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Delinière A, Haddad C, Herrera-Siklody C, Hermida A, Pruvot E, Bressieux-Degueldre S, Millat G, Janin A, Hermida JS, Asatryan B, Chevalier P. Phenotypic Characterization of Timothy Syndrome Caused by the CACNA1C p.Gly402Ser Variant. Circ Genom Precis Med 2023:e004010. [PMID: 37009738 DOI: 10.1161/circgen.122.004010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Antoine Delinière
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
- University of Lyon, Claude Bernard Lyon 1 University, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, Lyon, France (A.D., P.C.)
| | - Christelle Haddad
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
| | - Claudia Herrera-Siklody
- Arrhythmia Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (C.H.-S., P.C.)
| | - Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France (A.H., J.-S.H.)
| | | | - Sabrina Bressieux-Degueldre
- Pediatric Cardiology Unit, Woman-Mother-Child Department, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (S.B.-D.)
| | - Gilles Millat
- Cardiogenetic laboratory, Centre de biologie et pathologie Est, Hospices Civils de Lyon (HCL), Lyon, France (G.M., A.J.)
| | - Alexandre Janin
- Cardiogenetic laboratory, Centre de biologie et pathologie Est, Hospices Civils de Lyon (HCL), Lyon, France (G.M., A.J.)
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France (A.H., J.-S.H.)
| | - Babken Asatryan
- Department of Cardiology, Inselspital, Bern University Hospital, Switzerland (B.A.)
| | - Philippe Chevalier
- National Reference Center for Inherited Arrhythmias of Lyon, Department of Cardiac Electrophysiology, Hôpital Cardiologique Louis Pradel, Hospices Civils de Lyon (HCL), Bron (A.D., C.H., P.C.)
- University of Lyon, Claude Bernard Lyon 1 University, MeLiS, CNRS UMR 5284, INSERM U1314, Institut NeuroMyoGène, Lyon, France (A.D., P.C.)
- Arrhythmia Unit, Department of Cardiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (C.H.-S., P.C.)
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Laredo M, Tovia-Brodie O, Milman A, Michowitz Y, Roudijk RW, Peretto G, Badenco N, Te Riele ASJM, Sala S, Duthoit G, Arbelo E, Ninni S, Gasperetti A, van Tintelen JP, Paglino G, Waintraub X, Andorin A, Peichl P, Bosman LP, Calo L, Giustetto C, Radinovic A, Jorda P, Casado-Arroyo R, Zorio E, Bermúdez-Jiménez FJ, Behr ER, Havranek S, Tfelt-Hansen J, Sacher F, Hermida JS, Nof E, Casella M, Kautzner J, Lacroix D, Brugada J, Duru F, Bella PD, Gandjbakhch E, Hauer R, Belhassen B. Electrocardiographic findings in patients with arrhythmogenic cardiomyopathy and right bundle branch block ventricular tachycardia. Europace 2023; 25:1025-1034. [PMID: 36635857 PMCID: PMC10062349 DOI: 10.1093/europace/euac267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/02/2022] [Indexed: 01/14/2023] Open
Abstract
AIMS Little is known about patients with right bundle branch block (RBBB)-ventricular tachycardia (VT) and arrhythmogenic cardiomyopathy (ACM). Our aims were: (i) to describe electrocardiogram (ECG) characteristics of sinus rhythm (SR) and VT; (ii) to correlate SR with RBBB-VT ECGs; and (iii) to compare VT ECGs with electro-anatomic mapping (EAM) data. METHODS AND RESULTS From the European Survey on ACM, 70 patients with spontaneous RBBB-VT were included. Putative left ventricular (LV) sites of origin (SOOs) were estimated with a VT-axis-derived methodology and confirmed by EAM data when available. Overall, 49 (70%) patients met definite Task Force Criteria. Low QRS voltage predominated in lateral leads (n = 37, 55%), but QRS fragmentation was more frequent in inferior leads (n = 15, 23%). T-wave inversion (TWI) was equally frequent in inferior (n = 28, 42%) and lateral (n = 27, 40%) leads. TWI in inferior leads was associated with reduced LV ejection fraction (LVEF; 46 ± 10 vs. 53 ± 8, P = 0.02). Regarding SOOs, the inferior wall harboured 31 (46%) SOOs, followed by the lateral wall (n = 17, 25%), the anterior wall (n = 15, 22%), and the septum (n = 4, 6%). EAM data were available for 16 patients and showed good concordance with the putative SOOs. In all patients with superior-axis RBBB-VT who underwent endo-epicardial VT activation mapping, VT originated from the LV. CONCLUSIONS In patients with ACM and RBBB-VT, RBBB-VTs originated mainly from the inferior and lateral LV walls. SR depolarization and repolarization abnormalities were frequent and associated with underlying variants.
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Affiliation(s)
- Mikael Laredo
- Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, and Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Oholi Tovia-Brodie
- Department of Cardiology, Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Anat Milman
- Leviev Heart Institute, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Michowitz
- Department of Cardiology, Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Rob W Roudijk
- Netherlands Heart Institute, Utrecht, The Netherlands
| | | | - Nicolas Badenco
- Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, and Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Anneline S J M Te Riele
- Netherlands Heart Institute, Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, Utrecht, The Netherlands
| | - Simone Sala
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Guillaume Duthoit
- Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, and Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Elena Arbelo
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, and IDIBAPS, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Sandro Ninni
- Université de Lille et Institut Cœur-Poumon, CHRU Lille, Lille, France
| | - Alessio Gasperetti
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | - J Peter van Tintelen
- Netherlands Heart Institute, Utrecht, The Netherlands.,Department of Genetics, University Medical Center, Utrecht, The Netherlands
| | | | - Xavier Waintraub
- Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, and Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | | | - Petr Peichl
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Laurens P Bosman
- Netherlands Heart Institute, Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, Utrecht, The Netherlands
| | - Leonardo Calo
- Division of Cardiology, Policlinico Casilino, Roma, Italy
| | - Carla Giustetto
- Division of Cardiology, University of Torino, Department of Medical Sciences, Città della Salute e della Scienza Hospital, Torino, Italy
| | | | - Paloma Jorda
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, and IDIBAPS, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ruben Casado-Arroyo
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Esther Zorio
- Cardiology Department at Hospital Universitario y Politecnico La Fe and Research Group on Inherited Heart Diseases, Sudden Death and Mechanisms of Disease (CaFaMuSMe) from the Instituto de Investigación Sanitaria (IIS) La Fe, Valencia, Spain.,Center for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Madrid, Spain
| | | | - Elijah R Behr
- Cardiovascular Sciences and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, London, UK
| | - Stepan Havranek
- Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, and Section of genetics, Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frederic Sacher
- Hôpital Cardiologique du Haut-Lévêque & Université Bordeaux, LIRYC Institute, Bordeaux, France
| | | | - Eyal Nof
- Leviev Heart Institute, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Dominique Lacroix
- Université de Lille et Institut Cœur-Poumon, CHRU Lille, Lille, France
| | - Josep Brugada
- Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, and IDIBAPS, Institut d'Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, Zurich, Switzerland
| | | | - Estelle Gandjbakhch
- Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, and Sorbonne Université, 47-83 boulevard de l'Hôpital, 75013, Paris, France
| | - Richard Hauer
- Netherlands Heart Institute, Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, Utrecht, The Netherlands
| | - Bernard Belhassen
- Heart Institute, Hadassah University Hospital, Jerusalem and Sackler School of Medicine, Tel-Aviv University, Kyriat Hadassah, PO Box 12000, 91120, Jerusalem, Israel
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Hermida A, Burtin J, Kubala M, Fay F, Lallemand PM, Buiciuc O, Lieu A, Zaitouni M, Beyls C, Hermida JS. Sex Differences in the Outcomes of Cryoablation for Atrial Fibrillation. Front Cardiovasc Med 2022; 9:893553. [PMID: 35665259 PMCID: PMC9157614 DOI: 10.3389/fcvm.2022.893553] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background The literature data on the outcomes of radiofrequency catheter ablation for atrial fibrillation (AF) in women are contradictory. Aim To determine and compare the outcomes and complications of cryoballoon pulmonary vein isolation (cryo-PVI) in men vs. women, and to identify predictors of atrial tachyarrhythmia (ATa) recurrence. Methods We included all consecutive patients having undergone cryo-PVI for the treatment of symptomatic AF in our center since 2012. Peri-operative complications were documented. All patients were prospectively monitored for the recurrence of ATa, and predictors were assessed. Results A total of 733 patients were included (550 men (75%) and 183 (25%) women). Paroxysmal AF was recorded in 112 (61%) female patients and 252 male patients (46%; p < 0.001). Female patients were older (p < 0.001) and had a greater symptom burden (p = 0.04). Female patients were more likely to experience complications (p = 0.02). After cryo-PVI for paroxysmal AF, 66% of the female patients and 79% of the male patients were free of ATa at 24 months (p = 0.001). Female sex was the only independent predictive factor for ATa recurrence (hazard ratio [95% confidence interval] = 1.87 [1.28; 2.73]; p = 0.001). After cryo-PVI for non-paroxysmal AF, 37% of the male patients and 39% of the female patients were free of ATa at 36 months (p = 0.73). Female patients were less likely than male patients to undergo repeat ablation after an index cryo-PVI for non-paroxysmal AF (p = 0.019). Conclusion A single cryo-PVI procedure for paroxysmal AF was significantly less successful in female patients than in male patients. Overall, the complication rate was higher in women than in men.
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Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Jacqueline Burtin
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Floriane Fay
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | | | - Otilia Buiciuc
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Audrey Lieu
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Mustafa Zaitouni
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Christophe Beyls
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
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Hermida A, Jedraszak G, Kubala M, Bourgain M, Bodeau S, Hermida JS. Use of ranolazine as rescue therapy in a patient with Timothy syndrome type 2. Rev Esp Cardiol (Engl Ed) 2022; 75:447-448. [PMID: 34844894 DOI: 10.1016/j.rec.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/25/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France; EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France.
| | - Guillaume Jedraszak
- EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France; Molecular Genetics Laboratory, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| | - Marion Bourgain
- Pediatric Cardiology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Sandra Bodeau
- Laboratory of Pharmacology and Toxicology, Amiens-Picardie University Hospital, Amiens, France
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
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5
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Hermida A, Jedraszak G, Kubala M, Bourgain M, Bodeau S, Hermida JS. Uso de ranolazina en paciente con síndrome de Timothy tipo 2. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hermida A, Hermida JS. Should cryoballoon ablation of paroxysmal atrial fibrillation be proposed as a first-line treatment? J Interv Card Electrophysiol 2022; 65:267-270. [PMID: 35119585 DOI: 10.1007/s10840-022-01140-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/27/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Alexis Hermida
- Service de Cardiologie, Rythmologie Et Stimulation Cardiaque CHU Amiens-Picardie, 1, rond-point du Professeur Christian Cabrol, 80054, Amiens Cedex, France.
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7
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Belhassen B, Laredo M, Roudijk RW, Peretto G, Zahavi G, Sen-Chowdhry S, Badenco N, Te Riele ASJM, Sala S, Duthoit G, van Tintelen JP, Paglino G, Sellal JM, Gasperetti A, Arbelo E, Andorin A, Ninni S, Rollin A, Peichl P, Waintraub X, Bosman LP, Pierre B, Nof E, Miles C, Tfelt-Hansen J, Protonotarios A, Giustetto C, Sacher F, Hermida JS, Havranek S, Calo L, Casado-Arroyo R, Conte G, Letsas KP, Zorio E, Bermúdez-Jiménez FJ, Behr ER, Beinart R, Fauchier L, Kautzner J, Maury P, Lacroix D, Probst V, Brugada J, Duru F, Chillou CD, Bella PD, Gandjbakhch E, Hauer R, Milman A. The prevalence of left and right bundle branch block morphology ventricular tachycardia amongst patients with arrhythmogenic cardiomyopathy and sustained ventricular tachycardia: insights from the European Survey on Arrhythmogenic Cardiomyopathy. Europace 2021; 24:285-295. [PMID: 34491328 DOI: 10.1093/europace/euab190] [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: 02/17/2021] [Accepted: 07/06/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS In arrhythmogenic cardiomyopathy (ACM), sustained ventricular tachycardia (VT) typically displays a left bundle branch block (LBBB) morphology while a right bundle branch block (RBBB) morphology is rare. The present study assesses the VT morphology in ACM patients with sustained VT and their clinical and genetic characteristics. METHODS AND RESULTS Twenty-six centres from 11 European countries provided information on 954 ACM patients who had ≥1 episode of sustained VT spontaneously documented during patients' clinical course. Arrhythmogenic cardiomyopathy was defined according to the 2010 Task Force Criteria, and VT morphology according to the QRS pattern in V1. Overall, 882 (92.5%) patients displayed LBBB-VT alone and 72 (7.5%) RBBB-VT [alone in 42 (4.4%) or in combination with LBBB-VT in 30 (3.1%)]. Male sex prevalence was 79.3%, 88.1%, and 56.7% in the LBBB-VT, RBBB-VT, and LBBB + RBBB-VT groups, respectively (P = 0.007). First RBBB-VT occurred 5 years after the first LBBB-VT (46.5 ± 14.4 vs 41.1 ± 15.8 years, P = 0.011). An implanted cardioverter-defibrillator was more frequently implanted in the RBBB-VT (92.9%) and the LBBB + RBBB-VT groups (90%) than in the LBBB-VT group (68.1%) (P < 0.001). Mutations in PKP2 predominated in the LBBB-VT (65.2%) and the LBBB + RBBB-VT (41.7%) groups while DSP mutations predominated in the RBBB-VT group (45.5%). By multivariable analysis, female sex was associated with LBBB + RBBB-VT (P = 0.011) while DSP mutations were associated with RBBB-VT (P < 0.001). After a median follow-up of 103 (51-185) months, death occurred in 106 (11.1%) patients with no intergroup difference (P = 0.176). CONCLUSION RBBB-VT accounts for a significant proportion of sustained VTs in ACM. Sex and type of pathogenic mutations were associated with VT type, female sex with LBBB + RBBB-VT, and DSP mutation with RBBB-VT.
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Affiliation(s)
- Bernard Belhassen
- Heart Institute, Hadassah University Hospital, Kalman Ya'Akov Man Street, 9112001, Jerusalem, Israel.,Sackler School of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel
| | - Mikael Laredo
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Rob W Roudijk
- Netherlands Heart Institute, Moreelsepark 1 3511 EP Utrecht, The Netherlands
| | - Giovanni Peretto
- IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Guy Zahavi
- Sackler School of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.,Department of Anesthesiology, Sheba Medical Center, Tel Hashomer, 5265601, Israel
| | - Srijita Sen-Chowdhry
- Institute of Cardiovascular Science University College London, 62 Huntley St, London WC1E 6DD, UK
| | - Nicolas Badenco
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Anneline S J M Te Riele
- Netherlands Heart Institute, Moreelsepark 1 3511 EP Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, 62 Huntley St, London WC1E 6DD, The Netherlands
| | - Simone Sala
- IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Guillaume Duthoit
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - J Peter van Tintelen
- Netherlands Heart Institute, Moreelsepark 1 3511 EP Utrecht, The Netherlands.,Department of Genetics, University Medical Center, Moreelsepark 1 3511 EP Utrecht, The Netherlands
| | - Gabriele Paglino
- IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Jean-Marc Sellal
- Département de Cardiologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre lès-Nancy, Rue du Morvan, 54500 France
| | - Alessio Gasperetti
- Department of Cardiology, University Heart Center Zurich, Hottingerstrasse 14 CH-8032 Zürich, Switzerland
| | - Elena Arbelo
- Cardiovascular Institute, Hospital Clinic and IDIBAPS, Calle Villarroel, 170 08036 Barcelona, Catalonia, Spain
| | - Antoine Andorin
- Service de Cardiologie, CHU de Nantes, Bd Jacques Monod - 44800 Saint-Herblain, Nantes, France
| | - Sandro Ninni
- Université de Lille et Institut Cœur-Poumon, CHRU, Boulevard du Professeur Jules Leclercq, 59000 Lille, France
| | - Anne Rollin
- Cardiology, University Hospital Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400 Toulouse, France
| | - Petr Peichl
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21 Praha 4, Prague, Czech Republic
| | - Xavier Waintraub
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Laurens P Bosman
- Netherlands Heart Institute, Moreelsepark 1 3511 EP Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, 62 Huntley St, London WC1E 6DD, The Netherlands
| | - Bertrand Pierre
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, 2 Boulevard Tonnellé, 37000 Tours, France
| | - Eyal Nof
- Sackler School of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.,Leviev Heart Institute, Sheba Medical Center, 5265601 Tel Hashomer, Israel
| | - Chris Miles
- Cardiovascular Sciences and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, Cranmer Terrace London SW17 0RE, UK
| | - Jacob Tfelt-Hansen
- The Department of Cardiology, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen 2100, Denmark.,Department of Forensic Medicine, Faculty of Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Alexandros Protonotarios
- Nikos Protonotarios Medical Centre, Περιφερειακός, 843 00, Naxos, Greece.,UCL Institute of Cardiovascular Science, 62 Huntley St, London WC1E 6DD, UK
| | - Carla Giustetto
- Division of Cardiology, Department of Medical Sciences, University of Torino, Città della Salute e della Scienza Hospital, Corso Bramante, 88, 10126 Torino TO, Italy
| | - Frederic Sacher
- Hôpital Cardiologique du Haut-Lévêque & Université Bordeaux, LIRYC Institute, Avenue du Haut Lévêque, 33600 Pessac, Bordeaux, France
| | - Jean-Sylvain Hermida
- Centre Hospitalier Universitaire d'Amiens-Picardie, 2 Place Victor Pauchet, 80080 Amiens, France
| | - Stepan Havranek
- Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Kateřinská 1660/32, 121 08 Nové Město, Prague, Czech Republic
| | - Leonardo Calo
- Division of Cardiology, Policlinico Casilino, Via Casilina, 1049, 00169 Roma RM, Italy
| | - Ruben Casado-Arroyo
- Department of Cardiology, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, 1070 Bruxelles, Belgium
| | - Giulio Conte
- Electrophysiology Unit, Department of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland
| | - Konstantinos P Letsas
- Arrhythmia Unit, Second Department of Cardiology, "Evangelismos" General Hospital of Athens, Ipsilantou 45-47, Athina 106 76, Athens, Greece
| | - Esther Zorio
- Cardiology Department at Hospital Universitario y Politecnico La Fe and Research Group on Inherited Heart Diseases, Sudden Death and Mechanisms of Disease (CaFaMuSMe) from the Instituto de Investigación Sanitaria (IIS) La Fe, Avenida Fernando Abril Martorell, Torre 106 A 7planta, Valencia, Spain.,Center for Biomedical Network Research on Cardiovascular Diseases (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029, Madrid, Spain
| | - Francisco J Bermúdez-Jiménez
- Cardiology Department, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas, 2, 18014 Granada, Spain
| | - Elijah R Behr
- Cardiovascular Sciences and Cardiology Clinical Academic Group St. George's University Hospitals NHS Foundation Trust, Cranmer Terrace London SW17 0RE, UK
| | - Roy Beinart
- Sackler School of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.,Leviev Heart Institute, Sheba Medical Center, 5265601 Tel Hashomer, Israel
| | - Laurent Fauchier
- Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, 2 Boulevard Tonnellé, 37000 Tours, France.,Université François Rabelais, 60 rue du Plat D'Etain 37020 Tours cedex 1, France
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Vídeňská 1958, 140 21 Praha 4, Prague, Czech Republic
| | - Philippe Maury
- Cardiology, University Hospital Rangueil, 1 Avenue du Professeur Jean Poulhès, 31400 Toulouse, France
| | - Dominique Lacroix
- Université de Lille et Institut Cœur-Poumon, CHRU, Boulevard du Professeur Jules Leclercq, 59000 Lille, France
| | - Vincent Probst
- Service de Cardiologie, CHU de Nantes, Bd Jacques Monod - 44800 Saint-Herblain, Nantes, France
| | - Josep Brugada
- Cardiovascular Institute, Hospital Clínic Pediatric Arrhythmia Unit, Hospital Sant Joan de Déu University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Firat Duru
- Department of Cardiology, University Heart Center Zurich, Hottingerstrasse 14 CH-8032 Zürich, Switzerland
| | - Christian de Chillou
- Département de Cardiologie, Centre Hospitalier Universitaire de Nancy, Vandœuvre lès-Nancy, Rue du Morvan, 54500 France
| | - Paolo Della Bella
- IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132 Milano, Italy
| | - Estelle Gandjbakhch
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Institut de Cardiologie, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Richard Hauer
- Netherlands Heart Institute, Moreelsepark 1 3511 EP Utrecht, The Netherlands.,Department of Cardiology, University Medical Center, 62 Huntley St, London WC1E 6DD, The Netherlands
| | - Anat Milman
- Sackler School of Medicine, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel.,Leviev Heart Institute, Sheba Medical Center, 5265601 Tel Hashomer, Israel
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8
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Laredo M, Belhassen B, Peretto G, Roudijk R, Zahavi G, Sen-Chowdhry S, Badenco N, Riele AT, Sala S, Duthoit G, van Tintelen P, Paglino G, Sellal JM, Gasperetti A, Arbelo E, Andorin A, Ninni S, Rollin A, Peichl P, Waintraub X, Bosman LP, Pierre B, Nof E, Miles C, Tfelt J, Protonarios A, Giustetto C, Sacher F, Hermida JS, Havranek S, Calo L, Casado R, Conte G, Letsas K, Zorio E, Jimenez F, Behr E, Beinart R, Fauchier L, Kautzner J, Maury P, Lacroix D, Probst V, Brugada J, Duru F, de Chillou C, Della Bella P, Gandjbakhch E, Hauer RN, Milman A. B-PO01-063 LATER ONSET OF FIRST SUSTAINED RBBB-VT AS COMPARED TO FIRST LBBB-VT IN PATIENTS WITH ARRHYTHMOGENIC CARDIOMYOPATHY. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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9
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Laredo M, Belhassen B, Roudijk R, Peretto G, Zahavi G, Sen-Chowdhry S, Badenco N, te Riele AS, Sala S, Duthoit G, van Tintelen JP, Sellal JM, Gasperetti A, Arbelo E, Andorin A, Ninni S, Rollin A, Peichl P, Waintraub X, Bosman LP, Eyal Nof, Miles C, Tflet-Hansen J, Protonarios A, Giustetto C, Sacher F, Hermida JS, Leonardo Calo SH, Casado R, Conte G, Letsas K, Zorio E, Bermúdez Jiménez FJ, Behr E, Beinart R, Fauchier L, Kautzner J, Maury P, Lacroix D, Probst V, Brugada J, Duru F, Chillou CD, Della Bella P, Gandjbakhch E, Hauer RN, Milman A. B-PO04-170 SEX DIFFERENCES IN PATIENTS WITH ARRHYTHMOGENIC CARDIOMYOPATHY WITH RESPECT TO VENTRICULAR TACHYCARDIA MORPHOLOGY. Heart Rhythm 2021. [DOI: 10.1016/j.hrthm.2021.06.862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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10
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Garcia R, Combes N, Defaye P, Narayanan K, Guedon-Moreau L, Boveda S, Blangy H, Bouet J, Briand F, Chevalier P, Cottin Y, Da Costa A, Degand B, Deharo JC, Eschalier R, Extramiana F, Goralski M, Guy-Moyat B, Guyomar Y, Hermida JS, Jourda F, Lellouche N, Mahfoud M, Manenti V, Mansourati J, Martin A, Pasquié JL, Ritter P, Rollin A, Tibi T, Yalioua A, Gras D, Sadoul N, Piot O, Leclercq C, Marijon E. Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study. Europace 2021; 23:73-81. [PMID: 33257972 PMCID: PMC7842091 DOI: 10.1093/europace/euaa268] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
Aims We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability. Methods and results Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services. Overall, 1157 patients were included (mean age 60 ± 12 years, 16% women; 46% prospectively): 82.1% with ischaemic cardiomyopathy, 10.3% after implantable cardioverter-defibrillator explant, and 7.6% before heart transplantation. Median WCD usage period was 62 (37–97) days. Median daily wear time of WCD was 23.4 (22.2–23.8) h. In multivariate analysis, younger age was associated with lower compliance [adjusted odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95–0.99, P < 0.01]. A total of 18 participants (1.6%) received at least one appropriate shock, giving an incidence of appropriate therapy of 7.2 per 100 patient-years. Patient-response button allowed the shock to be aborted in 35.7% of well-tolerated sustained ventricular arrhythmias and in 95.4% of inappropriate ventricular arrhythmia detection, finally resulting in an inappropriate therapy in eight patients (0.7%). Conclusion Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients. Moreover, they emphasize the fact that when prescribed appropriately, in concert with adequate patient education and dedicated follow-up using specific remote monitoring system, compliance with WCD is high and the device well-tolerated by the patient.
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Affiliation(s)
- Rodrigue Garcia
- Department of Cardiology, Poitiers University Hospital, 86021 Poitiers, France.,Univ Poitiers, 86000 Poitiers, France
| | - Nicolas Combes
- Department of Cardiology, Pasteur Clinic, 33000 Toulouse, France
| | - Pascal Defaye
- Department of Cardiology, Grenoble University Hospital, 38043 Grenoble, France
| | - Kumar Narayanan
- Department of Cardiology, European Georges Pompidou Hospital, 75015 Paris, France.,University of Paris, PARCC, INSERM, F-75015 Paris, France.,Cardiology Department, Medicover Hospitals, Hyderabad, India
| | | | - Serge Boveda
- Department of Cardiology, Pasteur Clinic, 33000 Toulouse, France
| | - Hugues Blangy
- Department of Cardiology, Nancy University Hospital, 54500 Vandoeuvre-Lès-Nancy, France
| | - Jérôme Bouet
- Department of Cardiology, Hospital Center of Aix, 13080 Aix En Provence, France
| | - Florent Briand
- Department of Cardiology, Besançon University Hospital, 25000 Besançon, France
| | | | - Yves Cottin
- Department of Cardiology, Dijon University Hospital, 28000 Dijon, France
| | - Antoine Da Costa
- Department of Cardiology, Saint-Etienne University Hospital, 42000 Saint-Étienne, France
| | - Bruno Degand
- Department of Cardiology, Poitiers University Hospital, 86021 Poitiers, France
| | - Jean-Claude Deharo
- Department of Cardiology, University Hospital La Timone, 13000 Marseille, France
| | - Romain Eschalier
- Department of Cardiology Clermont-Ferrand University Hospital, 63000 Clermont Ferrand, France
| | - Fabrice Extramiana
- Department of Cardiology, Bichat Hospital - Claude Bernard, 75877 Paris, France
| | - Marc Goralski
- Department of Cardiology, General Hospital of Oréans, 45000 Orléans, France
| | - Benoit Guy-Moyat
- Department of Cardiology, Limoges University Hospital, 87000 Limoges, France
| | - Yves Guyomar
- Department of Cardiology, Hospital Center Saint Philibert, 59160 Lomme, France
| | | | - François Jourda
- Department of Cardiology, General Hospital of Auxerre, 89000 Auxerre, France
| | - Nicolas Lellouche
- Department of Cardiology, University Hospital Henri Mondor, 94000 Creteil, France
| | - Mohanad Mahfoud
- Department of Cardiology, Hospital Center Sud Francilien, 91100 Corbeil Essonnes, France
| | - Vladimir Manenti
- Department of Cardiology, Jacques Cartier Institute, 91300 Massy, France
| | - Jacques Mansourati
- Department of Cardiology, Brest University Hospital, 29200 Brest, France
| | - Angéline Martin
- Department of Cardiology, Fontaine Clinic, 21121 Fontaine-Lès-Dijon, France
| | - Jean-Luc Pasquié
- Department of Cardiology, Montpellier University Hospital, 34000 Montpellier, France
| | - Philippe Ritter
- Department of Cardiology, Bordeaux University Hospital, 33600 Pessac, France
| | - Anne Rollin
- Department of Cardiology, Toulouse University Hospital, 31000 Toulouse, France
| | - Thierry Tibi
- Department of Cardiology, General Hospital of Cannes, 06150 Cannes, France
| | - Arab Yalioua
- Department of Cardiology, General Hospital of Angoulême, 16000 Angoulême, France
| | - Daniel Gras
- Department of Cardiology, Hopital privé du Confluent, 44000 Nantes, France
| | - Nicolas Sadoul
- Department of Cardiology, Nancy University Hospital, 54500 Vandoeuvre-Lès-Nancy, France
| | - Olivier Piot
- Department of Cardiology, Cardiology Center of Nord, 93200 Saint Denis, France
| | | | - Eloi Marijon
- Department of Cardiology, European Georges Pompidou Hospital, 75015 Paris, France.,University of Paris, PARCC, INSERM, F-75015 Paris, France
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11
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Spaulding C, Armero S, Champagnac D, Bhugaloo H, Ternacle J, Lellouche N, Audureau E, Le Corvoisier P. Left atrial appendage closure for stroke prevention in atrial fibrillation: Final report from the French left atrial appendage closure registry. Catheter Cardiovasc Interv 2021; 98:788-799. [PMID: 34051135 DOI: 10.1002/ccd.29795] [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: 01/19/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The French left atrial appendage (LAA) closure registry (FLAAC) aimed to assess the safety and efficacy of LAA closure in daily practice. BACKGROUND LAA closure has emerged as an alternative for preventing thromboembolic events (TE) in patients with non-valvular atrial fibrillation (NVAF). Clinical data in this field remains limited and few investigator-initiated, real-world registries have been reported. METHODS This nationwide, prospective study was performed in 36 French centers. The primary endpoint was the TE rate after successful LAA closure. RESULTS The FLAAC registry included 816 patients with a mean age of 75.5 ± 0.3 years, mean follow-up of 16.0 ± 0.3 months, high TE (CHA2 DS2 -VASc score: 4.6 ± 0.1) and bleeding risks (HAS-BLED score: 3.2 ± 0.05) and common contraindications to long-term anticoagulation (95.7%). Procedure or device-related serious adverse events occurred in 49 (6.0%) patients. The annual rate of ischemic stroke/systemic embolism was 3.3% (2.4-4.6). This suggests a relative 57% reduction compared to the risk of stroke in historical NVAF populations without antithrombotic therapy. By multivariate analysis, history of TE was the only factor associated with stroke/systemic embolism during follow-up (HR, 3.3 [1.58-6.89], p = 0.001). The annual mortality rate was 10.2% (8.4-12.3). Most of the deaths were due to comorbidities or underlying cardiovascular diseases and unrelated to the device or to TE. CONCLUSIONS Our study suggests that LAA closure can be an option in patients with NVAF. Long-term follow-up mortality was high, mostly due to comorbidities and underlying cardiovascular diseases, highlighting the importance of multidisciplinary management after LAA closure. REGISTRATION NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Jean-Benoit Thambo
- Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France
| | - Pascal Defaye
- Department of Rhythmology, University Hospital of Grenoble-Alpes, Grenoble, France
| | | | - Sélim Abbey
- Interventional Cardiology Unit, Hôpital Prive du Confluent, Nantes, France
| | - Didier Klug
- Department of Electrophysiology, Lille University Hospital, Lille, France
| | - Jean-Michel Juliard
- Département de Cardiologie, Hôpital Bichat, Université Paris-Diderot, Inserm U-1148, AP-HP, Paris, France
| | - Christian Spaulding
- Department of Cardiology, European Hospital Georges Pompidou, AP-HP, Paris Descartes University, INSERM U 970, Sudden Cardiac Death Expert Center, Paris, France
| | | | | | - Hamza Bhugaloo
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France
| | - Julien Ternacle
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Nicolas Lellouche
- Department of Cardiology, Henri Mondor University Hospital, AP-HP, Creteil, France
| | - Etienne Audureau
- Public Health Department, Hôpital Henri Mondor, Créteil, France.,U955-IMRB, Equipe CEpiA, Inserm, UPEC, Créteil, France
| | - Philippe Le Corvoisier
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France.,U955-IMRB, Equipe 03, Inserm, UPEC, Ecole Nationale Vétérinaire d'Alfort, Créteil, France
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12
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Hermida A, Kubala M, Hermida JS. Air Bubble Trapped in the Left Atrial Appendage After Occluder Delivery. CJC Open 2021; 3:693-694. [PMID: 34027376 PMCID: PMC8134932 DOI: 10.1016/j.cjco.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
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13
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Pavlovic N, Kuniss M, Velagic V, Hermida JS, Healey S, Arena G, Badenco N, Meyer C, Chen J, Iacopino S, Anselme F, Kaplon RE, Chierchia GB. Impact of initial rhythm control with cryoballoon ablation versus drug therapy on atrial fibrillation recurrence and quality of life: results from the Cryo-FIRST study. Europace 2021. [DOI: 10.1093/europace/euab116.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Medtronic
OnBehalf
The Cryo-FIRST Investigators
Background
Cryoballoon ablation (CBA) as a first-line rhythm control strategy is superior to antiarrhythmic drugs (AADs) for preventing atrial arrhythmia recurrence; however, the impact of first-line CBA specifically on atrial fibrillation (AF) recurrence and quality of life (QoL) has not been well characterized.
Purpose
To compare AF recurrence and QoL following first-line CBA vs. AAD therapy in patients with paroxysmal AF within the CryoFIRST trial (NCT01803438).
Methods
Patients with recurrent symptomatic paroxysmal AF who had not been administered class I or III AAD therapy for >48 hours were enrolled at 18 sites in 9 countries. Patients were randomized (1:1) to CBA or AAD treatment (Class I or III). Subjects were followed by 7-day Holter at 1, 3, 6, 9, and 12 months. Time-to-first AF recurrence outside of a 90-day blanking period was estimated by Kaplan-Meier analysis. QoL was evaluated using the Atrial Fibrillation Effect on Quality of Life (AFEQT) and 36-Item Short Form Health Survey (SF-36) v2 questionnaires.
Results
Of the 218 randomized subjects, 187 (86%) completed the 12-month follow-up. By intention-to-treat (ITT) analysis, freedom from AF after blanking was achieved in 86.6% in the CBA and 74.5% in the AAD group (p = 0.023). There was no difference in the time-to-first serious adverse event between groups. In total, 84.3% of patients in the CBA vs. 75.0% of patients in the AAD arm had a clinically important improvement (≥5 points) in the AFEQT summary score. The adjusted mean difference in the AFEQT summary score at 12 months was 9.9 points higher in the CBA group (95% CI: 5.5-14.2; P < 0.001). All AFEQT subscale scores were more favorable in the CBA vs. AAD group at 12 months. There were no significant group differences in any of the SF-36 health domain scores at 12 months in the ITT analysis. In the per-protocol analysis, clinically important and significant group differences in favor of CBA were observed at 12 months for 3 of 8 SF-36 health domain scores (physical functioning, general health and social functioning).
Conclusion
CBA is superior to AAD for preventing AF recurrence and improving AF-specific QoL in patients with paroxysmal AF. AFEQT Scores at Baseline and 12 MonthsAFEQT Score, Mean ± Standard DeviationCBAAADAdjusted Mean Difference at 12 Months (CBA vs. AAD)p-valueBaseline12 MonthsBaseline12 MonthsDaily Activities65.3 ± 25.887.8 ± 17.161.0 ± 27.976.6 ± 25.48.9 (3.2-14.6)0.002Symptoms59.9 ± 24.888.8 ± 15.658.4 ± 25.280.9 ± 22.27.1 (1.5-12.7)0.014Treatment Concern59.9 ± 23.189.8 ± 14.060.4 ± 24.577.7 ± 22.212.7 (7.9-17.5)<0.001AFEQT, Atrial Fibrillation Effect on Quality of Life questionnaire. CBA, cryoballoon ablation. AAD antiarrhythmic drug.Abstract Figure. Freedom From Atrial Fibrillation
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Affiliation(s)
- N Pavlovic
- University Hospital Sestre Milosrdnice, Zagreb, Croatia
| | - M Kuniss
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - V Velagic
- University Hospital Centre Zagreb, Zagreb, Croatia
| | - JS Hermida
- University Hospital of Amiens, Amiens, France
| | - S Healey
- Monash Health, Clayton, Australia
| | - G Arena
- Ospedale Apuane, Massa Carrara, Italy
| | | | - C Meyer
- University Heart Centre Hamburg, Hamburg, Germany
| | - J Chen
- Haukeland University Hospital, Bergen, Norway
| | - S Iacopino
- Maria Cecilia Hospital, Cotignola, Italy
| | | | - RE Kaplon
- Medtronic, Mounds View, United States of America
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14
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Lellouche N, Arrouasse R, Ternacle J, Gallet R, Hermida JS, Hamon D, Juliard JM, Pasquie JL, Dhanjal T, Teiger E, Le Corvoisier P. Atrial fibrillation evolution and rhythm control strategy following left appendage closure: new insights from the prospective FLAAC registry. BMC Cardiovasc Disord 2021; 21:227. [PMID: 33941095 PMCID: PMC8091509 DOI: 10.1186/s12872-021-01994-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 04/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Percutaneous left atrial appendage (LAA) closure is an alternative to oral anticoagulation (OAC) for atrial fibrillation (AF) patients with high thromboembolism risk, particularly with contraindications to OAC. The LAA itself could possess proarrhythmogenic properties. As patients undergoing LAA closure could be candidates for cardioversion or ablation, we aimed to evaluate AF disease progression following LAA closure and the outcome of patients undergoing a rhythm control strategy after the procedure. METHODS The prospective multicenter French Nationwide Observational LAA Closure Registry (FLAAC) comprises 33 French interventional cardiology departments. Patients were included if they fulfilled the following criteria: history of non-valvular AF, successful LAA closure and long-term ECG follow-up. RESULTS A total of 331 patients with successful LAA closure were enrolled in the study. Patients mean age was 75.4 ± 0.5 years. The study population was characterized by a high thromboembolic risk (CHA2DS2-VASc score: 4.5 ± 0.1) and frequent comorbidities. The median follow-up was 11.9 months. One hundred and nineteen (36.0%) patients were in sinus rhythm (SR) at baseline. Among SR patients, documented AF was observed in 16 (13.4%) patients whereas 15 (7.1%) patients in AF at baseline restored SR, at the end of follow up. Finally, only 13 patients (4%) underwent procedures to restore SR without complications during the follow-up. CONCLUSIONS The vast majority of patients undergoing LAA closure have the same AF status at baseline and one year after the index procedure. During the follow-up, a very small proportion (4%) of our population underwent procedures to restore SR without complications whatever the post-procedural antithrombotic strategy was.
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Affiliation(s)
- Nicolas Lellouche
- Cardiology Unit Henri Mondor University Hospital Paris XII, Creteil, France. .,AP-HP, University Hospital Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France.
| | | | - Julien Ternacle
- Cardiology Unit Henri Mondor University Hospital Paris XII, Creteil, France
| | - Romain Gallet
- Cardiology Unit Henri Mondor University Hospital Paris XII, Creteil, France
| | | | - David Hamon
- Cardiology Unit Henri Mondor University Hospital Paris XII, Creteil, France
| | - Jean-Michel Juliard
- Department of Cardiology, Bichat Hospital, APHP, University Paris VII, DHU FIRE, Sorbonne Paris-Cité, INSERM U-1148, Paris, France
| | - Jean-Luc Pasquie
- Montpellier University Hospital, CNRS UMR9214-Inserm U1046-PHYMEDEXP, Montpellier, France
| | - Tarvinder Dhanjal
- Department of Electrophysiology, University Hospital Coventry & Warwickshire, Coventry, UK
| | - Emmanuel Teiger
- Cardiology Unit Henri Mondor University Hospital Paris XII, Creteil, France
| | - Philippe Le Corvoisier
- Inserm, CIC 1430, Henri Mondor University Hospital, Creteil, France.,Inserm, U955 team 3, Henri Mondor University Hospital, Creteil, France
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15
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Hermida A, Jedraszak G, Kubala M, Mathiron A, Berna P, Bennis Y, Hermida JS. Long-term follow-up of a patient with type 2 Timothy syndrome and the partial efficacy of mexiletine. Gene 2021; 777:145465. [PMID: 33524520 DOI: 10.1016/j.gene.2021.145465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/23/2020] [Accepted: 01/22/2021] [Indexed: 11/15/2022]
Abstract
We report a detailed case of type 2 TS due to a p.(Gly402Ser) mutation in exon 8 of the CACNA1C gene. The patient shows a marked prolongation of repolarization with a mean QTc of 540 ms. He shows no structural heart disease, syndactyly, or cranio-facial abnormalities. However, he shows developmental delays, without autism, and dental abnormalities. The cardiac phenotype is very severe, with a resuscitated cardiac arrest at 2.5 years of age, followed by 26 appropriate shocks during nine years of follow-up. Adding mexiletine to nadolol resulted in a reduction of the QTc and a slight decrease in the number of appropriate shocks.
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Affiliation(s)
- Alexis Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France.
| | - Guillaume Jedraszak
- Molecular Genetics Laboratory, Amiens-Picardie University Hospital, Amiens, France; EA4666 HEMATIM, University of Picardie-Jules Verne, Amiens, France
| | - Maciej Kubala
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
| | - Amel Mathiron
- Pediatric Cardiology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Pascal Berna
- Department of Thoracic Surgery Service, Amiens-Picardie University Hospital, Amiens, France
| | - Youssef Bennis
- Laboratory of Pharmacology and Toxicology, Amiens-Picardie University Hospital, Amiens, France
| | - Jean-Sylvain Hermida
- Cardiology, Arrhythmia, and Cardiac Stimulation Service, Amiens-Picardie University Hospital, Amiens, France
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16
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Haïssaguerre M, Hocini M, Cheniti G, Duchateau J, Sacher F, Puyo S, Cochet H, Takigawa M, Denis A, Martin R, Derval N, Bordachar P, Ritter P, Ploux S, Pambrun T, Klotz N, Massoullié G, Pillois X, Dallet C, Schott JJ, Scouarnec S, Ackerman MJ, Tester D, Piot O, Pasquié JL, Leclerc C, Hermida JS, Gandjbakhch E, Maury P, Labrousse L, Coronel R, Jais P, Benoist D, Vigmond E, Potse M, Walton R, Nademanee K, Bernus O, Dubois R. Localized Structural Alterations Underlying a Subset of Unexplained Sudden Cardiac Death. Circ Arrhythm Electrophysiol 2019; 11:e006120. [PMID: 30002064 PMCID: PMC7661047 DOI: 10.1161/circep.117.006120] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [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: 10/04/2017] [Accepted: 05/08/2018] [Indexed: 01/17/2023]
Abstract
Supplemental Digital Content is available in the text. Background: Sudden cardiac death because of ventricular fibrillation (VF) is commonly unexplained in younger victims. Detailed electrophysiological mapping in such patients has not been reported. Methods: We evaluated 24 patients (29±13 years) who survived idiopathic VF. First, we used multielectrode body surface recordings to identify the drivers maintaining VF. Then, we analyzed electrograms in the driver regions using endocardial and epicardial catheter mapping during sinus rhythm. Established electrogram criteria were used to identify the presence of structural alterations. Results: VF occurred spontaneously in 3 patients and was induced in 16, whereas VF was noninducible in 5. VF mapping demonstrated reentrant and focal activities (87% versus 13%, respectively) in all. The activities were dominant in one ventricle in 9 patients, whereas they had biventricular distribution in others. During sinus rhythm areas of abnormal electrograms were identified in 15/24 patients (62.5%) revealing localized structural alterations: in the right ventricle in 11, the left ventricle in 1, and both in 3. They covered a limited surface (13±6 cm2) representing 5±3% of the total surface and were recorded predominantly on the epicardium. Seventy-six percent of these areas were colocated with VF drivers (P<0.001). In the 9 patients without structural alteration, we observed a high incidence of Purkinje triggers (7/9 versus 4/15, P=0.033). Catheter ablation resulted in arrhythmia-free outcome in 15/18 patients at 17±11 months follow-up. Conclusions: This study shows that localized structural alterations underlie a significant subset of previously unexplained sudden cardiac death. In the other subset, Purkinje electrical pathology seems as a dominant mechanism.
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Affiliation(s)
- Michel Haïssaguerre
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.). .,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Mélèze Hocini
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ghassen Cheniti
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Josselin Duchateau
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Frédéric Sacher
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Stéphane Puyo
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Hubert Cochet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Masateru Takigawa
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Arnaud Denis
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ruairidh Martin
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Nicolas Derval
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Pierre Bordachar
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Philippe Ritter
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Sylvain Ploux
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Thomas Pambrun
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Nicolas Klotz
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Gregoire Massoullié
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Xavier Pillois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Corentin Dallet
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Jean-Jacques Schott
- Inserm UMR 915 l'institut du thorax IRT, Nantes Cedex, France (J.-J.S., S.L.S.)
| | | | - Michael J Ackerman
- Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN (M.J.A., D.T.)
| | - David Tester
- Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN (M.J.A., D.T.)
| | | | | | | | | | | | | | - Louis Labrousse
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - Ruben Coronel
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Pierre Jais
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,Bordeaux University Hospital (CHU), Cardiac Electrophysiology and Cardiac Stimulation Team, Pessac, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., L.L., P.J.)
| | - David Benoist
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Edward Vigmond
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux, IMB UMR 5251, CNRS (E.V.).,CNRS, IMB, UMR5251, Talence (E.V.)
| | - Mark Potse
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.)
| | - Richard Walton
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Koonlawee Nademanee
- Pacific Rim Electrophysiology Research Institute, White Memorial Medical Center, Los Angeles, CA (K.N.)
| | - Olivier Bernus
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
| | - Remi Dubois
- IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, France (M. Haïssaguerre, M. Hocini, G.C., J.D., F.S., S.P., H.C., M.T., A.D., R.M., N.D., P.B., P.R., S.P., T.P., N.K., G.M., X.P., C.D., L.L., R.C., P.J., D.B., E.V., M.P., R.W., O.B., R.D.).,Univ. Bordeaux (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.).,INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, France (M. Haïssaguerre, M. Hocini, J.D., F.S., S.P., H.C., A.D., N.D., P.B., P.R., S.P., P.J., D.B., R.W., O.B., R.D.)
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Maury P, Defaye P, Klug D, Alonso C, Anselme F, Fauchier L, Gandjbakhch E, Gras D, Hermida JS, Laurent G, Mansourati J, Marijon E, Sacher F, Taieb J, Boveda S, Piot O, Sadoul N. Reply to the letter about the position paper concerning the competence, performance and environment required in the practice of complex ablation procedures. Arch Cardiovasc Dis 2019; 112:290-291. [PMID: 30898475 DOI: 10.1016/j.acvd.2018.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Philippe Maury
- University hospital Rangueil, 31059 Toulouse, France; Unité Inserm U 1048, 31432 Toulouse, France.
| | - Pascal Defaye
- University hospital of Grenoble-Alpes, 38700 La Tronche, France
| | - Didier Klug
- University hospital of Lille, 59000 Lille, France
| | | | | | | | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, 44200 Nantes, France
| | | | | | | | - Eloi Marijon
- Georges Pompidou European hospital, 75015 Paris, France
| | | | - Jérôme Taieb
- Aix-en-Provence hospital, 13100 Aix-en-Provence, France
| | | | - Olivier Piot
- Centre cardiologique du Nord, 93200 St.-Denis, France
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Maury P, Defaye P, Klug D, Alonso C, Anselme F, Fauchier L, Gandjbakhch E, Gras D, Hermida JS, Laurent G, Mansourati J, Marijon E, Sacher F, Taieb J, Boveda S, Piot O, Sadoul N. Position paper concerning the competence, performance and environment required in the practice of complex ablation procedures. Arch Cardiovasc Dis 2019; 112:67-73. [DOI: 10.1016/j.acvd.2018.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/05/2018] [Accepted: 05/14/2018] [Indexed: 10/28/2022]
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Pasquie JL, Rioufol G, Lepillier A, Elbaz M, Horvilleur J, Brenot P, Pierre B, Le Corvoisier P, Amabile N, Andronache M, Anselme F, Armero S, Aubry P, Audureau E, Babuty D, Bakouboula B, Bars C, Baruteau AE, Bille J, Bonnet JL, Brigadeau F, Brochet E, Bun SS, Cailla G, Cesari O, Champagnac D, Chevalier P, Combes N, Comet B, Commeau P, Dearo JC, Dompnier A, Farah B, Garot P, Gras D, Giraudeau C, Granier M, Guerin P, Iriart X, Jalal Z, Jesel-Morel L, Jeu A, Kamtchueng P, Lellouche N, Meneveau N, Nighoghossian N, Otmani A, Pelliere R, Pillière R, Pons M, Popovic B, Pujadas P, Rossi R, Roux A, Saludas Y, Spaulding C, Statiev V, Ternacle J, Traulle S, Winum PF. Percutaneous Left Atrial Appendage Closure Is a Reasonable Option for Patients With Atrial Fibrillation at High Risk for Cerebrovascular Events. Circ Cardiovasc Interv 2018. [DOI: 10.1161/circinterventions.117.005841] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/20/2022]
Abstract
Background—
Percutaneous left atrial appendage (LAA) closure is an emerging option for patients with atrial fibrillation at high risk for cerebrovascular events. The multicenter FLAAC registry (French Nationwide Observational LAA Closure Registry) was established to assess LAA closure outcomes in everyday practice.
Methods and Results—
Four hundred thirty-six patients referred from April 2013 to September 2015 to 33 French interventional cardiology centers for percutaneous LAA closure were included prospectively in the FLAAC registry. Mean age was 75.4±0.4 years. The stroke risk was high (mean CHA
2
DS
2
–VASc score, 4.5±0.1) and most patients had experienced clinically significant bleeding (HAS-BLED score, 3.1±0.05). The device used was Amplatzer LAA occluder in 58% and the Watchman device in 42% of the patients. The procedural success rate was 98.4%. Median postprocedure follow-up was 12.0 (11.8–12.0) months and a single patient was lost to follow-up. During the periprocedural and subsequent follow-up period, procedure-related severe adverse events occurred in 21 (4.9%) and 10 (2.3%) patients, respectively. One-year cumulative incidences of ischemic stroke and cerebral hemorrhage were 2.9% (1.6–5.0) and 1.5% (0.7–3.2), respectively. Overall, 1-year mortality was 9.3% (6.9–12.5) with 7 of the 39 deaths related or possibly related to the device or procedure.
Conclusions—
This nationwide prospective registry shows that, in the French population, LAA closure is mainly used in patients with high comorbidity rates and a poor prognosis. LAA closure in such patients seems reasonable to decrease the stroke rate. The overall health status of these patients should be taken into account during the preprocedural evaluation process.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Benoit Thambo
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Pascal Defaye
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Sylvain Hermida
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Sélim Abbey
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Didier Klug
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Michel Juliard
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Luc Pasquie
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Gilles Rioufol
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Antoine Lepillier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Meyer Elbaz
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jerome Horvilleur
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Brenot
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Bertrand Pierre
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Le Corvoisier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
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Hermida A, Lallemand PM, Kubala M, Tournevache F, Buiciuc O, Quenum S, Hermida JS. P757Half of recurrences occurs after 1-year follow-up after cryoablation of persistent atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Hermida
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - P M Lallemand
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - M Kubala
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - F Tournevache
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - O Buiciuc
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - S Quenum
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
| | - J S Hermida
- University Hospital of Amiens, Cardiac Arrhythmia Department, Amiens, France
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Defaye P, Klug D, Anselme F, Gras D, Hermida JS, Piot O, Alonso C, Fauchier L, Gandjbakhch E, Marijon E, Maury P, Taieb J, Boveda S, Sadoul N. Recommendations for the implantation of leadless pacemakers from the French Working Group on Cardiac Pacing and Electrophysiology of the French Society of Cardiology. Arch Cardiovasc Dis 2018; 111:53-58. [DOI: 10.1016/j.acvd.2017.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/27/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
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Kubala M, Guédon-Moreau L, Anselme F, Klug D, Bertaina G, Traullé S, Buiciuc O, Savouré A, Diouf M, Hermida JS. Utility of Frailty Assessment for Elderly Patients Undergoing Cardiac Resynchronization Therapy. JACC Clin Electrophysiol 2017; 3:1523-1533. [DOI: 10.1016/j.jacep.2017.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/14/2017] [Accepted: 06/30/2017] [Indexed: 01/24/2023]
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Hermida A, Kubala M, Traullé S, Buiciuc O, Quenum S, Hermida JS. Prevalence and predictive factors of left atrial tachycardia occurring after second-generation cryoballoon ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2017; 29:46-54. [PMID: 29024212 DOI: 10.1111/jce.13364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Assess the prevalence and predictors of left atrial tachycardia (LAT) after cryoballoon ablation of pulmonary veins. METHODS AND RESULTS Patients who underwent catheter ablation of pulmonary veins with a second-generation cryoballoon for symptomatic paroxysmal (151 of 270, 56%) or persistent (119 of 270, 44%) atrial fibrillation were entered in a single-center prospective registry. Patients who experienced postcryoballoon LAT (pcryo-LAT) were selected on the basis of 12-lead ECG characteristics. Left atrial origin was confirmed during conventional EP study and electroanatomical activation mapping, and patients were treated by RF catheter ablation. Pcryo-LAT was observed in 15 (5.6%) of 270 patients and was attributed to a reentrant mechanism in 11 patients (73%). The other four cases of pcryo-LAT were due to focal atrial tachycardia associated with reconnection of one pulmonary vein. In comparison with patients who remained in sinus rhythm, LA area (HR = 1.09; CI 1.01, 1.2; P = 0.02), LVEF (HR = 0.94; CI 0.90, 0.97; P < 0.001), and LVEF <50% (HR = 8.5; CI 3.1, 23.6; P < 0.001) were predictors of pcryo-LAT. After multivariate Cox analysis, only left ventricular ejection fraction < 50% remained predictive of pcryo-LAT, (HR = 7.8, CI 2.3 26.7, P = 0.002). With a mean survival of 23 months, 73% of patients who experienced pcryo-LAT were in sinus rhythm versus 78% of patients without pcryo-LAT (log rank P = 0.85). CONCLUSION The prevalence of pcryo-LAT in patients with atrial fibrillation is low. Left ventricular ejection fraction < 50% is associated with an increased risk of pcryo-LAT. When treated by RF catheter ablation, the presence of pcryo-LAT is not a predictive factor of subsequent recurrence of atrial fibrillation during follow-up.
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Affiliation(s)
- Alexis Hermida
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Sarah Traullé
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Otilia Buiciuc
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
| | - Serge Quenum
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, France
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Souissi Z, Boulé S, Hermida JS, Doucy A, Mabo P, Pavin D, Anselme F, Auquier N, Ninni S, Coisne A, Brigadeau F, Deken-Delannoy V, Klug D, Lacroix D. Catheter ablation reduces ventricular tachycardia burden in patients with arrhythmogenic right ventricular cardiomyopathy: insights from a north-western French multicentre registry. Europace 2016; 20:362-369. [DOI: 10.1093/europace/euw332] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/29/2016] [Indexed: 11/13/2022] Open
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Kubala M, Chadha GD, Renard C, Traullé S, Hermida JS. Cardiac resynchronisation therapy device implantation in a patient with persistent left superior vena cava: is it still a challenge? Kardiol Pol 2016; 74:599. [DOI: 10.5603/kp.2016.0092] [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: 09/29/2015] [Accepted: 10/07/2015] [Indexed: 11/25/2022]
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Traullé S, Kubala M, Doucy A, Quenum S, Hermida JS. Feasibility and safety of temporary subcutaneous venous figure-of-eight suture to achieve haemostasis after ablation of atrial fibrillation. Europace 2015; 18:815-9. [DOI: 10.1093/europace/euv266] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/12/2015] [Indexed: 11/12/2022] Open
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Marijon E, Leclercq C, Narayanan K, Boveda S, Klug D, Lacaze-Gadonneix J, Defaye P, Jacob S, Piot O, Deharo JC, Perier MC, Mulak G, Hermida JS, Milliez P, Gras D, Cesari O, Hidden-Lucet F, Anselme F, Chevalier P, Maury P, Sadoul N, Bordachar P, Cazeau S, Chauvin M, Empana JP, Jouven X, Daubert JC, Le Heuzey JY. Causes-of-death analysis of patients with cardiac resynchronization therapy: an analysis of the CeRtiTuDe cohort study. Eur Heart J 2015; 36:2767-76. [PMID: 26330420 PMCID: PMC4628644 DOI: 10.1093/eurheartj/ehv455] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/17/2015] [Indexed: 01/14/2023] Open
Abstract
Aims The choice of resynchronization therapy between with (CRT-D) and without (CRT-P) a defibrillator remains a contentious issue. Cause-of-death analysis among CRT-P, compared with CRT-D, patients could help evaluate the extent to which CRT-P patients would have additionally benefited from a defibrillator in a daily clinical practice. Methods and results A total of 1705 consecutive patients implanted with a CRT (CRT-P: 535 and CRT-D: 1170) between 2008 and 2010 were enrolled in CeRtiTuDe, a multicentric prospective follow-up cohort study, with specific adjudication for causes of death at 2 years. Patients with CRT-P compared with CRT-D were older (P < 0.0001), less often male (P < 0.0001), more symptomatic (P = 0.0005), with less coronary artery disease (P = 0.003), wider QRS (P = 0.002), more atrial fibrillation (P < 0.0001), and more co-morbidities (P = 0.04). At 2-year follow-up, the annual overall mortality rate was 83.80 [95% confidence interval (CI) 73.41–94.19] per 1000 person-years. The crude mortality rate among CRT-P patients was double compared with CRT-D (relative risk 2.01, 95% CI 1.56–2.58). In a Cox proportional hazards regression analysis, CRT-P remained associated with increased mortality (hazard ratio 1.54, 95% CI 1.07–2.21, P = 0.0209), although other potential confounders may persist. By cause-of-death analysis, 95% of the excess mortality among CRT-P subjects was related to an increase in non-sudden death. Conclusion When compared with CRT-D patients, excess mortality in CRT-P recipients was mainly due to non-sudden death. Our findings suggest that CRT-P patients, as currently selected in routine clinical practice, would not potentially benefit with the addition of a defibrillator.
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Affiliation(s)
- Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
| | | | | | | | - Didier Klug
- Lille University Hospital and University of Lille, Lille, France
| | - Jonathan Lacaze-Gadonneix
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France
| | - Pascal Defaye
- Arrhythmia Department, University Hospital, Grenoble, France
| | | | - Olivier Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | | | | | | | | | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | | | | | | | | | - Philippe Maury
- Cardiology Division, Rangueil University Hospital, Toulouse, France
| | - Nicolas Sadoul
- Cardiology Division, Nancy University Hospital, Nancy, France
| | | | | | | | | | - Xavier Jouven
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
| | | | - Jean-Yves Le Heuzey
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
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Hermida JS, Caus T, Traullé S, Kubala M. Partial extravenous course of cardiac pacemaker leads. A major risk during device-assisted extraction. HeartRhythm Case Rep 2015; 1:506-508. [PMID: 28491616 PMCID: PMC5419709 DOI: 10.1016/j.hrcr.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Thierry Caus
- Cardiac Surgery Service, Amiens-Picardie University Hospital, Amiens, France
| | - Sarah Traullé
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
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Laurent G, Amara W, Mansourati J, Bizeau O, Couderc P, Delarche N, Garrigue S, Guyomar Y, Hermida JS, Moïni C, Popescu E. Role of patient education in the perception and acceptance of home monitoring after recent implantation of cardioverter defibrillators: the EDUCAT study. Arch Cardiovasc Dis 2014; 107:508-18. [PMID: 25218008 DOI: 10.1016/j.acvd.2014.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 06/04/2014] [Accepted: 06/11/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Much attention is being paid to the education of and provision of medical information to patients, to optimize their understanding and acceptance of their disease. AIMS To ascertain the impact of educating recent recipients of an implantable cardioverter defibrillator (ICD) on their perception and acceptance of a home monitoring (HM) system. METHODS Questionnaire 1, completed one month after ICD implantation, was designed to assess: the quality of patient preparation for HM; patient comprehension of HM; and patient anxiety experienced during its installation. The comprehension questions were assigned a score of -2 for an incorrect answer, +1 for a correct answer and 0 for neither (total score ranging from -40 to +20). Questionnaire 2, completed six months after ICD implantation, assessed patient acceptance of and anxiety about HM. RESULTS The registry included 571 patients (mean age 63.9±12.8 years; 83% men; 76% of ICDs implanted for primary prevention) followed by HM for 6.2±1.2 months. Questionnaire 1 was completed by 430 (75.3%) patients and questionnaire 2 by 398 (69.7%) patients. Younger patients had a better comprehension of HM than older patients. High-quality training conditions improved the comprehension score, and a positive association was observed between anxiety and acceptance levels and the comprehension score. The 80±20% mean data transmission rate (days of transmission/days of follow-up ratio) was unrelated to the comprehension scores. CONCLUSION A clear understanding was associated with a higher acceptance of HM, although it was unrelated to the data transmission rate.
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Affiliation(s)
- Gabriel Laurent
- Service de rythmologie et d'insuffisance cardiaque, centre hospitalier universitaire Le Bocage, 2, boulevard de Lattre-Tassigny, BP 77908, 21079 Dijon cedex, France.
| | - Walid Amara
- Centre hospitalier intercommunal de Montfermeil, Montfermeil, France
| | | | - Olivier Bizeau
- Centre hospitalier régional Orléans-La-Source, Orléans, France
| | | | | | | | - Yves Guyomar
- Centre hospitalier Saint-Philibert, Lomme, France
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Guédon-Moreau L, Lacroix D, Sadoul N, Clémenty J, Kouakam C, Hermida JS, Aliot E, Kacet S. Costs of remote monitoring vs. ambulatory follow-ups of implanted cardioverter defibrillators in the randomized ECOST study. Europace 2014; 16:1181-8. [PMID: 24614572 PMCID: PMC4114330 DOI: 10.1093/europace/euu012] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [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] [Indexed: 11/14/2022] Open
Abstract
AIMS The Effectiveness and Cost of ICD follow-up Schedule with Telecardiology (ECOST) trial evaluated prospectively the economic impact of long-term remote monitoring (RM) of implantable cardioverter defibrillators (ICDs). METHODS AND RESULTS The analysis included 310 patients randomly assigned to RM (active group) vs. ambulatory follow-ups (control group). Patients in the active group were seen once a year unless the system reported an event mandating an ambulatory visit, while patients in the control group were seen in the ambulatory department every 6 months. The costs of each follow-up strategy were compared, using the actual billing documents issued by the French health insurance system, including costs of (i) (a) ICD-related ambulatory visits and transportation, (b) other ambulatory visits, (c) cardiovascular treatments and procedures, and (ii) hospitalizations for the management of cardiovascular events. The ICD and RM system costs were calculated on the basis of the device remaining longevity at the end of the study. The characteristics of the study groups were similar. Over a follow-up of 27 months, the mean non-hospital costs per patient-year were €1695 ± 1131 in the active, vs. €1952 ± 1023 in the control group (P = 0.04), a €257 difference mainly due to device management. The hospitalization costs per patient-year were €2829 ± 6382 and €3549 ± 9714 in the active and control groups, respectively (P = 0.46). Adding the ICD to the non-hospital costs, the savings were €494 (P = 0.005) or, when the monitoring system was included, €315 (P = 0.05) per patient-year. CONCLUSION From the French health insurance perspective, the remote management of ICD patients is cost saving. CLINICAL TRIALS REGISTRATION NCT00989417, www.clinicaltrials.gov.
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Affiliation(s)
| | | | - Nicolas Sadoul
- Centre Hospitalier Universitaire Brabois, F-54500 Nancy, France
| | - Jacques Clémenty
- Centre Hospitalier Universitaire Haut-Lévêque, F-33064 Pessac, France
| | - Claude Kouakam
- Centre Hospitalier Régional Universitaire, F-59037 Lille, France
| | | | - Etienne Aliot
- Centre Hospitalier Universitaire Brabois, F-54500 Nancy, France
| | - Salem Kacet
- Centre Hospitalier Régional Universitaire, F-59037 Lille, France
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Bouzeman A, Traulle S, Messali A, Extramiana F, Denjoy I, Narayanan K, Marijon E, Hermida JS, Leenhardt A. Long-term follow-up of asymptomatic Brugada patients with inducible ventricular fibrillation under hydroquinidine. Europace 2013; 16:572-7. [PMID: 24068450 DOI: 10.1093/europace/eut279] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 11/14/2022] Open
Abstract
AIMS To evaluate the long-term efficacy and safety of an electrophysiologically guided therapy, based on a strategy of treatment using hydroquinidine (HQ) among asymptomatic Brugada patients with inducible ventricular fibrillation (VF). METHODS AND RESULTS In two French reference centres, consecutive asymptomatic type 1 Brugada patients with inducible VF were treated with HQ (600 mg/day, targeting a therapeutic range between 3 and 6 µmol/L) and enroled in a specific follow-up (mean 6.6 ± 3 years), including a second programmed ventricular stimulation (PVS) under HQ. An implantable cardioverter defibrillator (ICD) was eventually implanted in patients inducible under HQ, or during follow-up in case of HQ intolerance, as well as occurrence of arrhythmic events. From a total of 397 Brugada patients, 44 were enroled (47 ± 10 years, 95% male). Of these, 34 (77%) were no more inducible (Group PVS-), and were maintained under HQ alone during a mean follow-up of 6.2 ± 3 years. In this group, an ICD was eventually implanted in four patients (12%), with occurrence of appropriate ICD therapies in one. Among the 10 other patients (22%), who remained inducible and received ICD (Group PVS+), none of them received appropriate therapy during a mean follow-up of 7.7 ± 2 years. The overall annual rate of arrhythmic events was 1.04% (95% confidence interval 0.00-2.21), without any significant difference according to the result of PVS under HQ. One-third of patients experienced device-related complications. CONCLUSION Our long-term follow-up results emphasize that the rate of arrhythmic events among asymptomatic Brugada patients with inducible VF remains low over time. Our results also suggest that residual inducibility under HQ is of limited value to predict events during follow-up.
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Affiliation(s)
- Abdeslam Bouzeman
- Département de Cardiologie et Centre de référence des maladies cardiaques Héréditaires, AP-HP, Hôpital Bichat, 75018 Paris, France
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Hermida JS, Arnalsteen-Dassonvalle É, Kubala M, Mathiron A, Traulle S, Anbazhagan K, Hermida A, Rochette J. Dual phenotypic transmission in Brugada syndrome. Arch Cardiovasc Dis 2013; 106:366-72. [DOI: 10.1016/j.acvd.2013.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 02/24/2013] [Accepted: 04/10/2013] [Indexed: 11/24/2022]
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Traullé S, Kubala M, Hermida JS. 208: Midterm follow-up of patients with paroxysmal and persistent atrial fibrillation after pulmonary vein isolation by cryoballoon ablation. Archives of Cardiovascular Diseases Supplements 2013. [DOI: 10.1016/s1878-6480(13)71138-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Guédon-Moreau L, Lacroix D, Sadoul N, Clémenty J, Kouakam C, Hermida JS, Aliot E, Boursier M, Bizeau O, Kacet S. A randomized study of remote follow-up of implantable cardioverter defibrillators: safety and efficacy report of the ECOST trial. Eur Heart J 2012; 34:605-14. [PMID: 23242192 PMCID: PMC3578267 DOI: 10.1093/eurheartj/ehs425] [Citation(s) in RCA: 210] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS The ECOST trial examined prospectively the long-term safety and effectiveness of home monitoring (HM) of implantable cardioverter defibrillators (ICD). METHODS AND RESULTS The trial's primary objective was to randomly compare the proportions of patients experiencing ≥ 1 major adverse event (MAE), including deaths from all causes, and cardiovascular, procedure-related, and device-related MAE associated with HM (active group) vs. ambulatory follow-ups (control group) in a sample of 433 patients. The 221 patients assigned to the active group were seen once a year, unless HM reported an ICD dysfunction or a clinical event requiring an ambulatory visit, while the 212 patients in the control group underwent ambulatory visits every 6 months. The characteristics of the study groups were similar. Over a follow-up of 24.2 months, 38.5% of patients in the active and 41.5% in the control group experienced ≥ 1 MAE (P < 0.05 for non-inferiority). The overall number of shocks delivered was significantly lower in the active (n = 193) than in the control (n = 657) group (P < 0.05) and the proportion of patients who received inappropriate shocks was 52% lower in the active (n = 11) than in the control (n = 22) group (P < 0.05). At the end of the follow-up, the battery longevity was longer in the active group because of a lower number of capacitor charges (499 vs. 2081). CONCLUSION Our observations indicate that long-term HM of ICD is at least as safe as standard ambulatory follow-ups with respect to a broad spectrum of MAE. It also lowered significantly the number of appropriate and inappropriate shocks delivered, and spared the device battery. Clinical trials registration NCT00989417.
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Piot O, Anselme F, Bovéda S, Chauvin M, Daubert JC, Defaye P, Deharo JC, Gras D, Hermida JS, Kacet S, Klug D, Leenhardt A, le Heuzey JY, Mabo P, Pisapia A, Sadoul N, Salvador-Mazenq M, Cazeau S. Guidelines issued by the French Society of Cardiology concerning the competence, performance and environment required in the practice of diagnostic and interventional cardiac electrophysiology. Arch Cardiovasc Dis 2011; 104:586-90. [DOI: 10.1016/j.acvd.2011.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 09/08/2011] [Indexed: 10/15/2022]
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Kubala M, Hermida JS, Nadji G, Quenum S, Traulle S, Jarry G. Normal pulmonary veins anatomy is associated with better AF-free survival after cryoablation as compared to atypical anatomy with common left pulmonary vein. Pacing Clin Electrophysiol 2011; 34:837-43. [PMID: 21418249 DOI: 10.1111/j.1540-8159.2011.03070.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pulmonary vein cryoablation (PVC) is a new approach in the treatment of recurrent atrial fibrillation (AF). Computed tomography (CT) can be used to evaluate the left atrium anatomy and PVs dimensions to facilitate the procedure. In radiofrequency procedures, some anatomic variants such as common left (CLPV) or right (CRPV) PV were reported as factors associated with technical procedure difficulties and potential long-term complications. We hypothesized that the absence of CLPV as determined by CT would predict better AF-free survival after PVC. METHODS AND RESULTS We included 118 consecutive patients (mean age 56 ± 10 years; 77% males) with drug refractory paroxysmal (72%)/persistent (28%) AF, with more than 6 months follow-up, who underwent PVC. On CT scanning images performed within 1 month prior to ablation, we evaluated PV anatomic patterns: presence of CLPV or CRPV. Each patient was evaluated by 24-hour Holter monitoring within 1 and 3 months and all patients were periodically evaluated at 1, 3, and 6 months, and every 6 months thereafter. Patients were asked to record their 12-lead electrocardiogram whenever they experienced symptoms suggestive of AF. Recurrence was defined as AF that lasted at least 30 seconds. CLPV was present in 30 (25%) patients and no patients with CRPV were identified. At the end of the 13 months follow-up, patients with normal PVs had significantly better AF-free survival compared to patients with CLPV (67% vs 50%, P = 0.02). The difference was present in patients with paroxysmal AF (P = 0.008) but not in patients with persistent AF (P = 0.92). CONCLUSION In patients undergoing cryoballoon PV isolation for AF, the presence of normal PVs pattern is associated with better AF-free survival as compared to atypical PV anatomy with CLPV, particularly in patients with paroxysmal AF.
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Affiliation(s)
- Maciej Kubala
- Department of Cardiac Arrhythmia, Cardiology Division, Picardie University Hospital, Amiens, France.
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Hermida JS, Dassonvalle E, Six I, Amant C, Coviaux F, Clerc J, Herent D, Hermida A, Rochette J, Jarry G. Prospective evaluation of the familial prevalence of the brugada syndrome. Am J Cardiol 2010; 106:1758-62. [PMID: 21126620 DOI: 10.1016/j.amjcard.2010.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Revised: 07/28/2010] [Accepted: 07/28/2010] [Indexed: 11/30/2022]
Abstract
The familial prevalence of Brugada syndrome (BrS) in a consecutive series of patients was prospectively determined. BrS is genetically determined with autosomal dominant transmission. The familial prevalence of the BrS is unknown. A detailed pedigree of each family of patients with BrS was assembled and permission was obtained to invite relatives for electrocardiography and an ajmaline challenge. Sixty-two of 98 patients participated in the study and were included over a 6-year period. SCN5A genotyping was performed in 56 of these 62 patients (90%). Electrocardiograms (ECGs) of 488 relatives (mean age 38 ± 20 years, 45% men) were recorded and 270 of these relatives agreed to undergo an ajmaline challenge. Spontaneous type 1 BrS ECG was found in 4 of 488 relatives (0.8%). In the group of relatives in whom ajmaline challenge was performed (n = 270), the finding was positive in 79 subjects (29%). SCN5A genotyping identified 5 other affected relatives. As a result, the total number of affected relatives was 88. Standard 12-lead ECG was normal in 64 of the 88 affected relatives (73%). Mean percentage of affected relatives per family was 27 ± 32% (95% confidence interval 19 to 35). Familial forms of BrS were observed in 41 of the 62 families (66%) and no SCN5A mutations were found in sporadic forms. In conclusion, after active family screening affected relatives were found in almost 1/3 of subjects. BrS appeared to be a familial disease in 2/3 of subjects.
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Affiliation(s)
- Jean-Sylvain Hermida
- Centre d'Activité de Rythmologie, Hôpital Sud, Centre Hospitalier Universitaire d'Amiens-Picardie, France.
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Arnalsteen-Dassonvalle E, Hermida JS, Kubala M, Six I, Quenum S, Leborgne L, Jarry G. Ajmaline challenge for the diagnosis of Brugada syndrome: Which protocol? Arch Cardiovasc Dis 2010; 103:570-8. [DOI: 10.1016/j.acvd.2010.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Revised: 10/06/2010] [Accepted: 10/07/2010] [Indexed: 11/16/2022]
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Abstract
Brugada syndrome (BS) is associated with sudden cardiac death in patients with a structurally normal heart. The ECG pattern of BS has also been described in patients with myocardial abnormalities. Cardiac hypersensitivity and myopericarditis have been reported during long-term treatment with mesalazine. We report the case of a man, treated with mesalazine for Crohn's disease who developed drug-induced pericarditis. The ECG showed a coved ST-segment elevation in the right precordial leads V1-V3, a pattern mimicking BS. The ECG normalized in a few days after mesalazine withdrawal and the follow-up was uneventful. The ECG remained normal. Two ajmaline tests were both negative and ruled out the diagnosis of BS. This observation illustrates that a coved ST-segment elevation in the right precordial leads should not be, systematically, regarded as a marker of a specific syndrome, but may also reflect a common electrical manifestation of abnormalities in the right ventricle or pericardium.
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Affiliation(s)
- Jean-Sylvain Hermida
- Cardiology Department, Amiens-Picardie University Hospital, Service de Cardiologie A, Groupe Hospitalier Sud, Avenue René Laënnec, 80054 Amiens Cedex 1, France.
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Hermida JS, Denjoy I, Jarry G, Jandaud S, Bertrand C, Delonca J. Electrocardiographic predictors of Brugada type response during Na channel blockade challenge. Europace 2005; 7:447-53. [PMID: 16087108 DOI: 10.1016/j.eupc.2005.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2004] [Accepted: 05/08/2005] [Indexed: 11/24/2022] Open
Abstract
AIM To identify ECG predictors of Brugada type response during Na channel blockade challenge. METHODS We studied prospectively 103 patients (M = 76, 45 +/- 13 years) in whom ECGs were collected during ajmaline challenge. ECG recordings included the high right precordial leads (-2V(1) and -2V(2)). A positive response was defined by a >0.2 mV J point or ST segment elevation and a down-sloping pattern of the ST segment in at least one right precordial lead. RESULTS Ajmaline challenge was positive in 48 (47%) of the 103 cases. Baseline J wave elevation was greater in -2V(1) (0.077 +/- 0.078 mV vs. 0.038 +/- 0.046 mV, P = 0.003) and -2V(2) (0.149 +/- 0.103 mV vs. 0.043 +/- 0.088 mV, P < 0.001) in cases with a subsequent positive response. In contrast, ST segment elevation and T wave amplitudes were reduced in V(1), V(2) and V(3). Logistic regression showed that J wave elevation in -2V(2) and decreased T wave amplitude in V(3) at baseline were independent predictors of a positive response. Baseline J wave elevation >0.16 mV in -2V(2) had a specificity of 100%, a sensitivity of 40%, a positive predictive value of 100% and a negative predictive value of 28%. CONCLUSION J wave elevation >0.16 mV in -2V(2) was the strongest predictor of a Brugada type response to Na channel blockade challenge when Brugada syndrome was suspected on a baseline ECG.
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Hermida JS, Kubala M, Lescure FX, Delonca J, Clerc J, Otmani A, Jarry G, Rey JL. Atrial septal pacing to prevent atrial fibrillation in patients with sinus node dysfunction: results of a randomized controlled study. Am Heart J 2004; 148:312-7. [PMID: 15309002 DOI: 10.1016/j.ahj.2004.03.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND In order to assess the preventive effects of right atrial septal pacing on atrial fibrillation (AF) in patients with sinus node dysfunction, we conducted a prospective randomized controlled study in patients requiring atrial pacing. METHODS The inclusion criterion was the presence of a sinus node dysfunction with or without episodes of AF. Pacing sites were randomized to either the right atrial septum or appendage. Patients with permanent AF or with atrioventricular (AV) block without sinus node dysfunction were excluded. Patients were discharged at a pacing rate of 65 beats per minute after setting of the optimal AV delay. The antiarrhythmic therapy remained unchanged until the first recurrence of AF. Sequential analyses were performed with the triangular test. RESULTS Mean baseline characteristics were not different between the septum (n = 57) and the appendage (n = 67) groups. The triangular test evidenced a lack of effect of septal pacing at the last sequential analysis. The rates of AF-free survival were not different between the septum and the appendage group (65% vs 64%, P =.28). In the subgroup of patients with at least 1 episode of AF 3 months before pacing, AF-free survival was increased by atrial septal pacing (70% vs 40%, P =.018). The mean follow-up was 16 +/- 13 months (range, 1-54). CONCLUSIONS Atrial septal pacing does not have a preventive effect on the occurrence of AF in patient requiring atrial pacing for sinus node dysfunction. Subgroup analysis suggests that atrial septal pacing may benefit patients with >or=1 episode of AF in the 3 months preceding pacing.
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Hermida JS, Jandaud S, Lemoine JL, Rodriguez-Lafrasse C, Delonca J, Bertrand C, Jarry G, Rochette J, Rey JL. Prevalence of drug-induced electrocardiographic pattern of the Brugada syndrome in a healthy population. Am J Cardiol 2004; 94:230-3. [PMID: 15246910 DOI: 10.1016/j.amjcard.2004.03.072] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2003] [Revised: 03/19/2004] [Accepted: 03/19/2004] [Indexed: 11/15/2022]
Abstract
To determine the prevalence of drug-induced Brugada's syndrome (BrS) electrocardiograms (ECGs) in a healthy population, a sodium channel blockade challenge was performed in previously identified subjects with BrS-compatible (BrC) ECGs. These subjects were detected in 1,000 normal patients in whom first ECGs were systematically recorded. Because of the intermittent nature of electrocardiographic modifications in BrS, second ECGs were also recorded in a representative sample of the population presenting with first ECGs with normal results. The prevalence of typical drug-induced BrS ECGs was 5 of the 1,000 patients. This value was fivefold greater than the reported prevalence of spontaneous BrS ECGs in the healthy population.
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Hermida JS, Tcheng E, Jarry G, Moullart V, Arlot S, Rey JL, Delonca J, Schvartz C. Radioiodine ablation of the thyroid to prevent recurrence of amiodarone-induced thyrotoxicosis in patients with resistant tachyarrhythmias. Europace 2004; 6:169-74. [PMID: 15018878 DOI: 10.1016/j.eupc.2003.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2003] [Accepted: 11/02/2003] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Amiodarone-induced thyrotoxicosis (AIT) is a common complication of amiodarone therapy. Although permanent withdrawal of amiodarone is recommended due notably to the risk of worsening of tachyarrhythmias, some patients may require the reintroduction of amiodarone several months after normalizing their thyroid function. We, retrospectively, assessed the effects of (131)I therapy to prevent recurrence of AIT in euthyroid patients requiring reintroduction of amiodarone. SUBJECTS AND METHODS Amiodarone was required in 10 cases of recurrent symptomatic paroxysmal atrial fibrillation (AF) and in 5 cases of ventricular tachycardia (VT) (M = 12, F = 3, mean age: 63 +/- 14). The underlying heart disease was dilated cardiomyopathy (n = 4), ischaemic heart disease (n = 4), hypertensive heart disease (n = 2), arrhythmogenic right ventricular dysplasia (n = 27) and valvulopathy (n = 1). Two patients had idiopathic paroxysmal AF. RESULTS A mean (131)I dose of 579 +/- 183 MBq was administered 34 +/- 37 after the episode of AIT. Amiodarone was reintroduced in 14 of 15 patients after a mean interval of 103 +/- 261 d. Fourteen patients developed definite hypothyroidism necessitating l-thyroxine but we observed no late recurrence of AIT. After a mean follow-up of 22 +/- 16 months, tachyarrhythmias were controlled in 12 of 14 patients. CONCLUSION (131)I therapy appears to be an effective and safe approach to prevent the recurrence of AIT in a patient requiring the reintroduction of amiodarone for tachyarrhythmias.
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Affiliation(s)
- Jean-Sylvain Hermida
- Cardiology Department, Hôpital Sud, Centre Hospitalier Universitaire, University Hospital, 80054 Amiens Cedex, France
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Hermida JS, Denjoy I, Clerc J, Extramiana F, Jarry G, Milliez P, Guicheney P, Di Fusco S, Rey JL, Cauchemez B, Leenhardt A. Hydroquinidine therapy in Brugada syndrome. J Am Coll Cardiol 2004; 43:1853-60. [PMID: 15145111 DOI: 10.1016/j.jacc.2003.12.046] [Citation(s) in RCA: 154] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2003] [Revised: 11/22/2003] [Accepted: 12/09/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVES We sought to assess hydroquinidine (HQ) efficacy in selected patients with Brugada syndrome (BrS). BACKGROUND Management of asymptomatic patients with BrS and inducible arrhythmias remains a key issue. Effectiveness of class Ia antiarrhythmic drugs, which inhibit the potassium transient outward current of the action potential, has been suggested in BrS. METHODS From a cohort of 106 BrS patients, we studied 35 who received HQ (32 men; mean age 48 +/- 11 years). Patients had asymptomatic BrS and inducible arrhythmia (n = 31) or multiple appropriate shocks from an implantable cardioverter-defibrillator (ICD) (n = 4). Asymptomatic patients with inducible arrhythmia underwent electrophysiologic (EP)-guided therapy. When ventricular tachycardia (VT)/ventricular fibrillation (VF) inducibility was not prevented, or in case of HQ intolerance, an ICD was placed. RESULTS Hydroquinidine prevented VT/VF inducibility in 76% of asymptomatic patients who underwent EP-guided therapy. Syncope occurred in two of the 21 patients who received long-term (17 +/- 13 months) HQ therapy (1 syncope associated with QT interval prolongation and 1 unexplained syncope associated with probable noncompliance). In asymptomatic patients who received an ICD (n = 10), one appropriate shock occurred during a follow-up period of 13 +/- 8 months. In patients with multiple ICD shocks, HQ prevented VT/VF recurrence in all cases during a mean follow-up of 14 +/- 8 months. CONCLUSIONS Hydroquinidine therapy prevented VT/VF inducibility in 76% of asymptomatic patients with BrS and inducible arrhythmia, as well as VT/VF recurrence in all BrS patients with multiple ICD shocks. These preliminary data suggest that preventive treatment by HQ may be an alternative strategy to ICD placement in asymptomatic patients with BrS and inducible arrhythmia.
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Hermida JS, Jarry G, Tcheng E, Moullart V, Arlot S, Rey JL, Delonca J, Schvartz C. Radioiodine ablation of the thyroid to allow the reintroduction of amiodarone treatment in patients with a prior history of amiodarone-induced thyrotoxicosis. Am J Med 2004; 116:345-8. [PMID: 14984821 DOI: 10.1016/j.amjmed.2003.09.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2003] [Revised: 08/22/2003] [Accepted: 08/22/2003] [Indexed: 11/17/2022]
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Hermida JS, Jarry G, Tcheng E, Moullart V, Arlot S, Rey JL, Schvartz C. [Prevention of recurrent amiodarone-induced hyperthyroidism by iodine-131]. Arch Mal Coeur Vaiss 2004; 97:207-13. [PMID: 15106744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Amioradone-induced hyperthyroidism is a common complication of amiodarone therapy. Although definitive interruption of amiodarone is recommended because of the risks of aggravation of the arrhythmias, some patients may require the reintroduction of amiodarone several months after normalisation of thyroid function. The authors undertook a retrospective study of the effects of preventive treatment of recurrences of amiodarone-induced hyperthyroidism with I131. The indication of amiodarone therapy was recurrent, symptomatic, paroxysmal atrial fibrillation in 13 cases and ventricular tachycardia in 5 cases (M = 14, average age 64 +/- 13 years). The underlying cardiac disease was dilated cardiomyopathy (N = 5), ischaemic heart disease (N = 3), hypertensive heart disease (N = 2), arrhythmogenic right ventricular dysplasia (N = 2) or valvular heart disease (N = 2). Two patients had idiopathic atrial fibrillation. An average dose of 576 +/- 184 MBq of I131 was administered 34 +/- 37 months after an episode of amiodarone-induced hyperthyroidism. Amiodarone was reintroduced in 16 of the 18 patients after a treatment-free period of 98 +/- 262 days. Transient post-radioiodine hyperthyroidism was observed in 3 cases (17%). Sixteen patients (89%) developed hypothyroidism requiring replacement therapy with L-thyroxine. There were no recurrences of amiodarone-induced hyperthyroidism. After 24 +/- 17 months follow-up, the arrhythmias were controlled in 13 of the 16 patients (81%) who underwent the whole treatment sequence. The authors conclude that preventive treatment with I131 is an effective alternative to prevent recurrence of amiodarone-induced hyperthyroidism in patients requiring reintroduction of amiodarone to control their arrhythmias.
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Affiliation(s)
- J S Hermida
- Département de cardiologie, CHU, hôpital Sud, Amiens.
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Hermida JS, Leenhardt A, Cauchemez B, Denjoy I, Jarry G, Mizon F, Milliez P, Rey JL, Beaufils P, Coumel P. Decreased nocturnal standard deviation of averaged NN intervals. An independent marker to identify patients at risk in the Brugada Syndrome. Eur Heart J 2004; 24:2061-9. [PMID: 14613743 DOI: 10.1016/j.ehj.2003.08.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
AIMS Risk-stratification of asymptomatic Brugada Syndrome (BS) patients remains a key-issue. A typical spontaneous BS-ECG pattern and ventricular tachycardia (VT)/ventricular fibrillation (VF) inducibility are two recognized risk markers. The aim of the study was to identify additional risk markers in asymptomatic BS. METHODS AND RESULTS We have compared Holter recordings in symptomatic and in asymptomatic patients with BS. Heart rate variability (HRV), QT-interval rate-dependence and ST-segment elevation (ST-SE) were analysed. The study population included 47 BS patients (M=36, mean age=45+/-13 years) with a malignant ventricular arrhythmia in 11 cases, an unexplained syncope in 10 cases and no symptoms in the remaining 26 cases. A typical spontaneous BS-ECG was present in 21 cases and a drug-induced BS-ECG in 26 cases. A downward trend of the time domain variables of HRV was observed. During the nocturnal period, standard deviation (SD) of the 5min averaged NN intervals (SDANN) (46+/-13 vs 57+/-18ms, P=0.02) and ultra low frequency component (3287+/-2312 vs 5030+/-3270 ms(2), P=0.04) were significantly lower in symptomatic versus asymptomatic patients. In contrast, no difference was found in QT-interval rate dependence and in ST-SE. At multivariate logistic regression, VT/VF inducibility, typical spontaneous BS-ECG and a decreased nocturnal SDANN were associated with arrhythmic events (P=0.003). CONCLUSIONS A decreased nocturnal SDANN was an independent marker of arrhythmic events in these BS patients.
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El Hajjar M, Hermida JS, Caron FM, Nassif D, Bourges-Petit E, Maingourd Y. Myocardiopathie rythmique de l’enfant : un diagnostic difficile mais une forme curable de dysfonction ventriculaire gauche. Arch Pediatr 2004; 11:24-8. [PMID: 14700756 DOI: 10.1016/j.arcped.2003.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
UNLABELLED Tachycardia-induced cardiomyopathy is a reversible left ventricular dysfunction caused by cardiac arrhythmia. Because of its reversibility, a correct diagnosis and treatment are necessary. The aim of our study was to precise the diagnostic procedures of the tachycardia-induced cardiomyopathy and to study the left ventricular function after the correction of the arrhythmia. PATIENTS AND METHODS A retrospective study done between 1992 and 2001. Children studied were followed-up for: an idiopathic form of cardiomyopathy, in which the etiological research showed a cardiac arrhythmia; a cardiac arrhythmia associated to a cardiomyopathy. An electrocardiogram recorded the cardiac arrhythmia. The left ventricular function was evaluated by an echocardiography before and every month after the correction of the cardiac arrhythmia. RESULTS Twelve children were included, ages ranged from 2 months to 15 years (median 11 years). Four patients presented a cardiac insufficiency associated to arrhythmia; three followed-up for an arrhythmia developed a cardiomyopathy; five whose cardiac arrhythmia was not easy to demonstrate had an idiopathic form of cardiomyopathy. The Wilcoxon test showed a significant amelioration (P < 0.01) of the left ventricular function after the correction of the cardiac arrhythmia. CONCLUSIONS Tachycardia-induced cardiomyopathy in children is curable and the diagnosis is quite difficult. Pediatricians and family doctors should try to look for specific signs of cardiac insufficiency or arrhythmia. Pediatric cardiologists should search a tachycardia-induced cardiomyopathy in every idiopathic form of cardiomyopathy.
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Affiliation(s)
- M El Hajjar
- Unité de cardiologie pédiatrique, hôpital Nord, 80054 Amiens, France.
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