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Polton G, Borrego JF, Clemente-Vicario F, Clifford CA, Jagielski D, Kessler M, Kobayashi T, Lanore D, Queiroga FL, Rowe AT, Vajdovich P, Bergman PJ. Melanoma of the dog and cat: consensus and guidelines. Front Vet Sci 2024; 11:1359426. [PMID: 38645640 PMCID: PMC11026649 DOI: 10.3389/fvets.2024.1359426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/12/2024] [Indexed: 04/23/2024] Open
Abstract
Melanoma of the dog and cat poses a clinical challenge to veterinary practitioners across the globe. As knowledge evolves, so too do clinical practices. However, there remain uncertainties and controversies. There is value for the veterinary community at large in the generation of a contemporary wide-ranging guideline document. The aim of this project was therefore to assimilate the available published knowledge into a single accessible referenced resource and to provide expert clinical guidance to support professional colleagues as they navigate current melanoma challenges and controversies. Melanocytic tumors are common in dogs but rare in cats. The history and clinical signs relate to the anatomic site of the melanoma. Oral and subungual malignant melanomas are the most common malignant types in dogs. While many melanocytic tumors are heavily pigmented, making diagnosis relatively straightforward, melanin pigmentation is variable. A validated clinical stage scheme has been defined for canine oral melanoma. For all other locations and for feline melanoma, TNM-based staging applies. Certain histological characteristics have been shown to bear prognostic significance and can thus prove instructive in clinical decision making. Surgical resection using wide margins is currently the mainstay of therapy for the local control of melanomas, regardless of primary location. Radiotherapy forms an integral part of the management of canine oral melanomas, both as a primary and an adjuvant therapy. Adjuvant immunotherapy or chemotherapy is offered to patients at high risk of developing distant metastasis. Location is the major prognostic factor, although it is not completely predictive of local invasiveness and metastatic potential. There are no specific guidelines regarding referral considerations for dogs with melanoma, as this is likely based on a multitude of factors. The ultimate goal is to provide the best options for patients to extend quality of life and survival, either within the primary care or referral hospital setting.
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Affiliation(s)
- Gerry Polton
- North Downs Specialist Referrals, Bletchingley, United Kingdom
| | - Juan F. Borrego
- Hospital Aúna Especialidades Veterinarias IVC Evidensia, Paterna, Spain
| | | | | | - Dariusz Jagielski
- Veterinary Institute, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Martin Kessler
- Department of Clinical Oncology, Tierklinik Hofheim, Hofheim, Germany
| | | | | | | | | | - Péter Vajdovich
- Department of Physiology and Oncology, University of Veterinary Medicine, Budapest, Hungary
| | - Philip J. Bergman
- VCA Clinical Studies, Katonah-Bedford Veterinary Center, Bedford Hills, NY, United States
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Biel B, Skoczyński P, Hrymniak B, Jakobson R, Kuliczkowski W, Obremska M, Sokołowski J, Zyśko D, Banasiak W, Jagielski D. Outcomes for patients with implanted cardioverter-defibrillators admitted to the Emergency Department due to electrical shock during the pre-pandemic and COVID-19 era. Kardiol Pol 2024; 82:156-165. [PMID: 38230463 DOI: 10.33963/v.kp.98604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Implantable cardioverter-defibrillators (ICD)/cardiac resynchronization therapy with defibrillation (CRT-D) recipients may be susceptible to the arrhythmic effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. AIMS We aimed to evaluate characteristics and outcomes of patients hospitalized for ICD/CRT-D shocks during the pandemic compared to the pre-pandemic period. METHODS This retrospective study analyzed medical records of patients hospitalized for ICD/CRT-D shock in the pre-pandemic (January 1, 2018-December 31, 2019) and pandemic periods (March 4, 2020-March 3, 2022). Survival data were obtained on October 24, 2022. RESULTS In total, 198 patients (average age 65.6 years) had 138 pre-pandemic and 124 pandemic visits. Of these patients, 115 were hospitalized during pre-pandemic, 108 during the pandemic, and 25 in both periods. No significant differences were noted in age, sex, number of shocks, or appropriateness of therapy between these periods. During the pandemic, during 14 hospital stays of patients with SARS-CoV-2, 8 (57.1%) received electrical shocks, compared to 12 (10.9%) with negative SARS-CoV-2 tests (P <0.001). The in-hospital mortality rate was 2 of 115 patients hospitalized during the pre-pandemic and 7 of 108 during pandemic periods (4 patients with and 3 without SARS-CoV-2 [P = 0.10]). During the follow-up, there were 66 deaths. Cox regression analysis showed that survival decreased with age and heart failure decompensation in medical history but increased with higher ejection fraction. The pandemic alone was not a survival predictor. However, SARS-CoV-2 infection, older age, and heart failure decompensation in medical history predicted worse outcomes during the pandemic period. CONCLUSIONS The pandemic did not increase the number of hospital visits due to ICD/CRT-D discharges. SARS-CoV-2 infection predicts increased mortality in patients with ICD/CRT-D shocks.
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Affiliation(s)
- Bartosz Biel
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Przemysław Skoczyński
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Bruno Hrymniak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
| | - Rafał Jakobson
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | | | - Marta Obremska
- Institute for Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Janusz Sokołowski
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Dorota Zyśko
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wrocław, Poland
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Szyller J, Antoniak R, Wadowska K, Bil-Lula I, Hrymniak B, Banasiak W, Jagielski D. Redox imbalance in patients with heart failure and ICD/CRT-D intervention. Can it be an underappreciated and overlooked arrhythmogenic factor? A first preliminary clinical study. Front Physiol 2023; 14:1289587. [PMID: 38028798 PMCID: PMC10663344 DOI: 10.3389/fphys.2023.1289587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction: Redox imbalance and oxidative stress are involved in the pathogenesis of arrhythmias. They also play a significant role in pathogenesis of heart failure (HF). In patients with HFand implanted cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D), the direct current shocks may be responsible for additional redox disturbances and additionally increase arrhythmia risk. However, the precise role of oxidative stress in potentially fatal arrhythmias and shock induction remains unclear. Methods: 36 patients with diagnosed HF and implanted ICD/CRT-D were included in this study. Patients were qualified to the study group in case of registered ventricular arrhythmia and adequate ICD/CRT-D intervention. The control group consisted of patients without arrhythmia with elective replacement indicator (ERI) status. Activity of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione (GSH) in erythrocyte (RBC), SOD, GPx activity and reactive oxygen/nitrogen species (ROS/RNS) concentration in plasma were determined. The values were correlated with glucose, TSH, uric acid, Mg and ion concentrations. Results: In the perishock period, we found a significant decrease in RBC and extracellular (EC) SOD and RBC CAT activity (p = 0.0110, p = 0.0055 and p = 0.0002, respectively). EC GPx activity was also lower (p = 0.0313). In all patients, a decrease in the concentration of all forms of glutathione was observed compared to the ERI group. Important association between ROS/RNS and GSH, Mg, TSH and uric acid was shown. A relationship between the activity of GSH and antioxidant enzymes was found. Furthermore, an association between oxidative stress and ionic imbalance has also been demonstrated. The patients had an unchanged de Haan antioxidant ratio and glutathione redox potential. Conclusion: Here we show significant redox disturbances in patients with HF and ICD/CRT-D interventions. Oxidative stress may be an additional risk factor for the development of arrhythmia in patients with HF. The detailed role of oxidative stress in ventricular arrhythmias requires further research already undertaken by our team.
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Affiliation(s)
- Jakub Szyller
- Division of Clinical Chemistry and Laboratory Hematology, Department of Medical Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Radosław Antoniak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Katarzyna Wadowska
- Division of Clinical Chemistry and Laboratory Hematology, Department of Medical Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Iwona Bil-Lula
- Division of Clinical Chemistry and Laboratory Hematology, Department of Medical Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Wroclaw, Poland
| | - Bruno Hrymniak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
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Przybylski A, Jagielski D, Hrymniak B, Michalak M, Wójcik T, Syska P, Fabiszak T, Rokicki J, Małecka B, Ząbek A, Kaczmarek K, Zaręba L, Sterliński M. Employment of the Evolution RL sheath as a first-choice device shortens transvenous lead extraction time without affecting procedural safety and efficacy compared to its auxiliary use: Insights from the prospective multicenter EVO registry. ADV CLIN EXP MED 2023; 32:1249-1256. [PMID: 37078411 DOI: 10.17219/acem/161961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 02/18/2023] [Accepted: 03/07/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Transvenous lead extraction (TLE) is recommended in cases of local and systemic infections related to cardiac implantable electronic devices (CIEDs). Additionally, TLE is indicated in the event of lead damage or CIED malfunction. The extraction procedure is associated with a risk of life-threatening complications. OBJECTIVES The aim of the EVO registry was to assess the safety and efficacy of birotational Evolution tool usage. MATERIAL AND METHODS This registry study was prospectively conducted in 8 high-volume implantation centers in Poland. The study included 133 patients aged 63.5 ±15.1 years, and 76.69% were male. Indications for the procedure were: local or systemic infection (33.1%) and lead dysfunction (66.9%). The number of leads extracted varied from 1 (39.84%) to 3 (9.77%). RESULTS Clinical procedural success was achieved in 99.1% of cases. A total of 226 leads were extracted, and 206 used the Evolution system. Two procedural strategies were identified while using the Evolution system: (1) usage of locking stylet, propylene sheaths and the Evolution system (118 leads, 52%) - group A; (2) usage of locking stylet and Evolution (88 leads, 39%) - group B. There were no differences in the number of complications between these 2 groups. The extraction time was significantly shorter (p = 0.02) in group B than in group A. Major complications occurred in 5.2% of cases with 2 intraprocedural deaths. Minor complications occurred in 1.5% of patients. CONCLUSIONS The registry confirmed the efficacy and relative safety of the birotational Evolution sheath. Using the rotational sheath as a first attempt significantly reduces extraction time without compromising its safety.
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Affiliation(s)
| | | | - Bruno Hrymniak
- 4th Military Clinical Hospital with Polyclinic, Wrocław, Poland
| | - Marcin Michalak
- 1st Department of Cardiology, Medical University of Warsaw, Poland
| | - Tomasz Wójcik
- Clinical Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Poland
| | - Paweł Syska
- National Institute of Cardiology, Warsaw, Poland
| | - Tomasz Fabiszak
- College of Medical Sciences, University of Rzeszów, Poland
- Department of Cardiology and Internal Diseases, Collegium Medicum, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Jakub Rokicki
- 1st Department of Cardiology, Medical University of Warsaw, Poland
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Poland
| | - Barbara Małecka
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Electrocardiology, The John Paul II Hospital, Kraków, Poland
| | - Andrzej Ząbek
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Electrocardiology, The John Paul II Hospital, Kraków, Poland
| | | | - Lech Zaręba
- Interdisciplinary Centre for Computational Modelling, College of Natural Sciences, University of Rzeszów, Poland
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Stec S, Wileczek A, Reichert A, Śledź J, Kosior J, Jagielski D, Polewczyk A, Zając M, Kutarski A, Karbarz D, Zyśko D, Nowarski Ł, Stodółkiewicz-Nowarska E. Shared Decision Making and Cardioneuroablation Allow Discontinuation of Permanent Pacing in Patients with Vagally Mediated Bradycardia. J Cardiovasc Dev Dis 2023; 10:392. [PMID: 37754821 PMCID: PMC10532162 DOI: 10.3390/jcdd10090392] [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: 07/17/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Safe discontinuation of pacemaker therapy for vagally mediated bradycardia is a dilemma. The aim of the study was to present the outcomes of a proposed diagnostic and therapeutic process aimed at discontinuing or not restoring pacemaker therapy (PPM) in patients with vagally mediated bradycardia. METHODS The study group consisted of two subgroups of patients with suspected vagally mediated bradycardia who were considered to have PPM discontinued or not to restore their PPM if cardioneuroablation (CNA) would successfully treat their bradycardia. A group of 3 patients had just their pacemaker explanted but reimplantation was suggested, and 17 patients had preexisting pacemakers implanted. An invasive electrophysiology study was performed. If EPS was negative, extracardiac vagal nerve stimulation (ECVS) was performed. Then, patients with positive ECVS received CNA. Patients with an implanted pacemaker had it programmed to pace at the lowest possible rate. After the observational period and control EPS including ECVS, redo-CNA was performed if pauses were induced. The decision to explant the pacemaker was obtained based on shared decision making (SDM). RESULTS After initial clinical and electrophysiological evaluation, 17 patients were deemed eligible for CNA (which was then performed). During the observational period after the initial CNA, all 17 patients were clinically asymptomatic. The subsequent invasive evaluation with ECVS resulted in pause induction in seven (41%) patients, and these patients underwent redo-CNA. Then, SDM resulted in the discontinuation of pacemaker therapy or a decision to not perform pacemaker reimplantation in all the patients after CAN. The pacemaker was explanted in 12 patients post-CNA, while in 2 patients explantation was postponed. During a median follow-up of 18 (IQR: 8-22) months, recurrent syncope did not occur in the CNA recipients. CONCLUSIONS Pacemaker therapy in patients with vagally mediated bradycardia could be discontinued safely after CNA.
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Affiliation(s)
- Sebastian Stec
- Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, 38-500 Sanok, Poland
| | - Antoni Wileczek
- Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, 38-500 Sanok, Poland
| | - Agnieszka Reichert
- Department of Invasive Cardiology, County Specialistic Hospital, 37-450 Stalowa Wola, Poland
| | - Janusz Śledź
- El-Medica, EP-NETWORK, 26-110 Skarzysko-Kamienna, Poland
| | - Jarosław Kosior
- Department of Cardiology, Masovian Specialist Hospital, 26-617 Radom, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, 50-981 Wroclaw, Poland
- Faculty of Medicine, Wrocław University of Science and Technology, 50-370 Wroclaw, Poland
| | - Anna Polewczyk
- Department of Physiology, Pathophysiology and Clinical Immunology, Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
- Department of Cardiac Surgery, Świętokrzyskie Center of Cardiology, 25-736 Kielce, Poland
| | - Magdalena Zając
- Department of Special Pedagogy and Speech Therapy, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland
| | - Andrzej Kutarski
- Department of Cardiology, Medical University, 20-059 Lublin, Poland
| | | | - Dorota Zyśko
- Department of Emergency Medicine, Wrocław Medical University, 50-367 Wroclaw, Poland
| | - Łukasz Nowarski
- Vascular Surgery Department, The Brothers of Saint John of God Hospital, 31-061 Krakow, Poland
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Zyśko D, Kluwak K, Furdal M, Skoczyński P, Gogolewski G, Chourasia G, Banasiak W, Jagielski D, Klempous R, Rozenblit J. Capnography derived breath variability analysis feasibility and its importance for pulmonary embolism prediction. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104910] [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: 04/03/2023]
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Szamborski M, Janc J, Leśnik P, Milnerowicz A, Jagielski D, Łysenko L. Ultrasound-Guided Pectoserratus Plane Block and Superficial Serratus Anterior Plane Block for Subcutaneous Implantable Cardioverter-Defibrillator Implantation: A Comparative Study. Med Sci Monit 2023; 29:e940541. [PMID: 37475210 PMCID: PMC10368141 DOI: 10.12659/msm.940541] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The combination of pectoserratus plane block (PSP) and superficial serratus anterior plane block (S-SAP) was established to reduce the risk of general anesthesia for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation in patients with high operative risk (American Society of Anesthesiologistsgrade III or IV). This study compared outcomes from ultrasound-guided PSP and S-SAP in 16 patients requiring a subcutaneous implantable cardioverter-defibrillator (S-ICD) at a single center in Poland. MATERIAL AND METHODS A group of 16 patients with ASA grade III and IV qualified for S-ICD implantation was included. The pain assessment using numerical rating scale (NRS), patient's comfort using Quality of Recovery-15 (QoR-15), the operator's satisfaction using Operator's Comfort Scale, adverse event occurrence, and the parameters' stability were evaluated. RESULTS The mean volume of the local anesthetics mixture of PSP block was 19.4 mL; S-SAP was 34.7 mL (mean total volume, 54.1 mL). The mean duration of the block was 21.3 min; the mean time of the S-ICD implantation was 108.4 min. Neither circulatory nor respiratory instability was observed. In 8 patients (50%), non-opioid analgesics were administered intraoperatively; in 11 patients (69%), fentanyl bolus ≤200 μg was administered. The intraoperative NRS score was low (max 2 points); NRS 24 h after the procedure was low (max 4 points). The mean value of QoR-15 was 133.9 points. CONCLUSIONS S-SAP combined with PSP is feasible and safe in providing anesthesia/analgesia during S-ICD implantation and showed good effects in a group of patients with high operative risk (ASA III or IV).
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Affiliation(s)
- Marek Szamborski
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, Wrocław, Poland
| | - Jarosław Janc
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, Wrocław, Poland
| | - Patrycja Leśnik
- Department of Anaesthesiology and Intensive Therapy, 4th Military Clinical Hospital, Wrocław, Poland
| | - Artur Milnerowicz
- Department of Vascular Surgery, 4th Military Clinical Hospital, Wrocław, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Clinical Hospital, Wrocław, Poland
| | - Lidia Łysenko
- Department of Anesthesiology and Intensive Therapy, Wrocław Medical University, Wrocław, Poland
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Hrymniak B, Skoczyński P, Biel B, Banasiak W, Jagielski D. Atrioventricular synchronous leadless pacing: Micra AV. Cardiol J 2023; 31:147-155. [PMID: 37246458 PMCID: PMC10919563 DOI: 10.5603/cj.a2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 05/01/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023] Open
Abstract
Since the arrival of leadless pacemakers (LPs), they have become a cornerstone in remedial treatment of bradycardia and atrioventricular (AV) conduction disorders, as an alternative to transvenous pacemakers. Even though clinical trials and case reports show indisputable benefits of LP therapy, they also bring some doubts. Together with the positive results of the MARVEL trials, AV synchronization has become widely available in LPs, presenting a significant development in leadless technology. This review presents the Micra AV (MAV), describes major clinical trials, and introduces the basics of AV synchronicity obtained with the MAV and its unique programming options.
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Affiliation(s)
- Bruno Hrymniak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland.
| | - Przemysław Skoczyński
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
- Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Biel
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
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Kempa M, Budrejko S, Tajstra M, Syska P, Lewandowski M, Fabiszak T, Michalak M, Stanek A, Nowak K, Mitkowski P, Kaczmarek K, Orski Z, Janowski M, Szafarz P, Filipecki A, Sokal A, Szołkiewicz M, Jagielski D, Przybylski A. Subcutaneous implantable cardioverter-defibrillator therapy in Poland: Results of the Polish S-ICD Registry. Kardiol Pol 2023:VM/OJS/J/94162. [PMID: 36871295 DOI: 10.33963/kp.a2023.0046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/12/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND The use of a subcutaneous implantable cardioverter-defibrillator (S-ICD) has been expanding in Poland since 2014. The Polish Registry of S-ICD Implantations was held by the Heart Rhythm Section of the Polish Cardiac Society between May 2020 and September 2022 to monitor the implementation of that therapy in Poland. AIMS To investigate and present the state-of-the-art of S-ICD implantation in Poland. METHODS Implanting centers reported clinical data of patients undergoing S-ICD implantations and replacements, including: age, gender, height, weight, underlying disease, history of pacemaker and defibrillator implantations, indications for S-ICD, electrocardiographical parameters, procedural techniques, and complications. RESULTS 440 patients undergoing S-ICD implantation (411) or replacement (29) were reported by 16 centers. Most patients were in New York Heart Association class II (218 patients, 53%) or I (150 patients, 36.5%). Left ventricular ejection fraction was 10-80%, median (IQR) 33% (25%‒55%). Primary prevention indications were present in 273 patients (66.4%). Non-ischemic cardiomyopathy was reported in 194 patients (47.2%). The main reason for the choice of S-ICD were: young age (309, 75.2%), risk of infective complications (46, 11.2%), prior infective endocarditis (36, 8.8%), hemodialysis (23, 5.6%), and immunosuppressive therapy (7, 1.7%). Electrocardiographic screening was performed in 90% of patients. The rate of adverse events was low (1.7%). No surgical complications were observed. CONCLUSIONS Qualification for S-ICD in Poland was slightly different when compared to the rest of Europe. The implantation technique was mostly consistent with the current guidelines. S-ICD implantation was safe, and the complication rate was low.
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Affiliation(s)
- Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland
| | - Szymon Budrejko
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland.
| | - Mateusz Tajstra
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Paweł Syska
- 2nd Department of Heart Arrhythmia, National Institute of Cardiology, Warszawa, Poland
| | - Michał Lewandowski
- 2nd Department of Heart Arrhythmia, National Institute of Cardiology, Warszawa, Poland
| | - Tomasz Fabiszak
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marcin Michalak
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Adrian Stanek
- Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Krzysztof Nowak
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | | | | | - Zbigniew Orski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warszawa, Poland
| | - Marcin Janowski
- Chair and Department of Cardiology Medical University of Lublin, Lublin, Poland
| | - Piotr Szafarz
- 1st Department of Cardiology with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, Rzeszów, Poland
| | - Artur Filipecki
- 1st Chair and Department of Cardiology, Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Adam Sokal
- Silesian Center for Heart Diseases 1st Department of Cardiology and Angiology, Zabrze, Poland.,Medical University of Silesia, Faculty of Health Sciences, Department of Dietetics, Bytom, Poland
| | - Marek Szołkiewicz
- Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, Wejherowo, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Andrzej Przybylski
- 1st Department of Cardiology with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, Rzeszów, Poland.,Medical College of Rzeszow University, Rzeszów, Poland
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10
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Graczyk S, Pasławski R, Grzeczka A, Litwińska L, Jagielski D, Pasławska U. Stents in Veterinary Medicine. Materials (Basel) 2023; 16:1480. [PMID: 36837110 PMCID: PMC9959717 DOI: 10.3390/ma16041480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Stenting in veterinary medicine has been a rapidly growing method of interventional surgery for several years. This procedure is usually performed in the respiratory and urinary tracts, but there are cases of stenting of blood vessels or gastrointestinal structures. It is based on maintaining the permeability of a given tubular structure, thus allowing the passage of gas or liquid. This procedure is often performed as a first-line treatment in situations where pharmacological agents do not work and as an alternative method, often cheaper than the classically performed ones. There are also cases where stenting is used as a palliative treatment, e.g., to enable defecation in colonic obstruction due to tumour infiltration of the colon wall. Stenting is often a life-saving or comfort-improving procedure for animals, but one should also be aware of possible postoperative complications and be prepared for any adversity. For this reason, this review provides an insight into the current knowledge in veterinary medicine about stenting and the consequences associated with this procedure.
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11
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Stec S, Jankowska-Polańska B, Jagielski D, Wileczek A, Josiak K, Śledź J, Reichert A, Kustroń A, Zyśko D, Skonieczny B, Fedorowski A, Ratajska A, Zając M, Hering D, Wąsek W, Stodółkiewicz-Nowarska E. Rationale and design of SAN.OK randomized clinical trial and registry: Comparison of the effects of evidence-based pacemaker therapy and cardioneuroablation in sinus node dysfunction. Cardiol J 2022; 29:1031-1036. [PMID: 36385604 PMCID: PMC9788751 DOI: 10.5603/cj.a2022.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/10/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sebastian Stec
- Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, Sanok, Poland,Elmedica, EP-Network, SKA, Poland
| | | | - Dariusz Jagielski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Antoni Wileczek
- Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Subcarpathian Center for Cardiovascular Intervention, Sanok, Poland,Elmedica, EP-Network, SKA, Poland
| | - Krystian Josiak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland,Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | | | | | - Dorota Zyśko
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland,Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Skonieczny
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Artur Fedorowski
- Department of Cardiology, Karolinska University Hospital, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Anna Ratajska
- Psychological Therapeutic and Research Center, University Hospital No. 2, Bydgoszcz, Poland,Department of Humanization, Medicine and Sexology, Institute of Health Sciences, University of Zielona Gora, Poland
| | - Magdalena Zając
- Department of Pedagogy, University of Kazimierz Wielki, Bydgoszcz, Poland
| | - Dagmara Hering
- Department of Hyper tension and Diabetology, Medical University of Gdansk, Poland
| | - Wojciech Wąsek
- Department of Internal Medicine, Institute of Health Sciences, College of Medical Sciences, Rzeszow University, Poland
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12
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Rzepecka A, Jagielski D, Cywińska A, Sapierzyński R, Żmigrodzka M, Witkowska-Piłaszewicz O, Winnicka A. MHCII Expression on Peripheral Blood Monocytes in Canine Lymphoma: An Impact of Glucocorticoids. Animals (Basel) 2022; 12:ani12162135. [PMID: 36009726 PMCID: PMC9404857 DOI: 10.3390/ani12162135] [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: 06/11/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary Loss or decreased expression of human leukocyte antigen—D-related (HLA-DR) on the surface of monocytes is related to the dysfunction of the immune system and was reported in human neoplasia, including lymphoma. Canine lymphoma is frequently presented as a valuable comparative model for studies on human non-Hodgkin’s lymphoma. However, there are no studies on the expression of analogue proteins—MHCII antigens—on monocytes in canine lymphoma. In this study, we have evaluated the changes in the expression of MHCII on monocytes in the blood of dogs with lymphoma before any treatment and in dogs that had previously received glucocorticoids. Glucocorticoids are often used by clinicians as first drugs after diagnosis for immediate health improvement and are known to impact monocyte number. We have shown an increase in the percentage of MHCII− monocytes, regardless of treatment. However, only in dogs that had received glucocorticoids were changes in the proportion of MHCII+ and MHCII− monocytes reflected also by the changes in the number of MHCII− monocytes in the blood, which was significantly higher. Evaluating the changes in canine monocytes might be helpful in the diagnosis of various tumor types, monitoring of the treatment or assessing the immune status of dogs. Abstract An increase in the percentage of monocytes with reduced HLA-DR expression and immunosuppressive properties has been reported in numerous human neoplastic diseases, including lymphoma. However, there are no analogous studies on phenotypical variations in the peripheral blood monocytes in dogs with lymphoma. The aim of this study was to determine the difference in the expression of the MHCII molecule on peripheral blood monocytes in dogs with lymphoma before any treatment (NRG) and in dogs that had previously received glucocorticoids (RG) in comparison to healthy dogs. Flow cytometry immunophenotyping of peripheral blood leukocytes was performed using canine-specific or cross-reactive antibodies against CD11b, CD14 and MHCII. In the blood of dogs with lymphoma (NRG and RG), compared to that of healthy ones, the MHCII+ and MHCII− monocytes ratio was changed due to an increase in the percentage of MHCII− monocytes. The number of MHCII− monocytes was significantly higher only in RG dogs compared to healthy ones, which might result from the release of these cells from the blood marginal pool due to the action of glucocorticoids. Our results encourage further studies to assess if changes in MHCII expression affect immune status in dogs with lymphoma.
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Affiliation(s)
- Alicja Rzepecka
- Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
- Correspondence:
| | | | - Anna Cywińska
- Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University, 87-100 Toruń, Poland
| | - Rafał Sapierzyński
- Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | - Magdalena Żmigrodzka
- Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
| | | | - Anna Winnicka
- Institute of Veterinary Medicine, Warsaw University of Life Sciences, 02-787 Warsaw, Poland
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13
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Josiak K, Stec S, Zyśko D, Skonieczny B, Kosior J, Śledź J, Wilczek A, Stodółkiewicz-Nowarska E, Biel B, Szymkiewicz P, Skoczyński P, Karbarz D, Ludwik B, Banasiak W, Jagielski D. Safety and efficacy of His bundle pacing validated by extracardiac vagal nerve stimulation (HIS-STORY). Cardiol J 2022; 29:698-701. [PMID: 35703044 PMCID: PMC9273250 DOI: 10.5603/cj.a2022.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Krystian Josiak
- Cardiology Department, 4th Military Hospital, Wroclaw, Poland. .,Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland, Wroclaw, Poland.
| | - Sebastian Stec
- Subcarpathian Center for Cardiovascular Intervention, Sanok, Poland
| | - Dorota Zyśko
- Cardiology Department, 4th Military Hospital, Wroclaw, Poland
| | | | - Jaroslaw Kosior
- Cardiology Department, Mazovian Speciality Hospital, Radom, Poland
| | - Janusz Śledź
- Cardiology Department, Mazovian Speciality Hospital, Radom, Poland
| | - Antoni Wilczek
- Subcarpathian Center for Cardiovascular Intervention, Sanok, Poland
| | - Edyta Stodółkiewicz-Nowarska
- CardioMedicum, Krakow, Poland.,Department of Interventional Cardiology, Cardiovascular Center, American Heart of Poland, Chrzanow, Poland
| | - Bartosz Biel
- Cardiology Department, 4th Military Hospital, Wroclaw, Poland
| | | | | | - Dariusz Karbarz
- Cardiology Department, Mazovian Speciality Hospital, Radom, Poland
| | - Bartosz Ludwik
- Department of Cardiology, Regional Specialist Hospital Centre for Research and Development, Wroclaw, Poland
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14
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Drożdż G, Hrymniak B, Biel B, Skoczyński P, Drożdż W, Zyśko D, Banasiak W, Jagielski D. Implantation of a Leadless Pacemaker after Incomplete Transvenous Lead Extraction in a 90-Year-Old Pacemaker-Dependent Patient. Int J Environ Res Public Health 2022; 19:6313. [PMID: 35627850 PMCID: PMC9141955 DOI: 10.3390/ijerph19106313] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/15/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023]
Abstract
Transluminal lead extraction (TLE) is a well-established procedure for the removal of damaged or infected pacing systems. Despite its high efficacy, the procedure is associated with significant risks, some of which may contribute to severe life-threatening complications. Herein, we present the case of a 90-year-old female who was 100% pacemaker-dependent (PM-dependent) and had ventricular lead fragmentation after the TLE procedure. In this elderly patient, after taking into account the whole clinical context-age, frailty syndrome, infection, and high peri- and postprocedural risks-we decided on MICRA VR implantation as well as leaving the remains of the ventricular lead in the right heart chambers. A Leadless pacemaker (LP) is an excellent alternative to PM-dependent individuals, in whom implantation of permanent transvenous PM is precluded due to multiple infectious and non-infectious issues.
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Affiliation(s)
- Gerald Drożdż
- Department of General Internal Medicine, Kantonsspital Graubünden, 7000 Chur, Switzerland;
| | - Bruno Hrymniak
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
| | - Bartosz Biel
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
| | - Przemysław Skoczyński
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
- Department of Emergency Medicine, Wrocław Medical University, 50-367 Wroclaw, Poland
| | - Wiktoria Drożdż
- Department of General Internal Medicine, Kantonsspital Graubünden, 7000 Chur, Switzerland;
| | - Dorota Zyśko
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
- Department of Emergency Medicine, Wrocław Medical University, 50-367 Wroclaw, Poland
| | - Waldemar Banasiak
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
| | - Dariusz Jagielski
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland; (B.H.); (B.B.); (P.S.); (D.Z.); (W.B.); (D.J.)
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15
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Hrymniak B, Biel B, Szwarc B, Piotrowska K, Banasiak W, Jagielski D. Implantation of a leadless pacemaker in a patient with an atrioventricular block and COVID-19. Kardiol Pol 2021; 79:1294-1295. [PMID: 34599492 DOI: 10.33963/kp.a2021.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Bruno Hrymniak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland.
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | | | - Katarzyna Piotrowska
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
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16
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Obremska M, Pazgan-Simon M, Budrewicz K, Bilaszewski L, Wizowska J, Jagielski D, Jankowska-Polanska B, Nadolny K, Madowicz J, Zuwala-Jagiello J, Zysko D, Banasiak W, Simon K. Simple demographic characteristics and laboratory findings on admission may predict in-hospital mortality in patients with SARS-CoV-2 infection: development and validation of the covid-19 score. BMC Infect Dis 2021; 21:945. [PMID: 34521357 PMCID: PMC8438286 DOI: 10.1186/s12879-021-06645-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 05/25/2021] [Accepted: 08/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a major health burden worldwide due to high mortality rates and hospital bed shortages. SARS-CoV-2 infection is associated with several laboratory abnormalities. We aimed to develop and validate a risk score based on simple demographic and laboratory data that could be used on admission in patients with SARS-CoV-2 infection to predict in-hospital mortality. Methods Three cohorts of patients from different hospitals were studied consecutively (developing, validation, and prospective cohorts). The following demographic and laboratory data were obtained from medical records: sex, age, hemoglobin, mean corpuscular volume (MCV), platelets, leukocytes, sodium, potassium, creatinine, and C-reactive protein (CRP). For each variable, classification and regression tree analysis were used to establish the cut-off point(s) associated with in-hospital mortality outcome based on data from developing cohort and before they were used for analysis in the validation and prospective cohort. The covid-19 score was calculated as a sum of cut-off points associated with mortality outcome. Results The developing, validation, and prospective cohorts included 129, 239, and 497 patients, respectively (median age, 71, 67, and 70 years, respectively). The following cut of points associated with in-hospital mortality: age > 56 years, male sex, hemoglobin < 10.55 g/dL, MCV > 92.9 fL, leukocyte count > 9.635 or < 2.64 103/µL, platelet count, < 81.49 or > 315.5 103/µL, CRP > 51.14 mg/dL, creatinine > 1.115 mg/dL, sodium < 134.7 or > 145.4 mEq/L, and potassium < 3.65 or > 6.255 mEq/L. The AUC of the covid-19 score for predicting in-hospital mortality was 0.89 (0.84–0.95), 0.850 (0.75–0.88), and 0.773 (0.731–0.816) in the developing, validation, and prospective cohorts, respectively (P < 0.001The mortality of the prospective cohort stratified on the basis of the covid-19 score was as follows: 0–2 points,4.2%; 3 points, 15%; 4 points, 29%; 5 points, 38.2%; 6 and more points, 60%. Conclusion The covid-19 score based on simple demographic and laboratory parameters may become an easy-to-use, widely accessible, and objective tool for predicting mortality in hospitalized patients with SARS-CoV-2 infection.
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Affiliation(s)
- Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Pazgan-Simon
- Ist Department of Infectious Diseases Regional Specialistic Hospital, Wroclaw, Poland
| | - Katarzyna Budrewicz
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland.
| | - Lukasz Bilaszewski
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | - Joanna Wizowska
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | | | | | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Jarosław Madowicz
- Provincial Specialist Hospital, Tychy, Poland.,Department of Health Sciences, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | | | - Dorota Zysko
- Department of Emergency Medicine, Wroclaw Medical University, ul. Borowska 213, 50-556, Wroclaw, Poland
| | | | - Krzysztof Simon
- Ist Department of Infectious Diseases Regional Specialistic Hospital, Wroclaw, Poland.,Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Wroclaw, Poland
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17
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Kempa M, Przybylski A, Budrejko S, Fabiszak T, Lewandowski M, Kaczmarek K, Tajstra M, Grabowski M, Mitkowski P, Tubek S, Jędrzejczyk-Patej E, Lenarczyk R, Jagielski D, Romanek J, Rydlewska A, Orski Z, Zakrzewska-Koperska J, Filipecki A, Janowski M, Potpara T, Boveda S. Utilization of Subcutaneous Cardioverter-Defibrillator in Poland and Europe-Comparison of the Results of Multi-Center Registries. Int J Environ Res Public Health 2021; 18:ijerph18137178. [PMID: 34281115 PMCID: PMC8297309 DOI: 10.3390/ijerph18137178] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
The implantation of a subcutaneous cardioverter-defibrillator (S-ICD) may be used instead of a traditional transvenous system to prevent sudden cardiac death. Our aim was to compare the characteristics of S-ICD patients from the multi-center registry of S-ICD implantations in Poland with the published results of the European Snapshot Survey on S-ICD Implantation (ESSS-SICDI). We compared data of 137 Polish S-ICD patients with 68 patients from the ESSS-SICDI registry. The groups did not differ significantly in terms of sex, prevalence of ischemic cardiomyopathy, concomitant diseases, and the rate of primary prevention indication. Polish patients had more advanced heart failure (New York Heart Association (NYHA) class III: 11.7% vs. 2.9%, NYHA II: 48.9% vs. 29.4%, NYHA I: 39.4% vs. 67.7%, p < 0.05 each). Young age (75.9% vs. 50%, p < 0.05) and no vascular access (7.3% vs. 0%, p < 0.05) were more often indications for S-ICD. The percentage of patients after transvenous system removal due to infections was significantly higher in the Polish group (11% vs. 1.5%, p < 0.05). In the European population, S-ICD was more frequently chosen because of patients’ active lifestyle and patients’ preference (both 10.3% vs. 0%, p < 0.05). Our analysis shows that in Poland, compared to other European countries, subcutaneous cardioverters-defibrillators are being implanted in patients at a more advanced stage of chronic heart failure. The most frequent reason for choosing a subcutaneous system instead of a transvenous ICD is the young age of a patient.
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Affiliation(s)
- Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Andrzej Przybylski
- Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (A.P.); (J.R.)
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland
| | - Szymon Budrejko
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-210 Gdansk, Poland;
- Correspondence: ; Tel.: +48-58-3493910
| | - Tomasz Fabiszak
- Department of Cardiology and Internal Diseases, Collegium Medicum, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland;
| | - Michał Lewandowski
- 2nd Department of Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Krzysztof Kaczmarek
- Department of Electrocardiology, Medical University of Lodz, 90-647 Lodz, Poland;
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Przemysław Mitkowski
- 1st Department of Cardiology, Chair of Cardiology, Karol Marcinkowski University of Medical Sciences, 61-701 Poznan, Poland;
| | - Stanisław Tubek
- Department of Heart Diseases, Wroclaw Medical University, 50-367 Wroclaw, Poland;
| | - Ewa Jędrzejczyk-Patej
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland; (E.J.-P.); (R.L.)
| | - Radosław Lenarczyk
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Medical University of Silesia Silesian Centre for Heart Diseases, 41-800 Zabrze, Poland; (E.J.-P.); (R.L.)
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, 50-981 Wroclaw, Poland;
| | - Janusz Romanek
- Medical College, University of Rzeszow, 35-959 Rzeszow, Poland; (A.P.); (J.R.)
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, 35-301 Rzeszow, Poland
| | - Anna Rydlewska
- Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- Department of Electrocardiology, The John Paul II Hospital, 31-202 Krakow, Poland
| | - Zbigniew Orski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | | | - Artur Filipecki
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Marcin Janowski
- Chair and Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Tatjana Potpara
- School of Medicine, Belgrade University, 11000 Belgrade, Serbia;
| | - Serge Boveda
- Cardiology, Cardiac Arrhythmias Management Department, Clinique Pasteur, 31076 Toulouse, France;
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18
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Kempa M, Przybylski A, Budrejko S, Krupa W, Kaczmarek K, Ostręga M, Syska P, Sokal A, Grabowski M, Jagielski D, Grymuza M, Romanek J, Tubek S, Janowski M, Orski Z, Zakrzewska-Koperska J, Stanek A, Orszulak M. Evolution of implantation technique and indications for a subcutaneous cardioverter-defibrillator over 7 years of experience in Poland. Kardiol Pol 2021; 79:1016-1018. [PMID: 34176114 DOI: 10.33963/kp.a2021.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland
| | - Andrzej Przybylski
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No 2, Rzeszów, Poland.,Medical College, University of Rzeszow, Rzeszów, Poland
| | - Szymon Budrejko
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland.
| | - Wojciech Krupa
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Mateusz Ostręga
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Paweł Syska
- 2nd Department of Arrhythmia, National Institute of Cardiology, Warszawa, Poland
| | - Adam Sokal
- 1st Department of Cardiology and Angiology, Silesian Centre of Heart Diseases, Zabrze, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Maciej Grymuza
- 1st Department of Cardiology, Chair of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Janusz Romanek
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No 2, Rzeszów, Poland.,Medical College, University of Rzeszow, Rzeszów, Poland
| | - Stanisław Tubek
- Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Marcin Janowski
- Chair and Department of Cardiology Medical University of Lublin, Lublin, Poland
| | - Zbigniew Orski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland
| | | | - Adrian Stanek
- Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Michał Orszulak
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Bilaszewski Ł, Timler W, Budrewicz K, Marczak M, Kozłowski R, Wizowska J, Timler M, Jagielski D, Dudek M, Rasmus P, Zyśko D, Timler D. The Impact of COVID-19 on Admissions and Management of Patients with Atrial Fibrillation Episodes in the Emergency Department. Int J Environ Res Public Health 2021; 18:ijerph18116048. [PMID: 34199795 PMCID: PMC8200085 DOI: 10.3390/ijerph18116048] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/21/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. MATERIALS AND METHODS A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July-December 2019 (pre-pandemic period) versus July-December 2020 (pandemic period) was performed. RESULTS During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/-13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5-30 h) during the pandemic period vs. 5 h (3-24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. CONCLUSIONS 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.
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Affiliation(s)
- Łukasz Bilaszewski
- Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (Ł.B.); (K.B.); (J.W.); (D.Z.)
| | - Wojciech Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-212 Lodz, Poland;
| | - Katarzyna Budrewicz
- Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (Ł.B.); (K.B.); (J.W.); (D.Z.)
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (M.T.)
| | - Remigiusz Kozłowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland;
| | - Joanna Wizowska
- Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (Ł.B.); (K.B.); (J.W.); (D.Z.)
| | - Małgorzata Timler
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland; (M.M.); (M.T.)
| | - Dariusz Jagielski
- Centre for Heart Diseases, Department of Cardiology, 4th Military Hospital, 50-981 Wroclaw, Poland;
| | - Michał Dudek
- Department of Anaesthesiology and Intensive Therapy, Medical University of Lodz, 90-153 Lodz, Poland;
| | - Paweł Rasmus
- Department of Medical Psychology, Medical University of Lodz, 90-131 Lodz, Poland;
| | - Dorota Zyśko
- Department of Emergency Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland; (Ł.B.); (K.B.); (J.W.); (D.Z.)
| | - Dariusz Timler
- Department of Emergency Medicine and Disaster Medicine, Medical University of Lodz, 92-212 Lodz, Poland;
- Correspondence: ; Tel.: +48-501306238
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20
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Wileczek A, Reichert A, Kluk M, Sledz S, Sledz A, Kosior J, Polewczyk A, Kutarski A, Jagielski D, Buchta-Nitecka A, Karbarz D, Stec S. Non-invasive and invasive autonomic tests to facilitate cardioneuroablation and complex indications for transcutaneous lead extraction and discontinuation of permanent pacing. Europace 2021. [DOI: 10.1093/europace/euab116.490] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
Rare-A-Care registry
Background
Extracardiac vagal nerve stimulation (ECANS) and cardioneuroablation (CNA) are promising methods to cure vagally mediated bradycardia and validate indications for permanent pacing for sinus node dysfunction (SND), atrioventricular blocks (AVB), tachycardia-bradycardia syndrome (TBS) and cardio-inhibitory or mixed reflex syncope (VVS). There are limited information on clinical utility of those procedures in validation of indication for continuation of permanent pacing (PM) and transcutaneous lead extraction (TLE).
Methods
Data were collected from prospective multicentre registry of CNA facilitated by interdisciplinary consultations, state-of-art autonomic tests, atropine/propranolol tests, electrophysiologic study as well as ECANS. Share-decision making were used by EP-HEART-TEAM to developed patient-oriented therapy.
Results
Between June 2018-Jan 2021 the first 102 consecutive patients underwent interdisciplinary approach before invasive EPS and/or invasive ECANS, to consider biatrial, binodal CNA, if possible to cure functional bradycardia. Eleven (10%) patients had implanted permanent PM"s due to SND/AVB/TBS/CI-VVS and were considered for TLE. In 2 out of 11 cases CNA was not performed due to: 1) structural advanced 2nd and 3rd degree AVB with indication for TLE and permanent HBP (no.1), 2) incidental severely symptomatic persistent 3rd degree AVB more than 15 year ago without any further bradycardia episodes (only TLE, no.2). In further 9 of 11 cases with PM CNA was performed, however TLE was not attempted in 2 patients [(SND + PVC ablation + indication for beta-blocker therapy due to IHD in older male. TLE had not yet been attempted to confirm long-term success therapy by patient and/or physician (no.3); two periprocedural successful CNA resulted in disappearance of CI reflex however despite pacing syncopal events persist due to mixed etiology (no.4)]. In further 7/11 cases TLE-s were performed. Three cases had TLE prior to CNA [VVS-CI + advanced functional AVB - prior 3 pacemaker reimplantations and further "rescue" CNA, (no.5); CI-VVS + pacemaker infection (no.6); TLE of PM + TBS no.7]. Finally, in 4 cases TLE was recommended after CNA [CI-VVS (no.8, no.9 and no.10); mixed etiology: TBS + VVS-CI + intermittent, recurrent pericardial efffusion due to lead perforation, PM syndrome, (no. 11)].
Conclusions
Interdisciplinary and comprehensive autonomic approach with ECANS and CNA enable EP-HEART-TEAM to offer patient-oriented therapy with a complex clinical scenarios before final decision about TLE and discontinuation of permanent pacing therapy.
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Affiliation(s)
- A Wileczek
- Subcarpathian Centre for Cardiovascular Interventions, Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Sanok, Poland
| | - A Reichert
- County Specialistic Hospital in Stalowa Wola, Department of Cardiology, Stalowa Wola, Poland
| | - M Kluk
- Swietokrzyskie Cardiology Center, Department of Interventional Cardiology, Kielce, Poland
| | - S Sledz
- El-Medica, EP-NETWORK, Skarzysko-Kamienna, Poland
| | - A Sledz
- El-Medica, EP-NETWORK, Skarzysko-Kamienna, Poland
| | - J Kosior
- Mazovian Specialist Hospital, Radom, Poland
| | - A Polewczyk
- Swietokrzyskie Cardiology Center, Department of Cardiac Surgery, Kielce, Poland
| | - A Kutarski
- Regional Hospital Pope John Paul II, Zamosc, Poland
| | | | | | - D Karbarz
- El-Medica, EP-NETWORK, Skarzysko-Kamienna, Poland
| | - S Stec
- Subcarpathian Centre for Cardiovascular Interventions, Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac Stimulation, Sanok, Poland
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21
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Kempa M, Przybylski A, Budrejko S, Krupa W, Kaczmarek K, Kurek A, Syska P, Sokal A, Grabowski M, Jagielski D, Grymuza M, Szafarz P, Tubek S, Orski Z, Zakrzewska-Koperska J, Machejek J, Kwaśniewski W. Multicenter Registry of Subcutaneous Cardioverter- -Defibrillator Implantations: a preliminary report. Kardiol Pol 2021; 79:697-699. [PMID: 34013514 DOI: 10.33963/kp.a2021.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland
| | - Andrzej Przybylski
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, Rzeszów, Poland.,Medical College, University of Rzeszow, Rzeszów, Poland
| | - Szymon Budrejko
- Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdańsk, Poland.
| | - Wojciech Krupa
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Anna Kurek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Silesian Centre for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Paweł Syska
- 2nd Department of Arrhythmia, National Institute of Cardiology, Warszawa, Poland
| | - Adam Sokal
- 1st Department of Cardiology and Angiology, Silesian Centre of Heart Diseases, Zabrze, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Maciej Grymuza
- 1st Department of Cardiology, Chair of Cardiology, Karol Marcinkowski University of Medical Sciences, Poznań, Poland
| | - Piotr Szafarz
- Cardiology Department with the Acute Coronary Syndromes Subdivision, Clinical Provincial Hospital No. 2, Rzeszów, Poland
| | - Stanisław Tubek
- Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Zbigniew Orski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warszawa, Poland
| | | | - Jakub Machejek
- Department of Electrocardiology, John Paul II Hospital, Kraków, Poland
| | - Wojciech Kwaśniewski
- 1st Department of Cardiology, Upper-Silesian Medical Centre of the Silesian Medical University in Katowice, Katowice, Poland
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22
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Kliczkowska-Klarowicz K, Jagielski D, Czopowicz M, Sapierzyński RA. Demographic and clinical characteristics of dogs with centroblastic lymphoma. Vet World 2021; 14:49-55. [PMID: 33642785 PMCID: PMC7896917 DOI: 10.14202/vetworld.2021.49-55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/24/2020] [Indexed: 11/22/2022] Open
Abstract
Background and Aim: Centroblastic lymphoma (CBL) is the most common morphological type of lymphoma found in dogs; it is usually identified through cytology in veterinary clinical practice. This study aimed to identify the demographic and clinical characteristics of dogs with CBL that was diagnosed with cytology and immunocytochemistry. Materials and Methods: Dogs with a suspicion of lymphoma were diagnosed by cytology supported by immunocytochemistry with the use of the updated Kiel classification adapted for dogs. During the analyzed time period, 336 lymphomas were diagnosed in dogs, including 171 cases of CBL. Epidemiological and clinical data from the dogs with CBL were provisionally collected. Results: The epidemiology analysis revealed an increased risk of CBL in Rottweilers, golden retrievers, and Bernese mountain dogs. At admission, most of the dogs displayed generalized lymphadenopathy with spleen and liver enlargement. The most common hematological abnormality was leukocytosis due to neutrophilia. The most common biochemical abnormality was elevated alanine aminotransferase and alkaline phosphatase activities and selective hypoproteinemia due to hypoalbuminemia. Conclusion: Rottweilers, Bernese mountain dogs, and golden retrievers appear to be overrepresented among dogs with CBL. CBL is usually diagnosed at an advanced clinical stage according to the World Health Organization; however, it is usually accompanied by only minor hematological and biochemical abnormalities.
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Affiliation(s)
- Katarzyna Kliczkowska-Klarowicz
- Department of Pathology and Veterinary Diagnostics, Division of Pathology, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159c, 02-776 Warsaw, Poland
| | | | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159c, 02-776 Warsaw, Poland
| | - Rafał A Sapierzyński
- Department of Pathology and Veterinary Diagnostics, Division of Pathology, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159c, 02-776 Warsaw, Poland
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23
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Niewinski P, Walczak T, Królicki T, Kudla T, Jagielski D, Nowak K, Josiak K, Tubek S, Banasiak W, Ponikowski P. Re: Pacing, takotsubo syndrome, and transient rise of pacing threshold: What is the mechanism? Pacing Clin Electrophysiol 2020; 43:772-773. [DOI: 10.1111/pace.13977] [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] [Received: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Piotr Niewinski
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
| | - Tomasz Walczak
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
- 4th Military Hospital Wroclaw Poland
| | - Tomasz Królicki
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
| | - Tobiasz Kudla
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
| | | | - Krzysztof Nowak
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
| | - Krystian Josiak
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
- 4th Military Hospital Wroclaw Poland
| | - Stanisław Tubek
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
| | | | - Piotr Ponikowski
- Department of Heart DiseasesWroclaw Medical University Wroclaw Poland
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24
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Niewinski P, Walczak T, Królicki T, Kudla T, Jagielski D, Nowak K, Josiak K, Tubek S, Banasiak W, Ponikowski P. Frailty and cognitive impairment are predictive of takotsubo syndrome following pacemaker implantation. Pacing Clin Electrophysiol 2020; 43:730-736. [PMID: 32304247 DOI: 10.1111/pace.13920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/19/2020] [Accepted: 04/12/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pacemaker (PM) implantation may cause acute emotional distress leading to takotsubo syndrome (TTS). Frailty and cognitive impairment are known to influence outcomes after surgical procedures. It is unclear whether they may also predispose to TTS following PM implantation. METHODS We identified nine cases (81 ± 6 years) of TTS following PM implantation that took place between 2013 and 2017 in one high volume implantation center. TTS was diagnosed based on typical echocardiographic appearance with resolution over time and (in cases where deemed necessary) normal coronary angiography. The TTS cases were compared with 30 consecutive cases of PM implantation (75 ± 9 years), which were not complicated by TTS (control group). Frailty was assessed using retrospective Risk Analysis Index (RAI-A). Pacing parameters were analyzed during PM implantation and after 1 month. RESULTS Cognitive impairment was more prevalent (67% vs 10%, P = .0005), and RAI-A index was significantly higher in the TTS group compared to the control group (26 ± 13.7 vs 13.1 ± 9.8, P = .008). Perioperative right ventricular threshold was significantly higher in patients with TTS comparing to controls (0.99 ± 0.43 V vs 0.74 ± 0.20 V, P = .04). The magnitude of decrease in right ventricular threshold between implantation and 1 month follow-up was greater in TTS patients compared to controls (-0.41 ± 0.29 V vs -0.15 ± 0.38 V, P = .049). CONCLUSIONS TTS is a rare complication of PM implantation. Patients with cognitive impairment and frailty are at risk of TTS. Right ventricular pacing threshold is acutely affected by TTS and improves over time.
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Affiliation(s)
- Piotr Niewinski
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Walczak
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,4th Military Hospital, Wroclaw, Poland
| | - Tomasz Królicki
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Tobiasz Kudla
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Krzysztof Nowak
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Krystian Josiak
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,4th Military Hospital, Wroclaw, Poland
| | - Stanisław Tubek
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Piotr Ponikowski
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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25
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Fudim M, Spector AR, Costanzo MR, Pokorney SD, Mentz RJ, Jagielski D, Augostini R, Abraham WT, Ponikowski PP, McKane SW, Piccini JP. Phrenic Nerve Stimulation for the Treatment of Central Sleep Apnea: A Pooled Cohort Analysis. J Clin Sleep Med 2019; 15:1747-1755. [PMID: 31855160 PMCID: PMC7099184 DOI: 10.5664/jcsm.8076] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Early evidence with transvenous phrenic nerve stimulation (PNS) demonstrates improved disease severity and quality of life (QOL) in patients with central sleep apnea (CSA). The goal of this analysis is to evaluate the complete prospective experience with PNS in order to better characterize its efficacy and safety, including in patients with concomitant heart failure (HF). METHODS Using pooled individual data from the pilot (n = 57) and pivotal (n = 151) studies of the remedē System in patients with predominant moderate to severe CSA, we evaluated 12-month safety and 6- and 12-month effectiveness based on polysomnography data, QOL, and cardiac function. RESULTS Among 208 combined patients (June 2010 to May 2015), a remedē device implant was successful in 197 patients (95%), 50/57 pilot study patients (88%) and 147/151 pivotal trial patients (97%). The pooled cohort included patients with CSA of various etiologies, and 141 (68%) had concomitant HF. PNS reduced apnea-hypopnea index (AHI) at 6 months by a median of -22.6 episodes/h (25th and 75th percentile; -38.6 and -8.4, respectively) (median 58% reduction from baseline, P < .001). Improvement in sleep variables was maintained through 12 months of follow-up. In patients with HF and ejection fraction ≤ 45%, PNS was associated with improvement in systolic function from 27.0% (23.3, 36.0) to 31.1% (24.0, 41.5) at 12 months (P = .003). In the entire cohort, improvement in QOL was concordant with amelioration of sleep measures. CONCLUSIONS Transvenous PNS significantly improves CSA severity, sleep quality, ventricular function, and QOL regardless of HF status. Improvements, which are independent of patient compliance, are sustained at 1 year and are associated with acceptable safety.
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Affiliation(s)
- Marat Fudim
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Andrew R. Spector
- Department of Neurology, Duke University Medical Center, Durham, North Carolina
| | | | - Sean D. Pokorney
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Robert J. Mentz
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Duke University Medical Center, Durham, North Carolina
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
| | - Ralph Augostini
- Division of Cardiology, Department of Medicine, The Ohio State University, Columbus, Ohio
| | - William T. Abraham
- Division of Cardiology, Department of Medicine, The Ohio State University, Columbus, Ohio
| | - Piotr P. Ponikowski
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
- Department of Cardiology, Medical University, Military Hospital, Wroclaw, Poland
| | | | - Jonathan P. Piccini
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Division of Cardiology, Duke University Medical Center, Durham, North Carolina
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26
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Żmigrodzka M, Witkowska-Piłaszewicz O, Rzepecka A, Cywińska A, Jagielski D, Winnicka A. Extracellular Vesicles in the Blood of Dogs with Cancer-A Preliminary Study. Animals (Basel) 2019; 9:ani9080575. [PMID: 31430895 PMCID: PMC6720862 DOI: 10.3390/ani9080575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022] Open
Abstract
Extracellular vesicles (EVs) are a heterogeneous population of submicron-sized structures released during the activation, proliferation, or apoptosis of various types of cells. Due to their size, their role in cell-to-cell communication in cancer is currently being discussed. In blood, the most abundant population of EVs is platelet-derived EVs (PEVs). The aim of this study was to estimate the absolute number and the origin of EVs in the blood of healthy dogs and of dogs with various types of cancer. The EV absolute number and cellular origin were examined by flow cytometry technique. EVs were classified on the basis of surface annexin V expression (phosphatidylserine PS+) and co-expression of specific cellular markers (CD61, CD45, CD3, CD21). The number of PEVs was significantly higher in dogs with cancer (median: 409/µL, range: 42-2748/µL vs. median: 170/µL, range: 101-449/µL in controls). The numbers of EVs derived from leukocytes (control median: 86/µL, range: 40-240/µL; cancer median: 443/µL, range: 44-3 352/µL) and T cells (control median: 5/µL, range: 2-66/µL; cancer median: 108/µL, range: 3-1735/µL) were higher in dogs with neoplasia compared to healthy controls. The estimation of PEV and leukocyte-derived EV counts may provide a useful biological marker in dogs with cancer.
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Affiliation(s)
- Magdalena Żmigrodzka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-787 Warsaw, Poland.
| | - Olga Witkowska-Piłaszewicz
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-787 Warsaw, Poland
| | - Alicja Rzepecka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-787 Warsaw, Poland
| | - Anna Cywińska
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-787 Warsaw, Poland
| | - Dariusz Jagielski
- Veterinary Clinic BIALOBRZESKA, Częstochowska 20, 02-344 Warsaw, Poland
| | - Anna Winnicka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, 02-787 Warsaw, Poland
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27
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Jagielski D, Zyśko D, Nadolny K, Wizowska J, Biel B, Banasiak W, Ponikowski P. Prognostic importance of serum troponin concentration in patients with an implanted cardioverter‑defibrillator admitted to the emergency department due to electric shock. Kardiol Pol 2019; 77:618-623. [PMID: 31066727 DOI: 10.33963/kp.14810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND High-energy implantable cardioverter-defibrillator (ICD) therapy may increase serum troponin (cTnI) concentration. Aims: We aimed to assess an impact of cTnI concentration after ICD high-energy therapy on mortality. METHODS A total of 150 patients aged 64.2 +/- 12.8 years admitted to the Emergency Departments (EDs) due to at least one electrical shock during the last 24 hours with measured serum cTnI concentration at admission were included. Age, gender, comorbidities, shocks' numbers, therapy appropriateness, serum creatinine concentration, and left ventricular ejection fraction were noted for the retrospective analysis. Survival was obtained using the personal identification numbers (PESEL), on November 2018 until death or a period of three years had elapsed (1057 days). RESULTS cTnI concentration was increased in 92 (61.3%) patients. The mortality rate was related to age - HR: 1.04, 95% CI: 1.01-1.08, p = 0.026; increased cTnI concentration - HR: 2.88, 95% CI: 1.30-6.37, p = 0.009; diabetes - HR: 2.19, 95% CI: 1.09-4.39, p = 0.027; ischemic heart disease - HR: 2.96, 95% CI: 1.11-7.87, p = 0.030, serum creatinine concentration - HR: 2.17, 95% CI: 1.18-4.00, p = 0.013; LVEF (HR 0.95, 95% CI: 0.91-0.99, p = 0.009), and previous or current CABG or PCI (HR: 0.38, 95% CI: 0.15-0.96, p = 0.040 and HR: 0.29, 95% CI: 0.13-0.65, p = 0.003, respectively). CONCLUSIONS Increased mortality rate in patients with ICD shocks is multifactorial. Increased cTnI concentration at ED admission, but not the number of ICD shocks, is an independent marker of higher long-term mortality.
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Affiliation(s)
- Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Dorota Zyśko
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Medical University of Bialystok, Wrocław, Poland
| | - Joanna Wizowska
- Department of Emergency Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
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Jankowska U, Jagielski D, Czopowicz M, Sapierzyński R. Epidemiology, clinical and cytological features of lymphoma in Boxer dogs. Acta Vet Hung 2019; 67:224-240. [PMID: 31238736 DOI: 10.1556/004.2019.024] [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] [Indexed: 11/19/2022]
Abstract
The aim of this study was to evaluate the epidemiology, clinical and laboratory characteristics of canine lymphomas as well as some aspects of treatment outcomes. The study was conducted on Boxer dogs with lymphoma diagnosed by cytology and immunocytochemistry (CD3 and CD79 alpha). During the study period, lymphoma was diagnosed in 63 Boxers; 86.8% were T-cell (based on the Kiel classification: small clear cell lymphoma, pleomorphic small cell lymphoma, pleomorphic mixed T-cell lymphoma, pleomorphic large T-cell lymphoma, lymphoblastic lymphoma/acute lymphoblastic leukaemia) and 13.2% were B-cell lymphomas (according to the Kiel classification: B-cell chronic lymphocytic leukaemia, centroblastic/centroblastic polymorphic lymphoma). Overall survival (OS) was significantly longer in dogs with low-grade than with high-grade lymphoma (median OS of 6.8 and 4.7 months, respectively; P = 0.024). OS was not influenced by WHO clinical stage, WHO clinical substage, presence of splenomegaly, early administration of glucocorticoids or the time from the first presentation to the beginning of chemotherapy. There are no significant differences in clinical and laboratory parameters between low-grade and high-grade lymphomas. Boxer dogs are predisposed to T-cell lymphoma, with a predominance of high-grade tumour, especially pleomorphic, mixed small and large T-cell subtype. It is possible that Boxer dogs may respond less favourably to chemotherapy than patients of other breeds.
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Affiliation(s)
| | | | - Michał Czopowicz
- 2Laboratory of Veterinary Epidemiology and Economics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - Rafał Sapierzyński
- 3Division of Animal Pathomorphology, Department of Pathology and Veterinary Diagnostics and Faculty of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska str. 166, 02-787 Warsaw, Poland
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Jagielski D, Kołodziej A, Westlund R, Biel B, Nowak K, Szemplińska I, Flinta I, Krawczyk M, Kulej K, Krakowiak B, Germany R, Panteleon A, McKane S, Banasiak W, Abraham WT, Ponikowski P. Phrenic nerve stimulation in patients with central sleep apnea: a single‑center experience from pilot and pivotal trials evaluating the remedē System. Kardiol Pol 2019; 77:553-560. [PMID: 30964196 DOI: 10.5603/kp.a2019.0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with central sleep apnea (CSA) have recently been shown to have improved sleep metrics and quality of life (QoL) with phrenic nerve stimulation (PNS). AIMS The aim of this study was to report the results of a partnership between cardiology, sleep medicine, and electrophysiology in a single clinical center as well as the enrollment, implantation, and follow‑up experience demonstrating both the safety and efficacy of PNS. METHODS This analysis included data from the pilot and pivotal trials investigating the effect of PNS using an implantable transvenous system in patients with CSA. We present our experience and data on the enrollment processes, implantation feasibility and safety, sleep indices, and QoL at 6 and 12 months of follow‑up. RESULTS Between June 2010 and May 2015, cardiology patients were prescreened and 588 of them were sent for in‑home sleep test. Ninety‑six patients were referred for polysomnographic studies, and 33 were enrolled and had an implant attempt, with 31 successfully receiving an implant. The apnea-hypopnea index was reduced in the pilot trial (mean [SD] of 48.7 [15.5] events/h to 22.5 [13.2] events/h; P <0.001) and in the pivotal trial (mean [SD] of 48.3 [18.8] events/h to 26.0 [21.9] events/h; P <0.001). Improvement in QoL was also observed. CONCLUSIONS We showed that PNS improved sleep metrics and QoL in patients with CSA, which is a result of multiple factors, including a comprehensive coordination between cardiology, sleep medicine, and electrophysiology. This ensures appropriate patient identification leading to safe implantation and full patient compliance during follow‑up visits.
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Affiliation(s)
- Dariusz Jagielski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Adam Kołodziej
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | | | - Bartosz Biel
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Krzysztof Nowak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Heart Diseases, Wrocław Medical University, Wrocław, Poland
| | - Iwona Szemplińska
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Irena Flinta
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Physiology, Wrocław Medical University, Wrocław, Poland
| | - Magdalena Krawczyk
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Physiology, Wrocław Medical University, Wrocław, Poland
| | - Katarzyna Kulej
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Bartosz Krakowiak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Robin Germany
- Respicardia Inc., Minnetonka, Minnesota, United States
| | | | - Scott McKane
- Respicardia Inc., Minnetonka, Minnesota, United States
| | - Waldemar Banasiak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - William T Abraham
- Division of Cardiovascular Medicine, Ohio State University, Columbus, Ohio, United States
| | - Piotr Ponikowski
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland,Department of Heart Diseases, Wrocław Medical University, Wrocław, Poland
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Augostini RS, Afzal MR, Costanzo MR, Westlund R, Stellbrink C, Gutleben K, Gupta S, Saleem M, Smith TW, Peterson M, Drucker M, Merliss A, Hayes J, Butter C, Hutchinson M, Jagielski D. How to implant a phrenic nerve stimulator for treatment of central sleep apnea? J Cardiovasc Electrophysiol 2019; 30:792-799. [PMID: 30834611 PMCID: PMC6850096 DOI: 10.1111/jce.13898] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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] [Received: 01/03/2019] [Revised: 02/25/2019] [Accepted: 02/28/2019] [Indexed: 01/01/2023]
Abstract
Background Central sleep apnea (CSA) is a breathing disorder caused by the intermittent absence of central respiratory drive. Transvenous phrenic nerve stimulation is a new therapeutic option, recently approved by the FDA , for the treatment of CSA. Objective To describe the technique used to implant the transvenous phrenic nerve stimulation system (the remedē System, Respicardia, Inc). Methods The remedē System is placed in the pectoral region, typically on the right side. A single stimulation lead is placed in either the left pericardiophrenic vein (PPV) or the right brachiocephalic vein (RBC). A sensing lead is placed into the azygous vein to detect respiration. Results In the remedē System Pivotal trial, 147 of 151 (97%) patients were successfully implanted with the system. Sixty‐two percent of stimulation leads were placed in the PPV and 35% in the RBC. Mean procedure time was 2.7 ± 0.8 hours and 94% of patients were free from implant‐related serious adverse events through 6 months. Conclusion In patients with CSA, transvenous phrenic nerve stimulation is an effective and safe therapy with an implant procedure similar to that of cardiac implantable electronic devices.
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Affiliation(s)
| | | | | | | | | | | | - Sanjaya Gupta
- Department of Cardiology, University of Missouri-Kansas City School of Medicine, Saint Luke's Mid-America Heart Institute, Kansas City, Missouri
| | | | - Timothy W Smith
- Washington University School of Medicine, St Louis, Missouri
| | | | | | | | - John Hayes
- Marshfield Clinic, Marshfield, Wisconsin
| | - Christen Butter
- Heart Center Brandenburg in Bernau/Berlin & Brandenburg Medical School, Bernau, Delaware
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Jagielski D, Banasiak W, Ponikowski P. Stymulacja nerwu przeponowego w leczeniu centralnego bezdechu sennego u chorych z niewydolnością serca. Folia Cardiologica 2019. [DOI: 10.5603/fc.2018.0119] [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: 11/25/2022] Open
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32
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Niewinski P, Jagielski D, Josiak K, Nowak K, Biel B, Tubek S, Walczak T, Szemplinska I, Siennicka A, Banasiak W, Ponikowski P. Seat belts-related behaviors in car drivers with cardiac implantable electronic devices. Pacing Clin Electrophysiol 2019; 42:400-406. [PMID: 30740756 DOI: 10.1111/pace.13617] [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] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Seat belt use is the single most effective means of reducing fatal injuries in road traffic accidents. The presence of a cardiac implantable electronic device (CIED) might influence seat belt-related behaviors due to the physical proximity of the seat belt and left subclavian area in which the device is usually implanted. Understanding the underlying mechanisms of improper seat belt use may improve safety of these patients. METHODS We performed a prospective study using a structured questionnaire with 120 CIED recipients (age, 63.9 ± 10.9 years) attending a pacing outpatient clinic. All study participants were active drivers and predominantly male. The majority of patients (79%) had undergone high-energy device implantation. RESULTS We found that 18% of study participants do not fasten seat belts on a regular basis or use the seat belt in an atypical fashion (such as under the armpit). Moderate or high level of discomfort from the interaction between seat belt and CIED was present in 27%, while more than half (51%) were afraid of seat belt-induced CIED damage. In multifactorial analysis, we found the following independent predictors of improper seat belt use: (1) at least moderate level of discomfort at the CIED site (P = 0.02); (2) fear of CIED damage (P = 0.009); and (3) irregular seat belt use prior to CIED implantation (P = 0.037). CONCLUSIONS Improper seat belt-related behaviors are common in CIED recipients. They arise from previous habits and from CIED-related physical and psychological factors. Patients' education regarding the importance and safety of proper seat belt use is a priority.
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Affiliation(s)
- Piotr Niewinski
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Dariusz Jagielski
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
| | - Krystian Josiak
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Nowak
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
| | - Stanislaw Tubek
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Walczak
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Iwona Szemplinska
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
| | - Agnieszka Siennicka
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Department of Physiology, Wroclaw Medical University, Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.,Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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Jagielski D, Zyśko D, Nadolny K, Wizowska J, Biel B, Banasiak W, Ponikowski P. Predictors of inappropriate shocks from implantable cardioverter-defibrillators. Wiad Lek 2019; 72:1243-1246. [PMID: 31398149] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Introduction: Inappropriate shocks in patients with an implantable cardioverter-defibrillator (ICD) are associated with significant psychological and physical consequences and increased long-term mortality. The aim: To assess predictors associated with inappropriate high-energy discharges of implantable cardioverter-defibrillators. PATIENTS AND METHODS Material and Methods: Retrospective data analysis of 150 patients aged 64.2±12.8 years (84.7% male) admitted to the Hospital Emergency Department due to at least one cardioverter-defibrillator discharge was performed. All of the discharges were inappropriate in the group of 33 patients, and in the group of 117 patients at least one discharge was appropriate. The following data: age, gender, concomitant diseases, type of ICD implantation (primary vs. secondary prevention), type of discharge, number of discharges, serum potassium, and sodium concentration were collected. RESULTS Results: Patients with only inappropriate discharges were younger, significantly more often had chronic atrial fibrillation, a significantly higher number of discharges, and ischaemic cardiomyopathy. Logistic regression analysis revealed that the occurrence of only inappropriate discharges was related to the number of discharges over three, the age of patients below 60 years, the serum sodium concentration between 135 mEq/L and 142 mEq/L, and the primary type of prevention of sudden cardiac death. CONCLUSION Conclusions: 1. Predictors of inappropriate discharges include: age, serum sodium concentration, and primary type of indications for cardioverter-defibrillator implantation. 2. Further research is necessary to determine the influence of disturbances in the sodium economy on the occurrence of appropriate and inappropriate interventions of implantable cardioverter-defibrillators.
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Affiliation(s)
- Dariusz Jagielski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Dorota Zyśko
- Department and Clinic Of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medicine, Białystok Medical University, Bialystok, Poland, University of Strategic Planning in Dabrowa Górcznia, Poland
| | - Joanna Wizowska
- Department and Clinic Of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Biel
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Waldemar Banasiak
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Department of Cardiology, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland, Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
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Sapierzyński R, Czopowicz M, Jagielski D. Metastatic lymphadenomegaly in dogs - cytological study. Pol J Vet Sci 2018; 20:731-736. [PMID: 29611644 DOI: 10.1515/pjvs-2017-0091] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Enlarged lymph nodes are frequently examined cytologically in dogs and metastatic lymphadenomegaly of various origin is a common cytological finding in these cases. In this study we aimed to examine epidemiological data, and to determine factors affecting the location of neoplastic metastases in the lymph nodes. Samples for cytological examination were obtained by fine-needle biopsy (FNB) of enlarged lymph nodes and stained with Giemsa solution. Cases meeting the following criteria were enrolled in the study: lymphadenomegaly detected in clinical examination, presence of primary mass confirmed by cytopathology or histopathology as a solid malignant tumour, and cytological diagnosis of metastatic tumour. Cytological pattern of lymph node involvement was classified as low, medium and massive. During study period 125 dogs met the eligibility criteria, with age ranged from 1.8 to 19 years. No sex predisposition to particular types of tumors was observed, except for adenocarcinoma which was diagnosed in females more often. Metastatic tumors were various in origin, with predominance of mast cell tumors, adenocarcinomas, and melanomas. Massive involvement predominated in all lymph nodes affected. Neoplastic lymphadenomegally is recognized usually in older dogs, with female predisposition related to dissemination of mammary cancers. Mast cell tumor, adenocarcinoma and melanoma are the most common causes of metastatic lymphadenomegaly, and in the vast majority of the cases massive lymph node involvement is observed.
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Affiliation(s)
- R Sapierzyński
- Department of Pathology and Veterinary Diagnostics Warsaw University of Life Sciences (SGGW), Nowoursynowska 159c, 02-766 Warsaw, Poland
| | - M Czopowicz
- Laboratory of Veterinary Epidemiology and Economics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159c, 02-766 Warsaw, Poland
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Jagielski D, Zyśko D, Josiak K, Niewiński P, Banasia WK, Ponikowski P. [Patient with the intervention of an implantable cardioverter-defibrillator in a hospital emergency department]. Wiad Lek 2018; 71:1685-1689. [PMID: 30737923] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Introduction: Implantable cardioverter-defibrillators (ICD) improve prognosis in patients with malignant ventricular arrhythmias. Patients with ICD represent a significant proportion of all Emergency Department (ED) admissions. The number of these visits due to the high-energy therapy or antitachycardia pacing (ATP) delivered by the implanted cardioverter-defibrillator is constantly increasing. The aim: To present the prevalence and type of therapeutic interventions of an ICD in patients admitted to ED in 2014-2017 at two medical centers covering approx. 400 000 residents. PATIENTS AND METHODS Materials and methods: The patients' documentation was analyzed to find patients admitted to emergency department because of the suspicion of the ventricular arrhythmias' therapy delivered by ICD. RESULTS Results: In most cases adequate high-energy therapies due to life-threatening ventricular arrhythmias were the reason for hospitalization. We identified 126 patients aged 63.0±12.0 years, 108 (86&) of male and 18 (14&) of female. Among 171 ED admissions 6 were associated with ATP and 149 with high-energy therapy, 10 cases presented with VT without therapies, 5 with fantom shocks and in one case the patient had only a pacemaker but not ICD. The number of ICD shocks ranged from 1 to 108. Inadequate ICD discharges were found in 26 (17.4&) of high energy therapies. CONCLUSION Conclusions:1. The number of patients with ICD admitted to Emergency Department due to the initiation of high-energy or anti-tachyarrhythmic therapy has been steadily increasing in recent years. 2. In most cases, the reason for the admissions are adequate high-energy therapies, i.e. ICD discharges that disrupt the potentially life threatening arrhythmia. 3. Accurate medical history, the possibility of assessing the heart rate stored in the ICD memory during its intervention form the basis for establishing a plan of action in patients with ICD.
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Affiliation(s)
- Dariusz Jagielski
- Klinika Kardiologii, Ośrodek Chorób Serca, 4 Wojskowy Szpital Kliniczny, Wrocław, Polska
| | - Dorota Zyśko
- Katedra i Klinika Medycyny Ratunkowej, Uniwersytet Medyczny im. Piastów Śląskich, Wrocław, Polska
| | - Krystian Josiak
- Klinika Kardiologii, Ośrodek Chorób Serca, 4 Wojskowy Szpital Kliniczny, Wrocław, Polska, Katedra i Klinika Chorób Serca, Uniwersytet Medyczny im. Piastów Śląskich, Wrocław, Polska
| | - Piotr Niewiński
- Klinika Kardiologii, Ośrodek Chorób Serca, 4 Wojskowy Szpital Kliniczny, Wrocław, Polska, Katedra i Klinika Chorób Serca, Uniwersytet Medyczny im. Piastów Śląskich, Wrocław, Polska
| | - Waldemar K Banasia
- Klinika Kardiologii, Ośrodek Chorób Serca, 4 Wojskowy Szpital Kliniczny, Wrocław, Polska
| | - Piotr Ponikowski
- Klinika Kardiologii, Ośrodek Chorób Serca, 4 Wojskowy Szpital Kliniczny, Wrocław, Polska, Katedra i Klinika Chorób Serca, Uniwersytet Medyczny im. Piastów Śląskich, Wrocław, Polska
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Sapierzyński R, Kliczkowska-Klarowicz K, Jankowska U, Jagielski D. Cytodiagnostics of canine lymphomas - possibilities and limitations. Pol J Vet Sci 2017; 19:433-9. [PMID: 27487521 DOI: 10.1515/pjvs-2016-0055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Malignant lymphomas are one of the most common malignant tumours occurring in dogs. The basic method of lymphoma diagnosis in human, as well as in canine oncology is histopathology supported by immunohistochemistry. It was suggested that in veterinary medicine excisional biopsy of lymph node and histopathology should be considered only where the cytologic diagnosis is equivocal or needs to be confirmed. There are at least three basic reasons for which cytological examination ought to be accepted as a sufficient and reliable diagnostic method for lymphoma in dogs. Firstly, most dog owners consider the fine-needle biopsy as an acceptable non-harmful method of sample collection. Secondly, an increasing number of studies recommend cytology as an accurate test for diagnosing and subtyping canine lymphoma. Finally, the vast majority of canine lymphoma subtypes belong to 4-5 categories characterized by a typical cytological picture. Immunocytochemical staining of cytological smears gives new diagnostic possibilities, such as detection of markers better characterizing given growth or a potential goal for target therapy in individual cases (for example inhibitors of platelet-derived growth factor).
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Żmigrodzka M, Guzera M, Miśkiewicz A, Jagielski D, Winnicka A. The biology of extracellular vesicles with focus on platelet microparticles and their role in cancer development and progression. Tumour Biol 2016; 37:14391-14401. [PMID: 27629289 PMCID: PMC5126185 DOI: 10.1007/s13277-016-5358-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 09/07/2016] [Indexed: 12/21/2022] Open
Abstract
Extracellular vesicles (EVs) are a heterogeneous group of structures which can be classified into smaller in size and relatively homogenous exosomes (EXSMs)—spherical fragments of lipid bilayers from inner cell compartments—and bigger in size ectosomes (ECSMs)—a direct consequence of cell-membrane blebbing. EVs can be found in body fluids of healthy individuals. Their number increases in cancer and other pathological conditions. EVs can originate from various cell types, including leukocytes, erythrocytes, thrombocytes, and neoplastic cells. Platelet microparticles (PMPs) are the most abundant population of EVs in blood. It is well documented that PMPs, being a crucial element of EVs signaling, are involved in tumor growth, metastasis, and angiogenesis and may participate in the development of multidrug resistance by tumor cells. The aim of this review is to present the role of PMPs in carcinogenesis. The biology and functions of PMPs with a particular emphasis on the most recent scientific reports on EV properties are also characterized.
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Affiliation(s)
- M Żmigrodzka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, Warsaw, Poland
| | - M Guzera
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, UK
| | - A Miśkiewicz
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, Warsaw, Poland.
| | - D Jagielski
- Veterinary Clinic BIALOBRZESKA, Częstochowska 20, Warsaw, Poland
| | - A Winnicka
- Department of Pathology and Veterinary Diagnostics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159c, Warsaw, Poland
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Bojarczuk J, Josiak K, Kasztura M, Kustrzycka-Kratochwil D, Nowak K, Jagielski D, Banasiak W, Jankowska EA, Ponikowski P. Iron deficiency in heart failure: Impact on response to cardiac resynchronization therapy. Int J Cardiol 2016; 222:133-134. [PMID: 27494725 DOI: 10.1016/j.ijcard.2016.07.280] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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] [Received: 07/05/2016] [Accepted: 07/30/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Joanna Bojarczuk
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Krystian Josiak
- Department for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland.
| | - Monika Kasztura
- Department for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | | | - Krzysztof Nowak
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Dariusz Jagielski
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Waldemar Banasiak
- Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Ewa Anita Jankowska
- Department for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
| | - Piotr Ponikowski
- Department for Heart Diseases, Wroclaw Medical University, Wroclaw, Poland; Cardiology Department, Centre for Heart Diseases, Military Hospital, Wroclaw, Poland
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Jagielski D, Ponikowski P, Augostini R, Kolodziej A, Khayat R, Abraham WT. Transvenous stimulation of the phrenic nerve for the treatment of central sleep apnoea: 12 months' experience with the remedē®System. Eur J Heart Fail 2016; 18:1386-1393. [DOI: 10.1002/ejhf.593] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 04/12/2016] [Accepted: 04/28/2016] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Piotr Ponikowski
- 4th Military Hospital; Wroclaw Poland
- Medical University; Wroclaw Poland
| | - Ralph Augostini
- Division of Cardiovascular Medicine; Ohio State University; Columbus OH USA
| | | | - Rami Khayat
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine; Ohio State University; Columbus OH USA
| | - William T. Abraham
- Division of Cardiovascular Medicine; Ohio State University; Columbus OH USA
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Jankowska U, Jagielski D, Czopowicz M, Sapierzyński R. The animal-dependent risk factors in canine T-cell lymphomas. Vet Comp Oncol 2015; 15:307-314. [PMID: 26300427 DOI: 10.1111/vco.12164] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/10/2015] [Accepted: 07/01/2015] [Indexed: 11/28/2022]
Abstract
Malignant lymphomas are one of the most common malignancies occurring in dogs; among them T-cell tumours are less commonly recognized. Recently, many authors have recommended cytology as a sufficient diagnostic method for canine lymphomas, especially if supported by immunocytochemistry or flow cytometry. The aim of the study was to characterize animal-dependent risk factors in canine T-cell lymphomas (TCLs) in Poland, including specific cytological subtypes. Determination of the type and subtype of the tumour was made based on the updated Kiel cytological classification adopted for dogs as previously described. Two breeds turned out predisposed to TCL (dog de Bordeaux and Boxer) while no predisposition to B-cell lymphoma could be evidenced. Dogs with low-grade lymphoma were significantly older than those with high-grade lymphoma.
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Affiliation(s)
- U Jankowska
- Białobrzeska Veterinary Surgery in Warsaw, Warsaw, Poland
| | - D Jagielski
- Białobrzeska Veterinary Surgery in Warsaw, Warsaw, Poland
| | - M Czopowicz
- Laboratory of Veterinary Epidemiology and Economics, Faculty of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
| | - R Sapierzyński
- Division of Animal Pathomorphology, Department of Pathology and Veterinary Diagnostics, Warsaw University of Life Sciences (SGGW), Warsaw, Poland
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Tubek S, Niewinski P, Jagielski D, Skiba J, Gemel M, Jazwiec P, Jankowska EA, Banasiak W, Ponikowski P. Late Cardiac Tamponade as a Result of Parietal Pericardium Erosion. Ann Thorac Surg 2015; 100:715-7. [PMID: 26234848 DOI: 10.1016/j.athoracsur.2014.09.085] [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] [Received: 04/19/2014] [Revised: 09/06/2014] [Accepted: 09/19/2014] [Indexed: 11/17/2022]
Abstract
Late onset cardiac tamponade is a rare and particularly challenging (both from diagnostic and management perspectives) complication of intracardiac lead implantation. We present a case of a late tamponade leading to cardiogenic shock, which occurred 1,164 days after implantable cardioverter-defibrillator (ICD) implantation. Open repair revealed unusual and, to our knowledge, not yet reported mechanism of the disease. A pressure sore caused by an ICD lead was found in the parietal layer of pericardium with no visible damage to the visceral layer. Conservative management in the described clinical scenario could be fatal, thus awareness of this pathomechanism of tamponade is critical.
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Affiliation(s)
- Stanislaw Tubek
- Department of Cardiology, 4(th) Military Hospital, Wroclaw, Poland; Department of Heart Disease, Faculty of Health Sciences, Medical University in Wroclaw, Wroclaw, Poland.
| | - Piotr Niewinski
- Department of Cardiology, 4(th) Military Hospital, Wroclaw, Poland; Department of Heart Disease, Faculty of Health Sciences, Medical University in Wroclaw, Wroclaw, Poland
| | | | - Jacek Skiba
- Department of Cardiac Surgery, 4(th) Military Hospital, Wroclaw, Poland
| | - Marek Gemel
- Department of Cardiac Surgery, 4(th) Military Hospital, Wroclaw, Poland
| | - Przemyslaw Jazwiec
- Department of Clinical Radiology and Imaging Diagnostics, 4(th) Military Hospital, Wroclaw, Poland
| | - Ewa Anita Jankowska
- Department of Cardiology, 4(th) Military Hospital, Wroclaw, Poland; Department of Heart Disease, Faculty of Health Sciences, Medical University in Wroclaw, Wroclaw, Poland
| | | | - Piotr Ponikowski
- Department of Cardiology, 4(th) Military Hospital, Wroclaw, Poland; Department of Heart Disease, Faculty of Health Sciences, Medical University in Wroclaw, Wroclaw, Poland
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Kliczkowska K, Jankowska U, Jagielski D, Czopowicz M, Sapierzyński R. Epidemiological and morphological analysis of feline injection site sarcomas. Pol J Vet Sci 2015; 18:313-22. [DOI: 10.1515/pjvs-2015-0041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Feline injection site sarcomas (FISS) are malignant neoplasms of mesenchymal origin which arise in sites of injections in cats. The prevalence is estimated between 1 in 1000 and 1 in 10 000 vaccinations in the United Kingdom. The aim of this study was to estimate the incidence of FISS in Poland and to analyse clinical aspects and histological and cytological features of injection site sarcomas. In our study the prevalence of FISS was 0.16% (16 FISS on 10.000 of cats) in feline patients in one of a veterinary surgery which conducts the general practice and 85 on 10.000 cats in a practice focused on veterinary oncology. The most typical microscopic features of FISS found in the present analysis were: the presence of perilesional scarring and inflammation, aggregates of lymphocytes at the tumour periphery, moderate but usually marked cellular pleomorphism and intralesional necrosis. The most typical cytologic features of FISS found in present study were: the presence of neutrophils, marked cellular pleomorphism, the presence of lymphocytes and macrophages, the presence of extremely large nuclei in the neoplastic cells, and high sample cellularity.
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Abstract
Large granular lymphomas (LGLs) comprise a specific group of lymphomas regardless of classifi- cation scheme. An LGL consists of cells that show less or more mature morphology, but typically neoplastic cells possess cytoplasmic azurophilic granules clearly visible during cytological examin- ation. The aim of the present study was to present clinical and cytological data on large granular lymphomas in cats and to analyses the therapeutic responses in treated cases. During the period from 2012 to 2014 six cats were as having large granular lymphoma. In one cat a nasal form of LGL was recognized, a systemic form was recognized in another cat, and in four cases an alimentary form was recognized. Cellular samples for cytopathology were collected from the cat with nasal cavity mass, from the enlarged mandibular lymph node and thoracic cavity from second cat, and in four cats from the abdominal mass during ultrasound-assisted fine-needle biopsy. Therapy was introduced in 5 of the 6 cats. In two cases palliative therapy with glucocorticoids was conducted, in two cases chemotherapy with COP protocol, and therapy with masitinib in one case. The median of survival time for cats treated with anticancer therapy was 9 months, the median of survival time for cats treated with glucocorticoids was 1.5 months. In conclusion, large granular lymphomas, especially the alimentary form, are a relatively common type of lymphoma in cats. Simple diagnostic methods such as clinical examination, imaging techniques and routine cytology are sufficient in majority of cases. Despite aggressive behavior and poor general prognosis, conventional chemotherapy lead to a good response in some treated cats regardless of anatomic form and histologic grade of malignancy.
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Josiak K, Nowak K, Fuglewicz A, Jagielski D, Banasiak W, Ponikowski P. Does right ventricular pacing increase the risk of ventricular arrhythmias in patients with an implantable cardioverter-defibrillator? Kardiol Pol 2014; 72:381-4. [DOI: 10.5603/kp.2014.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 05/08/2013] [Indexed: 11/25/2022]
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Abraham WT, Jagielski D, Oldenburg O, Augostini R, Krueger S, Kolodziej A, Gutleben KJ, Khayat R, Merliss A, Javaheri S, Ponikowski P. The effects of chronic implanted transvenous phrenic nerve stimulation in central sleep apnea: The remede(R) System pilot study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ponikowski P, Ponikowski P, Jagielski D, Oldenburg O, Augostini R, Krueger S, Kolodziej A, Gutleben KJ, Khayat R, Merliss A, Javaheri S, Abraham W. TCT-134 Transvenous Phrenic Nerve Stimulation in the Treatment of Central Sleep Apnea in Patients with Reduced Ejection Fraction: A Report from the remede(r) System Pilot Study. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ponikowski P, Javaheri S, Michalkiewicz D, Bart BA, Czarnecka D, Jastrzebski M, Kusiak A, Augostini R, Jagielski D, Witkowski T, Khayat RN, Oldenburg O, Gutleben KJ, Bitter T, Karim R, Iber C, Hasan A, Hibler K, Germany R, Abraham WT. Transvenous phrenic nerve stimulation for the treatment of central sleep apnoea in heart failure. Eur Heart J 2011; 33:889-94. [PMID: 21856678 DOI: 10.1093/eurheartj/ehr298] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [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: 12/30/2022] Open
Abstract
AIMS Periodic breathing with central sleep apnoea (CSA) is common in heart failure patients and is associated with poor quality of life and increased risk of morbidity and mortality. We conducted a prospective, non-randomized, acute study to determine the feasibility of using unilateral transvenous phrenic nerve stimulation for the treatment of CSA in heart failure patients. METHODS AND RESULTS Thirty-one patients from six centres underwent attempted transvenous lead placement. Of these, 16 qualified to undergo two successive nights of polysomnography-one night with and one night without phrenic nerve stimulation. Comparisons were made between the two nights using the following indices: apnoea-hypopnoea index (AHI), central apnoea index (CAI), obstructive apnoea index (OAI), hypopnoea index, arousal index, and 4% oxygen desaturation index (ODI4%). Patients underwent phrenic nerve stimulation from either the right brachiocephalic vein (n = 8) or the left brachiocephalic or pericardiophrenic vein (n = 8). Therapy period was (mean ± SD) 251 ± 71 min. Stimulation resulted in significant improvement in the AHI [median (inter-quartile range); 45 (39-59) vs. 23 (12-27) events/h, P = 0.002], CAI [27 (11-38) vs. 1 (0-5) events/h, P≤ 0.001], arousal index [32 (20-42) vs. 12 (9-27) events/h, P = 0.001], and ODI4% [31 (22-36) vs. 14 (7-20) events/h, P = 0.002]. No significant changes occurred in the OAI or hypopnoea index. Two adverse events occurred (lead thrombus and episode of ventricular tachycardia), though neither was directly related to phrenic nerve stimulation therapy. CONCLUSION Unilateral transvenous phrenic nerve stimulation significantly reduces episodes of CSA and restores a more natural breathing pattern in patients with heart failure. This approach may represent a novel therapy for CSA and warrants further study.
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Ponikowski P, Zhang SJ, Witkowski T, Hasan A, Khayat R, Bart B, Jagielski D, Zhang X. CENTRAL SLEEP APNEA EVENTS ARE TERMINATED BY PHRENIC NERVE STIMULATION. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)60290-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Biełous-Wilk A, Poreba M, Staniszewska-Marszałek E, Poreba R, Podgórski M, Kałka D, Jagielski D, Rusiecki L, Pilecki W, Baran E, Andrzejak R, Sobieszczańska M. Electrocardiographic evaluation in patients with systemic scleroderma and without clinically evident heart disease. Ann Noninvasive Electrocardiol 2009; 14:251-7. [PMID: 19614636 DOI: 10.1111/j.1542-474x.2009.00306.x] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In patients with systemic scleroderma (SSc), clinically evident cardiac involvement is recognized to be a poor prognostic factor. The aim of the study was to evaluate electrocardiographic changes, parameters of heart rate variability (HRV), and heart rate turbulence (HRT) in patients with SSc without evident symptoms of heart disease. METHODS A group of 27 patients with SSc were subjected to standard electrocardiography (ECG) examination and 24-hour Holter monitoring. Analysis of HRV in time and frequency domains, HRT, and echocardiography were also performed. RESULTS Holter monitoring revealed a larger number of premature supraventricular contractions (PSVCs), as well as premature ventricular contractions (PVCs) in the patients with systemic scleroderma, as compared with the control group. Moreover, the SSc patients showed decreased parameters of time and frequency domains, as referred to the controls, especially during night hours. In four patients, abnormal HRT values were present. On echocardiography, only slight changes were found, however in five patients left ventricle diastolic dysfunction was diagnosed. CONCLUSIONS The noninvasive electrocardiographic methods seems to be useful for detecting early heart involvement in course of SSc and could be recommended for routine used in clinical practice. Significance of HRT analysis in patients with SSc needs further elucidation.
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Affiliation(s)
- Anna Biełous-Wilk
- Department of Pathophysiology, Wroclaw Medical University, Wroclaw, Poland
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Hoffmann-Jagielska M, Winnicka A, Jagielski D, Micuń J, Zmudzka M, Lechowski R. Influence of naturally acquired feline leukemia virus (FeLV) infection on the phagocytic and respiratory burst activity of neutrophils and monocytes of peripheral blood. Pol J Vet Sci 2005; 8:93-7. [PMID: 15989127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The purpose of this study was cytometric evaluation of phagocytic and oxidative burst activity of neutrophils and monocytes in cats naturally infected with FeLV. To conduct the study, the peripheral blood was obtained from 33 cats naturally infected with FeLV. The control group consisted of 30 FeLV-, FIV-, clinically healthy cats. The percentage of phagocytizing neutrophils of peripheral blood was lower in FeLV+ than in FeLV- cats. The percentage of neutrophils and monocytes in which an oxidative burst occurred was lower in FeLV+ than in FeLV-animals. Also an oxidative product formation in neutrophils after E. coli and PMA stimulation was lower in FeLV+ than in FeLV-animals. Obtained results allow to conclude that diminished phagocytic and oxidative burst activity of peripheral blood leukocytes may cause impairment of innate immunity in cats infected with FeLV.
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Affiliation(s)
- M Hoffmann-Jagielska
- Department of Clinical Science, Faculty of Veterinary Medicine, Agricultural University of Warsaw, Nowoursynowska 159C, 02-786 Warsaw, Poland.
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