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Fusco F, Scognamiglio G, Roma AS, Abbate M, Papaccioli G, Merola A, Palma M, Borrelli N, Barracano R, Correra A, Grimaldi N, Ciriello GD, D'Abbraccio M, Scavone C, Capuano A, Sarubbi B. Mid-term follow-up after COVID-19 vaccination in adults with CHD: a prospective study. Cardiol Young 2023; 33:2574-2580. [PMID: 37038838 DOI: 10.1017/s1047951123000689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND Long-term data on COVID-19 vaccine safety, immunogenicity, and acceptance in adults with CHD are lacking. METHODS This is a prospective study including adults with CHD patients undergoing COVID-19 vaccination from January 2021 to June 2022. Data on adverse events, antispike IgG titre, previous or subsequent COVID-19 infection, booster doses, and patients' attitude towards vaccination were collected. RESULTS Four hundred and ninety CHD patients (36 ± 13 years, 53% male, 94% with moderate/complex defects) were prospectively included: 433 (88%) received a Pfizer-BioNTech mRNA vaccine, 31 (6%) Moderna mRNA vaccine, 23 (5%) AstraZeneca-Oxford ChAdOx1 nCov-19 vaccine, and 3 (0.6%) Janssen Vaccine; 310 (63%) received a booster dose. Median follow-up after vaccination was 1.53 [1.41-1.58] years. No major adverse event was reported. Eighty-two fully vaccinated patients contracted COVID-19 during follow-up after a median of 5.4 [4.3-6.5] months from the last dose. One patient with Ebstein's disease died from severe COVID-19. Symptoms' duration in patients who tested positive after vaccination was significantly shorter than in the group tested positive before vaccination (5.5 [3-8] versus 9 [2.2-15] days, p = 0.04). Median antispike IgG titre measured in 280 individuals (57%) at a median of 1.4 [0.7-3.3] months from the last dose was 2381 [901-8307] BAU/ml. Sixty patients (12%) also showed positive antinucleocapsid antibodies, demonstrating previous SARS-COV2 exposure. Twenty-nine percent appeared to have concerns regarding vaccine safety and 42% reported fearing potential effects of the vaccine on their cardiac disease before discussing with their CHD cardiologist. CONCLUSION COVID-19 vaccines appear safe in the mid-term follow-up in adults with CHD with satisfactory immunogenicity and reduction of symptoms' duration in case of infection.
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Affiliation(s)
- Flavia Fusco
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Anna Selvaggia Roma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Massimiliana Abbate
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Giovanni Papaccioli
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Assunta Merola
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Michela Palma
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Nunzia Borrelli
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Rosaria Barracano
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Anna Correra
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | - Nicola Grimaldi
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
| | | | - Maurizio D'Abbraccio
- Vaccination Unit for Vulnerable Patients, AO dei Colli - Cotugno Hospital, Naples, Italy
| | - Cristina Scavone
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Annalisa Capuano
- Section of Pharmacology "L. Donatelli", Department of Experimental Medicine, University of Campania "LuigiVanvitelli", Naples, Italy
| | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, AO dei Colli - Monaldi Hospital, Naples, Italy
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Sarubbi B, Ciriello GD, Papaccioli G, Correra A, Romeo E, Grimaldi N, Colonna D, Palma M. Combined subcutaneous implantable cardioverter defibrillator and pacemaker devices in complex congenital heart disease: a single-center experienced based study. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01670-1. [PMID: 37878161 DOI: 10.1007/s10840-023-01670-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Subcutaneous implantable cardioverter defibrillators (S-ICD) are widely accepted therapy in congenital heart disease (CHD) patients at risk of life-threatening ventricular arrhythmias or sudden cardiac death (SCD) when pacing is not required. Occasionally, pacemaker (PM)-dependent CHD patients will subsequently develop an indication for a cardioverter defibrillator. The use of S-ICD in complex CHD patients who have had already PM devices implanted implies some specific considerations, as the safety for these patients in unknown and recommendations among physicians may vary widely. METHODS We review the data and studied the indications for S-ICD in complex CHD with previous PM and discuss its usefulness in clinical practice. RESULTS From a large cohort of 345 patients enrolled in the S-ICD Monaldi care registry, which encompass all the patients implanted in the Monaldi Hospital of Naples, we considered 11 consecutive complex CHD patients (10M/1F aged 40.4 ±18.4 years) who underwent S-ICD implant after a previous PM implant, from February 2015 to October 2022. Mean follow-up was 25.5 ± 22 months. All the patients showed a good compliance to the device system with no complications (infections or skin erosions). CONCLUSIONS In complex CHD with already implanted PM devices, S-ICD implant appears to be a safe alternative to PM upgrading to transvenous ICD system, avoiding abandoned leads or life-threatening lead extraction. However, there are important issues with regard to testing and programming that need to be addressed at the time of implantation.
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Affiliation(s)
- Berardo Sarubbi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
| | | | | | - Anna Correra
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Emanuele Romeo
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Nicola Grimaldi
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Diego Colonna
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Michela Palma
- Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
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Borrelli N, Grimaldi N, Papaccioli G, Fusco F, Palma M, Sarubbi B. Telemedicine in Adult Congenital Heart Disease: Usefulness of Digital Health Technology in the Assistance of Critical Patients. Int J Environ Res Public Health 2023; 20:5775. [PMID: 37239504 PMCID: PMC10218523 DOI: 10.3390/ijerph20105775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/26/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023]
Abstract
The number of adults with congenital heart disease (ACHD) has progressively increased in recent years to surpass that of children. This population growth has produced a new demand for health care. Moreover, the 2019 coronavirus pandemic has caused significant changes and has underlined the need for an overhaul of healthcare delivery. As a result, telemedicine has emerged as a new strategy to support a patient-based model of specialist care. In this review, we would like to highlight the background knowledge and offer an integrated care strategy for the longitudinal assistance of ACHD patients. In particular, the emphasis is on recognizing these patients as a special population with special requirements in order to deliver effective digital healthcare.
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Affiliation(s)
| | | | | | | | | | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, AO Dei Colli-Monaldi Hospital, 80131 Naples, Italy
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Ciriello GD, Colonna D, Papaccioli G, Correra A, Romeo E, Palladino MT, Cioppa ND, Russo MG, Sarubbi B. Triple Antiarrhythmic Therapy in Newborns with Refractory Atrioventricular Reentrant Tachycardia. Pediatr Cardiol 2023; 44:1040-1049. [PMID: 37093256 DOI: 10.1007/s00246-023-03162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023]
Abstract
Atrioventricular reentrant tachycardia (AVRT) is the most common form of supraventricular tachycardia in newborns. AVRT is sometimes refractory to conventional antiarrhythmic therapy. We describe our experience about the use of the triple combination of flecainide + propranolol + amiodarone as third-line regimen for refractory and recurrent AVRT in newborns. We considered a series of 14 patients who had failed both first-line and second-line therapy and were treated using the combination of flecainide + propranolol + amiodarone. Transoesophageal electrophysiologic study (TES) was performed to test the effectiveness of medical therapy during hospitalization and to try to reduce the amount of therapy, after amiodarone wash-out, before 1 year of age. TES was repeated at 1 year of age to test the spontaneous resolution of the arrhythmia after treatment discontinuation. Rhythm control was achieved in all 14 patients. At a mean age of 9.3 ± 2 months, AVRT was not inducible by TES in 11/12 amiodarone-free patients. At a mean age of 14.1 ± 3 months, AVRT was still inducible in 7/12 patients after interrupting the entire antiarrhythmic therapy (58.3%). Triple combination was effective as third-line option to suppress AVRT refractory to single and double antiarrhythmic therapy, with no significant adverse events. Our experience suggests that triple therapy could be maintained for a short-term treatment, discontinuing amiodarone before 1 year of age to avoid long-term side effects. Newborns who needed triple therapy appear to have a lower chance of accessory pathway disappearance at 1 year of age. TES could be useful for risk stratification of recurrences at the time of drug discontinuation in infants considered to be at higher risk of recurrent AVRT.
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Affiliation(s)
- Giovanni Domenico Ciriello
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy.
- Pediatric Cardiology Unit, Monaldi Hospital, "L.Vanvitelli" University, Naples, Italy.
| | - Diego Colonna
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
- Pediatric Cardiology Unit, Monaldi Hospital, "L.Vanvitelli" University, Naples, Italy
| | - Giovanni Papaccioli
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Anna Correra
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | - Emanuele Romeo
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
| | | | - Nadia Della Cioppa
- Pediatric Cardiology Unit, Monaldi Hospital, "L.Vanvitelli" University, Naples, Italy
| | - Maria Giovanna Russo
- Pediatric Cardiology Unit, Monaldi Hospital, "L.Vanvitelli" University, Naples, Italy
| | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, Monaldi Hospital, Via Leonardo Bianchi, 80131, Naples, Italy
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Russo V, Papaccioli G, Maddaloni V, Caputo A, Pepe N, Rago A, Maiorino M, Golino P, Nigro G. Case report: Lamin A/C gene mutation in patient with drug-induced type 1 Brugada syndrome at high arrhythmic risk. Front Cardiovasc Med 2023; 9:1099508. [PMID: 36704457 PMCID: PMC9871475 DOI: 10.3389/fcvm.2022.1099508] [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: 11/15/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
We report the case of drug-induced type 1 Brugada syndrome at high arrhythmic risk associated with Lamin A/C gene mutation.
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Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy,*Correspondence: Vincenzo Russo ✉
| | - Giovanni Papaccioli
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Valeria Maddaloni
- Clinical Biochemistry Unit, Genetic Section, Monaldi Hospital, Naples, Italy
| | - Adriano Caputo
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nicola Pepe
- Clinical Biochemistry Unit, Genetic Section, Monaldi Hospital, Naples, Italy
| | - Anna Rago
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Paolo Golino
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gerardo Nigro
- Cardiology Unit, Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
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Roma AS, Fusco F, Papaccioli G, Abbate M, Scognamiglio G, Merola A, Palma M, Correra A, Borrelli N, Barracano R, Grimaldi N, Colonna D, Romeo E, Sarubbi B. COVID-19 vaccination in adults with congenital heart disease: results of 1-year prospective study. Eur Heart J 2022. [PMCID: PMC9619553 DOI: 10.1093/eurheartj/ehac544.1857] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Adults with congenital heart disease (ACHD) are a vulnerable population. Routine vaccination is the only strategy to prevent a life-threatening infection. However, concerns on the cardiac safety and efficacy of COVID-19 vaccines have been raised. Aim To assess safety and efficacy of available COVID-19 vaccines in ACHD patients. Methods Data on COVID-19 infection and vaccines including booster doses and any suspected or confirmed adverse events were prospectively collected for all ACHD patients attending our tertiary centre from the beginning of the vaccination campaign (March 2021). A group of 75 healthy volunteers, matched per age and sex, was included for comparison. Antispike IgG titre was routinely obtained at the ACHD clinic. Patients' attitude towards COVID-19 was explored with a questionnaire. Results As of February 2022, 498 ACHD patients (36.7±16 years, 54% male,69% with moderate-complex defects, 48% with advanced physiological stage) were enrolled. Four hundred and sixty-one (92%) were fully vaccinated: the type of vaccine was Pfizer-BioNTech for 399 (86%) patients, Moderna for 20 (4%) and AstraZeneca for 26 (6%), 9 received a mixed vaccine regimen (2%). Forty-two (9%) had a history of previous COVID-19 infection and therefore received only one dose. Two-hundred and sixty-nine (58%) patients received a booster dose. Adverse events were mainly mild and transient. One patient complaining of chest pain following administration of mRNA-based vaccination was diagnosed with acute pericarditis, which made full remission after appropriate therapy. Two patients reported a non-specific increment of inflammatory markers. No other severe adverse events were reported. Thirty-seven (7%) refused COVID-19 vaccination being scared of potential cardiac/extra-cardiac adverse events. Among those not-vaccinated, 9 (24%) had a history of previous mild COVID-19 infection. IgG titre was measured in 243 patients at 1915 [835–5934] BAU/ml, which was significantly higher compared to controls (1196 [827–2048] BAU/ml, p=0.002). Three ACHD patients contracted COVID-19 infection after the first dose, while 65 (14%) fully vaccinated patients tested positive for COVID-19, all with mild to moderate symptoms. COVID-19 symptoms duration was significantly longer in case of infection before vaccination (10 [2.7–15] vs 3 [1.2–7], p=0.03). One Fontan patient was tested positive for COVID-19 twice, before and after COVID-19 vaccination, requiring hospitalization in both cases. Four hundred and seven patients completed the questionnaire: 128 (31%) declared to be scared of potential cardiac effects of the vaccine and that the discussion with the ACHD cardiologist was crucial to decide to undergo COVID-19 vaccination. Conclusions Our data provide real-world evidence on COVID-19 vaccines safety and efficacy in ACHD patients. Patients' education from the ACHD team may play a key role in vaccine acceptance in this vulnerable population. Funding Acknowledgement Type of funding sources: None.
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Affiliation(s)
- A S Roma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - F Fusco
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G Papaccioli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - M Abbate
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - G Scognamiglio
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Merola
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - M Palma
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - A Correra
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Borrelli
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - R Barracano
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - N Grimaldi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - D Colonna
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - E Romeo
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
| | - B Sarubbi
- AO dei Colli-Monaldi Hospital, Adult Congenital Heart Disease Unit , Naples , Italy
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7
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Ducceschi V, Divitiis M, Bianchi V, Calvanese R, Covino G, Rapacciuolo A, Russo V, Canciello M, Volpicelli M, Ammirati G, Sangiuolo R, Papaccioli G, Ciardiello C, Innocenti S, D'Onofrio A. Effects of COVID‐19 lockdown on arrhythmias in patients with implantable cardioverter‐defibrillators in southern Italy. J Arrhythm 2022; 38:439-445. [PMID: 35785398 PMCID: PMC9237340 DOI: 10.1002/joa3.12713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background The effects of lockdown on non‐COVID patients are varied and unexpected. The aim is to evaluate the burden of cardiac arrhythmias during a lockdown period because of COVID‐19 pandemics in a population implanted with cardiac defibrillators and followed by remote monitoring. Methods In this retrospective, multicentre cohort study, we included 574 remotely monitored implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy‐defibrillator (CRT‐D) recipients implanted before January 1, 2019, at seven hospitals in the Campania region, comparing the burden of arrhythmias occurred during the lockdown period because of COVID‐19 epidemics (from March 9 to May 1, 2020) with the arrhythmias burden of the corresponding period in 2019 (reference period). Data collection was performed through remote monitoring. Results During the lockdown period, we observed ventricular tachyarrhythmias (ventricular tachycardia or fibrillation) in 25 (4.8%) patients while in seasonal reference period we documented ventricular tachyarrhythmias in 12 (2.3%) patients; the comparison between the periods is statistically significant (P < .04). Atrial arrhythmias were detected in 38 (8.2%) subjects during the lockdown period and in 24 (5.2%) during the reference period (P < .004). Conclusion In seven hospitals in the Campania region, during the pandemic lockdown period, we observed a higher burden of arrhythmic events in ICD/CRT‐D patients through device remote monitoring.
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Affiliation(s)
| | | | - Valter Bianchi
- Electrophysiology and Cardiac Pacing Unit Monaldi Hospital Naples Italy
| | | | | | - Antonio Rapacciuolo
- Department of Advanced Biomedical Sciences Federico II University of Naples Naples Italy
| | - Vincenzo Russo
- Deparatment of Cardiology University of Campania "Luigi Vanvitelli," Monaldi Hospital Naples Italy
| | | | | | - Giuseppe Ammirati
- Department of Advanced Biomedical Sciences Federico II University of Naples Naples Italy
| | | | - Giovanni Papaccioli
- Deparatment of Cardiology University of Campania "Luigi Vanvitelli," Monaldi Hospital Naples Italy
| | | | | | - Antonio D'Onofrio
- Electrophysiology and Cardiac Pacing Unit Monaldi Hospital Naples Italy
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8
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Papaccioli G, Bassi G, Lugi C, Parente E, D'Andrea A, Proietti R, Imbalzano E, Alturki A, Russo V. Smartphone and new tools for Atrial Fibrillation diagnosis: evidence for clinical applicability. Minerva Cardiol Angiol 2022; 70:616-627. [PMID: 35212504 DOI: 10.23736/s2724-5683.22.05841-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia in adults. AF increases the risk of heart failure, cardiac ischemic disease, dementia and Alzheimer's disease. Either clinical and subclinical AF increase the risk of stroke and worsen the patients' clinical outcome. The early diagnosis of AF episodes, even if asymptomatic or clinically silent, is of pivotal importance to ensure prompt and adequate thromboembolic risk prevention therapies. The development of technology is allowing new systematic mass screening possibilities, especially in patients with higher stroke risk. The mobile health devices available for AF detection are: smartphones, wristworn, earlobe sensors and handheld ECG. These devices showed a high accuracy in AF detection especially when a combined approach with single-Lead ECG and photoplethysmography algorithms is used. The use of wearable devices for AF screening is a feasible method but more head-to-head comparisons between mHealth and medical devices are needed to establish their comparative effectiveness across different study populations.
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Affiliation(s)
- Giovanni Papaccioli
- Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Bassi
- Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Cecilia Lugi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Erika Parente
- Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Riccardo Proietti
- Liverpool center for cardiovascular science, University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK
| | - Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University Hospital of Messina G. Martino, University of Messina, Messina, Italy
| | - Ahmed Alturki
- Division of Cardiology, McGill University Health Center, Montreal, Canada
| | - Vincenzo Russo
- Department of Medical Translational Sciences, Monaldi Hospital, University of Campania Luigi Vanvitelli, Naples, Italy -
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9
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Santomauro M, Fazio S, Ferraro S, Maddalena G, Papaccioli G, Pappone C, Saccà L, Chiariello M. Follow-Up of a Respiratory Rate Modulated Pacemaker. Pacing Clin Electro 1992; 15:17-21. [PMID: 1370995 DOI: 10.1111/j.1540-8159.1992.tb02896.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The efficacy of 27 respiration sensitive rate modulated pacemakers (Biorate RDP-3 Biotec) implanted in the left pectoral area was evaluated every 3 months during a mean follow-up period of 29 months (range 10-50 months). Rate modulation function was unchanged other than for three patients in whom the auxiliary leads became displaced. Two implants lost ventricular sensing in this nonprogrammable model. In all but the three patients, Holter monitoring demonstrated pacing rate variation corresponding to daily activity. Stress test duration increased from 8.2 +/- 1.5 minutes (in fixed rate VVI rate) to 12.83 +/- 2.0 minutes (in the VVIR mode) (P less than 0.05). Right arm movement increased the pacing rate by 5 +/- 3 beats/min (NS), while the left arm movement increase was 30 +/- 5 beats/min (P less than 0.05). Mental, arithmetic, and nifedipine tests did not change the rate modulated pacing rate. The system responded to a change in respiratory rate by an increase in stimulation rate. A satisfactory response in sensitivity and velocity was present only with medium-high workloads. Interference with rate modulation occurred with movement of the arm ipsilateral to the implanted pulse generator.
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Affiliation(s)
- M Santomauro
- Department of Internal Medicine, Second Medical School, Federico II University of Naples, Italy
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Abstract
The purpose of this study was to evaluate the usefulness of phase analysis in detecting the altered activation sequence induced by different pacing modes. Radionuclide ventriculography and planar gated blood pool scintigraphy were performed at rest in 56 patients with different pacemakers. This method permitted us to localize the pacemaker impulse site in the right ventricle and its diffusion in the heart. In patients with VVI pacemaker, this technique showed an evident asynchronism of contraction and relaxation of each ventricle and the standard deviation of phase angle (sigma), calculated by computer, is greater during pacing than sinus rhythm for left (LV) and right (RV) ventricles (LV sigma: 17 degrees +/- 4 vs 11 degrees +/- 3, less than 0.001; RV sigma: 31 degrees +/- 7 vs 14 degrees +/- 4, P less than 0.001). In the patients with VVI rate responsive pacemakers, the LV sigma changed from 18.5 +/- 3 under pacing to 11 degrees +/- 3 in sinus rhythm, P less than 0.001, while the RV sigma changed from 30 degrees +/- 8 to 14 degrees +/- 4, P less than 0.001. Instead in the patients with DDD pacemakers, the LV sigma changed from 15.5 degrees +/- 2 under pacing to 11 degrees +/- 3 in sinus rhythm, P less than 0.05, while the RV sigma changed from 29.1 degrees +/- 6 to 14 degrees +/- 4, P less than 0.001.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Santomauro
- Department of Internal Medicine, 2nd Medical School, Federico II University, Naples, Italy
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