1
|
Gruwez H, Snoeck W, Evens S, Vijgen J, Le Polain De Waroux JB, Vandekerckhove Y, Pison L, Haemers P, Nuyens D, Blankoff I, Mairesse G, Willems R. Results from a nationwide atrial fibrillation screening effort in Belgium. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Atrial Fibrillation (AF) is associated with an increased risk of stroke that can be mitigated with anticoagulation therapy. Opportunistic screening for AF for primary stroke prevention is recommended in subjects above 65. However, the paroxysmal and asymptomatic nature of AF hampers early detection with a single time point screening. Multiple time point measurements are superior to single time point measurements for the detection of AF. New technologies such as photoplethysmography (PPG) enable large scale AF screening with repetitive measurements at low-cost using only a smartphone.
Purpose
To explore an entirely online AF screening program in subjects with an elevated stroke risk.
Methods
The Belgian Heart Rhythm Association launched a digital marketing campaign, to promote AF screening during “The Belgian Week of the Heart Rhythm”. Candidates were referred to an online questionnaire to calculate their CHADS-VASC score. Subjects older than 18 with a CHADS-VASC score of 2 or more were allowed to enter the screening program. AF screening was performed with a PPG-based smartphone application. A 60-second PPG trace is captured by placing a fingertip on the smartphone's camera. The smartphone application analyses the PPG trace with an artificial intelligence software. Subjects were instructed to perform measurement twice daily and while experiencing symptoms over the course of 7 days. Measurements were classified as AF or non-AF by the algorithm and were reviewed by medical technicians.
Results
Of the 12.602 candidates who completed the questionnaire, 6.020 subjects met the inclusion criteria and were offered screening. However, only 2.111 (35%) participated in the screening program. The mean age of participants was 63±11 years, 37.3% was male, median CHADS-VASC was 2 (2–3). 257 participants (12.2%) were previously known with AF. In total 25.362 PPG recordings of 60 seconds were performed of which 258 demonstrated AF. AF was detected in 56 participants (2.7%). This was a new finding in 36 participants (1.7%) meaning that 64.3% of participants demonstrating AF were not previously known with AF. The number needed to screen was 58.6 to detect AF in a population without a history of AF and the number needed to invite was 167.2. Only 20 participants (7.8%) with a history of AF demonstrated AF during the screening program.
Conclusions
AF screening in subjects with an elevated stroke risk is feasible with an entirely online screening program without the need for medical hardware or medical personnel with an acceptable number needed to screen. However, this approach failed to target subjects in the highest age groups and since almost two thirds of the subjects interested in the screening program failed to commence screening, approaches to increase this response (specifically in high-risk groups) needs to be explored.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- H Gruwez
- University Hospitals (UZ) Leuven, Cardiovascular sciences , Leuven , Belgium
| | - W Snoeck
- University Hospitals (UZ) Leuven , Leuven , Belgium
| | - S Evens
- Qompium NV , Hasselt , Belgium
| | - J Vijgen
- Jessa Hospital, Cardiology , Hasselt , Belgium
| | | | | | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology , Genk , Belgium
| | - P Haemers
- University Hospitals (UZ) Leuven, Cardiovascular sciences , Leuven , Belgium
| | - D Nuyens
- Hospital Oost-Limburg (ZOL), Department of Cardiology , Genk , Belgium
| | - I Blankoff
- CHU Charleroi, Cardiology , Charleroi , Belgium
| | - G Mairesse
- Clinique Du Sud Luxembourg, Cardiology , Arlon , Belgium
| | - R Willems
- University Hospitals (UZ) Leuven, Cardiovascular sciences , Leuven , Belgium
| |
Collapse
|
2
|
Gawalko M, Hermans ANL, Van Der Velden RMJ, Betz K, Verhaert DVM, Pluymaekers NAHA, Vernooy K, Sultan A, Pison L, Manninger M, Duncker D, Evans S, Sohaib A, Linz D, Hendriks JM. Patient motivation and adherence to an on-demand app-based heart rate and rhythm monitoring infrastructure for atrial fibrillation management through teleconsultation. TeleCheck-AF project results. Europace 2022. [DOI: 10.1093/europace/euac053.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
TeleCheck-AF is a mobile health (mHealth) infrastructure developed to provide remote management and comprehensive care to patients with atrial fibrillation (AF) during the Covid disease-19 pandemic lockdown within cardiology centers in Europe. TeleCheck-AF integrates an on-demand photoplethysmography-based heart rate/rhythm monitoring application supported a scheduled teleconsultation.
Purpose
The current sub-study of the TeleCheck-AF project aimed to provide the first real-world dataset on patient adherence and motivation to a standardized mHealth application integrated in remote AF management.
Methods
Patients were instructed to perform 60-second app-based heart rate/rhythm recordings three times daily and in case of symptoms for seven consecutive days prior to teleconsultation. Motivation was defined as number of days in which the expected number of measurements (≥three/day) were performed per number of days over the entire prescription period. Adherence was defined as number of performed measurements per number of expected measurements over the entire prescription period.
Results
Data from 990 consecutive patients with diagnosed AF (median age 64 [57-71] years, 39% female) from 10 centers that included the highest number of patients (≥25) were analyzed. Patients with both optimal motivation (100%) and adherence (≥100%) constituted 28% of the study population and had a lower percentage of recordings in sinus rhythm (90 [53-100%] vs 100 [64-100%], P<0.001) compared to others. Age and diabetes were predictors of both optimal motivation and adherence (odds ratio [OR] 1.02, 95% coincidence interval [95% CI] 1.01-1.04, P<0.001 and OR, 0.49, 95% CI 0.28-0.86, P=0.013, respectively). Patients with 100% motivation also had ≥100% adherence. Independent predictors for optimal adherence alone were age (OR 1.02, 95% CI 1.00-1.04, P=0.014), female sex (OR 1.70, 95% CI 1.29-2.23, P<0.001), previous AF ablation (OR 1.35, 95%CI 1.03-1.07, P=0.028).
Conclusion
In the TeleCheck-AF project, older age and diabetes were predictors of optimal patient motivation and adherence to app-based heart rate/rhythm monitoring. Therefore, physicians, nurses and allied health specialists involved in the management and care for patients with AF should not be discouraged to provide a mHealth infrastructure to elderly patients. Patient engagement improves mHealth adherence/motivation, hence, it is crucial to tailor the mHelath intervention to the needs and preferences of the patient.
Collapse
Affiliation(s)
- M Gawalko
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - ANL Hermans
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - RMJ Van Der Velden
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - K Betz
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - DVM Verhaert
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - NAHA Pluymaekers
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - K Vernooy
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - A Sultan
- Heart Center at the University of Cologne, Department of Electrophysiology, Cologne, Germany
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - M Manninger
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - D Duncker
- Hannover Medical School, Department of Cardiology and Angiology, Hannover, Germany
| | - S Evans
- Qompium NV, Hasselt, Belgium
| | - A Sohaib
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - D Linz
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - JM Hendriks
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| |
Collapse
|
3
|
Gruwez H, Evens S, Desteghe L, Knaepen L, Dreesen P, Wouters F, Deferm S, Dauw J, Smeets C, Pison L, Haemers P, Heidbuchel H, Vandervoort P. Performance of an artificial intelligence algorithm to detect atrial fibrillation on a 24-hour continuous photoplethysmography recording using a smartwatch: ACURATE study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the awakening era of mobile health, wearable devices capable of detecting atrial fibrillation (AF) are on the rise. Smartwatches and wristbands are equipped with photoplethysmography (PPG) technology that enables (semi)continuous rhythm monitoring. These devices have been pioneered already in a few screening trials. However, such devices are being spread among consumers at a pace that is not paralleled by the evidence supporting their clinical performance. This imbalance reflects the urgent need for validation studies.
Purpose
To determine the diagnostic performance of an artificial intelligence algorithm to detect AF using photoplethysmography acquired by a smartwatch.
Methods
One hundred patients (≥18 years) without a pacemaker-dependent heart rhythm who were referred to a university hospital or a large tertiary hospital for elective 24-hour ECG Holter monitoring were asked to wear a continuous PPG monitoring smartwatch (i.e. Samsung GWA2 or Empatica E4) simultaneously with the Holter. All activities of daily life were allowed. The ECG trace and PPG waveform were synchronised and fragmented in one-minute fragements. The one-minute ECG fragments were labelled as AF, non-AF, or insufficient quality based on the routine clinical interpretation of the 24-hour Holter (i.e. software + physician overreading). The one-minute PPG fragments were analysed by an artificial intelligence (AI) algorithm (i.e. FibriCheck) and were given the same labels. Diagnostic metrics of the PPG AI algorithm were calculated with respect to the ECG interpretation, for all fragments with sufficient quality for both PPG and ECG.
Results
Four patients had to be excluded due to technical error (3 Holter errors, 1 smartwatch error). The mean age in the remaining study population (n=96) was 59±16 years, 51 (53%) were men and 15 (15.6%) were known with permanent AF. In this population, simultaneous ECG and PPG monitoring was recorded for 115,245 one-minute fragments. Fragments of insufficient quality for ECG (n=1,454; 1.3%), PPG (n=25,704; 22.3%) or both (n=15,362; 13.3%) were excluded. PPG fragments were more frequently of insufficient quality (p<0.001). AF was present in 10,255 (14.1%) of the resulting 72,725 high-quality one-minute fragments. The sensitivity of PPG to detect AF was 93.4% (CI 92.9% - 93.8%). The specificity of PPG to exclude AF was 98.4% (CI 98.3% - 98.5%). As a result, the overall accuracy of the PPG algorithm on one-minute fragment level was 97.7% (CI 97.6%- 97.8%).
Conclusion
Continuous out-of-hospital PPG monitoring using a smartwatch in combination with an AI algorithm can accurately discriminate between AF and non-AF rhythms in a heterogenous patient population. PPG quality is more often affected than ECG quality during daily life activities.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Research Foundation-Flanders, Strategic Basic Research Fund
Collapse
Affiliation(s)
- H Gruwez
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - S Evens
- Qompium NV, Hasselt, Belgium
| | - L Desteghe
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - L Knaepen
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - P Dreesen
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - F Wouters
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - S Deferm
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - J Dauw
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - C Smeets
- Hospital Oost-Limburg (ZOL), Future Health Department, Genk, Belgium
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - P Haemers
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - P Vandervoort
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| |
Collapse
|
4
|
Gruwez H, Evens S, Desteghe L, Dreesen P, Knaepen L, Wouters F, Dauw J, Deferm S, Smeets C, Pison L, Haemers P, Heidbuchel H, Vandervoort P. Assessment of heart rate agreement on continuous photoplethysmography monitoring using a smartwatch versus beat-to-beat synchronized ECG monitoring. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In the awakening era of mobile health, wearables equipped with photoplethysmography (PPG) technology to monitor the heart rate (HR) and rhythm are on the rise. Smartwatches and wristbands enable HR monitoring for consumers at massive scale. Unfortunately, once consumers become patients, physicians are limited by insufficient evidence to support the clinical use of PPG based wearables. Accurate identification of heartbeats is the first step in the interpretation of PPG traces and should be validated.
Purpose
To assess the agreement between continuous PPG monitoring using a smartwatch and continuous ECG Holter monitoring in the identification of heartbeats and calculation of the HR.
Methods
One hundred patients (≥18 years) without a pacemaker-dependent heart rhythm who were referred to a university hospital and a large tertiary hospital for elective 24-hour ECG Holter monitoring were asked to wear a continuous PPG monitoring smartwatch (i.e. Samsung GWA2 or Empatica E4) simultaneously with the 24-hour Holter monitor. All activities of daily life were allowed. The ECG trace and PPG waveform were synchronised and fragmented in one-minute fragments. The one-minute ECG fragments were labelled as AF, non-AF, or insufficient quality based on the routine clinical interpretation (i.e. software + physician overreading), and the average HR during each fragment was calculated by Holter algorithm. The PPG fragments were analysed by an artificial intelligence (AI) algorithm (i.e. FibriCheck) that labelled fragments as sufficient or insufficient quality, identified the number of heartbeats and calculated the HR. The agreement between the HR on ECG and PPG in sufficient quality tracings was analysed with linear regression, Pearson's product-moment correlation and Bland-Altman analysis. A subanalysis was performed for AF rhythm and non-AF rhythms.
Results
A total of 72,725 simultaneous ECG and PPG one-minute fragments were recorded in 96 patients, after excluding 4 patients (due to 3 Holter and 1 smartwatch technical error) and 42,520 minutes (36.9%) of insufficient quality (ECG 1,454 (1.3%); PPG 25,704 (22.3%), ECG and PPG 15,362 (13.3%)). The correlation (r=0.935) between ECG and PPG HR was statistically significant (CI 0.934–0.936; P<0.001), with a mean difference between ECG and PPG of 0.8bpm. The lower and upper limit boundary (LLB and ULB; defined as ±1.96 SD) were −8.0bpm and 9.7bpm, respectively, i.e. 95% of PPG measurements identified the HR within 8bpm below or 10bpm above the ECG reference. The mean difference between ECG and PPG HR in the AF subgroup (n=10,255 (14.1%)) was 0.9bpm (LLB −8.4bpm; ULB 10.2bpm) and 0.8bpm in the non-AF subgroup (LLB −0.8bpm; ULB 9.6bpm).
Conclusion
The AI algorithm analysing continuous out-of-hospital PPG tracings can annotate heartbeats and assess HR without a clinically significant bias compared to continuous ECG monitoring, both during AF and non-AF rhythms in a heterogenous patient population.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation-Flanders, Strategic Basic Research Fund Correlation plot & Bland-Altman plot
Collapse
Affiliation(s)
- H Gruwez
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - S Evens
- Qompium NV, Hasselt, Belgium
| | - L Desteghe
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - P Dreesen
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - L Knaepen
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - F Wouters
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - J Dauw
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - S Deferm
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - C Smeets
- Hospital Oost-Limburg (ZOL), Future Health Department, Genk, Belgium
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - P Haemers
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - H Heidbuchel
- University Hospital Antwerp, Cardiology, Antwerp, Belgium
| | - P Vandervoort
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| |
Collapse
|
5
|
Gruwez H, Evens S, Proesmans T, Smeets C, Haemers P, Pison L, Vandervoort P. Evaluation of the device independent nature of a photoplethysmography-deriving smartphone app. Europace 2021. [DOI: 10.1093/europace/euab116.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Smartphone apps using photoplethysmography (PPG) technology enable digital heart rhythm monitoring through their built-in camera, without the need for additional, specific, or costly hardware. This may positively impact the availability and scalability of remote monitoring. However, the diversity of smartphone specifications on the consumer market may raise concerns regarding the robustness of AF detection algorithms between various devices.
Purpose
To study the device independency of AF detection performance by a PPG-based smartphone application.
Methods
Patients from the cardiology department were consecutively enrolled. Patients were handed 7 iOS models and 1 Android model and were asked to consecutively perform one PPG measurement per device. A 12-lead electrocardiogram (ECG) was collected during the same consultation and interpreted by a cardiologist as reference diagnosis. To allow an objective comparison across the devices, patients who failed to perform one successful measurement on each device were excluded. Additional exclusions were atrial flutter rhythms and insufficient quality results. Sensitivity, specificity and accuracy were calculated with respect to the reference diagnosis. McNemar’s analysis was used for the head-to-head comparison of the sensitivity and specificity of the proprietary algorithm on the different smartphone devices.
Results
A total of 150 patients participated in the study with a median CHA2DS2-VASc score of 3 (interquartile range: 1-5). The median age of the study population was 70 (interquartile range: 56-79) years. In total, 54.7% of the population was male and the AF-prevalence was 35.3%. After the exclusion of patients with atrial flutter (n = 14) and patients who did not successfully perform a PPG measurement on each device (n = 5), diagnostic-grade results of 131 patients were used to calculate the performance of the proprietary algorithm. The sensitivity and specificity of the AF detection algorithm ranged from 90.9% (95% CI 75.7-98.1) to 100.0% (95% CI 91.0-100) and 94.5% (95% CI 86.6-98.5) to 100.0% (95% CI 94.6-100), respectively. The overall accuracy across the devices ranged from 94.4% (95% CI 88.3-97.9) to 99.0% (95% CI 94.6-100). Head-to-head comparisons of the results did not reveal significant differences in sensitivity (P = 0.125-1.000) or specificity (P = 0.375-1.000) of the proprietary AF detection algorithm among the different devices.
Conclusion
This study demonstrated the device-independent nature of the PPG-deriving smartphone application with respect to 12-lead ECG diagnosis.
Collapse
Affiliation(s)
- H Gruwez
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - S Evens
- Qompium NV, Hasselt, Belgium
| | | | - C Smeets
- Hospital Oost-Limburg (ZOL), Future Health Department, Genk, Belgium
| | - P Haemers
- KU Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| | - P Vandervoort
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| |
Collapse
|
6
|
Gruwez H, Evens S, Proesmans T, Duncker D, Linz D, Heidbuchel H, Manninger M, Vandervoort P, Haemers P, Pison L. The accuracy of physician interpretation of PPG vs single-lead ECG vs 12-lead ECG for the detection of atrial fibrillation. Europace 2021. [DOI: 10.1093/europace/euab116.523] [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: None.
Introduction
The increasing availability of smartphones has enabled rhythm monitoring in large populations using standalone photoplethysmography (PPG) apps or singe-lead electrocardiography (ECG) with add-on devices. Current guidelines note that when atrial fibrillation (AF) is suspected by an automated algorithm, confirmation on an ECG tracing is required. The use of PPG alone to establish the diagnosis is not generally accepted, even when overread. The performance of physicians to discriminate between sinus rhythm (SR) and AF based on PPG alone is unknown.
Purpose
To study the performance of physicians to detect AF based on PPG vs single-lead ECG vs 12-lead ECG, and to explore the incremental value of a tachogram, Poincaré plot, and algorithm output to the interpretation of the PPG waveform by physicians.
Methods
PPG, single-lead ECG and 12-lead ECG data were simultaneously recorded in 30 patients. Diagnostic reference was the 12-lead ECG, read by two cardiologists. Cardiologists, electrophysiologists and cardiology fellows were invited to analyse the data of 30 patients (10 in SR, 10 in SR with extrasystoles and 10 in AF) through online surveys and classify the readings as ‘SR’, ‘ectopic/missed beats’, ‘AF’, ‘flutter’ or ‘unreadable’. For dichotomous analysis, ‘unreadable’ was reclassified as incorrect, the other options were reclassified as AF ‘present’ or ‘absent’. In the first survey, PPG data were presented subsequently as a waveform, stepwise adding the tachogram and Poincaré plot, and algorithm information. In the next two surveys, the single-lead and 12-lead ECG traces were presented. Sensitivity and specificity for all presentations were calculated with respect to the reference diagnosis. Diagnostic performances were compared with the Obuchowski-Rockette’s ANOVA approach with Jackknife covariance estimation and Benjamini-Hochberg correction.
Results
Sixty-five physicians completed the PPG survey and analysed the PPG waveforms with 88.8% sensitivity and 86.3% specificity for AF. The diagnostic metrics significantly increased to 95.5% sensitivity (P < 0.001) and 92.5% specificity (P < 0.001) after providing the tachogram and Poincaré plot. Fifty-seven physicians completed both ECG surveys and analysed the single-lead ECG outputs with 91.2% sensitivity and 93.9% specificity, while 12-lead ECG outputs were analysed with 93.9% sensitivity and 98.6% specificity. Hence, qualitative analysis of a PPG waveform with tachogram and Poincaré plot had a similar diagnostic performance to detect AF compared to single-lead ECG analysis and a similar sensitivity (P = 0.792) but lower specificity (P = 0.035) compared to 12-lead ECG.
Conclusions
PPG rhythm recordings, analysed by physicians as a waveform in combination with the corresponding tachogram and Poincaré plot, achieve similar diagnostic accuracy as single-lead ECG to detect AF. Abstract Figure.
Collapse
Affiliation(s)
- H Gruwez
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - S Evens
- Qompium NV, Hasselt, Belgium
| | | | - D Duncker
- Hannover Medical School, Department of Cardiology and Angiology, Hannover, Germany
| | - D Linz
- Maastricht University Medical Centre (MUMC), Department of Cardiology, Maastricht, Netherlands (The)
| | - H Heidbuchel
- Antwerp University Hospital, Department of Cardiology, Edegem, Belgium
| | - M Manninger
- Medical University of Graz, Department of Cardiology, Graz, Austria
| | - P Vandervoort
- Hasselt University, Faculty of Medicine and Life Science, Hasselt, Belgium
| | - P Haemers
- University of Leuven, Department of Cardiovascular sciences, Leuven, Belgium
| | - L Pison
- Hospital Oost-Limburg (ZOL), Department of Cardiology, Genk, Belgium
| |
Collapse
|
7
|
Gandjbakhch E, Laredo M, Berruezo A, Gourraud JB, Martins R, Wong T, Sellal JM, Sacher F, Pison L, Pruvot E, Kumar S, Dellabella P, Maury P. P5694Outcomes of patients with arrhythmogenic right ventricular cardiomyopathy after ventricular tachycardia ablation without an implantable cardioverter-defibrillator: a multicenter international study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), implantable cardioverter-defibrillators (ICD) after an episode of sustained monomorphic ventricular tachycardia (MVT) are currently recommended in most situations. However, radiofrequency catheter ablation (RCA) is effective in reducing recurrent VT and whether MVT is a surrogate of sudden cardiac death is debated when other risk factors are lacking.
Purpose
To report the outcomes of patients with ARVC/D who underwent RCA of well-tolerated MVT without a back-up ICD.
Methods
Patients with a definite ARVC/D diagnosis according to the 2010 Task Force revised criteria who underwent RCA of well-tolerated MVT at 9 tertiary centers across 5 countries, without an ICD prior to RCA and in the 3 following months were retrospectively included. Patients presenting with syncope or electrical storm, and patients with left ventricular ejection fraction <50% were excluded. Similar patients implanted with an ICD prior or without RCA in the same period served as controls.
Results
Sixty-five patients [median age 46.1 years, range (19.5–73.8), 75% males] underwent RCA of MVT between 2003 and 2016. Familial history of ARVC/D was found in 11% of patients. Epsilon-waves were present in 19% and T-waves inversion beyond V2 in 43%. A right ventricular (RV) ejection fraction ≤40% or fractional area change ≤33% was found in 14 (25%) patients. Median left ventricular ejection fraction was 61% (50–70). Clinical presentation was palpitations in 81% of patients and near-syncope in 14%. Prior to RCA, patients were on beta-blockers alone in 18%, class I drugs in 37% and amiodarone in 9%, while 15% of patients were free any antiarrhythmic medication. Only 1 patient (2%) had >1 clinical VT morphology. Median VT rate was 180 (110–270). An epicardial approach was used in 31% patients. The clinical VT was inducible in 84% of patients. The median number of targeted RV site was 1 (1–3) (RV outflow tract in 72%). Full acute success defined inability to induce any VT was achieved in 72% of patients. During a median follow-up time of 49 month (1.4–162), there was no death or aborted cardiac arrest. Survival without VT recurrence was estimated at 82%, 71% and 60%, 12-, 36- and 60-months after RCA. No VT recurrence was observed among patient who had undergone an epicardial ablation. Among patients with VT recurrence, 6 (35%) did not receive an ICD, and 14 (70%) underwent redo RCA. An ICD was implanted in 10 patients, including 5 for VT recurrence. Fifty-eight patients constituted the control group, and 64% had appropriate ICD interventions during follow-up.
Conclusions
Despite a significant rate of VT recurrence, selected patients with ARVC/D who underwent RCA for stable MVT without an ICD did not experience any arrhythmic death. Further prospective studies are mandatory to precise the respective places of ICD and RCA in the management of ARVC/D patients with well-tolerated MVT.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- E Gandjbakhch
- Hospital Pitie-Salpetriere, Unité de Rythmologie, Département de Cardiologie, Paris, France
| | - M Laredo
- Hospital Pitie-Salpetriere, Unité de Rythmologie, Département de Cardiologie, Paris, France
| | - A Berruezo
- Barcelona Centre Medic, Barcelona, Spain
| | | | - R Martins
- University Hospital of Rennes, Service de Cardiologie et Maladies Vasculaires, Rennes, France
| | - T Wong
- Royal Brompton Hospital, London, United Kingdom
| | - J M Sellal
- Hospital Brabois of Nancy, Vandoeuvre les Nancy, France
| | - F Sacher
- University Hospital of Bordeaux, Bordeaux, France
| | - L Pison
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands (The)
| | - E Pruvot
- University Hospital Centre Vaudois (CHUV), Lausanne, Switzerland
| | - S Kumar
- Westmead Hospital, Sydney, Australia
| | | | - P Maury
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| |
Collapse
|
8
|
Pison L. Transseptal or retrograde approach for transcatheter ablation of left sided accessory pathways: Do all roads lead to Rome? Int J Cardiol 2018; 272:213-214. [PMID: 30072149 DOI: 10.1016/j.ijcard.2018.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 07/24/2018] [Indexed: 11/16/2022]
Affiliation(s)
- L Pison
- Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.
| |
Collapse
|
9
|
Heijmans J, Lozekoot P, Pison L, La Meir M. Clipping of left atrial appendage; effects on stroke volume, E and A-velocities and atrial pressure. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.181] [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: 11/11/2022]
|
10
|
Lepre L, Pison L, Siqueira L, Ando R, Costa Gomes M. Improvement of carbon dioxide absorption by mixing poly(ethylene glycol) dimethyl ether with ammonium-based ionic liquids. Sep Purif Technol 2018. [DOI: 10.1016/j.seppur.2017.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Schmidt B, Brugada J, Arbelo E, Laroche C, Bayramova S, Bertini M, Letsas K, Pison L, Pokushalov E, Romanov D, Scherr D, Tilz R, Maggioni A, Dagres N. 1011Ablation Strategies for different types of atrial fibrillation in Europe - Results of the EORP Atrial Fibrillation Ablation Long-Term Registry. Europace 2018. [DOI: 10.1093/europace/euy015.560] [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)
- B Schmidt
- Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
| | - J Brugada
- University of Barcelona, Barcelona, Spain
| | - E Arbelo
- University of Barcelona, Barcelona, Spain
| | - C Laroche
- European Society of Cardiology, Sophia-Antipolis, France
| | - S Bayramova
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - M Bertini
- Arcispedale Sant'Anna, Ferrara, Italy
| | - K Letsas
- “KAT” General Hospital of Attica, Athens, Greece
| | - L Pison
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | - E Pokushalov
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - D Romanov
- Novosibirsk State Medical University, Novosibirsk, Russian Federation
| | - D Scherr
- Medical University of Graz, Graz, Austria
| | - R Tilz
- Medical University, Lübeck, Germany
| | - A Maggioni
- European Society of Cardiology, Sophia-Antipolis, France
| | - N Dagres
- Heart Center of Leipzig, Leipzig, Germany
| |
Collapse
|
12
|
Zink MD, Zeemering S, Van Hunnik A, Verheule S, Pison L, Schotten U. P1159The signal averaged P-wave and acute procedural related effects after atrial fibrillation ablation in 12-lead electrocardiogram and novel atrial lead positions. Europace 2018. [DOI: 10.1093/europace/euy015.644] [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)
- M D Zink
- RWTH University Hospital Aachen, Internal Medicine I, Cardiology, Pulmonology & Vascular Medicine, Aachen, Germany
| | - S Zeemering
- Cardiovascular Research Institute Maastricht (CARIM), Physiology, Maastricht, Netherlands
| | - A Van Hunnik
- Cardiovascular Research Institute Maastricht (CARIM), Physiology, Maastricht, Netherlands
| | - S Verheule
- Cardiovascular Research Institute Maastricht (CARIM), Physiology, Maastricht, Netherlands
| | - L Pison
- Cardiovascular Research Institute Maastricht (CARIM), Physiology, Maastricht, Netherlands
| | - U Schotten
- Cardiovascular Research Institute Maastricht (CARIM), Physiology, Maastricht, Netherlands
| |
Collapse
|
13
|
Lepre LF, Szala-Bilnik J, Pison L, Traïkia M, Pádua AAH, Ando RA, Costa Gomes MF. Can the tricyanomethanide anion improve CO2 absorption by acetate-based ionic liquids? Phys Chem Chem Phys 2017; 19:12431-12440. [DOI: 10.1039/c7cp01559c] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The chemical reaction of carbon dioxide with 1-alkyl-3-methylimidazolium acetate ionic liquids is not affected by presence of the C(CN)3− anion, which leads to a faster gas absorption and a higher solubility.
Collapse
Affiliation(s)
- L. F. Lepre
- Laboratório de Espectroscopia Molecular
- Instituto de Química
- Departamento de Química Fundamental
- Universidade de São Paulo
- São Paulo 05513-970
| | - J. Szala-Bilnik
- Institut de Chimie de Clermont-Ferrand
- CNRS & Université Clermont Auvergne
- Aubière Cedex F-63171
- France
| | - L. Pison
- Institut de Chimie de Clermont-Ferrand
- CNRS & Université Clermont Auvergne
- Aubière Cedex F-63171
- France
| | - M. Traïkia
- Institut de Chimie de Clermont-Ferrand
- CNRS & Université Clermont Auvergne
- Aubière Cedex F-63171
- France
| | - A. A. H. Pádua
- Institut de Chimie de Clermont-Ferrand
- CNRS & Université Clermont Auvergne
- Aubière Cedex F-63171
- France
| | - R. A. Ando
- Laboratório de Espectroscopia Molecular
- Instituto de Química
- Departamento de Química Fundamental
- Universidade de São Paulo
- São Paulo 05513-970
| | - M. F. Costa Gomes
- Institut de Chimie de Clermont-Ferrand
- CNRS & Université Clermont Auvergne
- Aubière Cedex F-63171
- France
| |
Collapse
|
14
|
Pison L, Tilz R, Jalife J, Haïssaguerre M. Pulmonary vein triggers, focal sources, rotors and atrial cardiomyopathy: implications for the choice of the most effective ablation therapy. J Intern Med 2016; 279:449-56. [PMID: 26991806 DOI: 10.1111/joim.12490] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Understanding of the pathophysiological mechanism(s) underlying atrial fibrillation (AF) is the foundation on which current ablation strategies are built. In the vast majority of patients with paroxysmal AF, the ablation procedure should target the pulmonary veins. In patients with nonparoxysmal AF, however, pulmonary vein isolation alone seems to be insufficient to prevent the arrhythmia. Several recent clinical trials have investigated the concept that rotors (re-entry based on a meandering central core from which spiral waves emanate) might be the mechanism responsible for sustaining AF. Ablation of these localized AF sources is an important step towards substrate-driven procedures in persistent AF. Hybrid AF ablation procedures, based on the integration of endocardial transcatheter and epicardial off-pump surgical techniques, have been introduced to overcome their mutual shortcomings. The long-term results are encouraging, especially in currently challenging settings such as nonparoxysmal AF and failed endocardial catheter ablation procedures.
Collapse
Affiliation(s)
- L Pison
- Department of Cardiology, Maastricht University Medical Center and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
| | - R Tilz
- Department of Cardiology, Asklepios Klinik St Georg, Hamburg, Germany
| | - J Jalife
- Center for Arrhythmia Research, Department of Internal Medicine/Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M Haïssaguerre
- LIRYC Institute (Electrophysiology and Heart Modeling Institute), Hôpital Cardiologique du Haut Lévêque and Université Victor Segalen of Bordeaux II, Bordeaux, France
| |
Collapse
|
15
|
Camm AJ, Savelieva I, Potpara T, Hindriks G, Pison L, Blömstrom-Lundqvist C. The changing circumstance of atrial fibrillation - progress towards precision medicine. J Intern Med 2016; 279:412-27. [PMID: 27029018 DOI: 10.1111/joim.12478] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The prevalence of atrial fibrillation (AF) in the general population is between 1% and 2% in the developed world and is higher in men than in women. The arrhythmia occurs much more commonly in the elderly, and the estimated lifetime risk of developing AF is one in four for men and women aged 40 years and above. Projected data from multiple population-based studies in the USA and Europe predict a two- to threefold increase in the number of AF patients by 2060. The high lifetime risk of AF and increased longevity underscore the important public health burden posed by this arrhythmia worldwide. AF has multiple aetiologies and a broad variety of presentations. The primary pathologies underlying or promoting the occurrence of AF vary more than for any other cardiac arrhythmia, ranging from autonomic imbalance to organic heart disease and metabolic disorders, such as diabetes mellitus, metabolic syndrome, hyperthyroidism and kidney disease, and lifestyle factors such as smoking, alcohol consumption and participation in endurance sports. Biomarkers are increasingly being investigated and, together with clinical and genetic factors, will eventually lead to a clinically valuable detailed classification of AF which will also incorporate pathophysiological determinants and mechanisms of the arrhythmia. In turn, this will allow the development and application of precision medicine to this troublesome arrhythmia.
Collapse
Affiliation(s)
- A J Camm
- St. George's University of London, London, UK
| | - I Savelieva
- St. George's University of London, London, UK
| | - T Potpara
- Cardiology Clinic, School of Medicine, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia
| | - G Hindriks
- Department of Electrophysiology, Herzzentrum Leipzig GmbH, Leipzig, Germany
| | - L Pison
- Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute, Maastricht, The Netherlands
| | - C Blömstrom-Lundqvist
- Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden
| |
Collapse
|
16
|
Potpara TS, Larsen TB, Deharo JC, Rossvoll O, Dagres N, Todd D, Pison L, Proclemer A, Purefellner H, Blomstrom-Lundqvist C, Scientific Initiatives Committee of the Euro, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D. Oral anticoagulant therapy for stroke prevention in patients with atrial fibrillation undergoing ablation: results from the First European Snapshot Survey on Procedural Routines for Atrial Fibrillation Ablation (ESS-PRAFA). Europace 2015; 17:986-93. [DOI: 10.1093/europace/euv132] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Proclemer A, Bongiorni MG, Dagres N, Sciaraffia E, Todd D, Blomstrom-Lundqvist C, Scientific Initiative Committee, European, Blomstrom-Lundqvist C, Madrid A, Todd D, Sciaraffia E, Estner H, Chen J, Pison L, Bongiorni MG, Hocini M, Dagres N, Alessandro P, Potpara T, Larsen TB. How are European patients at risk of malignant arrhythmias or sudden cardiac death identified and informed about their risk profile: results of the European Heart Rhythm Association survey. Europace 2015; 17:994-8. [DOI: 10.1093/europace/euv203] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
18
|
Larsen TB, Potpara T, Dagres N, Proclemer A, Sciarrafia E, Blomstrom-Lundqvist C, Scientific Initiative Committee, European, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D, Savelieva I. Preference for oral anticoagulation therapy for patients with atrial fibrillation in Europe in different clinical situations: results of the European Heart Rhythm Association Survey. Europace 2015; 17:819-24. [DOI: 10.1093/europace/euv116] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
19
|
Pison L, Potpara TS, Chen J, Larsen TB, Bongiorni MG, Blomstrom-Lundqvist C, Scientific Initiative Committee, European, Blomstrom-Lundqvist C, Bongiorni MG, Pison L, Proclemer A, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Potpara T, Sciaraffia E, Todd D, Savelieva I. Left atrial appendage closure-indications, techniques, and outcomes: results of the European Heart Rhythm Association Survey. Europace 2015; 17:642-6. [DOI: 10.1093/europace/euv069] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
20
|
Potpara TS, Pison L, Larsen TB, Estner H, Madrid A, Blomstrom-Lundqvist C, Conducted by the Scientific Initiatives Comm, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D. How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey. Europace 2015; 17:468-72. [DOI: 10.1093/europace/euv025] [Citation(s) in RCA: 23] [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] [Indexed: 12/18/2022] Open
|
21
|
Hernandez-Madrid A, Hocini M, Chen J, Potpara T, Pison L, Blomstrom-Lundqvist C. How are arrhythmias managed in the paediatric population in Europe? Results of the European Heart Rhythm survey. Europace 2014; 16:1852-6. [DOI: 10.1093/europace/euu313] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
22
|
Grazia Bongiorni M, Dagres N, Estner H, Pison L, Todd D, Blomstrom-Lundqvist C. Management of malfunctioning and recalled pacemaker and defibrillator leads: results of the European Heart Rhythm Association survey. Europace 2014; 16:1674-8. [DOI: 10.1093/europace/euu302] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
23
|
Pison L, Hocini M, Potpara TS, Todd D, Chen J, Blomstrom-Lundqvist C, Blomstrom-Lundqvist C, Bongiorni MG, Pison L, Proclemer A, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Potpara T, Sciaraffia E, Todd D. Work-up and management of lone atrial fibrillation: results of the European Heart Rhythm Association Survey. Europace 2014; 16:1521-3. [DOI: 10.1093/europace/euu277] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
24
|
Mafi Rad M, Blaauw Y, Dinh T, Pison L, Crijns HJ, Prinzen FW, Vernooy K. Left ventricular lead placement in the latest activated region guided by coronary venous electroanatomic mapping. Europace 2014; 17:84-93. [DOI: 10.1093/europace/euu221] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
25
|
Kumar N, Timmermans C, Das M, Pison L, Maessen J, Crijns H. Re: CT imaging of complications of catheter ablation for atrial fibrillation. Clin Radiol 2014; 69:e367-8. [PMID: 24880756 DOI: 10.1016/j.crad.2014.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/15/2014] [Indexed: 01/11/2023]
|
26
|
Proclemer A, Grazia Bongiorni M, Etsner H, Todd D, Sciaraffia E, Blomstrom-Lundqvist C, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D. Current implantable cardioverter-defibrillator programming in Europe: the results of the European Heart Rhythm Association survey. Europace 2014; 16:935-8. [DOI: 10.1093/europace/euu143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
27
|
Larsen TB, Potpara T, Dagres N, Pison L, Estner H, Blomstrom-Lundqvist C, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D. Stroke and bleeding risk evaluation in atrial fibrillation: results of the European Heart Rhythm Association survey. Europace 2014; 16:698-702. [DOI: 10.1093/europace/euu089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
|
28
|
Hocini M, Pison L, Proclemer A, Larsen TB, Madrid A, Blomstrom-Lundqvist C. Diagnosis and management of patients with inherited arrhythmia syndromes in Europe: results of the European Heart Rhythm Association Survey. Europace 2014; 16:600-3. [DOI: 10.1093/europace/euu074] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
29
|
Arbelo E, Brugada J, Hindricks G, Maggioni AP, Tavazzi L, Vardas P, Laroche C, Anselme F, Inama G, Jais P, Kalarus Z, Kautzner J, Lewalter T, Mairesse GH, Perez-Villacastin J, Riahi S, Taborsky M, Theodorakis G, Trines SA, Brugada J, Arbelo E, Hindriks G, Maggioni AP, Morgan J, Tavazzi L, Vardas P, Alonso A, Ferrari R, Komajda M, Tavazzi L, Wood D, Vardas P, Brugada J, Mairesse G, Taborsky M, Kautzner J, Lewalter T, Riahi S, Jais P, Anselme F, Theodorakis G, Inama G, Trines S, Kalarus Z, Villacastin JP, Maggioni AP, Manini M, Gracia G, Laroche C, Missiamenou V, Taylor C, Konte M, Fiorucci E, Lefrancq EF, Glémot M, McNeill PA, Bois T, Heidbüchel H, Nuyens D, Boland J, Dinraths V, Herzet JM, Hoffer E, Malmendier D, Massoz M, Pourbaix S, Ballant E, Blommaert D, Deceuninck O, Dormal F, Xhaet O, De Potter T, Geelen P, Derycker K, Duytschaever M, Tavernier R, Vandekerckhove Y, Vankats D, Bulava A, Hanis J, Sitek D, Blahova M, Cihak R, Hanyasova L, Jansova H, Peichl P, Tanzerova M, Wichterle D, Duda J, Haman L, Parizek P, Coling L, Neuzil P, Petru J, Sediva L, Skoda J, Chovancik J, Fiala M, Neuwirth R, Karlsdottir A, Pehrson S, Gerdes C, Jensen H, Lukac P, Nielsen JC, Hansen J, Johannessen A, Hansen PS, Pedersen A, Heath F, Hjortshoj S, Thogersen A, Da Costa A, Martel I, Romeyer-Bouchard C, Sadki N, Schmid A, Haissaguerre M, Hocini M, Knecht S, Sacher F, Ait Said M, Cauchemez B, Ledoux F, Thomas O, Cebron JP, Decarsin N, Gras D, Hervouet S, Durand C, Durand-Dubief A, Poty H, Babuty D, Pierre B, Albenque JP, Boveda S, Combes N, Mas R, Hermida JS, Kubala M, Godin B, Savouré A, Soublin Y, Defaye P, Jacon P, Brigadeau F, Corbut S, Flament-Balzola F, Kacet S, Klug D, Lacroix D, Copie X, Gilles L, Hocine Z, Paziaud O, Piot O, Crocq C, Kaballu G, Le Moal V, Lotton P, Mabo P, Pavin D, Andronache M, De Chillou C, Magnin-Poull I, Deharo JC, Durand C, Franceschi F, Peyrouse E, Prevot S, Etchegoin M, Extramiana F, Leenhardt A, Messali A, Heine T, Schneider A, Winter N, Brachmann J, Ritscher G, Schertel-Gruenler B, Simon H, Sinha AM, Turschner O, Wystrach A, Stemberg M, Kuck KH, Metzner A, Tilz R, Wissner E, Heitmann K, Willems S, Andresen D, Mueller S, Volkmer M, Schmidt B, Kostopoulou A, Livanis E, Voudris V, Efremidis M, Letsas K, Tsikrikas S, Christoforatou E, Ioannidis P, Katsivas A, Kourouklis S, Andrikopoulos G, Rassias I, Tzeis S, Dakos G, Paraskevaidis S, Stavropoulos G, Theofilogiannakos E, Vassilikos V, Bongiorni M, Zucchelli G, Raviele A, Themistoclakis S, Pratola C, Tritto M, Della Bella P, Mazzone P, Moltrasio M, Tondo C, Calo L, De Luca L, Guarracini F, Lioy E, Dozza L, Frigoli E, Giannelli L, Pappone C, Saviano M, Schiavina G, Vicedomini G, De Ponti R, Doni LA, Marazzi R, Salerno-Uriarte J, Tamborini C, Anselmino M, Ferraris F, Gaita F, Bertaglia E, Brandolino G, Zoppo F, De Groot N, Janse P, Jordaens L, Pison L, Roos C, Van Gelder I, Manusama R, Meijer A, Van der Voort P, Trines S, Compier MG, Kazmierczak J, Kornacewicz-Jach Z, Wielusinski M, Baran J, Kulakowski P, Dzidowski M, Fuglewicz A, Nowak K, Pruszkowska-Skrzep P, Wozniak A, Nowak S, Trusz-Gluza M, Almendral J, Atienza F, Castellanos E, De Diego C, Ortiz M, Moreno Planas J, Perez Castellano N, Benezet J, Farre Muncharaz J, Rubio Campal J, Hernandez Madrid A, Matia R, Arana E, Pedrote A, Cozar R, Peinado R, Valverde I, Arbelo E, Berruezo A, Calvo N, Guiu E, Husseini S, Mont Girbau L. The Atrial Fibrillation Ablation Pilot Study: an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association. Eur Heart J 2014; 35:1466-78. [DOI: 10.1093/eurheartj/ehu001] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Elena Arbelo
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | - Josep Brugada
- Department of Cardiology, Thorax Institute, Hospital Clínic de Barcelona, C/ Villarroel 170, 6° - Escala 3, 08036, University of Barcelona, Barcelona, Spain
| | | | - Aldo P. Maggioni
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Luigi Tavazzi
- GVM Care and Research, E.S. Health Science Foundation, Maria Cecilia Hospital, Cotignola, Italy
| | - Panos Vardas
- Department of Cardiology, Heraklion University Hospital, Crete, Greece
| | - Cécile Laroche
- EURObservational Research Programme, European Society of Cardiology, Sophia – Antipolis, France
| | - Frédéric Anselme
- Service De Cardiologie, Hôpital Charles Nicolle, Rouen Cedex, France
| | | | - Pierre Jais
- Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France
| | - Zbigniew Kalarus
- Department of Cardiology, Silesian Academy of Medicine, Zabrze, Poland
| | - Josef Kautzner
- Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | | | | | | | - Sam Riahi
- AF Study Group, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Milos Taborsky
- Internal Cardiology Department, Faculty Hospital Olomouc, Olomouc, Czech Republic
| | | | - Serge A. Trines
- Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Proclemer A, Lewalter T, Bongiorni MG, Nielsen JH, Pison L, Lundqvist CB. Corrigendum to: Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy: results of the European Heart Rhythm Association survey Europace (2013) 15 (7): 1059-1062 doi:10.1093/europace/eut187. Europace 2013. [DOI: 10.1093/europace/eut341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
31
|
Bongiorni MG, Proclemer A, Dobreanu D, Marinskis G, Pison L, Blomstrom-Lundqvist C, Blomstrom-Lundqvist C, Bongiorni MG, Chen J, Dagres N, Estner H, Hernandez-Madrid A, Hocini M, Larsen TB, Pison L, Potpara T, Proclemer A, Sciraffia E, Todd D. Preferred tools and techniques for implantation of cardiac electronic devices in Europe: results of the European Heart Rhythm Association survey. Europace 2013; 15:1664-8. [DOI: 10.1093/europace/eut345] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
32
|
Pison L, Proclemer A, Bongiorni MG, Marinskis G, Hernandez-Madrid A, Blomstrom-Lundqvist C. Imaging techniques in electrophysiology and implantable device procedures: results of the European Heart Rhythm Association survey. Europace 2013; 15:1333-6. [DOI: 10.1093/europace/eut259] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
33
|
Pison L, Costa Gomes MF, Pádua AAH, Andrault D, Norman S, Hardacre C, Ribeiro MCC. Pressure effect on vibrational frequency and dephasing of 1-alkyl-3-methylimidazolium hexafluorophosphate ionic liquids. J Chem Phys 2013; 139:054510. [DOI: 10.1063/1.4817403] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
34
|
Proclemer A, Lewalter T, Bongiorni MG, Nielsen JH, Pison L, Lundqvist CB. Screening and risk evaluation for sudden cardiac death in ischaemic and non-ischaemic cardiomyopathy: results of the European Heart Rhythm Association survey. Europace 2013; 15:1059-62. [DOI: 10.1093/europace/eut187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
35
|
Marinskis G, Bongiorni MG, Dagres N, Lewalter T, Pison L, Blomstrom-Lundqvist C. X-ray exposure hazards for physicians performing ablation procedures and device implantation: results of the European Heart Rhythm Association survey. Europace 2013; 15:444-6. [DOI: 10.1093/europace/eut022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
36
|
Lewalter T, Dobreanu D, Proclemer A, Marinskis G, Pison L, Blomstrom-Lundqvist C. Atrial fibrillation ablation techniques. Europace 2012; 14:1515-7. [DOI: 10.1093/europace/eus320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
37
|
Proclemer A, Dobreanu D, Pison L, Lip GYH, Svendsen JH, Lundqvist CB. Current practice in out-of-hospital cardiac arrest management: a european heart rhythm association EP network survey. Europace 2012; 14:1195-8. [DOI: 10.1093/europace/eus232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
38
|
Bongiorni MG, Blomstrom-Lundqvist C, Kennergren C, Dagres N, Pison L, Svendsen JH, Auricchio A. Current practice in transvenous lead extraction: a European Heart Rhythm Association EP Network Survey. Europace 2012; 14:783-6. [DOI: 10.1093/europace/eus166] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
39
|
Blaauw Y, Pison L, van Opstal J, Dennert R, Heesen W, Crijns H. Reversal of ventricular premature beat induced cardiomyopathy by radiofrequency catheter ablation. Neth Heart J 2010; 18:493-8. [PMID: 20978594 PMCID: PMC2954302 DOI: 10.1007/bf03091821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/18/2022] Open
Abstract
Frequent monomorphic ventricular premature beats (VPBs) may lead to left ventricular dysfunction. We describe two patients with frequent monomorphic VPBs and dilated cardiomyopathy in whom left ventricular function normalised after elimination of the VPBs by radiofrequency catheter ablation. The recent literature on this topic is summarised and potential candidates for catheter ablation are discussed. (Neth Heart J 2010;18:493-8.).
Collapse
Affiliation(s)
- Y. Blaauw
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - L. Pison
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - J.M. van Opstal
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - R.M. Dennert
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - W.F. Heesen
- Department of Cardiology, VieCuri Medical Center, Venlo, the Netherlands
| | - H.J.G.M. Crijns
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| |
Collapse
|
40
|
Pison L, Canongia Lopes JN, Rebelo LPN, Padua AAH, Costa Gomes MF. Interactions of Fluorinated Gases with Ionic Liquids: Solubility of CF4, C2F6, and C3F8 in Trihexyltetradecylphosphonium Bis(trifluoromethylsulfonyl)amide. J Phys Chem B 2008; 112:12394-400. [DOI: 10.1021/jp8051714] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L. Pison
- Laboratoire de Thermodynamique et Interactions Moléculaires, Université Blaise Pascal, Clermont-Ferrand/CNRS, Aubière, France, Centro de Quimica Estrutural, Instituto Superior Técnico, Lisbon, Portugal, and Instituto de Tecnologia Quimica e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - J. N. Canongia Lopes
- Laboratoire de Thermodynamique et Interactions Moléculaires, Université Blaise Pascal, Clermont-Ferrand/CNRS, Aubière, France, Centro de Quimica Estrutural, Instituto Superior Técnico, Lisbon, Portugal, and Instituto de Tecnologia Quimica e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - L. P. N. Rebelo
- Laboratoire de Thermodynamique et Interactions Moléculaires, Université Blaise Pascal, Clermont-Ferrand/CNRS, Aubière, France, Centro de Quimica Estrutural, Instituto Superior Técnico, Lisbon, Portugal, and Instituto de Tecnologia Quimica e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - A. A. H. Padua
- Laboratoire de Thermodynamique et Interactions Moléculaires, Université Blaise Pascal, Clermont-Ferrand/CNRS, Aubière, France, Centro de Quimica Estrutural, Instituto Superior Técnico, Lisbon, Portugal, and Instituto de Tecnologia Quimica e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - M. F. Costa Gomes
- Laboratoire de Thermodynamique et Interactions Moléculaires, Université Blaise Pascal, Clermont-Ferrand/CNRS, Aubière, France, Centro de Quimica Estrutural, Instituto Superior Técnico, Lisbon, Portugal, and Instituto de Tecnologia Quimica e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| |
Collapse
|
41
|
Ghoufi A, Pison L, Morel JP, Morel-Desrosiers N, Bonal C, Malfreyt P. Computational and experimental investigations of supramolecular assemblies of p-sulfonatocalix[4]arene organized by weak forces. J Phys Chem B 2007; 111:11478-85. [PMID: 17850131 DOI: 10.1021/jp0721245] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 11/30/2022]
Abstract
We report the study of the supramolecular assemblies formed by the incorporation of quaternary ammonium cations such as Me4N+ or Et4N+ into host-guest assemblies with p-sulfonatocalix[4]arene in the presence of a lanthanide(III) cation in water. We use microcalorimetry to characterize the formation of these supramolecular assemblies. We obtain a molecular description of these assemblies by performing molecular dynamics simulations over a very large period of time. The structures of these supramolecular complexes have been determined and discussed through specific interaction energy contributions. By combining MD simulations and 1NMR spectroscopy, we highlight a specific behavior of the supramolecular assembly with the Me4N+.
Collapse
Affiliation(s)
- A Ghoufi
- Laboratoire de Thermodynamique des Solutions et des Polymeres, UMR CNRS 6003, Université Blaise Pascal (Clermont-Ferrand II), 24 avenue des Landais, 63177 Aubière Cedex, France
| | | | | | | | | | | |
Collapse
|
42
|
Abstract
Apical ballooning of the left ventricle was first introduced as takotsubo-like left ventricular dysfunction in 1990 by Satoh and colleagues. The syndrome is characterised by reversible extensive akinesia of the apical and mid-portions of the left ventricle with hypercontraction of the basal segment. For the first time two sisters with this syndrome are reported, suggesting a possible genetic aetiology.
Collapse
Affiliation(s)
- L Pison
- Ziekenhuis Oost Limburg, Schiepse Bos 6, Genk 3600, Belgium.
| | | | | |
Collapse
|
43
|
Corluy L, Pison L, Lauweryns P, Samson I, Westhovens R. An unusual non-traumatic atlantoaxial subluxation in an adult patient: Grisel's syndrome. Clin Rheumatol 2004; 23:182-3. [PMID: 15045640 DOI: 10.1007/s10067-003-0834-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2003] [Accepted: 10/08/2003] [Indexed: 10/26/2022]
|
44
|
|