, Newtown, Sydney, Australia.,Department of Cardiology, Royal Prince Alfred Hospital, Locked Bag 6, Newtown, Sydney, Australia
| | - Minoru Horie
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Japan
| | - Wataru Shimizu
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, 5 Chome-7-1 Fujishirodai, Suita, Osaka, Japan.,Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, Japan
| | - Janice A Till
- Department of Cardiology, Royal Brompton Hospital, Sydney St, Chelsea, London, UK
| | - Antoine Leenhardt
- Service de Cardiologie et CNMR Maladies Cardiaques Héréditaires Rares, Hôpital Bichat, 46 Rue Henri Huchard, Paris, France
| | - Michael J Ackerman
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, 200 First St SW, Rochester, MN, USA
| | - Arthur A Wilde
- Amsterdam UMC, University of Amsterdam, Heart Centre, and Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.,Brahim Centre of Excellence in Research of Hereditary Disorders, Princess Al-Jawhara Al, 7393 Al-Malae'b St, King Abdul Aziz University, Jeddah, Kingdom of Saudi Arabia
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Waldmann V, Amet D, Zhao A, Ladouceur M, Karsenty C, Maltret A, Pontnau F, Legendre A, Soulat G, Lavergne T, Bonnet D, Jouven X, Vouhe P, Marijon E, Iserin L. Catheter ablation in adults with congenital heart disease: a 15-year perspective from a tertiary center. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
With the growing population of adults with congenital heart disease (ACHD), the number of catheter ablation procedures is expected to increase over time.
Purpose
We aimed to describe temporal trends in volume and outcomes of catheter ablation procedures in ACHD patients in a large tertiary center.
Methods
Retrospective observational study including all consecutive ACHD patients undergoing catheter ablation in a tertiary reference center over a 15-year period. Acute procedural success rate (including complete success in case of non-inducibility of any arrhythmia at the end of the procedure) as well as freedom from recurrence at 12 months were analyzed.
Results
From November 2004 to November 2019, 302 catheter ablations in 221 ACHD patients (43.6±15.0 years, 58.9% males) were performed. The annual number of catheter ablation increased progressively from 4 to 60 by year (p<0.001). Intra-atrial reentrant tachycardia/focal atrial tachycardia was the most common targeted arrhythmia (n=217, 71.9%). Over the study period, acute procedural success rate increased from 45.0% to 93.3% (p<0.001), including complete acute procedural success from 45.0% to 88.1% (p<0.001) (Figure 1). The use of irrigated catheters (30.0% to 94.8%, p<0.001), 3D-mapping systems (60.0% to 96.3%, p<0.001), contact force catheters (0.0% to 91.9%, <0.001), and high-density mapping (0.0% to 71.9%, p<0.01) increased significantly. Use of irrigated catheters (OR=3.96, 95% CI: 1.79–8.55), 3D-mapping system (OR=3.55, 95% CI: 1.62–7.55), contact force catheters (OR=3.46, 95% CI: 1.71–7.25), and high-density mapping (OR=3.85, 95% CI: 1.60–7.26) were associated with acute procedural success. The rate of freedom from any recurrence at 12 months increased from 29.4% to 66.2% (p=0.001). Seven (2.3%) non-fatal complications occurred.
Conclusions
The number of catheter ablation procedures in ACHD patients has considerably increased over the last 15 years. Advances in ablative technologies appear to be associated with a low rate of complications and a significant improvement in acute and midterm outcomes.
Evolution of acute procedural success
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- V Waldmann
- European Georges Pompidou Hospital, Paris, France
| | - D Amet
- European Georges Pompidou Hospital, Paris, France
| | - A Zhao
- European Georges Pompidou Hospital, Paris, France
| | - M Ladouceur
- European Georges Pompidou Hospital, Paris, France
| | - C Karsenty
- European Georges Pompidou Hospital, Paris, France
| | | | - F Pontnau
- European Georges Pompidou Hospital, Paris, France
| | - A Legendre
- European Georges Pompidou Hospital, Paris, France
| | - G Soulat
- European Georges Pompidou Hospital, Paris, France
| | - T Lavergne
- European Georges Pompidou Hospital, Paris, France
| | | | - X Jouven
- European Georges Pompidou Hospital, Paris, France
| | - P Vouhe
- European Georges Pompidou Hospital, Paris, France
| | - E Marijon
- European Georges Pompidou Hospital, Paris, France
| | - L Iserin
- European Georges Pompidou Hospital, Paris, France
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27
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Waldmann V, Amet D, Zhao A, Ladouceur M, Otmani A, Karsenty C, Maltret A, Soulat G, Mousseaux E, Lavergne T, Jouven X, Iserin L, Marijon E. Catheter ablation of intra-atrial reentrant/focal atrial tachycardia in adult congenital heart disease: Value of final programmed atrial stimulation. Heart Rhythm 2020; 17:1953-1959. [DOI: 10.1016/j.hrthm.2020.05.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/18/2020] [Accepted: 05/31/2020] [Indexed: 11/26/2022]
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28
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Ng K, Titus EW, Lieve KV, Roston TM, Mazzanti A, Deiter FH, Denjoy I, Ingles J, Till J, Robyns T, Connors SP, Steinberg C, Abrams DJ, Pang B, Scheinman MM, Bos JM, Duffett SA, van der Werf C, Maltret A, Green MS, Rutberg J, Balaji S, Cadrin-Tourigny J, Orland KM, Knight LM, Brateng C, Wu J, Tang AS, Skanes AC, Manlucu J, Healey JS, January CT, Krahn AD, Collins KK, Maginot KR, Fischbach P, Etheridge SP, Eckhardt LL, Hamilton RM, Ackerman MJ, Noguer FRI, Semsarian C, Jura N, Leenhardt A, Gollob MH, Priori SG, Sanatani S, Wilde AAM, Deo RC, Roberts JD. An International Multicenter Evaluation of Inheritance Patterns, Arrhythmic Risks, and Underlying Mechanisms of CASQ2-Catecholaminergic Polymorphic Ventricular Tachycardia. Circulation 2020; 142:932-947. [PMID: 32693635 PMCID: PMC7484339 DOI: 10.1161/circulationaha.120.045723] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Genetic variants in calsequestrin-2 (CASQ2) cause an autosomal recessive form of catecholaminergic polymorphic ventricular tachycardia (CPVT), although isolated reports have identified arrhythmic phenotypes among heterozygotes. Improved insight into the inheritance patterns, arrhythmic risks, and molecular mechanisms of CASQ2-CPVT was sought through an international multicenter collaboration. METHODS Genotype-phenotype segregation in CASQ2-CPVT families was assessed, and the impact of genotype on arrhythmic risk was evaluated using Cox regression models. Putative dominant CASQ2 missense variants and the established recessive CASQ2-p.R33Q variant were evaluated using oligomerization assays and their locations mapped to a recent CASQ2 filament structure. RESULTS A total of 112 individuals, including 36 CPVT probands (24 homozygotes/compound heterozygotes and 12 heterozygotes) and 76 family members possessing at least 1 presumed pathogenic CASQ2 variant, were identified. Among CASQ2 homozygotes and compound heterozygotes, clinical penetrance was 97.1% and 26 of 34 (76.5%) individuals had experienced a potentially fatal arrhythmic event with a median age of onset of 7 years (95% CI, 6-11). Fifty-one of 66 CASQ2 heterozygous family members had undergone clinical evaluation, and 17 of 51 (33.3%) met diagnostic criteria for CPVT. Relative to CASQ2 heterozygotes, CASQ2 homozygote/compound heterozygote genotype status in probands was associated with a 3.2-fold (95% CI, 1.3-8.0; P=0.013) increased hazard of a composite of cardiac syncope, aborted cardiac arrest, and sudden cardiac death, but a 38.8-fold (95% CI, 5.6-269.1; P<0.001) increased hazard in genotype-positive family members. In vitro turbidity assays revealed that p.R33Q and all 6 candidate dominant CASQ2 missense variants evaluated exhibited filamentation defects, but only p.R33Q convincingly failed to dimerize. Structural analysis revealed that 3 of these 6 putative dominant negative missense variants localized to an electronegative pocket considered critical for back-to-back binding of dimers. CONCLUSIONS This international multicenter study of CASQ2-CPVT redefines its heritability and confirms that pathogenic heterozygous CASQ2 variants may manifest with a CPVT phenotype, indicating a need to clinically screen these individuals. A dominant mode of inheritance appears intrinsic to certain missense variants because of their location and function within the CASQ2 filament structure.
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Affiliation(s)
- Kevin Ng
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
- Cairns Hospital, Queensland, Australia
| | - Erron W. Titus
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Krystien V. Lieve
- Amsterdam University Medical Centre, University of Amsterdam, Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
| | - Thomas M. Roston
- Heart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea Mazzanti
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Frederick H. Deiter
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Isabelle Denjoy
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Service de Cardiologie et CNMR Maladies Cardiacques Héréditaires Rares, Hôpital Bichat, Paris, France
| | - Jodie Ingles
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia
| | - Jan Till
- Department of Cardiology, Royal Brompton Hospital, London, United Kingdom
| | - Tomas Robyns
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Department of Cardiovascular Disease, University Hospitals Leuven, Leuven, Belgium
| | - Sean P. Connors
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Memorial University, St. John’s, Newfoundland and Labrador, Canada
| | | | - Dominic J. Abrams
- Inherited Cardiac Arrhythmia Program, Boston Children’s Hospital, Harvard Medical School, Massachusetts, USA
| | - Benjamin Pang
- Arrhythmia Service, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Melvin M. Scheinman
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - J. Martijn Bos
- Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen A. Duffett
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Memorial University, St. John’s, Newfoundland and Labrador, Canada
| | - Christian van der Werf
- Amsterdam University Medical Centre, University of Amsterdam, Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
| | - Alice Maltret
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Service de Cardiologie et CNMR Maladies Cardiacques Héréditaires Rares, Hôpital Bichat, Paris, France
| | - Martin S. Green
- Arrhythmia Service, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Julie Rutberg
- Arrhythmia Service, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Seshadri Balaji
- Department of Pediatrics, Division of Cardiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Julia Cadrin-Tourigny
- Cardiovascular Genetics Center, Montreal Heart Institute, Université de Montréal, Montréal, Canada
| | - Kate M. Orland
- University of Wisconsin-Madison Inherited Arrhythmia Clinic, Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Linda M. Knight
- Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, Georgia, USA
| | - Caitlin Brateng
- Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Jeremy Wu
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | - Anthony S. Tang
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | - Allan C. Skanes
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | - Jaimie Manlucu
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
| | - Jeff S. Healey
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Craig T. January
- University of Wisconsin-Madison Inherited Arrhythmia Clinic, Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Cellular and Molecular Arrhythmia Research Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Andrew D. Krahn
- Heart Rhythm Services, Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn K. Collins
- Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Kathleen R. Maginot
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Peter Fischbach
- Children’s Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, Georgia, USA
| | - Susan P. Etheridge
- Department of Pediatrics, University of Utah, and Primary Children’s Hospital, Salt Lake City, Utah, USA
| | - Lee L. Eckhardt
- University of Wisconsin-Madison Inherited Arrhythmia Clinic, Division of Cardiovascular Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Cellular and Molecular Arrhythmia Research Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Robert M. Hamilton
- The Labatt Family Heart Centre (Department of Pediatrics) and Translational Medicine, The Hospital for Sick Children and the University of Toronto, Toronto, Ontario, Canada
| | - Michael J. Ackerman
- Departments of Cardiovascular Medicine (Division of Heart Rhythm Services), Pediatric and Adolescent Medicine (Division of Pediatric Cardiology), and Molecular Pharmacology & Experimental Therapeutics (Windland Smith Rice Sudden Death Genomics Laboratory), Mayo Clinic, Rochester, Minnesota, USA
| | | | - Christopher Semsarian
- Agnes Ginges Centre for Molecular Cardiology at Centenary Institute, The University of Sydney, Sydney, Australia
| | - Natalia Jura
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
- Department of Cellular and Molecular Pharmacology, University of California San Francisco, San Francisco, California, USA
| | - Antoine Leenhardt
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Service de Cardiologie et CNMR Maladies Cardiacques Héréditaires Rares, Hôpital Bichat, Paris, France
| | - Michael H. Gollob
- Department of Physiology and Department of Medicine, Toronto General Hospital, University of Toronto, Ontario, Canada
| | - Silvia G. Priori
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
- Molecular Cardiology, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Shubhayan Sanatani
- Department of Pediatrics, Children’s Heart Centre, BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Arthur A. M. Wilde
- Amsterdam University Medical Centre, University of Amsterdam, Heart Centre, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart
| | - Rahul C. Deo
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
- One Brave Idea and Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Jason D. Roberts
- Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Western University, London, Ontario, Canada
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Frontera A, Vlachos K, Kitamura T, Mahida S, Pillois X, Fahy G, Marquie C, Cappato R, Stuart G, Defaye P, Kaski JP, Ector J, Maltret A, Scanu P, Pasquie JL, Deisenhofer I, Blankoff I, Scherr D, Manninger M, Aizawa Y, Koutbi L, Denis A, Pambrun T, Ritter P, Sacher F, Hocini M, Maury P, Jaïs P, Bordachar P, Haïssaguerre M, Derval N. Long-Term Follow-Up of Idiopathic Ventricular Fibrillation in a Pediatric Population: Clinical Characteristics, Management, and Complications. J Am Heart Assoc 2020; 8:e011172. [PMID: 31057083 PMCID: PMC6512137 DOI: 10.1161/jaha.118.011172] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background The natural history and long‐term outcome in pediatric patients with idiopathic ventricular fibrillation (IVF) are poorly characterized. We sought to define the clinical characteristics and long‐term outcomes of a pediatric cohort with an initial diagnosis of IVF. Methods and Results Patients were included from an International Registry of IVF (consisting of 496 patients). Inclusion criteria were: (1) VF with no identifiable cause following comprehensive analysis for ischemic, electrical or structural heart disease and (2) age ≤16 years. These included 54 pediatric IVF cases (age 12.7±3.7 years, 59% male) among whom 28 (52%) had a previous history of syncope (median 2 syncopal episodes [interquartile range 1]). Thirty‐six (67%) had VF in situations associated with high adrenergic tone. During a median 109±12 months of follow‐up, 31 patients (57%) had recurrence of ventricular arrhythmias, mainly VF. Two patients developed phenotypic expression of an inherited arrhythmia syndrome during follow‐up (hypertrophic cardiomyopathy and long QT syndrome, respectively). A total of 15 patients had positive genetic testing for inherited arrhythmia syndromes. Ten patients (18%) experienced device‐related complications. Three patients (6%) died, 2 due to VF storm. Conclusions In pediatric patients with IVF, a minority develop a definite clinical phenotype during long‐term follow‐up. Recurrent VF is common in this patient group.
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Affiliation(s)
- Antonio Frontera
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | | | - Takeshi Kitamura
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
| | - Saagar Mahida
- 3 Department of Cardiac Electrophysiology and Inherited Cardiac Diseases Liverpool Heart and Chest Hospital Liverpool United Kingdom
| | - Xavier Pillois
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | | | | | - Riccardo Cappato
- 6 Humanitas Clinical and Research Center Rozzano, Milan, Italy and Humanitas University, Department of Biomedical Sciences Milan Italy
| | | | | | - Juan Pablo Kaski
- 9 Centre for Inherited Cardiovascular Diseases Great Ormond Street Hospital London United Kingdom.,10 UCL Institute of Cardiovascular Science London United Kingdom
| | - Joris Ector
- 11 University Hospital Gasthuisberg Leuven Belgium
| | - Alice Maltret
- 12 Hôpital Necker Enfants Malades Service de Cardiologie Pédiatrique et Centre de Référence des Maladies Cardiaques Héréditaires Université Paris Descartes Paris France
| | | | | | | | - Ivan Blankoff
- 16 Centre Hospitalier University of Charleroi Belgium
| | - Daniel Scherr
- 17 Division of Cardiology Department of Medicine Medical University of Graz Austria
| | - Martin Manninger
- 17 Division of Cardiology Department of Medicine Medical University of Graz Austria
| | - Yoshifusa Aizawa
- 18 Niigata University Graduate School of Medical and Dental Science Niigata Japan
| | | | - Arnaud Denis
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
| | - Thomas Pambrun
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
| | - Philippe Ritter
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
| | - Frederic Sacher
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
| | - Meleze Hocini
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | | | - Pierre Jaïs
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | - Pierre Bordachar
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | - Michel Haïssaguerre
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France.,2 Liryc Institute Bordeaux France
| | - Nicolas Derval
- 1 Electrophysiology Department, Hopital Haut Lévêque Bordeaux France
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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.)
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31
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Fiorina L, Marijon E, Maupain C, Coquard C, Larnier L, Rischard J, Bourmaud A, Salerno F, Horvilleur J, Lacotte J, Ait Said M, Manenti V, Maltret A, Li J, Gardella C. 222AI-based strategy enables faster Holter ECG analysis with equivalent clinical accuracy compared to a classical strategy. Europace 2020. [DOI: 10.1093/europace/euaa162.374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
Analysis of Holter recordings can be challenging and time-consuming, therefore requiring significant clinical resources in order to achieve a high-quality diagnosis. Such resources depend largely on the qualifications of the person conducting the analysis and the duration of the recordings. A novel Holter analysis platform has been developed, based on deep neural networks trained with a dataset of one million ECGs, to allow fast and reliable Holter recording analysis.
PURPOSE
This study sought to compare the performance of an artificial intelligence (AI)-based Holter analysis platform using deep learning tools with a classical one used on a daily basis in hospitals (the reference). The main endpoints evaluated were duration to complete the analysis by the physician operating it as well as diagnostic accuracy of each strategy, when platforms are used by electrophysiologists (EPs).
METHODS
For this prospective evaluation, a total of 159 Holter recordings (24-hour) were selected from a large Holter dataset from 1 hospital, with a relatively high prevalence of electrical rhythm and conduction disorders. Recordings were analysed by four EPs using independently both the AI-based and classical analysis platforms. All four EPs had no previous experience with the AI-based platform, except for an introductory 6-hour training session. Three EPs had multiple years of experience with the traditional platform, while one EP had limited experience. For each recording, in addition to the analysis duration, diagnostic accuracy was evaluated through the analysis of the presence or absence of predefined cardiac arrhythmias and conduction disorders (prevalence): pauses (25.2%), ventricular tachycardia (VT, 30.2%), atrial fibrillation (AF, 26.4%), high grade atrioventricular block (AVB, 10.1%) and burden of premature ventricular complex larger than 10% (PVC, 23.9%). Definite diagnostics were established by an expert EP after a careful examination of all available analysis reports.
RESULTS
Time required for the AI-based analysis was on average 42% shorter compared to the traditional platform (6.65 min vs 11.5 min, p < 0.0001). Regarding accuracy to detect electrical disorders, there was no statistically significant differences between AI-based and classical platforms (AF: 98.7% vs 96.9%, Pause: 99.4% vs 100%, PVC: 98.7% vs 98.7%, VT: 92.5% vs 96.2%, AVB: 98.7% vs 94.3%). CONCLUSION: These preliminary findings suggest that an AI-based strategy to analyse Holter recordings may be highly accurate in detecting cardiac electrical abnormalities, with significant time savings compared to a classical strategy, even for users with no previous experience with the novel AI-based platform. An AI-based Holter analysis platform may contribute to a broader and more resource-efficient adoption of Holter monitoring.
Abstract Figure. analysis duration using each strategy
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Affiliation(s)
- L Fiorina
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - E Marijon
- European Hospital Georges Pompidou, Cardiology, Paris, France
| | - C Maupain
- PITIE SALPETRIERE APHP UNIVERSITY HOSPITAL, electrophysiology, Paris, France
| | - C Coquard
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - L Larnier
- PITIE SALPETRIERE APHP UNIVERSITY HOSPITAL, electrophysiology, Paris, France
| | - J Rischard
- European Hospital Georges Pompidou, Cardiology, Paris, France
| | - A Bourmaud
- University Paris Diderot , Paris, France
| | - F Salerno
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Horvilleur
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Lacotte
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - M Ait Said
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - V Manenti
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - A Maltret
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Li
- Cardiologs Techologies, Paris, France
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Belhadjer Z, Méot M, Bajolle F, Khraiche D, Legendre A, Abakka S, Auriau J, Grimaud M, Oualha M, Beghetti M, Wacker J, Ovaert C, Hascoet S, Selegny M, Malekzadeh-Milani S, Maltret A, Bosser G, Giroux N, Bonnemains L, Bordet J, Di Filippo S, Mauran P, Falcon-Eicher S, Thambo JB, Lefort B, Moceri P, Houyel L, Renolleau S, Bonnet D. Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic. Circulation 2020; 142:429-436. [PMID: 32418446 DOI: 10.1161/circulationaha.120.048360] [Citation(s) in RCA: 825] [Impact Index Per Article: 206.3] [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] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention. METHODS Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state. RESULTS Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2-16 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was <30% in one-third; 80% required inotropic support with 28% treated with extracorporeal membrane oxygenation. Inflammation markers were suggestive of cytokine storm (interleukin-6 median, 135 pg/mL) and macrophage activation (D-dimer median, 5284 ng/mL). Mean BNP (B-type natriuretic peptide) was elevated (5743 pg/mL). Thirty-one of 35 patients (88%) tested positive for SARS-CoV-2 infection by polymerase chain reaction of nasopharyngeal swab or serology. All patients received intravenous immunoglobulin, with adjunctive steroid therapy used in one-third. Left ventricular function was restored in the 25 of 35 of those discharged from the intensive care unit. No patient died, and all patients treated with extracorporeal membrane oxygenation were successfully weaned. CONCLUSIONS Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.
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Affiliation(s)
- Zahra Belhadjer
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Mathilde Méot
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Fanny Bajolle
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Diala Khraiche
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Antoine Legendre
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Samya Abakka
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Johanne Auriau
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Marion Grimaud
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Mehdi Oualha
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Maurice Beghetti
- Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)
| | - Julie Wacker
- Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)
| | - Caroline Ovaert
- Paediatric and Congenital Cardiology Department, M3C Regional CHD Center, La Timone University Hospital, Marseille, France (C.O.)
- INSERM UMR 1251, Marseille Medical Genetics, University of Aix-Marseille, Marseille, France (C.O.)
| | - Sebastien Hascoet
- M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Groupe Hospitalier Saint-Joseph, Paris Sud University, Plessis-Robinson, France (S.H.)
| | - Maëlle Selegny
- Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France (M.S.)
| | - Sophie Malekzadeh-Milani
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Alice Maltret
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
| | - Gilles Bosser
- CHRU de Nancy, Service de cardiologie congénitale et pédiatrique, Vandoeuvre-lès-Nancy, France (G.B., N..G.)
| | - Nathan Giroux
- CHRU de Nancy, Service de cardiologie congénitale et pédiatrique, Vandoeuvre-lès-Nancy, France (G.B., N..G.)
| | - Laurent Bonnemains
- Department of Cardiac Surgery, University of Strasbourg, France (L.B., J.B.)
| | - Jeanne Bordet
- Department of Cardiac Surgery, University of Strasbourg, France (L.B., J.B.)
| | - Sylvie Di Filippo
- Pediatric Cardiology and Congenital Heart Disease Department, Cardiovascular Louis-Pradel Hospital, Hospices Civils de Lyon, France (S.D.F.)
| | - Pierre Mauran
- Department of Paediatric and Congenital Cardiology, Center de compétence M3C, American Memorial Hospital, CHU de Reims, France (P. Mauran)
| | | | - Jean-Benoît Thambo
- CHU Bordeaux, Department of Pediatric Cardiology, Bordeaux-II University, France (J.-B.T.)
| | - Bruno Lefort
- Unité de Cardiologie Pédiatrique, Hôpital des Enfants Gatien de Clocheville, INSERM UMR 1069 et Université François Rabelais, Tours, France (B.L.)
| | - Pamela Moceri
- Department of Cardiology, Hôpital Pasteur, CHU de Nice, France (P. Moceri)
| | - Lucile Houyel
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Sylvain Renolleau
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
| | - Damien Bonnet
- M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)
- Université de Paris, France (Z.B., L.H., S.R., D.B.)
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Waldmann V, Ladouceur M, Bougouin W, Combes N, Maltret A, Dumas F, Iserin L, Cariou A, Marijon E, Jouven X. Sudden Cardiac Arrest in Adults With Congenital Heart Disease. JACC Clin Electrophysiol 2019; 5:1355-1356. [DOI: 10.1016/j.jacep.2019.07.017] [Citation(s) in RCA: 2] [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] [Received: 06/19/2019] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 10/25/2022]
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Costedoat-Chalumeau N, Morel N, Fischer-Betz R, Levesque K, Maltret A, Khamashta M, Brucato A. Routine repeated echocardiographic monitoring of fetuses exposed to maternal anti-SSA antibodies: time to question the dogma. Lancet Rheumatol 2019; 1:e187-e193. [PMID: 38229394 DOI: 10.1016/s2665-9913(19)30069-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/21/2022]
Abstract
In around 1% of exposed pregnancies, anti-Ro/SSA and anti-La/SSB antibodies lead to congenital heart block, the main feature of neonatal lupus syndrome. As such, echocardiographic screening to detect congenital heart block, done every other week from 16 weeks to at least 24 weeks gestation, is widely recommended for anti-SSA-positive pregnant women. Such screening is now routinely done in many centres worldwide. In this Viewpoint, we call this dogma into question for several reasons. Even if congenital heart block is discovered (which is rare), the usefulness of treatment with fluorinated steroids has not been shown, whereas the associated side-effects are well known. The discovery of congenital heart block very early in the pregnancy does not modify obstetric management, and at least 500 ultrasounds are needed to find one case of congenital heart block, which would ultimately be found by other means. Finally, this screening strategy misses most cases of congenital heart block because most affected women are not known to have anti-SSA antibodies, and thus are not screened. Accordingly, except in the context of research protocols, which are certainly needed and are outside the scope of this Viewpoint, overturning the dogma of routine repeated screenings for congenital heart block could save money and health-care staff time and prevent maternal stress without substantial clinical consequences.
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Affiliation(s)
- Nathalie Costedoat-Chalumeau
- Assistance Publique - Hôpitaux de Paris, Cochin Hospital, Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Paris, France; Centre of Research in Epidemiology and Statistics, Institut National de la Santé et de la Recherche Médicale, Institut National de la Recherche Agronomique, Université de Paris, Paris, France.
| | - Nathalie Morel
- Assistance Publique - Hôpitaux de Paris, Cochin Hospital, Internal Medicine Department, Referral Center for Rare Autoimmune and Systemic Diseases, Paris, France
| | - Rebecca Fischer-Betz
- Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Medical Faculty, Heinrich-Heine-University, Dusseldorf, Germany
| | - Kateri Levesque
- Service Médecine Interne Gynéco-obstétricale, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Canada
| | - Alice Maltret
- Assistance Publique - Hôpitaux de Paris, Service de Cardiologie, Hôpital Necker, Paris, France
| | - Munther Khamashta
- Lupus Clinic Rheumatology Department, Dubai Hospital, Dubai, United Arab Emirates
| | - Antonio Brucato
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, Ospedale Fatebenefratelli, Milano, Italy
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35
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Bougouin W, Dumas F, Lamhaut L, Marijon E, Carli P, Combes A, Pirracchio R, Aissaoui N, Karam N, Deye N, Sideris G, Beganton F, Jost D, Cariou A, Jouven X, Adnet F, Agostinucci JM, Aissaoui-Balanant N, Algalarrondo V, Alla F, Alonso C, Amara W, Annane D, Antoine C, Aubry P, Azoulay E, Beganton F, Benhamou D, Billon C, Bougouin W, Boutet J, Bruel C, Bruneval P, Cariou A, Carli P, Casalino E, Cerf C, Chaib A, Cholley B, Cohen Y, Combes A, Crahes M, Da Silva D, Das V, Demoule A, Denjoy I, Deye N, Dhonneur G, Diehl JL, Dinanian S, Domanski L, Dreyfuss D, Duboc D, Dubois-Rande JL, Dumas F, Empana JP, Extramiana F, Fartoukh M, Fieux F, Gabbas M, Gandjbakhch E, Geri G, Guidet B, Halimi F, Henry P, Hidden Lucet F, Jabre P, Jacob L, Joseph L, Jost D, Jouven X, Karam N, Kassim H, Lacotte J, Lahlou-Laforet K, Lamhaut L, Lanceleur A, Langeron O, Lavergne T, Lecarpentier E, Leenhardt A, Lellouche N, Lemiale V, Lemoine F, Linval F, Loeb T, Ludes B, Luyt CE, Maltret A, Mansencal N, Mansouri N, Marijon E, Marty J, Maury E, Maxime V, Megarbane B, Mekontso-Dessap A, Mentec H, Mira JP, Monnet X, Narayanan K, Ngoyi N, Perier MC, Piot O, Pirracchio R, Plaisance P, Plu I, Raux M, Revaux F, Ricard JD, Richard C, Riou B, Roussin F, Santoli F, Schortgen F, Sharifzadehgan A, Sideris G, Spaulding C, Teboul JL, Timsit JF, Tourtier JP, Tuppin P, Ursat C, Varenne O, Vieillard-Baron A, Voicu S, Wahbi K, Waldmann V. Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study. Eur Heart J 2019; 41:1961-1971. [DOI: 10.1093/eurheartj/ehz753] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [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] [Received: 12/28/2018] [Revised: 03/26/2019] [Accepted: 10/01/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes.
Methods and results
We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8–2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5–1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5–10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1–4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5–5.9; P = 0.002).
Conclusions
In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.
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Affiliation(s)
- Wulfran Bougouin
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Florence Dumas
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Lionel Lamhaut
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Pierre Carli
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Alain Combes
- Medical-Surgical Intensive Care Unit, iCAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpétrière Hospital, APHP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Romain Pirracchio
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Surgical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nadia Aissaoui
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicolas Deye
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Medical ICU, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Georgios Sideris
- Cardiology Department, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
| | - Daniel Jost
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Brigade de Sapeurs Pompiers de Paris (BSPP), 1 Place Jules Renard, 75017 Paris, France
| | - Alain Cariou
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical Intensive Care Unit, Cochin Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
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Mazzanti A, Tenuta E, Marino M, Pagan E, Morini M, Memmi M, Colombi B, Tibollo V, Frassoni S, Curcio A, Raimondo C, Maltret A, Monteforte N, Bloise R, Napolitano C, Bellazzi R, Bagnardi V, Priori SG. Efficacy and Limitations of Quinidine in Patients With Brugada Syndrome. Circ Arrhythm Electrophysiol 2019. [DOI: 10.1161/circep.118.007143] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Andrea Mazzanti
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
- Department of Molecular Medicine (A. Mazzanti., C.N., S.G.P.), University of Pavia, Italy
| | - Elisavietta Tenuta
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Maira Marino
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Eleonora Pagan
- Department of Statistics and Quantitative Methods, University of Milan—Bicocca, Italy (E.P., S.F., V.B.)
| | - Massimo Morini
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Mirella Memmi
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Barbara Colombi
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Valentina Tibollo
- Department of Electrical, Computer and Biomedical Engineering (V.T., R.B.), University of Pavia, Italy
| | - Samuele Frassoni
- Department of Statistics and Quantitative Methods, University of Milan—Bicocca, Italy (E.P., S.F., V.B.)
| | - Antonio Curcio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy (A.C.)
| | - Cristina Raimondo
- Department of Pediatric Cardiology, Hospital Necker, Paris, France (C.R., A. Maltret)
| | - Alice Maltret
- Department of Pediatric Cardiology, Hospital Necker, Paris, France (C.R., A. Maltret)
| | - Nicola Monteforte
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Raffaella Bloise
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
| | - Carlo Napolitano
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
- Department of Molecular Medicine (A. Mazzanti., C.N., S.G.P.), University of Pavia, Italy
| | - Riccardo Bellazzi
- Department of Electrical, Computer and Biomedical Engineering (V.T., R.B.), University of Pavia, Italy
| | - Vincenzo Bagnardi
- Department of Statistics and Quantitative Methods, University of Milan—Bicocca, Italy (E.P., S.F., V.B.)
| | - Silvia G. Priori
- Division of Molecular Cardiology, IRCCS ICS Maugeri, Pavia, Italy (A. Mazzanti, E.T., M. Marino, M. Morini, M. Memmi, B.C., N.M., R.B., C.N., S.G.P.)
- Department of Molecular Medicine (A. Mazzanti., C.N., S.G.P.), University of Pavia, Italy
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Mazzanti A, Ovics P, Shauer A, Mameli S, Marino M, Bloise R, Monteforte N, Raimondo C, Maltret A, Napolitano C, Bagnardi V, Priori SG. Unexpected Risk Profile of a Large Pediatric Population With Brugada Syndrome. J Am Coll Cardiol 2019; 73:1868-1869. [DOI: 10.1016/j.jacc.2019.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/15/2019] [Accepted: 02/18/2019] [Indexed: 10/27/2022]
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Stirnemann J, Maltret A, Haydar A, Stos B, Bonnet D, Ville Y. Successful in utero transesophageal pacing for severe drug-resistant tachyarrhythmia. Am J Obstet Gynecol 2018; 219:320-325. [PMID: 30055126 DOI: 10.1016/j.ajog.2018.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/11/2018] [Accepted: 07/19/2018] [Indexed: 01/08/2023]
Abstract
Sustained fetal tachyarrhythmia can evolve into a life-threatening condition in 40% of cases when hydrops develops, with a 27% risk of perinatal death. Several antiarrhythmic drugs can be given solely or in combination to the mother to achieve therapeutic transplacental concentrations. Therapeutic failure could lead to progressive cardiac insufficiency and restrict therapeutic options to either elective delivery or direct fetal administration of antiarrhythmic drugs, which may increase the risk of death. We report for the first time successful fetal transesophageal pacing to treat a hydropic fetus with drug-resistant tachyarrhythmia.
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Maury P, Gandjbakhch E, Baruteau AE, Bessière F, Kyndt F, Bouvagnet P, Rollin A, Bonnet D, Probst V, Maltret A. Cardiac Phenotype and Long-Term Follow-Up of Patients With Mutations in NKX2-5 Gene. J Am Coll Cardiol 2018; 68:2389-2390. [PMID: 27884258 DOI: 10.1016/j.jacc.2016.08.064] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 08/25/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022]
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Alazard M, Lacotte J, Horvilleur J, Ait-Said M, Salerno F, Manenti V, Piechaud JF, Garot J, Bonnet D, Maltret A. Preventing the risk of coronary injury in posteroseptal accessory pathway ablation in children: different strategies and advantages of fluoroscopy integrated 3D-mapping system (CARTO-UNIVU™). J Interv Card Electrophysiol 2018. [PMID: 29532274 DOI: 10.1007/s10840-018-0339-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/17/2022]
Abstract
PURPOSE To evaluate various strategies in order to minimize the risk of coronary injury during posteroseptal accessory pathways ablation in children. METHODS We retrospectively reviewed 68 posteroseptal accessory pathways ablation procedures (20 decremental and 48 typical accessory pathways) performed in 62 pediatric patients at our institution between July 2009 and December 2016. Only posteroseptal accessory pathways targeted near or within the coronary sinus were included and ablation was mostly performed using irrigated tip radiofrequency. RESULTS Median patient age was 11 years with a median body weight of 39 kg. Thirty patients underwent a coronary angiogram, 21 were coupled to the 3D navigation system CARTO-UNIVU™. The coronary angiogram showed a distance of less than 5 mm between the coronary artery and the ablation site in 40% of our cases; 3 patients had a coronary injury related to RF ablation, 6 patients were switched for cryoablation, 3 patients received limited RF energy (20 W). There were no demographic data predicting the proximity of the coronary artery to the ablation site. CONCLUSION Ablation of posteroseptal accessory pathways specifically in children carries a risk of coronary artery injury which is probably underestimated. The use of merged 3D images and coronary angiograms, the reduction of RF energy or the switch to cryoablation are possible alternatives to limit the risk of coronary injury.
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Affiliation(s)
- Margaux Alazard
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France.
| | - Jérôme Lacotte
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Jérôme Horvilleur
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Mina Ait-Said
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Fiorella Salerno
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Vladimir Manenti
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Jean-François Piechaud
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Jérôme Garot
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France
| | - Damien Bonnet
- M3C-Necker, Sorbonne Paris Cité, Hôpital Universitaire Necker Enfants malades, Université Paris Descartes, Paris, France
| | - Alice Maltret
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, 6 avenue du Noyer Lambert, 91300, Massy, France.,M3C-Necker, Sorbonne Paris Cité, Hôpital Universitaire Necker Enfants malades, Université Paris Descartes, Paris, France
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Ainsworth HC, Marion MC, Bertero T, Brucato A, Cimaz R, Costedoat-Chalumeau N, Fredi M, Gaffney P, Kelly J, Levesque K, Maltret A, Morel N, Ramoni V, Ruffatti A, Langefeld CD, Buyon JP, Clancy RM. Association of Natural Killer Cell Ligand Polymorphism HLA-C Asn80Lys With the Development of Anti-SSA/Ro-Associated Congenital Heart Block. Arthritis Rheumatol 2017; 69:2170-2174. [PMID: 29045069 DOI: 10.1002/art.40228] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/08/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Fetal exposure to maternal anti-SSA/Ro antibodies is necessary but not sufficient for the development of autoimmune congenital heart block (CHB), suggesting that other factors, such as fetal genetic predisposition, are important. Given the previously described association between major histocompatibility complex alleles and CHB risk, we undertook the present study to test the hypothesis that a variant form of HLA-C Asn80Lys, which binds with high affinity to an inhibitory killer cell immunoglobulin-like receptor (KIR) and thus renders natural killer (NK) cells incapable of restricting inflammation, contributes to the development of CHB. METHODS Members of 192 pedigrees in the US and Europe (194 cases of CHB, 91 unaffected siblings, 152 fathers, 167 mothers) and 1,073 out-of-study controls were genotyped on the Immunochip single-nucleotide polymorphism microarray. Imputation was used to identify associations at HLA-C Asn80Lys (Asn, C1; Lys, C2) and KIR. Tests for association were performed using logistic regression. McNemar's test and the pedigree disequilibrium test (PDT) were used for matched analyses between affected and unaffected children. RESULTS Compared with out-of-study controls of the same sex, the C2 allele was less frequent in the mothers (odds ratio [OR] 0.63, P = 0.0014) and more frequent in the fathers (OR 1.40, P = 0.0123), yielding a significant sex-by-C2 interaction (P = 0.0002). The C2 allele was more frequent in affected siblings than in unaffected siblings (OR 3.67, P = 0.0025), which was consistent with the PDT results (P = 0.016); these results were observed in both sexes and across the US and European cohorts. There was no difference in the frequency of the inhibitory KIR genotype (KIR AA) between affected and unaffected children (P = 0.55). CONCLUSION These data establish C2 as a novel genetic risk factor associated with CHB. This observation supports a model in which fetuses with C2 ligand expression and maternal anti-SSA/Ro positivity may have impaired NK cell surveillance, resulting in unchecked cardiac inflammation and scarring.
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Affiliation(s)
| | | | | | | | - Rolando Cimaz
- Meyer Children's Hospital and University of Florence, Florence, Italy
| | | | - Micaela Fredi
- Reumatologia e Immunologia, Spedali Civili e Università di Brescia, Brescia, Italy
| | - Patrick Gaffney
- Oklahoma Medical Research Foundation, University of Oklahoma, Oklahoma City
| | - Jennifer Kelly
- Oklahoma Medical Research Foundation, University of Oklahoma, Oklahoma City
| | - Kateri Levesque
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Alice Maltret
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Nathalie Morel
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | | | | | | | - Jill P Buyon
- New York University Langone Medical Center, New York, New York
| | - Robert M Clancy
- New York University Langone Medical Center, New York, New York
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Atallah V, Lacotte J, Ait Said M, Salerno F, Horvilleur J, Bonnet D, Maltret A. Risk stratification of sudden death in pediatric patient with ventricular pre-excitation: is there a difference between symptomatic and asymptomatic patients? Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30911-4] [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]
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Raimondo C, Maltret A, Horvilleur J. P432Prophylactic endocardial leads extraction in children. Europace 2017. [DOI: 10.1093/ehjci/eux141.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lacotte J, Garrot J, Raimondo C, Durand P, Miatello J, Sacher F, Maltret A. P485Successful epicardial ablation of ventricular tachycardia electric storm in an 8 years-old boy with idiopathic left ventricle aneurysm - CASE REPORT. Europace 2017. [DOI: 10.1093/ehjci/eux141.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Combes N, Derval N, Hascoët S, Zhao A, Amet D, Le Bloa M, Maltret A, Heitz F, Thambo JB, Marijon E. Ablation of supraventricular arrhythmias in adult congenital heart disease: A contemporary review. Arch Cardiovasc Dis 2017; 110:334-345. [DOI: 10.1016/j.acvd.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 10/19/2022]
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Maury P, Baruteau A, Gandjbakhch E, Francis B, Patrice B, Florence K, Sebastien H, Sylvie DF, Anne R, Hidden-Lucet F, Yves D, Chevalier P, Philippe A, Bonnet D, Probst V, Maltret A. 73-04: Cardiac phenotype and prognosis of patients with mutations in NKX2.5 gene. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i56c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Andorin A, Behr ER, Denjoy I, Crotti L, Dagradi F, Jesel L, Sacher F, Petit B, Mabo P, Maltret A, Wong LCH, Degand B, Bertaux G, Maury P, Dulac Y, Delasalle B, Gourraud JB, Babuty D, Blom NA, Schwartz PJ, Wilde AA, Probst V. Impact of clinical and genetic findings on the management of young patients with Brugada syndrome. Heart Rhythm 2016; 13:1274-82. [PMID: 26921764 DOI: 10.1016/j.hrthm.2016.02.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [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: 10/16/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Brugada syndrome (BrS) is an arrhythmogenic disease associated with sudden cardiac death (SCD) that seldom manifests or is recognized in childhood. OBJECTIVES The objectives of this study were to describe the clinical presentation of pediatric BrS to identify prognostic factors for risk stratification and to propose a data-based approach management. METHODS We studied 106 patients younger than 19 years at diagnosis of BrS enrolled from 16 European hospitals. RESULTS At diagnosis, BrS was spontaneous (n = 36, 34%) or drug-induced (n = 70, 66%). The mean age was 11.1 ± 5.7 years, and most patients were asymptomatic (family screening, (n = 67, 63%; incidental, n = 13, 12%), while 15 (14%) experienced syncope, 6(6%) aborted SCD or symptomatic ventricular tachycardia, and 5 (5%) other symptoms. During follow-up (median 54 months), 10 (9%) patients had life-threatening arrhythmias (LTA), including 3 (3%) deaths. Six (6%) experienced syncope and 4 (4%) supraventricular tachycardia. Fever triggered 27% of LTA events. An implantable cardioverter-defibrillator was implanted in 22 (21%), with major adverse events in 41%. Of the 11 (10%) patients treated with hydroquinidine, 8 remained asymptomatic. Genetic testing was performed in 75 (71%) patients, and SCN5A rare variants were identified in 58 (55%); 15 of 32 tested probands (47%) were genotype positive. Nine of 10 patients with LTA underwent genetic testing, and all were genotype positive, whereas the 17 SCN5A-negative patients remained asymptomatic. Spontaneous Brugada type 1 electrocardiographic (ECG) pattern (P = .005) and symptoms at diagnosis (P = .001) were predictors of LTA. Time to the first LTA event was shorter in patients with both symptoms at diagnosis and spontaneous Brugada type 1 ECG pattern (P = .006). CONCLUSION Spontaneous Brugada type 1 ECG pattern and symptoms at diagnosis are predictors of LTA events in the young affected by BrS. The management of BrS should become age-specific, and prevention of SCD may involve genetic testing and aggressive use of antipyretics and quinidine, with risk-specific consideration for the implantable cardioverter-defibrillator.
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Affiliation(s)
| | - Elijah R Behr
- Saint George's University of London, London, United Kingdom
| | | | - Lia Crotti
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Molecular Medicine, University of Pavia Pavia, Italy
| | - Federica Dagradi
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Fréderic Sacher
- CHU Bordeaux, Hôpital Cardiologique du Haut Lévêque, Bordeaux, France
| | | | | | - Alice Maltret
- AP-HP, Hôpital Necker-Enfants Malades, Paris, France
| | | | | | | | | | | | | | | | | | - Nico A Blom
- Department of Pediatric Cardiology, Leiden University Medical Centre, Leiden, The Netherlands; Department of Pediatric Cardiology and
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Arthur A Wilde
- Department of Clinical and Experimental Cardiology, Academic Medical Centre, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands,; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders, Jeddah, Kingdom of Saudi Arabia
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Maury P, Baruteau A, Gandjbakhch E, Bessiere F, Bouvagnet P, Kyndt F, Hascoet S, Difilippo S, Hidden-Lucet F, Chevalier P, Bonnet D, Probst V, Maltret A. 0292: Cardiac phenotype and prognosis of patients with mutations in NKX2.5 gene. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30288-9] [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]
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Levesque K, Morel N, Maltret A, Baron G, Masseau A, Orquevaux P, Piette JC, Barriere F, Le Bidois J, Fermont L, Fain O, Theulin A, Sassolas F, Pezard P, Amoura Z, Guettrot-Imbert G, Le Mercier D, Georgin-Lavialle S, Deligny C, Hachulla E, Mouthon L, Ravaud P, Villain E, Bonnet D, Costedoat-Chalumeau N, Bezanahary H, Bienvenu B, Blaison G, Blanche P, Bonnotte B, Cathebras P, Christides C, Cohen F, Cohen L, Devaud E, Diot E, Duhaut P, Dulac Y, Godeau B, Gournay V, Gronier C, Guillevin L, Hamidou M, Haroche J, Hayem G, Heitz F, Isnard R, Jallouli M, Korganow AS, Le Jeunne C, Lhote F, Lucron H, Lusson JR, Magnier S, Ninet J, Pangaud N, Papo T, Pellegrin JL, Pennaforte JL, Pouchot J, Sarrot-Reynauld F, Schleinitz N, Seve P, Stos B, Vital-Durand D, Wechsler B. Description of 214 cases of autoimmune congenital heart block: Results of the French neonatal lupus syndrome. Autoimmun Rev 2015; 14:1154-60. [DOI: 10.1016/j.autrev.2015.08.005] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 08/05/2015] [Indexed: 01/12/2023]
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Maury P, Baiuteau A, Gandjbakhch E, Bessière F, Bouvagnet P, Kyndt F, Hascoët S, Filippo SD, Hidden-Lucet F, Chevalier P, Bonnet D, Probst V, Maltret A. P2 Cardiac phenotype and prognosis of patients with mutations in NKX2.5 gene. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)30306-2] [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: 10/22/2022]
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