1
|
Luksza A, Swierzynska E, Horbacewicz J, Lockley A, Glowczynska R, Grabowski M, Szumowski L, Sterlinski M. The Simple Is Safe: Leadless Pacing in a Patient After Circulus Vitiosus of Complications and Multiple Cardiac Surgical Interventions. Anatol J Cardiol 2023; 27:E36-E37. [PMID: 37791773 DOI: 10.14744/anatoljcardiol.2023.3699] [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] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Affiliation(s)
- Aurelia Luksza
- Students' Scientific Society affiliated at National Institute of Cardiology, Warsaw, Poland
| | - Ewa Swierzynska
- First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland; First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Horbacewicz
- Department of Radiology, National Institute of Cardiology, Warsaw, Poland
| | - Andrew Lockley
- Students' Scientific Society affiliated at National Institute of Cardiology, Warsaw, Poland
| | - Renata Glowczynska
- First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Grabowski
- First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szumowski
- First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland
| | - Maciej Sterlinski
- First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
2
|
Ciszewski JB, Tajstra M, Kowalik I, Maciag A, Zajac D, Pytkowski M, Gasior M, Sterlinski M. Dubious effect of the high biventricular paced beats percentage itself on the cardiac resynchronization efficacy in patients with atrial fibrillation. The randomized Pilot-CRAfT Study results. Europace 2022. [DOI: 10.1093/europace/euac053.179] [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: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology statutory grant
Background
The presence of atrial fibrillation (AF) in cardiac resynchronization therapy (CRT) recipients is common and AF is a marker of poorer CRT response. The negative influence of AF on CRT efficacy is belived to be mediated mainly by the drop of effectively captured biventricular paced beats percentage (BiVp%). According to observational trials, the minimal BiVp associated with better outcomes is 95-98%, however there is lack of randomized trials to confirm this findings.
Purpose
The purpose of the study was to assess the influence of BiVp% itself on the clinical outcomes in the population CRT patients with atrial fibrillation in a prospective, randomized cohort.
Methods
The study included the prospective Pilot-CRAfT study participants that is patients with CRT and permanent or persistent AF lasting for ≥6 months that were randomly assigned to rhythm or rate control strategy. We divided the whole study population according to their BiVp at the 12 month follow-up with two borderline BiVp values (BiVp >98% vs <98% and >95% vs <95%) and analysed the echocardiographic indices, exercise tolerance and quality of life between the prespecified groups.
Results
The study included 43 CRT patients (97,7% males) aged 68,4 (SD: ±8,3) years with mean BiVp% 82,4% ±9,7% at baseline. The mean baseline left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and maximal oxygen uptake (VO2max) were: 30 ±8%, 65 ±8 mm, 14 ±5 mL/(kg*min), respectively. In both of the study arms the BiVp% raised significantly reaching 98,1 ±2,3% and 96,3 ±3,9% in the rhythm control and the rate control arms respectively (P=0,093). As a result the were overall 21 patients with BiVp >98% and 29 patients with BiVp >95% at the end of the study. The BiVp groups >98% vs <98% and >95% vs <95% did not differ as to baseline characteristics and we have not observed any differences in the mean LVEF, mean LVEDD, mean VO2max, and quality of life in the prespecified BiVp% groups at the end of the follow up. Moreover no linear correlations between the BiVp% and LVEF, LVEDD, VO2max values were observed. However, in the rate control group patients with AVNA performed had lower LVEDD at the end of the study (57,7 ±3,0 vs 65,4 ±7,0 p=0,007) and significant decrease in the LVEDD after AVNA was observed (-8,6 95%CI [-14,9; -2,3]).
Conclusions
The BiVp >98% or >95% alone does not seem to warrant good response to cardiac resynchronization in patients with persistent atrial fibrillation as assessed in the prospective randomized cohort. However, performing AVNA in this group of patients may be beneficial in terms of LVEDD decrease.
Collapse
Affiliation(s)
| | - M Tajstra
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - I Kowalik
- National Institute of Cardiology, Warsaw, Poland
| | - A Maciag
- National Institute of Cardiology, Warsaw, Poland
| | - D Zajac
- National Institute of Cardiology, Warsaw, Poland
| | - M Pytkowski
- National Institute of Cardiology, Warsaw, Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - M Sterlinski
- National Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
3
|
Ciszewski JB, Tajstra M, Gadula-Gacek E, Kowalik I, Maciag A, Chwyczko T, Jankowska A, Smolis-Bak E, Firek B, Zajac D, Szwed H, Pytkowski M, Gasior M, Sterlinski M. Rhythm or rate control strategy in CRT recipients with long-standing persistent atrial fibrillation - preliminary results of the PilotCRAfT study. Europace 2021. [DOI: 10.1093/europace/euab116.466] [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: Public Institution(s). Main funding source(s): National Institute of Cardiology in Warsaw Statutory Grant
Background
The presence of atrial fibrillation (AF) in cardiac resynchronization therapy (CRT) recipients is common and AF is a marker of poorer CRT response. The negative influence of AF on CRT efficacy is mediated mainly by the drop of the effectively captured biventricular paced beats percentage (BiVp%) which should exceed 95-98% to warrant good CRT response. Sinus rhythm (SR) restoration may improve CRT efficacy which in turn may protect AF recurrence. However, there is lack of randomized studies comparing rhythm and rate control strategies in these patients.
Purpose
The purpose of the Pilot-CRAfT study (NCT01850277) was to compare the efficacy of rhythm vs rate control strategy in CRT patients with long-standing persistent or permanent atrial fibrillation.
Methods
The study included patients with CRT and permanent or persistent AF lasting for ≥6 months, resulting in BiVp% <95%, who were randomly assigned to rhythm or rate control strategy. The rhythm control strategy comprised of external electrical cardioversion (EEC). The rate control strategy included pharmacotherapy and atrioventricular node ablation (AVNA) as needed. Both of the study arms received amiodarone. The follow-up lasted 12 months. The primary endpoint was the 12-month BiVp%. The patients underwent ECHO, cardiopulmonary test, quality of live (QoL) and clinical outcomes assessment.
Results
The study included 43 CRT patients (97,7% males) aged 68,4 (SD: ±8,3) years with mean BiVp% 82,4% ±9,7% at baseline. The mean duration of AF paroxysm was 25 ±19 months. The mean baseline left ventricular ejection fraction (LVEF), left atrium area and maximal oxygen uptake (VO2max) were: 30 ±8%, 33 ±7 cm2, 14 ±5 mL/(kg*min), respectively. The EEC was performed in 19 out of 22 patients assigned to the rhythm control arm. The immediate success rate of EEC was 58%. 42% of the rhythm control arm patients remained in SR after 12 months. In the rate control group 1 person underwent AVNA and in 1 patient spontaneous SR resumption was observed. After 12 months there was significant BiVp% increase in both the rhythm and the rate control arms (98,1 ±2,3 vs 96,3 ±3,9%, respectively. The BiVp% differences between the groups were not significant (P = 0,093). However, in the per protocol analysis, the rhythm control group had greater LVEF after 12 months as opposed to the rate control arm (36,8% vs 29,9% respectively, P = 0,039). The LVEF raised significantly in the rhythm control group (ΔLVEF 5,0 (95%CI: 1,54; 8,46)). No significant differences between the groups in the VO2max, QoL, clinical and safety end-points were noticed.
Conclusions
Structured follow-up of CRT patients with long-standing persistent or permanent AF leads to significant BiVp% increase exceeding 95%. The rate control strategy did not improve CRT effectivness, irrespective of high BiVp%. However limited in the efficacy, the rhythm control strategy may improve CRT outcome in these patients, resulting in LVEF increase.
Collapse
Affiliation(s)
- JB Ciszewski
- National Institute of Cardiology, Warsaw, Poland
| | - M Tajstra
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - E Gadula-Gacek
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - I Kowalik
- National Institute of Cardiology, Warsaw, Poland
| | - A Maciag
- National Institute of Cardiology, Warsaw, Poland
| | - T Chwyczko
- National Institute of Cardiology, Warsaw, Poland
| | - A Jankowska
- National Institute of Cardiology, Warsaw, Poland
| | - E Smolis-Bak
- National Institute of Cardiology, Warsaw, Poland
| | - B Firek
- National Institute of Cardiology, Warsaw, Poland
| | - D Zajac
- National Institute of Cardiology, Warsaw, Poland
| | - H Szwed
- National Institute of Cardiology, Warsaw, Poland
| | - M Pytkowski
- National Institute of Cardiology, Warsaw, Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - M Sterlinski
- National Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
4
|
Nadolny K, Bujak K, Obremska M, Zysko D, Sterlinski M, Szarpak L, Kubica J, Ladny JR, Gasior M. Glasgow Coma Scale score of more than four on admission predicts in-hospital survival in patients after out-of-hospital cardiac arrest. Am J Emerg Med 2021; 42:90-94. [PMID: 33497899 DOI: 10.1016/j.ajem.2021.01.018] [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: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 10/22/2022] Open
Abstract
AIM The aim of the study was to assess the usefulness of the Glasgow Coma Scale (GCS) score assessed by EMS team in predicting survival to hospital discharge in patients after out-of-hospital cardiac arrest (OHCA). METHODS Silesian Registry of OHCA (SIL-OHCA) is a prospective, population-based regional registry of OHCAs. All cases of OHCAs between the 1st of January 2018 and the 31st of December 2018 were included. Data were collected by EMS using a paper-based, Utstein-style form. OHCA patients aged ≥18 years, with CPR attempted or continued by EMS, who survived to hospital admission, were included in the current analysis. Patients who did not achieve return of spontaneous circulation (ROSC) in the field, with missing data on GCS after ROSC or survival status at discharge were excluded from the study. RESULTS Two hundred eighteen patients with OHCA, who achieved ROSC, were included in the present analysis. ROC analysis revealed GCS = 4 as a cut-off value in predicting survival to discharge (AUC 0.735; 95%CI 0.655-0.816; p < 0.001). Variables significantly associated with in-hospital survival were young age, short response time, witnessed event, previous myocardial infarction, chest pain before OHCA, initial shockable rhythm, coronary angiography, and GCS > 4. On the other hand, epinephrine administration, intubation, the need for dispatching two ambulances, and/or a physician-staffed ambulance were associated with a worse prognosis. Multivariable logistic regression analysis revealed GCS > 4 as an independent predictor of in-hospital survival after OHCA (OR of 6.4; 95% CI 2.0-20.3; p < 0.0001). Other independent predictors of survival were the lack of epinephrine administration, previous myocardial infarction, coronary angiography, and the patient's age. CONCLUSION The survival to hospital discharge after OHCA could be predicted by the GCS score on hospital admission.
Collapse
Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland; Faculty of Medicine, Katowice School of Technology, Katowice, Poland.
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Zysko
- Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Sterlinski
- 1st Department of Heart Arrhythmia National Institute of Cardiology, Warsaw, Poland
| | | | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Jerzy Robert Ladny
- Department Emergency Medicine, University Medicine of Białystok, Bialystok, Poland
| | - Mariusz Gasior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| |
Collapse
|
5
|
Ciszewski JB, Tajstra M, Gadula-Gacek E, Kowalik I, Maciag A, Chwyczko T, Jankowska A, Smolis-Bak E, Firek B, Kraska A, Zajac D, Szwed H, Pytkowski M, Gasior M, Sterlinski M. P429The efficacy of electrical cardioversion of long-standing persistent or permanent atrial fibrillation in cardiac resynchronization therapy recipients. Europace 2020. [DOI: 10.1093/europace/euaa162.161] [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
Institute of Cardiology statutory grant (grant no.: 2.30/VII/13)
Background
Atrial fibrillation (AF) and heart failure (HF) often co-exist and influence each other. The presence of AF is often regarded as a marker of HF severity. Moreover, AF in cardiac resynchronization therapy (CRT) recipients hinders the CRT effectiveness in HF treatment by the reduction of the percentage of biventricular paced beats (BiVp%). Sinus rhythm (SR) restoration makes CRT more effective in HF treatment which may protect AF recurrence.
Purpose
To establish the effectiveness of electrical external cardioversion (EEC) in CRT patients with long-standing persistent AF or permanent, pre-treated with amiodarone.
Methods
The population of the study comprised of the Pilot-CRAfT study participants (NCT01850277), that is patients with CRT, long-standing persistent or considered as permanent AF and BiVp ≤ 95% who were randomly assigned to the "rhythm control" or the "rate control" strategy. The inclusion criteria included an AF paroxysm lasting at least 6 months. Both treatment arms received amiodarone beginning with the loading dose. Subsequently, patients assigned to the rhythm control strategy underwent electrical cardioversion. Rate control strategy included pharmacotherapy and atrioventricular node ablation, as needed. The follow up visit was performed 3 months after the enrolment visit. The EEC effectiveness, an AF recurrence within the 3 month period, BiVp% changes, the EEC parameters and the EEC related complications were analysed.
Results
Out of 48 participants enrolled in the Pilot-CRAfT study, 25 patients were assigned to the rhythm control arm. The mean age of the rhythm control arm patients was 69,5 years , the mean left ventricular ejection fraction was 30,6% , the mean left atrium diameter was 53 mm and the median duration of persistent AF was 16 months. SR was obtained in 12 out of 20 (60%) patients who underwent the EEC . On the 3 month visit 8 patients remained in SR (40%). In patients with an AF paroxysm lasting less than 1 year the success rate was 100% vs 50% in the AF lasting 1 year at least (p = 0,11 ). After 3 months, SR remained in 100% vs 25% of patients, respectively (p =0,015.). The effectiveness of anterior-posterior EEC electrodes placement was 20% and it was 71% for the anterior-lateral patch location . The EEC resulted in significant BiVp% rise - also in the whole intention-to-treat (ITT) group: 88,58% before the EEC vs 96,68% after the EEC (p = 0,002). No severe adverse events of the EEC were observed.
Conclusions
The electrical cardioversion of persistent atrial fibrillation lasting more than 6 months in patients with severe HF and treated with CRT is characterised by modest success rate, even after the amiodarone pre-treatment. However, the ECC ensures significant rise in BiVp% close to 97%, even in the whole EEC group based on the ITT principle. The AF paroxysm duration <1 year and the anterior-posterior patch placement may ensure better EEC efficacy in this group of patients.
Collapse
Affiliation(s)
| | - M Tajstra
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - E Gadula-Gacek
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - I Kowalik
- Institute of Cardiology, Warsaw, Poland
| | - A Maciag
- Institute of Cardiology, Warsaw, Poland
| | | | | | | | - B Firek
- Institute of Cardiology, Warsaw, Poland
| | - A Kraska
- National Institute of Geriatrics Rheumatology and Rehabilitation, Cardiac Rehabilitation Department, Warsaw, Poland
| | - D Zajac
- Institute of Cardiology, Warsaw, Poland
| | - H Szwed
- Institute of Cardiology, Warsaw, Poland
| | | | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | | |
Collapse
|
6
|
Warchol I, Lubinski A, Sterlinski M, Kowalski O, Goscinska-Bis K, Pytkowski M, Mitkowski P, Kazmierczak J, Szwed H, Przybylski A, Trusz-Gluza M, Kempa M, Zienciuk-Krajka A, Sielski S, Pazdyga A. P1464A question of gender equality. Sex-related differences in survival after primary prevention implantable cardioverter-defibrillator implantation for dilated cardiomyopathy An analysis from POLKARD. Europace 2020. [DOI: 10.1093/europace/euaa162.325] [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: 11/12/2022] Open
Abstract
Abstract
OnBehalf
POLKARD Polish ICD Registry
Background
The protective effects of implantable cardioverter defibrillators (ICDs) in the primary prevention of sudden cardiac death of patients presenting with left ventricular (LV) systolic dysfunction are unequivocal. Nevertheless, female underrepresentation has been a consistent finding in all randomized controlled primary prevention ICD trials. Surprisingly, there is a vast body of literature on female primary prevention ICD patients exhibit a lower overall mortality.
Purpose
Therefore, we analyzed data from a large, nationwide POLKARD registry to evaluate the effect of sex on survival after primary prevention cardioverter-defibrillator implantation for dilated cardiomyopathy.
Methods
All patients enrolled in the Polish ICD Registry from 2008 to 2014 were identified. Patients were included in the study if they were designated as receiving an ICD for primary prevention of SCD after documented non-ischeamic cardiomyopathy. Kaplan-Meier survival analysis was used to assess all-cause mortality.
Results
Of the 964 ICD recipients, 241 (25%) were women (mean age of 64± 0,45 years). During a mean follow-up of 5,53 ± 2,48 years 32% of women and 42% of men died. Kaplan-Meier curve depicted a significantly lower mortality for women than for men (p = 0,05). The median survival time was 6,73 years (55 deaths per 1000 person-years) versus 6,37 years (78 deaths per 1000 person-years) for women and men, respectively.
Conclusions
In agreement with previous studies, our data indicate that primary prevention implantation rates for dilated cardiomyopathy are lower in women. However, the reasons are not entirely understood.
Collapse
Affiliation(s)
- I Warchol
- Medical University of Lodz, Lodz, Poland
| | - A Lubinski
- Medical University of Lodz, Lodz, Poland
| | | | - O Kowalski
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | | | | | - P Mitkowski
- Poznan University of Medical Sciences, Poznan, Poland
| | | | - H Szwed
- Institute of Cardiology, Warsaw, Poland
| | | | | | - M Kempa
- Medical University of Gdansk, Gdansk, Poland
| | | | - S Sielski
- University Hospital N°2, Bydgoszcz, Poland
| | - A Pazdyga
- Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
7
|
Warchol I, Lubinski A, Sterlinski M, Kowalski O, Goscinska-Bis K, Pytkowski M, Mitkowski P, Kazmierczak J, Szwed H, Przybylski A, Trusz-Gluza M, Kempa M, Zienciuk-Krajka A, Sielski S, Pazdyga A. P1463Regional variation in survival rates among primary prevention implantable cardioverter-defibrillator recipients in Eastern and Northern Europe POLKARD Polish ICD Registry perspective. Europace 2020. [DOI: 10.1093/europace/euaa162.326] [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
None.
OnBehalf
POLKARD Polish ICD Registry
Objective
The findings of Danish Study to assess the efficiency of ICD in patients with non ischemic heart failure has recently raised questions about the current strategy of ICD implantation for the primary prevention of sudden cardiac death. POLKARD - Polish ICD Registry is a prospective, non-randomised, central registry of patients who are referred for an implantation of an ICD in Poland. The Registry contains prospectively collected follow-up data including mortality.
Purpose
To compare survival rates between Polish and Danish ‘real-world’ non-ischemic primary prevention cohorts.
Methods
Retrospective analysis of clinical characteristics and long-term follow-up of patients referred for primary prophylactic implantable cardioverter defibrillator (ICD) implantation in Poland between April 2008 and November 2014 was performed. The primary outcome of the trial was all-cause mortality. Results: The polish study cohort was large (964) as compared to Danish population randomized to receive ICD therapy (556). The median follow-up time in DANISH Study and Polish ICD Registry was 67,6 and 77 months, respectively. Compared with patients enrolled in the DANISH Study, patients in the Polish ICD Registry were age-similar. However, the polish study population was male-dominated. What is more, male gender was identified as a risk factor for long-term mortality in polish study population (p = 0.005). In the matched cohorts, there was difference in survival between DANISH Study and Polish ICD Registry patients (all-cause mortality rates: 21,6% - 44 events per 1000 person-years and 39,3% - 72 events per 1000 person-years, respectively).
Conclusions
Our findings imply that survival among patients who receive a primary prevention ICD for non-ischemic cardiomyopathy in clinical practice in Central Europe is different from Northern Europe.
Collapse
Affiliation(s)
- I Warchol
- Medical University of Lodz, Lodz, Poland
| | - A Lubinski
- Medical University of Lodz, Lodz, Poland
| | | | - O Kowalski
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | | | | | - P Mitkowski
- Poznan University of Medical Sciences, Poznan, Poland
| | | | - H Szwed
- Institute of Cardiology, Warsaw, Poland
| | | | | | - M Kempa
- Medical University of Gdansk, Gdansk, Poland
| | | | - S Sielski
- University Hospital N°2, Bydgoszcz, Poland
| | - A Pazdyga
- Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
8
|
Mielczarek S, Syska P, Lewandowski M, Przybylski A, Sterlinski M, Maciag A, Zajac D, Kowalik I, Pytkowski M, Szwed H. P990Assessment of clinical risk factors for all-cause mortality among hypertrophic cardiomyopathy patients with ICDs. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0583] [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
Introduction
According to the literature, the annual mortality rate of hypertrophic cardiomyopathy (HCM) patients is estimated to 1–2%. Sudden cardiac death (SCD), heart failure and thromboembolism are the main causes of death among this population. Patients at high risk for SCD, identified using HCM risk score, are qualified for ICD implantation. Unfortunately for clinicians, there is no validated model or statistical tool for assessment of the risk of mortality within the HCM patients with ICDs.
Purpose
The aim of this study was to determine the main risk factors of all- cause mortality in HCM patients with ICDs.
Methods
The long-term follow-up of group of 104 consecutive patients with HCM, who had the ICD implanted between 1996 and 2006 in tertiary reference clinical unit was performed. Twenty patients who died during observation were the subject of the current analysis. ICD was implanted for primary (n=16) and secondary (n=4) prevention of SCD within this subpopulation. Analysis were performed for mentioned below potential risk factors: age at the time of implantation, syncopes, family history of SCD, atrial fibrillation/supraventricular tachycardia, decreased left ventricular ejection fraction (LVEF), non-sustained ventricular tachycardia (nsVT), maximum left ventricular wall thickness, abnormal exercise blood pressure response, left ventricular outflow tract obstruction.
Results
The average time of survival since ICD implantation was 8,5±4,6 years. Decreased LVEF (Wald chi2 4,57; p=0,033), secondary prevention (Wald chi2 8,57; p=0,003), family history of SCD (Wald chi2 4,93; p=0,026) and episodes of nsVT (Wald chi2 3,49; p=0,062) are the clinical risk factors that significantly affect the time of survival. The probability of death, expressed as Hazard Ratio, was 27-fold higher in secondary prevention group (HR=27,18), almost 10-fold higher in patients with positive family history of SCD (HR=9,74) and 3,7-fold higher when nsVT was detected. The cause of death was established in 16/20 patients. In 15 cases, these were deaths from cardiovascular causes: end-stage heart failure (8), complications of heart transplantation or circulatory support (4), SCD (1) and other cardiovascular (2).
Conclusion
Secondary prevention, positive family history of SCD, nsVT and decreased LVEF seem to be the most significant risk factors associated with all- cause mortality in HCM patients with ICDs. Despite the ICD implantation, subpopulation studied had poor prognosis with high incidence of progression to end-stage heart failure. Further studies to create validated model for assessment of death risk in long-term observation of patients with HCM after ICD implantation are required.
Collapse
Affiliation(s)
| | - P Syska
- Institute of Cardiology in Anin, Warsaw, Poland
| | | | | | | | - A Maciag
- Institute of Cardiology in Anin, Warsaw, Poland
| | - D Zajac
- Institute of Cardiology in Anin, Warsaw, Poland
| | - I Kowalik
- Institute of Cardiology in Anin, Warsaw, Poland
| | - M Pytkowski
- Institute of Cardiology in Anin, Warsaw, Poland
| | - H Szwed
- Institute of Cardiology in Anin, Warsaw, Poland
| |
Collapse
|
9
|
Warchol I, Lubinski A, Sterlinski M, Kowalski O, Goscinska-Bis K, Pytkowski M, Mitkowski P, Kazmierczak J, Szwed H, Przybylski A, Trusz-Gruza M, Kempa M, Zienciuk A, Sielski S, Pazdyga A. P2878Higher all-cause mortality in patients with implanted dual-chamber cardioverter-defibrillators for secondary prevention: an analysis from the Polish ICD Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In the Polish ICD Registry population secondary prevention recipients account for over 27%. Despite the evolution of indications for secondary prevention implantable cardioverter defibrillators (ICDs), recommendations regarding the use of ICDs for secondary prevention of sudden cardiac death (SCD) rely on information from a small number of randomized controlled trials that were performed decades ago, with mixed results. Moreover, research on the outcomes after implantations for secondary prevention of ICDs is limited. While dual-chamber devices offer theoretical advantage over single-chamber devices, dual-chamber ICDs (DC-ICDs) were announced not superior to single-chamber (SC-ICDs) in some research.
Purpose
Therefore, the aim of the study was to evaluate the all-cause mortality among patients from the Polish ICD Registry receiving either a single- or a dual-chamber device for secondary prevention in contemporary clinical practice.
Methods
All patients enrolled in the Polish ICD Registry from 1995 to 2016 were identified. Patients were included in the study if they were designated as receiving an ICD for secondary prevention of SCD after documented tachycardic arrest, sustained ventricular tachycardia (VT), or syncope. Kaplan-Meier survival analysis was used to assess all-cause mortality.
Results
In the study population of 3596 ICD recipients (mean age 69±12 years, 81% male, SC-ICD 61%, DC-ICD 39%), during mean follow-up of 79±43 months all-cause mortality rate was higher in the dual-chamber group than in the single chamber group, with a significant difference between the two groups as depicted in Kaplan-Meier curve (p<0,05). The median survival time was 98 months versus 110 months for SC and DC-ICD, respectively.
Conclusions
This study is the first to describe the characteristics of a national cohort of patients receiving a secondary prevention ICD in such a long follow-up period in contemporary practice. Implantation of a dual-chamber ICD was associated with higher all-cause mortality compared with single chamber devices.
Collapse
Affiliation(s)
- I Warchol
- Medical University of Lodz, Lodz, Poland
| | - A Lubinski
- Medical University of Lodz, Lodz, Poland
| | - M Sterlinski
- Institute of Cardiology, Klinika Zaburzen Rytmu Serca, Warsaw, Poland
| | - O Kowalski
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | | | | | - P Mitkowski
- Poznan University of Medical Sciences, Poznan, Poland
| | | | - H Szwed
- Institute of Cardiology, Warsaw, Poland
| | | | | | - M Kempa
- Medical University of Gdansk, Gdansk, Poland
| | - A Zienciuk
- Medical University of Gdansk, Gdansk, Poland
| | - S Sielski
- Nicolaus Copernicus University (NCU), Bydgoszcz, Poland
| | - A Pazdyga
- Medical University of Gdansk, Gdansk, Poland
| |
Collapse
|
10
|
Farkowski MM, Maciag A, Ciszewski J, Kowalik I, Syska P, Sterlinski M, Szwed H, Pytkowski M. The long term risk of lead failure in patients with cardiovascular implantable electronic devices undergoing catheter ablation. SCAND CARDIOVASC J 2019; 53:323-328. [DOI: 10.1080/14017431.2019.1653489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/26/2022]
Affiliation(s)
- Michal M. Farkowski
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Aleksander Maciag
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Jan Ciszewski
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Ilona Kowalik
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Pawel Syska
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Maciej Sterlinski
- Department of Heart Arrhythmia, Institute of Cardiology, Warsaw, Poland
| | - Hanna Szwed
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Mariusz Pytkowski
- Heart Arrhythmia Ward, II Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
11
|
Auricchio A, Gasparini M, Linde C, Dobreanu D, Cano Ó, Sterlinski M, Bogale N, Stellbrink C, Refaat MM, Blomström-Lundqvist C, Lober C, Dickstein K, Normand C. Sex-Related Procedural Aspects and Complications in CRT Survey II: A Multicenter European Experience in 11,088 Patients. JACC Clin Electrophysiol 2019; 5:1048-1058. [PMID: 31537334 DOI: 10.1016/j.jacep.2019.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study sought to compare sex difference for procedural aspects and complications in the European Society of Cardiology CRT Survey II, exploring whether adverse events were related to the type of CRT device implanted. BACKGROUND Sex-related differences in procedural aspects and complications in patients undergoing cardiac resynchronization therapy (CRT) implantation has not been explored in a real-life population. METHODS A post-hoc analysis of procedural data and complications in different sexes and factors associated with events was performed from data collected in the European Society of Cardiology CRT Survey II. RESULTS Of all patients (n = 11,088) included, 24.3% were women. The mean age (70 years of age) of male and female recipients was similar. Female patients more frequently had an idiopathic cardiomyopathy (67.4% vs. 44.1%) and fewer comorbidities, including atrial fibrillation (34.8% vs. 42.8%), diabetes (29.1% vs. 32.1%), chronic obstructive lung disease (10.3% vs. 12.6%), and renal failure (28.7% vs. 31.9%), compared with men. More women compared with men had a pacemaker (56.6% vs. 46.3%) and much less often an implantable cardioverter-defibrillator (CRT-D) (19.0% vs. 34.7%) implant. Periprocedural event rate was the highest in women with CRT with defibrillator (7.1% vs. 4.8% in men), followed by women with a CRT with pacing (5.5% vs. 4.4% in men). The higher periprocedural event rate in CRT-D women was attributable primarily to the occurrence of pneumothorax (1.4%), coronary sinus dissection (2.1%), and pericardial tamponade (0.3%). The rate of in-hospital major adverse events (6.0%) and complications necessitating reoperation (4.0%) was not different among sex and device type. CONCLUSIONS Women are more likely to experience adverse procedure-related events during CRT implantation. Thus, preventive strategies should be employed to minimize complication rate.
Collapse
Affiliation(s)
- Angelo Auricchio
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
| | - Maurizio Gasparini
- Department of Cardiology, Humanitas Research Hospital IRCCS, Rozzano, Italy
| | - Cecilia Linde
- Heart and Vascular Theme, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Dan Dobreanu
- Institute of Cardiovascular Disease and Transplant, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
| | - Óscar Cano
- Electrophysiology Section, Cardiology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Nigussie Bogale
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | | | - Marwan M Refaat
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine and Medical Center, American University of Beirut, Beirut, Lebanon
| | | | | | - Kenneth Dickstein
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway; Institute of Internal Medicine, University of Bergen, Bergen, Norway
| | - Camilla Normand
- Department of Cardiology, Stavanger University Hospital, Stavanger, Norway; Institute of Internal Medicine, University of Bergen, Bergen, Norway
| |
Collapse
|
12
|
Dabrowski R, Smolis-Bak E, Kowalik I, Maczynska J, Dobrowolski M, Syska P, Chwyczko T, Rymuza H, Jedrzejczyk B, Sterlinski M, Pytkowski M, Szwed H. P6058No benefits of exercise training and worst possible outcomes for heart failure patients with atrial fibrillation and cardiac resynchronization therapy in 54 months follow-up. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | - I Kowalik
- Institute of Cardiology, Warsaw, Poland
| | | | | | - P Syska
- Institute of Cardiology, Warsaw, Poland
| | | | - H Rymuza
- Institute of Cardiology, Warsaw, Poland
| | | | | | | | - H Szwed
- Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
13
|
Nadolny K, Szarpak L, Gotlib J, Panczyk M, Sterlinski M, Ladny JR, Smereka J, Galazkowski R. An analysis of the relationship between the applied medical rescue actions and the return of spontaneous circulation in adults with out-of-hospital sudden cardiac arrest. Medicine (Baltimore) 2018; 97:e11607. [PMID: 30045296 PMCID: PMC6078650 DOI: 10.1097/md.0000000000011607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/28/2018] [Indexed: 12/11/2022] Open
Abstract
Sudden cardiac arrest (SCA) is a significant medical and social issue, the main cause of death in Europe and the United States.The aim of the research was to evaluate the effectiveness of emergency medical procedures applied by emergency medical teams in prehospital care in the context of return of spontaneous circulation (ROSC).The case-control study was based on the medical documentation of the Rescue Service in Katowice (responsible for monitoring 2.7 million inhabitants of the region) referring to 2016. The research involved exclusively adults (ie, individuals older than 18 years) with out-of-hospital cardiac arrest (OHCA). After considering the above inclusion criteria, there were 1603 dispatch order forms (0.64% of all dispatch orders) involved in further research.On the basis of the emergency medical procedure forms, the actions of emergency medical teams were verified as medical procedures (endotracheal intubation, the use of suction pumps, defibrillation, the use of alternatives providing airway patency and ROSC was determined.The analysis covered 1603 cases of OHCA. SCA turned out more frequent in men than in women (P = .000). Most often, SCA occurred in domestic conditions during the day and was witnessed by a third person. In 59.9% of the cases, actions were taken by witnesses, which increased the probability of ROSC. Patients were usually intubated (51.4%). Respirators were used less frequently (20.2%). Ventricular fibrillation (VF) was reported only in 22.0% of the cases. The ROSC rate was higher in the group of patients with diagnosed VF than in those with nonshockable rhythms (VF, 55.43% vs asystole, 24.05%; P = .000).Successful resuscitation depends on the quality of emergency medical procedures performed at the place of incident. The highest probability of ROSC is related with defibrillation (in the cases of VF or ventricular tachycardia with no pulse), intubation, the application of a respirator, and performing mechanical ventilation, as well as with a shorter time from dispatch to arrival.
Collapse
Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Lukasz Szarpak
- Department of Emergency Medicine, Lazarski University, Warsaw
| | - Joanna Gotlib
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Mariusz Panczyk
- Division of Teaching and Outcomes of Education, Faculty of Health Sciences, Medical University of Warsaw
| | - Maciej Sterlinski
- Department of Arrhythmia, The Cardinal Stefan Wyszynski Institute of Cardiology
| | - Jerzy Robert Ladny
- Department of Emergency Medicine and Disasters, Medical University of Bialystok, Bialystok
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Robert Galazkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
14
|
Linde CM, Normand C, Bogale N, Auricchio A, Sterlinski M, Marinskis G, Sticherling C, Bulava A, Pérez ÓC, Maass AH, Witte KK, Rekvava R, Abdelali S, Dickstein K. Upgrades from a previous device compared to de novo cardiac resynchronization therapy in the European Society of Cardiology CRT Survey II. Eur J Heart Fail 2018; 20:1457-1468. [PMID: 29806208 DOI: 10.1002/ejhf.1235] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To date, there are no data from randomized controlled studies on the benefit of cardiac resynchronization therapy (CRT) when implanted as an upgrade in patients with a previous device as compared to de novo CRT. In the CRT Survey II we compared the baseline data of patients upgraded to CRT (CRT-P/CRT-D) from a previous pacemaker (PM) or implantable cardioverter-defibrillator (ICD) to de novo CRT implantation. METHODS AND RESULTS In the European CRT Survey II, clinical practice data of patients undergoing CRT and/or ICD implantation across 42 European Society of Cardiology (ESC) countries were collected between October 2015 and December 2016. Out of a total of 11 088 patients, 2396 (23.2%) were upgraded from a previous PM or ICD and 7933 (76.8%) underwent de novo implantation. Compared to de novo implantations, upgraded patients were older, more often male, more frequently had ischaemic heart failure aetiology, atrial fibrillation, reduced renal function, worse heart failure symptoms, and higher N-terminal pro-B-type natriuretic peptide levels. Upgraded patients were more often PM-dependent and less frequently received CRT-D. Total peri-procedural, in-hospital complications and length of hospital stay were similar. Upgraded patients were less frequently treated with heart failure medication at discharge. CONCLUSION Despite a lack of evidenced-based data, close to one quarter of all CRT implantations across 42 ESC countries were upgrades from a previous PM or ICD. Despite older age and worse symptoms, the CRT implantation procedures in upgraded patients were equally frequently successful and complications similar to de novo implantations. These results call for more studies.
Collapse
Affiliation(s)
- Cecilia M Linde
- Heart and Vascular Theme, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Camilla Normand
- Department of Internal Medicine, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger, Norway
| | | | - Angelo Auricchio
- Clinical Electrophysiology Unit, Fondazione Cardiocentro Ticino, Lugano, Switzerland; and University Magdeburg, Germany
| | | | | | | | - Alan Bulava
- Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic
| | - Óscar Cano Pérez
- Unidad de Arritmias, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Alexander H Maass
- University of Groningen, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Roin Rekvava
- Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | | | - Kenneth Dickstein
- Department of Internal Medicine, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger, Norway
| |
Collapse
|
15
|
Jackson T, Lenarczyk R, Sterlinski M, Sokal A, Francis D, Whinnett Z, Van Heuverswyn F, Vanderheyden M, Heynens J, Stegemann B, Cornelussen R, Rinaldi CA. Left ventricular scar and the acute hemodynamic effects of multivein and multipolar pacing in cardiac resynchronization. Int J Cardiol Heart Vasc 2018; 19:14-19. [PMID: 29946558 PMCID: PMC6016076 DOI: 10.1016/j.ijcha.2018.03.006] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 03/21/2018] [Indexed: 12/14/2022]
Abstract
Background We sought to determine whether presence, amount and distribution of scar impacts the degree of acute hemodynamic response (AHR) with multisite pacing. Multi-vein pacing (MVP) or multipolar pacing (MPP) with a multi-electrode left ventricular (LV) lead may offer benefits over conventional biventricular pacing in patients with myocardial scar. Methods In this multi-center study left bundle branch block patients underwent an hemodynamic pacing study measuring LV dP/dtmax. Patients had cardiac magnetic resonance scar imaging to assess the effect of scar presence, amount and distribution on AHR. Results 24 patients (QRS 171 ± 20 ms) completed the study (83% male). An ischemic etiology was present in 58% and the mean scar volume was 6.0 ± 7.0%. Overall discounting scar, MPP and MVP showed no significant AHR increase compared to an optimized “best BiV” (BestBiV) site. In a minority of patients (6/24) receiver-operator characteristic analysis of scar volume (cut off 8.48%) predicted a small AHR improvement with MPP (sensitivity 83%, specificity 94%) but not MVP. Patients with scar volume > 8.48% had a MPP-BestBiV of 3 ± 6.3% vs. −6.4 ± 7.7% for those below the cutoff. There was a significant correlation between the difference in AHR and scar volume for MPP-BestBiV (R = 0.49, p = 0.02) but not MVP-BestBiV(R = 0.111, p = 0.62). The multielectrode lead positioned in scar predicted MPP AHR improvement (p = 0.04). Conclusions Multisite pacing with MPP and MVP shows no AHR benefit in all-comers compared to optimized BestBiV pacing. There was a minority of patients with significant scar volume in relation to the LV site that exhibited a small AHR improvement with MPP. (Study identifier NCT01883141)
Collapse
Key Words
- AHR, acute hemodynamic response
- Acute hemodynamic response
- BiV, biventricular
- CI, confidence interval
- CMR, cardiac magnetic resonance
- CMR-LGE, cardiac magnetic resonance late gadolinium enhancement
- CRT, cardiac resynchronization therapy
- Cardiac resynchronization therapy
- ECG, electrocardiogram
- HF, heart failure
- LBBB, left bundle branch block
- LV, left ventricular
- Left ventricular scar
- MEL, multielectrode lead
- MPP, multipolar pacing
- MVP, multivein pacing
- Multisite pacing
- OR, odds ratio
Collapse
Affiliation(s)
- Tom Jackson
- Department of Cardiology, Guy's & St. Thomas' Hospitals & King's College London, London, United Kingdom
| | - Radoslaw Lenarczyk
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Zabrze, Poland
| | | | - Adam Sokal
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Zabrze, Poland
| | - Darrell Francis
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Zachary Whinnett
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | | | | | - Joeri Heynens
- Medtronic Inc., Bakken Research Centre, Maastricht, The Netherlands
| | | | | | - Christopher Aldo Rinaldi
- Department of Cardiology, Guy's & St. Thomas' Hospitals & King's College London, London, United Kingdom
| |
Collapse
|
16
|
Dickstein K, Normand C, Auricchio A, Bogale N, Cleland JG, Gitt AK, Stellbrink C, Anker SD, Filippatos G, Gasparini M, Hindricks G, Blomström Lundqvist C, Ponikowski P, Ruschitzka F, Botto GL, Bulava A, Duray G, Israel C, Leclercq C, Margitfalvi P, Cano Ó, Plummer C, Sarigul NU, Sterlinski M, Linde C. CRT Survey II: a European Society of Cardiology survey of cardiac resynchronisation therapy in 11 088 patients-who is doing what to whom and how? Eur J Heart Fail 2018; 20:1039-1051. [PMID: 29457358 DOI: 10.1002/ejhf.1142] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [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: 12/13/2017] [Accepted: 12/22/2017] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cardiac resynchronisation therapy (CRT) reduces morbidity and mortality in appropriately selected patients with heart failure and is strongly recommended for such patients by guidelines. A European Society of Cardiology (ESC) CRT survey conducted in 2008-2009 showed considerable variation in guideline adherence and large individual, national and regional differences in patient selection, implantation practice and follow-up. Accordingly, two ESC associations, the European Heart Rhythm Association and the Heart Failure Association, designed a second prospective survey to describe contemporary clinical practice regarding CRT. METHODS AND RESULTS A survey of the clinical practice of CRT-P and CRT-D implantation was conducted from October 2015 to December 2016 in 42 ESC member countries. Implanting centres provided information about their hospital and CRT service and were asked to complete a web-based case report form collecting information on patient characteristics, investigations, implantation procedures and complications during the index hospitalisation. The 11 088 patients enrolled represented 11% of the total number of expected implantations in participating countries during the survey period; 32% of patients were aged ≥75 years, 28% of procedures were upgrades from a permanent pacemaker or implantable cardioverter-defibrillator and 30% were CRT-P rather than CRT-D. Most patients (88%) had a QRS duration ≥130 ms, 73% had left bundle branch block and 26% were in atrial fibrillation at the time of implantation. Large geographical variations in clinical practice were observed. CONCLUSION CRT Survey II provides a valuable source of information on contemporary clinical practice with respect to CRT implantation in a large sample of ESC member states. The survey permits assessment of guideline adherence and demonstrates variations in patient selection, management, implantation procedure and follow-up strategy.
Collapse
Affiliation(s)
- Kenneth Dickstein
- Cardiology Division, Stavanger University Hospital, Stavanger, Norway.,Institute of Internal Medicine, University of Bergen, Bergen, Norway
| | - Camilla Normand
- Cardiology Division, Stavanger University Hospital, Stavanger, Norway.,Institute of Internal Medicine, University of Bergen, Bergen, Norway
| | - Angelo Auricchio
- Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
| | - Nigussie Bogale
- Cardiology Division, Stavanger University Hospital, Stavanger, Norway
| | - John G Cleland
- Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow and National Heart & Lung Institute, Imperial College London, UK
| | - Anselm K Gitt
- Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.,Medizinische Klinik B, Klinikum der Stadt Ludwigshafen, Ludwigshafen, Germany.,University of Cyprus, School of Medicine, Cyprus
| | | | - Stefan D Anker
- Division of Cardiology and Metabolism; Department of Cardiology (CVK); Berlin-Brandenburg Center for Regenerative Therapies (BCRT); German Centre for Cardiovascular Research (DZHK) partner site Berlin; Charité Universitätsmedizin Berlin, Germany.,Department of Cardiology and Pneumology, University Medicine Göttingen (UMG), and German Centre for Cardiovascular Research (DZHK), Göttingen, Germany
| | - Gerasimos Filippatos
- National and Kapodistrian University of Athens, School of Medicine, Department of Cardiology, Athens University Hospital Attikon, Athens, Greece
| | | | - Gerhard Hindricks
- Department of Cardiac Surgery, HELIOS Heart Center Leipzig, Leipzig, Germany
| | | | - Piotr Ponikowski
- Department of Heart Diseases, Medical University Wroclaw, Wroclaw, Poland
| | - Frank Ruschitzka
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Alan Bulava
- Department of Cardiology, Ceske Budejovice Hospital, Ceske Budejovice, Czech Republic.,Faculty of Health and Social Sciences, University of South Bohemia, Ceske Budejovice, Czech Republic.,Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Gabor Duray
- Clinical Electrophysiology, Department of Cardiology, Medical Centre, Hungarian Defence Forces, Budapest, Hungary
| | - Carsten Israel
- Klinik für Innere Medizin - Kardiologie, Diabetologie & Nephrologie, Evangelisches Krankenhaus Bielefeld, Bielefeld, Germany
| | | | - Peter Margitfalvi
- The National Institute of Cardiovascular Diseases, Bratislava, Slovak Republic
| | - Óscar Cano
- Unidad de Arritmias, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Chris Plummer
- Department of Cardiology, Freeman Hospital, Freeman Rd, Newcastle upon Tyne, UK
| | - Nedim Umutay Sarigul
- Department of Cardiology, Medicalpark Goztepe Hospital, Istanbul, Turkey.,Kardio Bremen, Bremen, Germany
| | | | - Cecilia Linde
- Heart and Vessels Theme, Karolinska University Hospital, Stockholm, and Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
17
|
Chwyczko T, Dabrowski R, Smolis-Bak E, Sterlinski M, Maciag A, Borowiec A, Jankowska A, Kowalik I, Pytkowski M, Szwed H. P656Baseline cardiopulmonary exercise test result is the most useful parameter in predicting positive response and long-term survival after cardiac resynchronization therapy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p656] [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: 11/14/2022] Open
|
18
|
DE Pooter J, El Haddad M, DE Buyzere M, Aranda HA, Cornelussen R, Stegemann B, Rinaldi CA, Sterlinski M, Sokal A, Francis DP, Jordaens L, Stroobandt RX, VAN Heuverswyn F, Timmermans F. Biventricular Paced QRS Area Predicts Acute Hemodynamic CRT Response Better Than QRS Duration or QRS Amplitudes. J Cardiovasc Electrophysiol 2016; 28:192-200. [PMID: 27885752 DOI: 10.1111/jce.13132] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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] [Received: 07/06/2016] [Revised: 10/20/2016] [Accepted: 11/14/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR). METHODS AND RESULTS VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system. Maximum QRS vector amplitudes (XAmpl , YAmpl , ZAmpl , and 3DAmp ) and QRS areas (XArea , YArea , ZArea , and 3DArea ) in the orthogonal leads (X, Y, and Z) and in 3-dimensional projection were measured. Volume of the 3D vector loop and global QRS duration (QRSD) on the surface electrocardiogram were assessed. Differences (Δ) in VCG parameters between BV paced and LBBB QRS complexes were calculated. An increase of 10% in dP/dt max was considered as AHR. LBBB conduction is characterized by a large ZArea (109 μVs, interquartile range [IQR]:75;135), significantly larger than XArea (22 μVs, IQR:10;57) and YArea (44 μVs, IQR:32;62, P < 0.001). Overall, QRS duration, amplitudes, and areas decrease significantly with BV pacing (P < 0.001). Of all VCG parameters, 3DAmpl , Δ3DAmpl , ZArea, ΔZArea , Δ3DArea , and ΔQRSD differentiate AHR response from nonresponse (P < 0.05). ΔZArea predicted best positive AHR (area under the curve = 0.813) and outperformed any other VCG parameter or QRSD measurement. CONCLUSION Of all VCG parameters, reduction in QRS area, calculated in Frank's Z lead, predicts acute hemodynamic response best. This method might be an easy, noninvasive tool to guide CRT implantation and optimization.
Collapse
Affiliation(s)
- Jan DE Pooter
- Ghent University Hospital, Heart Center, Ghent, Belgium
| | | | | | | | | | | | | | - Maciej Sterlinski
- The Second Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland
| | - Adam Sokal
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy Silesian Center of Heart Disease, Zabrze, Poland
| | - Darrel P Francis
- Faculty of Medicine, Imperial College Healthcare NHS Trust, London, England, UK
| | - Luc Jordaens
- Ghent University Hospital, Heart Center, Ghent, Belgium
| | | | | | | |
Collapse
|
19
|
Jackson T, Lenarczyk R, Sterlinski M, Sokal A, Francis D, Whinnett Z, Van Heuverswyn F, Vanderheyden M, Heynens J, Stegemann B, Cornelussen R, Rinaldi A. 89-03: The Impact of Left Ventricular Scar on the Acute Hemodynamic Improvement with Multisite Left Ventricular Pacing. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i57c] [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
|
20
|
De Pooter J, El Haddad M, De Buyzere M, Timmers L, Drieghe B, Timmermans F, Rinaldi A, Stegemann B, Francis D, Vanderheyden M, Sokal A, Sterlinski M, Alfonso Aranda H, Cornelussen R, Jordaens L, Stroobandt RX, Van Heuverswyn F. 89-06: Assessment of vectorcardiographic parameters of the paced QRS complex as prediction of acute hemodynamic response in CRT patients. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i59] [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: 11/14/2022] Open
|
21
|
Ciszewski J, Sterlinski M. Rhythm Control and AV Node Ablation in CRT Patients with Atrial Fibrillation: Should They be Performed Together or Alternatively? Pacing Clin Electrophysiol 2015; 38:906-7. [PMID: 25880466 DOI: 10.1111/pace.12651] [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] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 04/12/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Jan Ciszewski
- 2nd Department of Coronary Artery Disease, Institute of Cardiology in Warsaw, Warszawa.
| | - Maciej Sterlinski
- 2nd Department of Coronary Artery Disease, Institute of Cardiology in Warsaw, Warszawa
| |
Collapse
|
22
|
Kuteszko R, Pytkowski M, Farkowski MM, Maciag A, Sterlinski M, Jankowska A, Kowalik I, Zajac D, Firek B, Demkow M, Szwed H. Utility of automated template matching for the interpretation of pace mapping in patients ablated due to outflow tract ventricular arrhythmias. Europace 2015; 17:1428-34. [PMID: 25736562 DOI: 10.1093/europace/euu392] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 05/17/2014] [Accepted: 12/12/2014] [Indexed: 01/30/2023] Open
Abstract
AIMS One of the disadvantages of classic pace mapping (PM) is the operator's subjective interpretation. The aim of this single-centre retrospective study was to evaluate the value of automated template matching (AMT) in patients ablated due to ventricular outflow tract arrhythmias (OTAs). METHODS AND RESULTS From an overall group of 105 patients with OTA who were scheduled for transcatheter ablation (TA), AMT was accessible in 42 patients [21 right ventricular outflow tract (RVOT), 21 left ventricular outflow tract (LVOT), 28 women, aged 51.5 ± 12.7 years]. We used AMT to compare spontaneous arrhythmia ORS (spontQRS) with paced QRS complexes during PM in sites where radiofrequency (RF) applications were successful and in sites where RF applications were unsuccessful. The concordance was presented in per cents as objective matching scores (OMS). Then, at the successful ablation sites, we examined the relationship between OMS and the visual interpretation of PM was presented as electrophysiologists matching scores (EMS). The OMS of PM at sites of successful ablation varied from 78 to 99% (mean 94.1 ± 3.8) and from 47 to 95% (mean 80.2 ± 12.6%) at sites of unsuccessful ablation. Pace mapping in unsuccessful RF sites was significantly less similar to spontQRS morphologies than in successful RF sites (P = 0.0001). There was a significant correlation between OMS and EMS (r = 0.82; P < 0.0001). The OMS that indicated optimal ablation site was 89% (sensitivity = 95%; specificity = 80%). The mean OMS for successful sites at RVOT (95.1 ± 1.8%) and LVOT (93.1 ± 4.9%) were not different (P = 0.0551). CONCLUSION This analysis revealed that AMT is a valuable technique for the interpretation of PM and for the identification of successful ablation sites in OTA.
Collapse
Affiliation(s)
- Rafal Kuteszko
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Mariusz Pytkowski
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Michal M Farkowski
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Aleksander Maciag
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Maciej Sterlinski
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Agnieszka Jankowska
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Ilona Kowalik
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Dariusz Zajac
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Bohdan Firek
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland
| | - Hanna Szwed
- The Second Department of Coronary Artery Disease, Institute of Cardiology, 1 Spartanska Street, Warsaw 02-637, Poland
| |
Collapse
|
23
|
Ciszewski J, Maciag A, Kowalik I, Syska P, Lewandowski M, Farkowski MM, Borowiec A, Chwyczko T, Pytkowski M, Szwed H, Sterlinski M. Comparison of the rhythm control treatment strategy versus the rate control strategy in patients with permanent or long-standing persistent atrial fibrillation and heart failure treated with cardiac resynchronization therapy - a pilot study of Cardiac Resynchronization in Atrial Fibrillation Trial (Pilot-CRAfT): study protocol for a randomized controlled trial. Trials 2014; 15:386. [PMID: 25281275 PMCID: PMC4283117 DOI: 10.1186/1745-6215-15-386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 09/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The only subgroups of patients with heart failure and atrial fibrillation in which the efficacy of cardiac resynchronization therapy has been scientifically proven are patients with indications for right ventricular pacing and patients after atrioventricular junction ablation. However it is unlikely that atrioventricular junction ablation would be a standard procedure in the majority of the heart failure patients with cardiac resynchronization therapy and concomitant atrial fibrillation due to the irreversible character of the procedure and a spontaneous sinus rhythm resumption that occurs in about 10% of these patients. METHODS/DESIGN Pilot-CRAfT is the first randomized controlled trial evaluating the efficacy of a rhythm control strategy in atrial fibrillation patients with cardiac resynchronization therapy devices. The aim of this prospective, single center randomized controlled pilot study is to answer the question whether the patients with cardiac resynchronization therapy and permanent atrial fibrillation would benefit from a strategy to restore and maintain sinus rhythm (that is 'rhythm control' strategy) in comparison to rate control strategy. The study population consists of 60 patients with heart failure and concomitant long-standing persistent or permanent atrial fibrillation who underwent a cardiac resynchronization therapy device implantation at least 3 months before qualification. Study participants are randomly assigned to the rhythm control strategy (including electrical cardioversion and pharmacotherapy) or to the rate control group whose goal is to control ventricular rate. The follow-up time is 12 months. The primary endpoint is the ratio of effectively captured biventricular beats. The secondary endpoints include peak oxygen consumption, six-minute walk test distance, heart failure symptom escalation, reverse remodelling of the heart on echo and quality of life. TRIAL REGISTRATION NCT01850277 registered on 22 April 2013 (ClinicalTrials.gov).
Collapse
Affiliation(s)
- Jan Ciszewski
- From the Second Department of Coronary Artery Disease, Institute of Cardiology, Warszawa, Poland.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Chwyczko T, Smolis-Bak E, Kowalik I, Dabrowski R, Sterlinski M, Maciag A, Kraska A, Borowiec A, Pytkowski M, Szwed H. Cardiopulmonary exercise test may be superior to echocardiography in selection of potential responders to cardiac resynchronization therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3376] [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: 11/14/2022] Open
|
25
|
Sosnowski C, Janeczko-Sosnowska E, Dabrowski R, Sterlinski M, Ostrzycki A, Wozniak JA, Suminski A, Zalucka L, Kowalik I, Szwed H. Acute hyperglycaemia in contrast to chronic hyperglycaemia is a true contrast-induced nephropathy risk factor in patients with acute coronary syndrome undergoing interventional procedures. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4808] [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: 11/12/2022] Open
|
26
|
Fabbri GMT, Baldasseroni S, Panuccio D, Zoni Berisso M, Scherillo M, Lucci D, Di Pasquale G, Mathieu G, Burazor I, Burazor M, Perisic Z, Atanaskovic V, Erakovic V, Stojkovic A, Vogtmann T, Schoebel C, Sogorski S, Sebert M, Schaarschmidt J, Fietze I, Baumann G, Penzel T, Mornos C, Ionac A, Cozma D, Dragulescu D, Mornos A, Petrescu L, Pescariu L, Brembilla-Perrot B, Khachab H, Lamberti F, Bellini C, Remoli R, Cogliandro T, Nardo R, Bellusci F, Mazzuca V, Gaspardone A, Aguinaga Arrascue LE, Bravo A, Garcia Freire P, Gallardo P, Hasbani E, Quintana R, Dantur J, Inoue K, Ueoka A, Tsubakimoto Y, Sakatani T, Matsuo A, Fujita H, Kitamura M, Wegrzynowska M, Konduracka E, Pietrucha AZ, Mroczek-Czernecka D, Paradowski A, Bzukala I, Nessler J, Igawa O, Adachi M, Atarashi H, Kusama Y, Kodani E, Okazaki R, Nakagomi A, Endoh Y, Baez-Escudero JL, Dave AS, Sasaridis CM, Valderrabano M, Tilz R, Bai R, Di Biase L, Gallinghouse GJ, Gibson D, Pisapia A, Wazni O, Natale A, Arujuna A, Karim R, Rinaldi A, Cooklin M, Rhode K, Razavi R, O'neill M, Gill J, Kusa S, Komatsu Y, Kakita K, Takayama K, Taniguchi H, Otomo K, Iesaka Y, Ammar S, Reents T, Fichtner S, Wu J, Zhu P, Olimulder MAGM, Galjee MA, Van Dessel PFHM, Van Der Palen J, Wilde AAM, Scholten MF, Chouchou F, Poupard L, Philippe C, Court-Fortune I, Kolb C, Barthelemy JC, Roche F, Deshko MS, Snezhitsky VA, Dolgoshey TS, Madekina GA, Stempen TP, Sugiura S, Fujii E, Senga M, Hessling G, Dohi K, Sugiura E, Nakamura M, Ito M, Eitel C, Hindricks G, Sommer P, Gaspar T, Bollmann A, Arya A, Deisenhofer I, Piorkowski C, Mendell J, Lasseter K, Shi M, Urban L, Hatala R, Hlivak P, De Melis M, Garutti C, Corbucci G, Di Biase L, Mlcochova H, Maxian R, Cihak R, Wichterle D, Peichl P, Kautzner J, Arbelo E, Dogac A, Luepkes C, Ploessnig M, Gilbert G, Chronaki C, Hinterbuchner L, Guillen A, Brugada J, Bun SS, Latcu DG, Franceschi F, Prevot S, Koutbi L, Ricard P, Mohanty P, Saoudi N, Deharo JC, Nazari N, Alizadeh A, Sayah S, Hekmat M, Assadian M, Ahmadzadeh A, Pietrucha AZ, Bzukala I, Cunningham J, Wnuk M, Mroczek-Czernecka D, Jedrzejczyk-Spaho J, Kruszelnicka O, Piwowarska W, Nessler J, Fedorowski A, Burri P, Juul-Moller S, Melander O, Metz T, Mitro P, Murin P, Kirsch P, Habalova V, Slaba E, Matyasova E, Barlow MA, Blake RJ, Wnuk M, Pietrucha AZ, Horton R, Rostoff P, Wojewodka Zak E, Mroczek-Czernecka D, Wegrzynowska M, Piwowarska W, Nessler J, Froidevaux L, Sarasin FP, Louis-Simonet M, Hugli O, Gallinghouse GJ, Yersin B, Schlaepfer J, Mischler C, Pruvot E, Occhetta E, Frascarelli F, Piacenti M, Burali A, Dovellini E, Padeletti L, Natale A, Tao S, Yamauchi Y, Okada H, Maeda S, Obayashi T, Isobe M, Chan J, Johar S, Wong T, Markides V, Hussain W, Konstantinidou M, Wissner E, Tilz R, Fuernkranz A, Yoshiga Y, Metzner A, Kuck KH, Ouyang F, Kettering K, Gramley F, Mollnau H, Weiss C, Bardeleben S, Biasco L, Scaglione M, Caponi D, Di Donna P, Sergi D, Cerrato N, Blandino A, Gaita F, Kettering K, Mollnau H, Weiss C, Gramley F, Fiala M, Wichterle D, Sknouril L, Bulkova V, Chovancik J, Nevralova R, Pindor J, Januska J, Choi JI, Ban JE, Yasutsugu N, Park JS, Jung JS, Lim HE, Park SW, Kim YH, Kuhne M, Reichlin T, Ammann P, Schaer B, Osswald S, Sticherling C, Ohe M, Goya M, Hiroshima K, Hayashi K, Makihara Y, Nagashima M, Fukunaga M, An Y, Dorwarth U, Schmidt M, Wankerl M, Krieg J, Straube F, Hoffmann E, Deisenhofer I, Ammar S, Reents T, Fichtner S, Kathan S, Wu J, Kolb C, Hessling G, Kuhne M, Reichlin T, Ammann P, Schaer B, Osswald S, Sticherling C, Defaye P, Mbaye A, Cassagneau R, Gagniere V, Jacon P, Pokushalov E, Romanov A, Artemenko S, Shabanov V, Elesin D, Stenin I, Turov A, Losik D, Kondo K, Adachi M, Miake J, Yano A, Ogura K, Kato M, Shigemasa C, Sekiguchi Y, Tada H, Yoshida K, Naruse Y, Yamasaki H, Igarashi M, Machino T, Aonuma K, Chen S, Liu S, Chen G, Meng W, Zhang F, Yan Y, Sciarra L, Dottori S, Lanzillo C, De Ruvo E, De Luca L, Minati M, Lioy E, Calo' L, Lin J, Nie Z, Zhu M, Wang X, Zhao J, Hu W, Tao H, Ge J, Johansson B, Houltz B, Edvardsson N, Schersten H, Karlsson T, Wandt B, Berglin E, Hoyt RH, Jenson BP, Trines SAIP, Braun J, Tjon Joek Tjien A, Zeppenfeld K, Tavilla G, Klautz RJM, Schalij MJ, Krausova R, Cihak R, Peichl P, Wichterle D, Kautzner J, Pirk J, Skalsky I, Maly J, Imai K, Sueda T, Orihashi K, Picarra BC, Santos AR, Dionisio P, Semedo P, Matos R, Leitao M, Banha M, Trinca M, Elder DHJ, George J, Jain R, Lang CC, Choy AM, Konert M, Loescher S, Hartmann A, Aversa E, Chirife R, Sztyglic E, Mazzetti H, Mascheroni O, Tentori MC, Pop RM, Margulescu AD, Dulgheru R, Enescu O, Siliste C, Vinereanu D, Menezes Junior A, Castro Carneiro AR, De Oliveira BL, Shah AN, Kantharia B, De Lucia R, Soldati E, Segreti L, Di Cori A, Zucchelli G, Viani S, Paperini L, Bongiorni MG, Kutarski A, Czajkowski M, Pietura R, Malecka B, Heintze J, Eckardt L, Bauer A, Meine M, Van Erven L, Bloch Thomsen PE, Lopez Chicharro MP, Merhi O, Nagashima M, Goya M, Soga Y, Hayashi K, Ohe M, Andou K, Hiroshima K, Nobuyoshi M, Gonzalez-Mansilla A, Martin-Asenjo R, Unzue L, Torres J, Garralda E, Coma RR, Rodriguez Garcia JE, Yaegashi T, Furusho H, Kato T, Chikata A, Takashima S, Usui S, Takamura M, Kaneko S, Kutarski A, Pietura R, Czajkowski M, Chudzik M, Kutarski A, Mitkowski P, Przybylski A, Lewek J, Malecka B, Smukowski T, Maciag A, Castrejon Castrejon S, Perez-Silva A, Estrada A, Doiny D, Ortega M, Lopez-Sendon JL, Merino JL, O'mahony C, Coats C, Cardona M, Garcia A, Calcagnino M, Lachmann R, Hughes D, Elliott PM, Conti S, Pruiti GP, Puzzangara E, Romano SA, Di Grazia A, Ussia GP, Tamburino C, Calvi V, Radinovic A, Sala S, Latib A, Mussardo M, Sora S, Paglino G, Gullace M, Colombo A, Ohlow MAG, Lauer B, Wagner A, Schreiber M, Buchter B, Farah A, Fuhrmann JT, Geller JC, Nascimento Cardoso RM, Batista Sa LA, Campos Filho LFC, Rodrigues SV, Dutra MVF, Borges TRSA, Portilho DR, Deering T, Bernardes A, Veiga A, Gartenlaub O, Goncalves A, Jimenez A, Rousseauplasse A, Deharo JC, Striekwold H, Gosselin G, Sitbon H, Martins V, Molon G, Ayala-Paredes F, Rousseauplasse A, Sancho-Tello MJ, Fazal IA, Brady S, Cronin J, Mcnally S, Tynan M, Plummer CJ, Mccomb JM, Val-Mejias JE, Fazal IA, Tynan M, Plummer CJ, Mccomb JM, Oliveira RM, Costa R, Martinelli Filho M, Silva KR, Menezes LM, Tamaki WT, Mathias W, Stolf NAG, Misawa T, Ohta I, Shishido T, Miyasita T, Miyamoto T, Nitobe J, Watanabe T, Kubota I, Thibault B, Ducharme A, Simpson C, Stuglin C, Gagne CE, Gagne CE, Williams R, Mcnicoll S, Silvetti MS, Drago F, Penela D, Bijnens B, Doltra A, Silva E, Berruezo A, Mont L, Sitges M, Mcintosh R, Baumann O, Raju P, Gurunathan S, Furniss S, Patel N, Sulke N, Lloyd G, Mor M, Dror S, Tsadok Y, Bachner-Hinenzon N, Katz A, Liel-Cohen N, Etzion Y, Mlynarski R, Mlynarska A, Wilczek J, Sosnowski M, Sinha AM, Sinha D, Noelker G, Brachmann J, Weidemann F, Ertl G, Jones M, Searle N, Cocker M, Ilsley E, Foley P, Khiani R, Nelson KE, Turley AJ, Owens WA, James SA, Linker NJ, Velagic V, Cikes M, Pezo Nikolic B, Puljevic D, Separovic-Hanzevacki J, Lovric-Bencic M, Biocina B, Milicic D, Kawata H, Chen L, Phan H, Anand K, Feld G, Birgesdotter-Green U, Fernandez Lozano I, Mitroi C, Toquero Ramos J, Castro Urda V, Monivas Palomero V, Corona Figueroa A, Hernandez Reina L, Alonso Pulpon L, Gate-Martinet A, Da Costa A, Rouffiange P, Cerisier A, Bisch L, Romeyer-Bouchard C, Isaaz K, Morales MA, Bianchini E, Startari U, Faita F, Bombardini T, Gemignani V, Piacenti M, Adhya S, Kamdar RH, Millar LM, Burchardt C, Murgatroyd FD, Klug D, Kouakam C, Guedon-Moreau L, Marquie C, Benard S, Kacet S, Cortez-Dias N, Carrilho-Ferreira P, Silva D, Goncalves S, Valente M, Marques P, Carpinteiro L, Sousa J, Keida T, Nishikido T, Fujita M, Chinen T, Kikuchi T, Nakamura K, Ohira H, Takami M, Anjo D, Meireles A, Gomes C, Roque C, Pinheiro Vieira A, Lagarto V, Reis H, Torres S, Ortega DF, Barja LD, Montes JP, Logarzo E, Bonomini P, Mangani N, Paladino C, Chwyczko T, Smolis-Bak E, Sterlinski M, Maciag A, Pytkowski M, Firek B, Jankowska A, Szwed H, Nakajima I, Noda T, Okamura H, Satomi K, Aiba T, Shimizu W, Aihara N, Kamakura S, Brzozowski W, Tomaszewski A, Kutarski A, Wysokinski A, Bertoldi EG, Rohde LE, Zimerman LI, Pimentel M, Polanczyk CA, Boriani G, Lunati M, Gasparini M, Landolina M, Lonardi G, Pecora D, Santini M, Valsecchi S, Rubinstein BJ, Wang DY, Cabreriza SE, Richmond ME, Rusanov A, Quinn TA, Cheng B, Spotnitz HM, Kristiansen HM, Vollan G, Hovstad T, Keilegavlen H, Faerestrand S, Kawata H, Phan H, Anand K, Feld G, Brigesdotter-Green U, Nawar AMR, Ragab DALIA, Eluhsseiny RANIA, Abdelaziz AHMED, Nof E, Abu Shama R, Buber J, Kuperstein R, Feinberg MS, Barlev D, Eldar M, Glikson M, Badran H, Samir R, Tawfik M, Amin M, Eldamnhoury H, Khaled S, Tolosana JM, Martin AM, Hernandez-Madrid A, Macias A, Fernandez-Lozano I, Osca J, Quesada A, Mont L, Boriani G, Gasparini M, Landolina M, Lunati M, Santini M, Padeletti L, Botto GL, De Santo T, Lunati M, Szwed A, Martinez JG, Degand B, Villani GQ, Leclercq C, Rousseauplasse A, Ritter P, Estrada A, Doiny D, Castrejon Castrejon S, Perez-Silva A, Ortega M, Lopez-Sendon JL, Merino JL, Watanabe I, Nagashima K, Okumura Y, Kofune M, Ohkubo K, Nakai T, Hirayama A, Mikhaylov E, Vander M, Lebedev D, Zarse M, Suleimann H, Bogossian H, Stegelmeyer J, Ninios I, Karosienne Z, Kloppe A, Lemke B, John S, Gaspar T, Rolf S, Sommer P, Hindricks G, Piorkowski C, Berruezo A, Fernandez-Armenta J, Mont LL, Zeljko H, Andreu D, Herzcku C, Boussy T, Brugada J, Yamauchi Y, Okada H, Maeda S, Tao S, Obayahi T, Aonuma K, Hegrenes J, Lim E, Mediratta V, Bautista R, Teplitsky L, Van Huls Van Taxis CFB, Wijnmaalen AP, Gawrysiak M, Schuijf JD, Bax JJ, Schalij MJ, Zeppenfeld K, Huo Y, Richter S, Hindricks G, Arya A, Gaspar T, Bollmann A, Akca F, Bauernfeind T, Schwagten B, De Groot NMS, Jordaens L, Szili-Torok T, Hegrenes J, Miller S, Kastner G, Teplitsky L, Maury P, Della Bella P, Delacretaz E, Sacher F, Maccabelli G, Brenner R, Rollin A, Jais P, Vergara P, Trevisi N, Ricco A, Petracca F, Bisceglia C, Baratto F, Maccabelli G, Della Bella P, Salguero Bodes R, Fontenla Cerezuela A, De Riva Silva M, Lopez Gil M, Mejia Martinez E, Jurado Roman A, Montero Alvarez M, Arribas Ynsaurriaga F, Baszko A, Krzyzanowski K, Bobkowski W, Surmacz R, Zinka E, Siwinska A, Szyszka A, Perez Silva A, Doiny D, Castrejon Castrejon S, Estrada Mucci A, Ortega Molina M, Lopez Sendon JL, Merino Llorens JL, Kaitani K, Hanazawa K, Izumi C, Nakagawa Y, Yamanaka I, Hirahara T, Sugawara Y, Suga C, Ako J, Momomura S, Galizio N, Gonzalez J, Robles F, Palazzo A, Favaloro L, Diez M, Guevara E, Fernandez A, Greenberg S, Epstein A, Deering T, Goldman DS, Sangli C, Keeney JA, Lee K, Piers SRD, Van Rees JB, Thijssen J, Borleffs CJW, Van Der Velde ET, Van Erven L, Schalij MJ, Leclercq CH, Hero M, Mizobuchi M, Enjoji Y, Yazaki Y, Shibata K, Funatsu A, Kobayashi T, Nakamura S, Amit G, Pertzov B, Katz A, Zahger D, Robles F, Galizio N, Gonzalez J, Medesani L, Rana R, Palazzo A, Albano F, Fraguas H, Pedersen SS, Hoogwegt MT, Jordaens L, Theuns DAMJ, Van Den Broek KC, Tekle FB, Habibovic M, Alings M, Van Der Voort P, Denollet J, Vrazic H, Jilek C, Badran H, Lesevic H, Tzeis S, Semmler V, Deisenhofer I, Kolb C, Theuns DAMJ, Gold MR, Burke MC, Bardy GH, Varma N, Pavri B, Stambler B, Michalski J, Investigators TRUST, Safak E, Schmitz D, Konorza T, Wende C, Schirdewan A, Neuzner J, Simmers T, Erglis A, Gradaus R, Alings M, Goetzke J, Coutrot L, Goehl K, Bazan Gelizo V, Grau N, Valles E, Felez M, Sanjuas C, Bruguera J, Marti-Almor J, Chu SY, Li PW, Ding WH, Schukro C, Leitner L, Siebermair J, Stix G, Pezawas T, Kastner J, Wolzt M, Schmidinger H, Behar NATHALIE, Kervio G, Petit B, Maison-Balnche P, Bodi S, Mabo P, Foley PWX, Mutch E, Brashaw-Smith J, Ball L, Leyva F, Kim DH, Lee MJ, Lee WS, Park SD, Shin SH, Woo SI, Kwan J, Park KS, Munetsugu Y, Tanno K, Kikuchi M, Ito H, Miyoshi F, Kawamura M, Kobayashi Y, Man S, Algra AM, Schreurs CA, Van Erven L, Van Der Wall EE, Cannegieter SC, Schalij MJ, Swenne CA, Adachi M, Yano A, Miake J, Ogura K, Kato M, Iitsuka K, Kondo T, Zarse M, Goebbert K, Bogossian H, Karossiene Z, Stegelmeyer J, Ninios I, Kloppe A, Lemke B, Goldman D, Kallen B, Kerpi E, Sardo J, Arsenos P, Gatzoulis K, Manis G, Dilaveris P, Tsiachris D, Mytas D, Asimakopoulos S, Stefanadis C, Arsenos P, Gatzoulis K, Manis G, Dilaveris P, Sideris S, Kartsagoulis E, Mytas D, Stefanadis C, Barbosa O, Marocolo Junior M, Silva Cortes R, Moraes Brandolis RA, Oliveira LF, Pertili Rodrigues De Resende LA, Vieira Da Silva MA, Dias Da Silva VJ, Hegazy RA, Sharaf IA, Fadel F, Bazaraa H, Esam R, Deshko MS, Snezhitsky VA, Stempen TP, Kuroki K, Tada H, Igawa M, Yoshida K, Igarashi M, Sekiguchi Y, Kuga K, Aonuma K, Ferreira Santos L, Dionisio T, Nunes L, Machado J, Castedo S, Henriques C, Matos A, Oliveira Santos J, Kraaier K. Poster Session 3. Europace 2011. [DOI: 10.1093/europace/eur229] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
27
|
Lewandowski M, Sterlinski M, Maciag A, Syska P, Kowalik I, Szwed H, Chojnowska L, Przybylski A. Long-term follow-up of children and young adults treated with implantable cardioverter-defibrillator: the authors' own experience with optimal implantable cardioverter-defibrillator programming. Europace 2010; 12:1245-50. [PMID: 20650939 DOI: 10.1093/europace/euq263] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
28
|
Dułak E, Lubiński A, Bissinger A, Przybylski A, Sterlinski M, Filipecki A, Pazdyga A, Zienciuk A, Kempa M, Królak T, Szwed H, Trusz-Gluza M, Kargul W. Recurrence of ventricular arrhythmias in patients with non-ischaemic dilated cardiomyopathy: evidence-based predictors. Kardiol Pol 2009; 67:837-844. [PMID: 19784881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Ventricular arrhythmia (VA) is the most frequent cause of sudden death among patients with non-ischaemic dilated cardiomyopathy (DCM). AIM To identify the important VA risk factors in patients with DCM. METHODS AND RESULTS Eighty-five DCM patients (73 males, mean age 54 years) with DCM and implantable cardioverter defibrillators (ICD) were followed for 21+/-19 months after ICD implantation. The mean follow-up was 21 months. Data from 55 patients with VA recorded in the ICD memory and requiring ICD intervention during follow-up were compared with 30 patients without arrhythmia. Cox regression analysis identified the following univariate predictors of VA: alcoholic aetiology of DCM (0.05), diuretic treatment (0.003), history of cardiac arrest (0.03), right ventricular diastolic diameter (0.001). Both ACE inhibitor (ACEI) and statin treatments were associated with a tendency towards decreased risk of VA. Multivariate logistic analysis identified four predictors as significantly related to VA: alcoholic aetiology (HR 4.8, p=0.008), ACEI treatment (HR 0.4, p=0.01), diuretic treatment (HR 2.6, p=0.015), and statin treatment (HR 0.1, p=0.03). CONCLUSIONS The majority of patients with DCM and ICD have recurrences of VA. Alcoholic aetiology of DCM is associated with an increase in the incidence of arrhythmias. Treatment with ACEI and statins is associated with a reduction of arrhythmias.
Collapse
Affiliation(s)
- Elzbieta Dułak
- Department of Cardiology, J. Brudziński Hospital, Gdynia, Poland
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Pytkowski M, Jankowska A, Maciag A, Kowalik I, Sterlinski M, Szwed H, Saumarez RC. Paroxysmal atrial fibrillation is associated with increased intra-atrial conduction delay. Europace 2008; 10:1415-20. [DOI: 10.1093/europace/eun282] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
30
|
Saumarez RC, Pytkowski M, Sterlinski M, Bourke JP, Clague JR, Cobbe SM, Connelly DT, Griffith MJ, McKeown PP, McLeod K, Morgan JM, Sadoul N, Chojnowska L, Huang CLH, Grace AA. Paced ventricular electrogram fractionation predicts sudden cardiac death in hypertrophic cardiomyopathy. Eur Heart J 2008; 29:1653-61. [DOI: 10.1093/eurheartj/ehn111] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
31
|
Saumarez RC, Pytkowski M, Sterlinski M, Hauer RNW, Derksen R, Lowe MD, Szwed H, Huang CLH, Ward DE, Camm AJ, Grace AA. Delayed paced ventricular activation in the long QT syndrome is associated with ventricular fibrillation. Heart Rhythm 2006; 3:771-8. [PMID: 16818204 DOI: 10.1016/j.hrthm.2006.03.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2005] [Accepted: 03/10/2006] [Indexed: 11/23/2022]
Abstract
BACKGROUND LQTS may cause sudden cardiac death (SCD), but the mechanisms linking gene mutations to ventricular fibrillation (VF) are unclear. OBJECTIVE To determine whether ventricular activation delays in congenital long QT syndrome (LQTS) are associated with VF and to describe these delays clinically by measuring activation through ventricular myocardium after a premature extrastimulus. METHODS Forty-six patients with LQTS, including 16 with VF (LQTS VF) were investigated, and the results were compared with those from 24 patients with hypertrophic cardiomyopathy and VF (HCM VF). Electrograms in response to premature stimuli were analyzed for increases in electrogram duration (DeltaED) and the S1S2 coupling intervals at which electrogram latency starts to increase (S1S2(delay)). Two piecewise continuous straight line segments were fitted to the last electrogram deflection as a function of S1S2 interval in the LQTS and HCM VF populations, and the difference in their gradient (alpha) was taken as an index of the abruptness of the onset of this delay. RESULTS Thirteen LQTS VF and six LQTS non-VF patients had values of DeltaED and S1S2(delay) comparable to those in HCM VF patients, while the remainder (three LQTS VF and 24 LQTS non-VF) had lower values (P<.001). There was only a weak correlation between delay and the corrected QT interval. The HCM and LQTS VF patients could be separated by the value of alpha (P<.01), with the LQTS patients having a more abrupt onset of delay. CONCLUSIONS Large delays in ventricular activation after an extrastimulus occur in patients with the LQTS, especially those with VF. The change in delay is abrupt in the LQTS, indicating sudden block to activation creating a dynamic substrate for arrhythmogenesis.
Collapse
|
32
|
Dulak E, Lubinski A, Sterlinski M, Filipecki A, Trusz-Gluza M, Szwed H, Swiatecka G, Kargul W. 967 Can statins and IACE have antiarrhythmic action in patients with nonischaemic dilated cardiomyopathy and implanted cardioverter defibrillator? Results of multicenter study. Europace 2005. [DOI: 10.1016/eupace/7.supplement_1.233-a] [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: 11/28/2022] Open
Affiliation(s)
- E. Dulak
- Brudzinski Hospital, Cardiology Department, Gdynia, Poland
| | - A. Lubinski
- Medical University, II Department of Cardiology, Gdansk, Poland
| | - M. Sterlinski
- National Institute of Cardiology, Ischaemic Heart Disease Department, Warsaw, Poland
| | - A. Filipecki
- Medical University, I Department of Cardiology, Katowice, Poland
| | - M. Trusz-Gluza
- Medical University, I Department of Cardiology, Katowice, Poland
| | - H. Szwed
- National Institute of Cardiology, Ischaemic Heart Disease Department, Warsaw, Poland
| | - G. Swiatecka
- Medical University, II Department of Cardiology, Gdansk, Poland
| | - W. Kargul
- Medical University, II Department of Cardiology, Katowice, Poland
| |
Collapse
|
33
|
Pytkowski M, Jankowska A, Sterlinski M, Macia GA, Kowalik I, Kraska A, Szwed H. A23-6 Radiofrequency ablation of atrial flutter in patients with atrial fibrillation treated with propafenone or amiodarone. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b35-c] [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: 11/15/2022] Open
Affiliation(s)
- M. Pytkowski
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - A. Jankowska
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - M. Sterlinski
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - G. A. Macia
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - I. Kowalik
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - A. Kraska
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| | - H. Szwed
- Coronary Disease Department, Institute of Cardiology, Warsaw, Poland
| |
Collapse
|
34
|
Sterlinski M, Maciag A, Pytkowski M, Przybylski A, Szwed H. P-399 Influence of coronary sinus anathomy on short-term efficacy of the resynchronisation systems implantation — The role of venography. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b160-a] [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: 11/30/2022] Open
Affiliation(s)
- M. Sterlinski
- Institute of Cardiology
,
Spartanska 1, 02-637 Warszawa, Poland
| | - A. Maciag
- Institute of Cardiology
,
Spartanska 1, 02-637 Warszawa, Poland
| | - M. Pytkowski
- Institute of Cardiology
,
Spartanska 1, 02-637 Warszawa, Poland
| | - A. Przybylski
- Institute of Cardiology
,
Spartanska 1, 02-637 Warszawa, Poland
| | - H. Szwed
- Institute of Cardiology
,
Spartanska 1, 02-637 Warszawa, Poland
| |
Collapse
|
35
|
Saumarez RC, Chojnowska L, Derksen R, Pytkowski M, Sterlinski M, Huang CLH, Sadoul N, Hauer RNW, Ruzyłło W, Grace AA. Sudden death in noncoronary heart disease is associated with delayed paced ventricular activation. Circulation 2003; 107:2595-600. [PMID: 12743006 DOI: 10.1161/01.cir.0000068342.96569.a1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Slowed or delayed myocardial activation and dispersed refractoriness predispose to reentrant excitation that may lead to ventricular fibrillation (VF). Increased ventricular electrogram duration (DeltaED) in response to extrastimuli and increased S1S2 coupling intervals at which electrogram duration starts to increase (S1S2delay) are seen both in hypertrophic cardiomyopathy (HCM) in those at risk of VF and in patients with idiopathic VF (IVF). METHODS AND RESULTS DeltaED and S1S2delay have been measured using paced electrogram fractionation analysis in 266 patients with noncoronary heart disease. Of these, one group of 61 patients had a history of VF and included 21 HCM, 17 IVF, 13 long-QT syndrome (LQTS), 5 dilated cardiomyopathy (DCM), and 5 others. These were compared with 205 patients with similar diseases with no VF history (non-VF group) and a control group (n=12) without heart disease. Results from HCM VF patients (DeltaED, 19+/-3.3 ms; S1S2delay, 350+/-9.7 ms) differed sharply from observations in HCM non-VF patients (DeltaED, 7.3+/-1.35 ms; S1S2delay, 312+/-6.7 ms; P<0.001). DCM VF patients had longer delays (DeltaED, 14.3+/-5.9; S1S2delay, 344+/-11.2) than DCM non-VF patients (DeltaED, 5.8+/-1.87 ms; S1S2delay, 311+/-5.7 ms; P<0.001), with major differences also seen comparing LQTS VF (DeltaED, 12.4+/-5.3 ms; S1S2delay, 343+/-13.8 ms) and LQTS non-VF patients (DeltaED, 11.0+/-2.7 ms; S1S2delay, 320+/-5.4 ms; P<0.001). IVF patients had both severely abnormal and normal areas of myocardium. CONCLUSIONS Slowed or delayed myocardial activation is a common feature in patients with noncoronary heart disease with a history of VF, and its assessment may allow the prospective prediction of VF risk in these patients.
Collapse
MESH Headings
- Cardiac Pacing, Artificial
- Cardiomyopathy, Dilated/complications
- Cardiomyopathy, Dilated/diagnosis
- Cardiomyopathy, Dilated/physiopathology
- Cardiomyopathy, Hypertrophic/complications
- Cardiomyopathy, Hypertrophic/diagnosis
- Cardiomyopathy, Hypertrophic/physiopathology
- Death, Sudden, Cardiac/etiology
- Diagnosis, Differential
- Discriminant Analysis
- Electrocardiography
- Electrophysiologic Techniques, Cardiac
- Heart Conduction System/physiopathology
- Heart Diseases/complications
- Heart Diseases/diagnosis
- Heart Diseases/physiopathology
- Humans
- Long QT Syndrome/complications
- Long QT Syndrome/diagnosis
- Long QT Syndrome/physiopathology
- Tachycardia, Ventricular/complications
- Tachycardia, Ventricular/diagnosis
- Tachycardia, Ventricular/physiopathology
- Ventricular Dysfunction/complications
- Ventricular Dysfunction/diagnosis
- Ventricular Dysfunction/physiopathology
- Ventricular Fibrillation/complications
- Ventricular Fibrillation/diagnosis
- Ventricular Fibrillation/physiopathology
Collapse
Affiliation(s)
- Richard C Saumarez
- Department of Cardiology, Papworth Hospital, University of Cambridge, Cambridge CB3 8RE, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|