1
|
Guenoun M, Cohen S, Villaceque M, Sharareh A, Schwartz J, Hoffman O, Dib JC, Ouazana L, Assouline S, Parrens E, Garban T, Pradeau V, Guedj-Meynier D, Lequeux B, Cohen C, Durand P, Dievart F, Dhanjal TS, Sabouret P, Lellouche N. Characteristics of patients with atrial fibrillation treated with direct oral anticoagulants and new insights into inappropriate dosing: results from the French National Prospective Registry: PAFF. Europace 2023; 25:euad302. [PMID: 37801642 PMCID: PMC10590101 DOI: 10.1093/europace/euad302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/14/2023] [Indexed: 10/08/2023] Open
Abstract
AIMS Since the introduction of direct oral anticoagulant (DOAC) for atrial fibrillation (AF) therapy, inappropriate and/or underdosing of these drugs has been a major clinical challenge. We evaluated the characteristics of patients with AF treated with inappropriate and low-dose DOACs. METHODS AND RESULTS Patients with AF treated with inappropriate and low-dose DOACs from October 2021 to December 2021 were evaluated from the French National Prospective Registry (PAFF). We evaluated 1890 patients with AF receiving DOACs (apixaban 55%, dabigatran 7%, and rivaroxaban 38%). Inappropriate dosing was noted in 18% of the population. Patients with appropriate dosing had less comorbidities: younger age (75 ± 10 vs. 82 ± 8 years old, P < 0.0001), reduced chronic renal failure (26 vs. 61%, P < 0.0001), and lower CHA2DS2VASc and HASBLED scores (3 ± 2 vs. 4 ± 3, P < 0.0001; 2 ±1 vs. 2 ± 2, P < 0.0001), respectively. In multivariate analysis, older age (P < 0.0001) and a higher CHA2DS2VASc score (P = 0.0056) were independently associated with inappropriate DOAC dosing. Among 472 patients (27%) treated with low-dose rivaroxaban or apixaban, 46% were inappropriately underdosed. Patients inappropriately underdosed were younger (82.3 ± 8.4 vs. 85.9 ± 5.9 years, P < 0.0001) with less chronic renal disease (47 vs. 98%, P < 0.0001). However, these patients had higher rates of prior haemorrhagic events (18 vs. 10%, P = 0.01), clopidogrel use (11 vs. 3%, P = 0.0002), and apixaban prescription (74 vs. 50%, P < 0.0001). CONCLUSION Within this large registry, DOACs were associated with inappropriate dosing in 18% of cases. Independent predictors of inappropriate dosing were high CHA2DS2VASc scores and older age. Moreover, 46% of patients treated with low-dose DOACs were inappropriately underdosed and more frequently in patients treated with apixaban.
Collapse
Affiliation(s)
- Maxime Guenoun
- Almaviva Santé, Marseille, France
- College National des Cardiologues Français, Paris, France
| | - Serge Cohen
- College National des Cardiologues Français, Paris, France
| | | | - Ali Sharareh
- College National des Cardiologues Français, Paris, France
| | | | | | | | - Leon Ouazana
- College National des Cardiologues Français, Paris, France
| | | | - Eric Parrens
- College National des Cardiologues Français, Paris, France
- Clinique Tivoli-Ducos, Bordeaux, France
| | - Thierry Garban
- College National des Cardiologues Français, Paris, France
| | | | | | - Benoit Lequeux
- College National des Cardiologues Français, Paris, France
| | | | - Philippe Durand
- College National des Cardiologues Français, Paris, France
- Institut Arnaud Tzanck, Saint Laurent du Var, France
| | | | - Tarvinder S Dhanjal
- Department of Cardiac Electrophysiology, University of Warwick, Gibbet Hill, Coventry, UK
| | - Pierre Sabouret
- College National des Cardiologues Français, Paris, France
- Department of Cardiology, AP-HP, University Hospital Pitie-Salpetriere, Paris, France
| | - Nicolas Lellouche
- Department of Cardiology, AP-HP, University Hospital Henri Mondor, 51, Avenue du Maréchal de Lattre de Tassigny, Creteil 94000, France
| |
Collapse
|
2
|
Lemesle G, Bauters C, Bonello L, Fauchier L, Cayla G, Marijon E, Guenoun M, Schurtz G, Ninni S, Richardson M, Albert F, Cohen S, Lamblin N, Danchin N. Management of antithrombotics in situations with a gap in evidence: A national French survey focusing on patients with coronary artery disease and atrial fibrillation. Int J Cardiol 2021; 348:15-21. [PMID: 34864080 DOI: 10.1016/j.ijcard.2021.11.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND If several randomized studies allowed to better apprehend what should be the best antithrombotic strategy in patients with concomitant coronary artery disease (CAD) and atrial fibrillation (AF), there are still several clinical situations with a gap of evidence. METHODS We conducted a national French survey in September-October 2020 among cardiologists in order to assess what are daily practices regarding the antithrombotic management in several specific clinical settings where no or little scientific evidence is available. The questionnaires were built by a committee of 6 cardiologists routinely involved in the field of CAD and/or AF. RESULTS Among the 6388 French cardiologists, 483 (7.6%) cardiologists participated to the survey. The rate of participation was rather homogeneous across the country. The mean age of participants was 48 +/- 12.7. There were 134 women (27.7%) and 349 men. Altogether, 181 (37.5%) cardiologists worked in private, 153 (31.7%) in non-universitary public and 83 (17.2%) in universitary public centers. The remaining had shared activity. Among the participants, 150 were interventional (coronary) cardiologists (31.1%). Others were general cardiologists (n = 229), specialists in the field of rhythmology (n = 43), heart failure (n = 17) or imaging (n = 44). The survey consisted of 10 questions pertaining to 2 virtual clinical scenarios. CONCLUSIONS The present survey is an illustration of how therapeutic decisions may vary in such situations with little or no scientific evidence. Such surveys may help experts to build consensus (answers with little variability) and to target the need for future trials and more research (answers with a lot of variability).
Collapse
Affiliation(s)
- Gilles Lemesle
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Univ. Lille, F-59000, France; Institut Pasteur of Lille, Inserm U1011, F-59000 Lille, France; FACT (French Alliance for Cardiovascular Trials), F-75000 Paris, France.
| | - Christophe Bauters
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Institut Pasteur of Lille, Inserm U1167, F-59000 Lille, France; Univ. Lille, F-59000, France
| | - Laurent Bonello
- Aix-Marseille Univ, Intensive care unit, Department of Cardiology, Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France; Mediterranean Association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Centre for CardioVascular and Nutrition research (C2VN), INSERM 1263, INRA 1260, Marseille, France
| | - Laurent Fauchier
- Department of Cardiology, CHU de Trousseau, University François-Rabelais, 37170 Chambray-lès-, Tours, France
| | - Guillaume Cayla
- Department of Cardiology, University Hospital of Nîmes, 30000 Nîmes, France
| | - Eloi Marijon
- Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, Paris, France
| | - Maxime Guenoun
- Department of Cardiology, Hôpital Européen de Marseille, 13003 Marseille, France
| | - Guillaume Schurtz
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France
| | - Sandro Ninni
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Univ. Lille, F-59000, France; Institut Pasteur of Lille, Inserm U1011, F-59000 Lille, France; FACT (French Alliance for Cardiovascular Trials), F-75000 Paris, France
| | - Marjorie Richardson
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France
| | - Franck Albert
- Department of Cardiology, Hospital of Chartres, 28000 Chartres, France
| | - Serge Cohen
- Department of Cardiology, Hôpital St Antoine, APHP, Paris, France
| | - Nicolas Lamblin
- Heart and Lung Institute, University hospital of Lille, F-59000 Lille, France; Institut Pasteur of Lille, Inserm U1167, F-59000 Lille, France; Univ. Lille, F-59000, France
| | - Nicolas Danchin
- Department of Cardiology, Hôpital Européen Georges Pompidou, AP-HP, University of Paris, FACT (French Alliance for Cardiovascular Trials), Paris, France
| |
Collapse
|
3
|
Abstract
PURPOSE Although direct oral anticoagulants (DOACs) are associated with an overall favourable safety profile, the risk of gastrointestinal bleeding with DOACs compared with vitamin K antagonists (VKAs) remains controversial. Accordingly, we aimed to provide a focused overview of the risk of gastrointestinal bleeding associated with dabigatran, rivaroxaban, apixaban and edoxaban and its management. METHODS We reviewed published studies reporting on DOACs with gastrointestinal bleeding as an outcome, including randomised controlled trials (RCTs), retrospective database studies and large-scale prospective cohort studies. RESULTS Cumulative evidence confirms no notable difference in major gastrointestinal bleeding risk between DOACs and VKAs. Moreover, gastrointestinal bleeding in DOAC-treated patients seems less severe and requires less intensive management. The main cause of upper gastrointestinal bleeding in DOAC-treated patients appears to be gastroduodenal ulcers, whereas lower gastrointestinal bleedings are mainly due to diverticula followed by angiodysplasia and haemorrhoids. The lack of head-to-head RCTs with DOACs precludes drawing conclusions on the DOAC with the lowest gastrointestinal bleeding risk. Prescribing physicians should be aware of risk factors for DOAC-related gastrointestinal bleeding (e.g. age > 65, heavy alcohol use, uncontrolled hypertension, hepatic or renal dysfunction, active cancer, anaemia) and adopt preventive measures accordingly. Management of DOAC-associated major gastrointestinal bleeding involves temporary discontinuation of the DOAC, investigation of the bleeding source and treatment of bleeding with fluid resuscitation combined with transfusion and endoscopic haemostasis. CONCLUSION DOACs as a class do not increase the risk of major gastrointestinal bleeding compared to VKAs, which supports their continued use for different anticoagulant indications.
Collapse
Affiliation(s)
- Robert Benamouzig
- Department of Gastroenterology and Digestive Oncology, AP-HP Avicenne Hospital, Sorbonne Paris Nord University, 125 Rue de Stalingrad, 93000, Bobigny, France.
| | - Maxime Guenoun
- Department of Cardiology, Clinique Bouchard, Marseille, France
| | - David Deutsch
- Department of Gastroenterology and Digestive Oncology, AP-HP Avicenne Hospital, Sorbonne Paris Nord University, 125 Rue de Stalingrad, 93000, Bobigny, France
| | | |
Collapse
|
4
|
Giaime P, Guenoun M, Pedinielli N, Narbonne H, Bergounioux JP, Solas C, Guilhaumou R, Sampol J, Ollier J, Sichez H, Serveaux M, Brunner F, Bataille S. Hydroxychloroquine and azithromycin tolerance in haemodialysis patients during COVID-19 infection. Nephrol Dial Transplant 2020; 35:1346-1353. [PMID: 32844224 PMCID: PMC7499716 DOI: 10.1093/ndt/gfaa191] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/23/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Haemodialysis patients are at risk of developing severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: coronavirus disease 2019 (COVID-19). In March 2020, hydroxychloroquine (HCQ) and azithromycin (AZI) were proposed as potential treatments of COVID-19, but with warnings concerning their possible toxicity. No data are available regarding the toxicity of this treatment in haemodialysis patients. METHODS We report the use of HCQ and AZI in a cohort of COVID-19 haemodialysis patients with focus on safety concerns. RESULTS Twenty-one patients received 200 mg HCQ thrice daily during 10 days, and AZI 500 mg on Day 1, and 250 mg on the four following days. HCQ plasma concentrations were within the recommended range (0.1-1.0 µg/mL) in all patients except one, in which maximum concentration was 1.1 µg/mL. HCQ concentration raised until the third day and remained stable thereafter. No cardiac event occurred in spite of progressive lengthening of corrected QT interval (QTc) during the treatment. One patient experienced a long QTc syndrome (QTc >500 ms) without any arrhythmia episode, although HCQ concentration was in the target range. Five (23.8%) patients experienced hypoglycaemia, a well-known HCQ side-effect. SARS-CoV-2 RNA remained detectable in nasopharyngeal swabs for a long time in haemodialysis patients (mean time 21 days). CONCLUSIONS HCQ and AZI are safe in haemodialysis patients at these doses but can lead to long QTc syndrome and hypoglycaemia. HCQ concentrations were not correlated with side effects. We recommend monitoring of the QTc length throughout treatment, as well as glycaemia. SARS-CoV-2 could persist for longer in haemodialysis patients than in the general population.
Collapse
Affiliation(s)
- Philippe Giaime
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Maxime Guenoun
- Department of Cardiology, Clinique Bouchard, Marseille, France
| | - Nathalie Pedinielli
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Hervé Narbonne
- Department of Endocrinology, Clinique Bouchard, Marseille, France
| | | | - Caroline Solas
- Aix-Marseille Université, APHM, Unité des Virus Emergents (UVE) IRD 190, INSERM 1207, Laboratoire de Pharmacocinétique et Toxicologie, Hôpital La Timone, Marseille, France
| | - Romain Guilhaumou
- Service de Pharmacologie Clinique et Pharmacovigilance, APHM, Institut de Neurosciences des Systèmes, Inserm UMR 1106, Université d'Aix-Marseille, Marseille, France
| | - Jérôme Sampol
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Jacques Ollier
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Hélène Sichez
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Marianne Serveaux
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Flora Brunner
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Association pour le Traitement des Urémiques en Provence, Marseille, France
| | - Stanislas Bataille
- Phocean Nephrology Institute, Clinique Bouchard, Marseille, France
- Aix Marseille Université, INSERM, INRAE, C2VN, Marseille, France
| |
Collapse
|
5
|
Taieb J, Rosier A, Mansourati J, Lazarus A, Cebron J, Fossati F, Guenoun M. Remote monitoring of cardiovascular implantable electronic devices in France. The French Electra survey. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
6
|
Tarlet JM, Taieb J, Di Legge S, Boccara G, Coulon D, Guenoun M. Noninvasive detection of atrial fibrillation in cryptogenic stroke: Contribution of a new e-cardiology device. HeartRhythm Case Rep 2018; 4:412-414. [PMID: 30228967 PMCID: PMC6140617 DOI: 10.1016/j.hrcr.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jean-Michel Tarlet
- @-Health, Les Milles, France
- Cardiology Department, Pays D’Aix Hospital, Aix-en-Provence, France
- Address reprint requests and correspondence: Dr Jean-Michel Tarlet, Institution Centre de Cardiologie, 32 Blvd du Roy René, 13100 Aix-en-Provence, France.
| | - Jérôme Taieb
- Cardiology Department, Pays D’Aix Hospital, Aix-en-Provence, France
| | - Silvia Di Legge
- Neurology Department, Pays D’Aix Hospital, Aix-en-Provence, France
| | - Gilles Boccara
- Cardiology Department, Northern Hospital, Marseille, France
| | | | - Maxime Guenoun
- Cardiology Department, Northern Hospital, Marseille, France
- Cardiology Department, European Hospital, Marseille, France
| |
Collapse
|
7
|
Gauthier J, Guenoun M, Abastado P, Deharo J, Hanon O. Non-major bleedings in patients with atrial fibrillation treated with direct oral anticoagulants (DOACs): Cardiologists practical management approaches: The HEMICARD survey. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.014] [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: 11/30/2022]
|
8
|
Ponikowski ADGDTP, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GM, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P, Filippatos RDDG, McMurray JJ, Aboyans V, Achenbach S, Agewall S, Al-Attar N, James Atherton J, Bauersachs J, Camm AJ, Carerj S, Ceconi C, Coca A, Elliott P, Erol Ç, Ezekowitz J, Fernández-Golfín C, Fitzsimons D, Guazzi M, Guenoun M, Hasenfuss G, Hindricks G, Hoes AW, Iung B, Jaarsma T, Kirchhof P, Knuuti J, Kolh P, Konstantinides S, Lainscak M, Lancellotti P, Lip GY, Maisano F, Mueller C, Petrie MC, Piepoli MF, Priori SG, Torbicki A, Tsutsui H, van Veldhuisen DJ, Windecker S, Yancy C, Zamorano JL. Guía ESC 2016 sobre el diagnóstico y tratamiento de la insuficiencia cardiaca aguda y crónica. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.10.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
9
|
Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WM, Binno CAS, Backer RDDGD, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, Sutter JD, Egidi G, Fisher M, Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip GY, Mach F, Mancia G, Bermudo FM, Mezzani A, Niessner A, Ponikowski P, Rauch B, Rydén L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano JL. Guía ESC 2016 sobre prevención de la enfermedad cardiovascular en la práctica clínica. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
10
|
Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney MT, Corrà U, Cosyns B, Deaton C, Graham I, Hall MS, Hobbs FDR, Løchen ML, Löllgen H, Marques-Vidal P, Perk J, Prescott E, Redon J, Richter DJ, Sattar N, Smulders Y, Tiberi M, van der Worp HB, van Dis I, Verschuren WMM, De Backer G, Roffi M, Aboyans V, Bachl N, Bueno H, Carerj S, Cho L, Cox J, De Sutter J, Egidi G, Fisher M, Fitzsimons D, Franco OH, Guenoun M, Jennings C, Jug B, Kirchhof P, Kotseva K, Lip GYH, Mach F, Mancia G, Bermudo FM, Mezzani A, Niessner A, Ponikowski P, Rauch B, Rydén L, Stauder A, Turc G, Wiklund O, Windecker S, Zamorano JL. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol 2016; 23:NP1-NP96. [PMID: 27353126 DOI: 10.1177/2047487316653709] [Citation(s) in RCA: 567] [Impact Index Per Article: 70.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Ugo Corrà
- Societies: European Society of Cardiology (ESC)
| | | | | | - Ian Graham
- Societies: European Society of Cardiology (ESC)
| | | | | | | | | | | | - Joep Perk
- Societies: European Society of Cardiology (ESC)
| | | | | | | | - Naveed Sattar
- European Association for the Study of Diabetes (EASD)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Leslie Cho
- Societies: European Society of Cardiology (ESC)
| | | | | | | | - Miles Fisher
- European Association for the Study of Diabetes (EASD)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lars Rydén
- Societies: European Society of Cardiology (ESC)
| | | | | | | | | | | |
Collapse
|
11
|
Taieb J, Georger F, Fossati F, Mansourati J, Lazarus A, Cebron JP, Guenoun M. 56-13: Anesthesia in ablation procedures: differences between public and private centers. The French Electra Survey. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i35] [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
|
12
|
Taieb J, Guenoun M, Lazarus A, Mansourati J, Fossati F, Pierre Cebron J. 0131: Strategy of anticoagulation in pacemaker and ICD replacement procedure in real life. The French Electra survey. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)71684-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Danchin N, Ferrieres J, Guenoun M, Cattan S, Rushton-Smith SK, Greenlaw N, Ferrari R, Steg PG. Management of outpatients in France with stable coronary artery disease. Findings from the prospeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease (CLARIFY) registry. Arch Cardiovasc Dis 2014; 107:452-61. [DOI: 10.1016/j.acvd.2014.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 05/30/2014] [Accepted: 06/11/2014] [Indexed: 10/24/2022]
|
14
|
Blacher J, Peroz-Froz J, Huberman JP, Ferrini M, Jullien G, Guenoun M, Guedj-Meynier D. Ambulatory hypertensive patients treated by cardiologists in France. Arch Cardiovasc Dis 2013; 106:86-92. [DOI: 10.1016/j.acvd.2012.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Revised: 11/02/2012] [Accepted: 11/13/2012] [Indexed: 01/13/2023]
|
15
|
Peyrol M, Sbragia P, Uhry S, Boccara G, Dolla E, Quatre A, Guenoun M, Lévy S, Paganelli F. Slow pathway elimination for atrioventricular nodal reentrant tachycardia with the 8-mm tip cryoablation catheter: an 18-month follow-up study. J Interv Card Electrophysiol 2012; 37:105-9. [DOI: 10.1007/s10840-012-9768-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 11/25/2012] [Indexed: 10/27/2022]
|
16
|
Peyrol M, Sbragia P, Quatre A, Orabona M, Casalta AC, Boccara G, Zerrouk Z, Guenoun M, Lévy S, Paganelli F. Reduction of procedure duration and radiation exposure with a dedicated inner lumen mapping catheter during pulmonary vein cryoablation. Pacing Clin Electrophysiol 2012; 36:24-30. [PMID: 23078045 DOI: 10.1111/pace.12015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/15/2012] [Accepted: 08/21/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Achieve catheter (AC; Medtronic-CryoCath, Pointe-Claire, Canada) is a circular mapping catheter introduced through the lumen of the cryoballoon (CB) catheter which is safe and effective to both navigate the CB to the pulmonary veins (PV) and allow PV potential recording during PV cryoablation. The aim of this study was to evaluate the impact of the use of the AC on procedural outcomes. METHODS Sixteen consecutive patients (14 men) underwent AC-guided PV isolation (PVI) for drug-refractory paroxysmal atrial fibrillation (AF; AC group). Clinical and procedural data of these patients were compared to those obtained from 16 consecutive patients who had undergone PVI for paroxysmal AF with the regular "single transseptal" approach (control group). RESULTS Clinical characteristics of patients enrolled in both groups did not differ significantly. In the AC group, 64 PVs were targeted using a single 28-mm (n = 13) or 23-mm (n = 3) CB catheter with PVI achieved in 62 PVs (97%). In the control group, 66 PVs were targeted using a single 28-mm (n = 12) or 23-mm (n = 4) CB catheter with PVI achieved in 62 PVs (94%), (P = non-significant for CB size and PVI rate). Procedure duration and fluoroscopy time were significantly reduced in AC group compared to control group (96.6 ± 26 minutes vs 125.9 ± 25 minutes, P = 0.003 and 24.4 ± 10 minutes vs 32.6 ± 11 minutes, P = 0.04, respectively). CONCLUSION The use of the AC significantly reduced procedure duration and radiation exposure during PVI with the CB technique.
Collapse
Affiliation(s)
- Michaël Peyrol
- Division of Cardiology, Hôpital Nord, Aix-Marseille Université, Marseille, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Peyrol M, Sbragia P, Quatre A, Boccara G, Zerrouk Z, Yvorra S, Guenoun M, Lévy S, Paganelli F. Pulmonary vein isolation using a single size cryoballoon chosen according to transesophageal echocardiography information. Int J Cardiol 2012; 168:108-11. [PMID: 23044433 DOI: 10.1016/j.ijcard.2012.09.063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 06/25/2012] [Accepted: 09/14/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pulmonary vein isolation (PVI) using cryoballoon (CB) catheter is a new technique for atrial fibrillation (AF) ablation. Previous studies used computer tomography (CT) or magnetic resonance imaging (MRI) scan to determine the pulmonary vein (PV) diameter and anatomy for choosing the CB size. We evaluated pre-ablation transoesophageal-echocardiography (TEE) as an alternative to CT/MRI scan in patients undergoing AF ablation for determining the appropriate size of the CB. METHODS Fifty-five consecutive patients (men=43, women=12) with a mean age of 63 ± 12.5 years, and with drug-refractory paroxysmal AF (34 patients) or persistent AF (21 patients) were included in this prospective study. All patients underwent pre-ablation TEE. RESULTS Hypertension was present in 19 patients (34%). Mean anterior-posterior left atrium diameter was 45.1 ± 8.9 mm. In total, 217 PV were targeted using a single 23-mm (n=14) or 28-mm (n=40) CB catheter chosen according to TEE-obtained measurements. PVI was achieved in 195 PV (90%). Mean number of CB applications per patient was 9.8 ± 2.1 (range 8-14). Mean procedure duration and fluoroscopy times were 131 ± 27 min (90-190 min) and 36 ± 12 min (22-66 min) respectively. Phrenic nerve palsy occurred in 3 patients (5.4%) and was transient (<1 month) in all of them. CONCLUSION This study suggests that TEE is an easily available and effective tool to select the size of the CB for PVI according to evaluated PV diameters and anatomy.
Collapse
Affiliation(s)
- Michaël Peyrol
- Division of Cardiology, Hôpital Nord, Aix-Marseille Université, Marseille, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Mounier-Vehier C, Simon T, Guedj-Meynier D, Ferrini M, Ghannad E, Hubermann JP, Jullien G, Poncelet P, Achouba A, Quéré S, Guenoun M. Gender-related differences in the management of hypertension by cardiologists: the PARITE study. Arch Cardiovasc Dis 2012; 105:271-80. [PMID: 22709468 DOI: 10.1016/j.acvd.2012.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 03/10/2012] [Accepted: 03/15/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several studies have shown gender differences in the management of cardiovascular risk factors and diseases. Whether the management of hypertension by cardiologists in France differs according to patient gender has not been fully investigated. AIMS The main objective of this cross-sectional, multicentre study was to examine the management according to gender of hypertensive patients by office-based cardiologists in France. METHODS Cardiologists were asked to include consecutively two men and two women attending a routine consultation for essential hypertension. Therapeutic management was evaluated by comparing cardiovascular investigations in the preceding 6 months and hypertension control according to gender and the patients' global cardiovascular risk. RESULTS Overall, data from 3440 adult patients (53% men) referred to 654 cardiologists were analysed. Hypertension was uncontrolled in 76% of both men and women and 69% were at high global cardiovascular risk (75% of men, 62% of women; P<0.001). Significantly fewer cardiovascular investigations had been performed in the preceding 6 months in women (22.6% vs 44.2% in men; P<0.001). The treatment regimen was changed by the cardiologist in approximately 50% of patients regardless of gender or global cardiovascular risk. CONCLUSIONS The PARITE study shows that in French office-based cardiology practice, the antihypertensive regimen is adjusted as often in female as in male patients. However, the results suggest that there is room for improvement in the investigation of cardiovascular disease in women. Healthcare providers could be encouraged to implement established guidelines on the prevention of cardiovascular disease in women.
Collapse
Affiliation(s)
- Claire Mounier-Vehier
- Pôle cardiovasculaire et pulmonaire, médecine vasculaire et hypertension artérielle, faculté Henri-Warembourg, université de Lille, CHRU de Lille, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hero M, Guenoun M. 247 Ventricular tachycardia recorded by pacemakers: A retrospective survey for 700 patients. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70643-2] [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: 11/16/2022]
|
20
|
Wollmann CG, Globits S, Ameri L, Thudt K, Kaiser B, Salomonowitz E, Mayr H, Wilkoff B, Styperek R, Jumrussirikul P, Mirro M, Wong W, Ha K, Healey J, Kaufman ES, Nair GM, Armaganijan LV, Divakaramenon S, Mairesse GH, Brandes A, Crystal E, Tomassoni G, Ryu K, Muir M, O'brien E, Hesselson A, Greenberg S, Hamati F, Styperek R, Alonso J, Peress D, Lee L, Bolanos O, Burger H, Opalka B, Goebel G, Ehrlich W, Walther W, Ziegelhoeffer T, Milasinovic G, Quartieri F, Compton S, Kristiansen N, Li P, Ramza B, Dovellini EV, Michelucci A, Trapani M, Buonamici P, Valenti R, Antoniucci D, Hero M, Guenoun M, Ferrer Hita JJ, Rodriguez-Gonzalez A, Machado-Machado P, Perez-Hernandez LM, Raya-Sanchez JA, Lara-Padron A, Bosa-Ojeda F, Marrero-Rodriguez F, Luedorff G, Grove R, Wolff E, Thale J, Kranig W, Niazi I, Ryu K, Choudhuri I, Akhtar M, Jais P, Maury P, Reddy VY, Neuzil P, Morgan K, Bordachar P, Ritter P, Haissaguerre M, Doering M, Braunschweig F, Gaspar T, Eitel C, Wetzel U, Nitsche B, Piorkowski C, Hindricks G, Gras D, Boulogne E, Simon M, Abraham W. Flash Presentations II. Europace 2011. [DOI: 10.1093/europace/eur218] [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
|
21
|
Alings M, Vireca E, Bastian D, Wardeh AJ, Nimeth C, Tukkie R, Trinks S, Kainz W, Delaney C, Kaltofen G, Ziekenhuis A, Bloch-Thomsen PE, Cihalik C, Lawo T, Agraou B, Deutsch P, Bazin P, Guyomar Y, Bobillier M, Defaye P, Amiel A, Lazarus A, Guenoun M, Le Franc P, Oei FL, Nicastia D, Hoenen S, de Porto AE, Vontobel H, Robles de Medina R, Kainz W, Brunner P, Alzueta J, Santos JA, Navarro AB, Hie C, Kautzner J, Ammann-Kardiol P, Kaltofen G, Tukkie R, Zeindlhofer E, Nimeth C, Frommel M, Brachmann J, Gohl K, Trinks S, van der Meer P, Zenker G, Gebetsberger F, Unger T, Ruiter JH, Ramanna H, Hadj KB, Lang A, Predel D, Schnabel A, Martinek M, Cheng CW, Ward K, Jensen G, O'Nunain S, Jiang S, Terpstra WF, Budschedl E, van Doorn DJ, Marenne F, Wahlers T, Zeus T, Osswald S, Engby B, Christensen PD, Junbo G, van der Veen M. Clinical use of automatic pacemaker algorithms: results of the AUTOMATICITY registry. Europace 2011; 13:976-83. [DOI: 10.1093/europace/eur052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
22
|
Driss AB, Guenoun M, Malergue MC, Jourdain P, Paganelli F, Meurin P, Tabet JY, Guedj-Meynier D. 050 Left ventricular systolic dysfunction in patients with coronary artery disease and normal electrocardiogram: results from INDYCE registry. Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70052-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
23
|
Hero M, Guenoun M. 206 Ventricular arythmias in cardiac pacing patients: monocentric study. Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70208-7] [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: 11/30/2022]
|
24
|
Assyag P, Clerson P, Contre C, Guenoun M, Irina L, Poncelet P, Thebaut JF, Solal AC. 089 Heart Failure management in ambulatory care: what happens beyond hospital discharge? Results from the DEVENIR study. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70091-4] [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: 11/30/2022]
|
25
|
Meurin P, Guenoun M, Malergue MC, Paganelli F, Alamercery Y, Guedj D, Jourdain P. 292 Management of stable coronary artery disease patients: Very efficient for a population but probably insufficient for every single patient. The Indyce survey. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70294-9] [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: 11/15/2022]
|
26
|
Solal AC, Assyag P, Contre C, Guenoun M, Irina L, Poncelet P, Prost PL, Thebaut JF. 088 Prescription of beta blockers at hospital discharge and beyond, in patients with heart failure. Results from the DEVENIR study. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
27
|
Thebaut JF, Assyag P, Contre C, Guenoun M, Irina L, Poncelet P, Prost PL, Solal AC. 085 Therapeutic management of heart failure by french outhospital cardiologists is in line with ESH guidelines. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70087-2] [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: 11/30/2022]
|
28
|
Solal AC, Assyag P, Clerson P, Contre C, Guenoun M, Poncelet P, Thebaut JF, Irina L. 092 “Grey Zone” of 40-50% ejection fraction in ambulatory patient with Heart Failure. Who are these patients? Lessons from the DEVENIR study. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70094-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
29
|
Taieb J, Guenoun M, Hero M. 227 Follow-up of patients implanted with Pacemakers in France : The ELECTRA survey 2008. Archives of Cardiovascular Diseases Supplements 2010. [DOI: 10.1016/s1878-6480(10)70229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
30
|
Doshi A, Love C, Daoud E, Augostini R, Kalbfleisch S, Weiss R, Houmsse M, Hummel J, Patangay A, Siejko KZ, Da Cunha D, Pedraza A, Hamlin R, Binner L, Bodky J, Szendey I, Maunz M, Trautmann M, Kaltofen G, Eber B, Steiner A, Hero M, Guenoun M, Biffi M, Bertini M, Salomoni M, Bonfatti F, Balbo M, Martignani C, Ziacchi M, Boriani G, Choo WK, Tilling L, Gupta S, Adachi M, Igawa O, Yano A, Miake J, Inoue Y, Ogura K, Kato M, Iitsuka K, Freeman P, Huish J, Brooks V, Johns M, Ellis G, Bleasdale R, Galley D, Hoffmann E, Spitali G, Marras E, Prades E, Davy JM, Volkov D, Polivenok I, Shovkun S, Smirnov V, Boyko V, Tassin A, Vitali L, Treguer F, Breard G, Gaggini G, Kobeissi A, Furber A, Dupuis JM, Tassin A, Vitali L, Treguer F, Breard G, Gaggini G, Kobeissi A, Furber A, Dupuis JM, Hashizume K, Takahashi R, Inoue Y, Tsutsumi K, Suzuki S, Ishikawa N, Arie T, Stevenson RA, Dabney WS, Schaerf R, Develle R, Dalal Y, Snell JD, Bharmi R, Snell JR, Rooke R, Korsun N, Fatemi S, Morley B, Beynon RP, Pearce KA, Hill LM, Argyle RA, Ray SG, Davidson NC. Poster session 3: Pacemaker and sensor algorithm. Europace 2009. [DOI: 10.1093/europace/euq228] [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
|
31
|
Leizorovicz A, Cohen A, Guenoun M, Mismetti P, Weisslinger N. Influence of age on the prescription of vitamin K antagonists in outpatients with permanent atrial fibrillation in France. Pharmacoepidemiol Drug Saf 2007; 16:32-8. [PMID: 17063535 DOI: 10.1002/pds.1329] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE The aim of the study was to describe the current rate and determinants of the prescription of antithrombotics in outpatients with permanent atrial fibrillation, with a pre-specified emphasis on the influence of age on the prescription of vitamin K antagonists. METHODS This was a prospective observational survey in France among 5893 consecutive outpatients with documented permanent atrial fibrillation being seen by 770 physicians from August to December 2002. We recruited physicians from two random lists of general practitioners and cardiologists, respectively, stratified according to their administrative region, from the list of all French private general practitioners and cardiologists. RESULTS The mean age of patients was 75.8 years. Mean duration since diagnosis of atrial fibrillation was 5.0 years; 31.7% of patients had valvular heart disease and 60.3% hypertension. An antithrombotic was prescribed to 95.5% of patients at the time of consultation. The percentage of patients treated with vitamin K antagonists was 76.4%; it decreased from 86.0% in patients aged 60-70 years to 63.5% in patients aged 80 years or above. On multivariate analysis, high age was a significant predictor (p = 0.001) for the non-prescription of vitamin K antagonists. In patients above 70 years currently receiving an antithrombotic, the probability of prescription of vitamin K antagonists decreased on average by 9.6% per year. CONCLUSIONS Vitamin K antagonists are administered to most outpatients with permanent atrial fibrillation at high thromboembolic risk seen by French physicians in private practice. However, their use decreases with age.
Collapse
|
32
|
Guenoun M, Hero M, Roux O, Mainardis M. Cross-Ventricular Pacemaker-Mediated Tachycardia by Myopotential Induction during Biventricular Pacing. Pacing and Clinical Electrophysiology 2005; 28:585-7. [PMID: 15955194 DOI: 10.1111/j.1540-8159.2005.09447.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients in permanent atrial fibrillation treated for heart failure and ventricular asynchrony can be implanted with conventional dual chamber pacemakers (DDD) pacemakers used in the biventricular mode. The left ventricular lead is connected to the atrial channel. CASE REPORT We report the case of a patient who developed ventriculo-ventricular pacemaker-mediated tachycardia (PMT) induced by myopotential sensing in the atrial channel, inhibiting left ventricular pacing. CONCLUSION In the absence of specifically designed pacemakers, the use of DDD pacemakers in the biventricular mode requires certain precautions, such as anti-PMT mode activation, disabling automatic sensitivity, and lengthening the postventricular atrial refractory period (PVARP), or mode switch to DVIR.
Collapse
Affiliation(s)
- Maxime Guenoun
- Clinique Bouchard, 77 rue du Dr. Escat, 13006 Marseille, France.
| | | | | | | |
Collapse
|
33
|
Chauvin M, Frank R, Le Heuzey JY, Barnay C, Cazeau S, Djiane P, Guenoun M, Leenhardt A, Mabo P, Sadoul N. [Recommendations on the implantation and surveillance of implantable defibrillators]. Arch Mal Coeur Vaiss 2004; 97:915-9. [PMID: 15521486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
|
34
|
Leizorovicz A, Guenoun M, Yves J, Heuzey L, Jeandel C, Mismetti P, Cohen A. 1129-216 How does age influence the prescribing of antithrombotic therapy for ambulatory patients with permanent atrial fibrillation? J Am Coll Cardiol 2004. [DOI: 10.1016/s0735-1097(04)90571-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
35
|
Ricard P, Socas AG, Taramasco V, Guenoun M, Lévy S. [Cardioversion of atrial fibrillation with low energy internal electric shock]. Arch Mal Coeur Vaiss 1997; 90:1605-10. [PMID: 9587440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The efficacy and safety of low internal cardioversion for the reduction of atrial fibrillation was assessed prospectively in 104 consecutive patients. Sixty-two patients had chronic atrial fibrillation (Group I). 16 patients had paroxysmal atrial fibrillation (Group II) and 26 patients had induced atrial fibrillation (Group III). The average duration of the current episode of atrial fibrillation was 9 +/- 19 months in Group I, 4 +/- 2 days in Group II and 18 +/- 7 minutes in Group III. Two intracardiac defibrillation catheters were used, one (the cathode) in the right atrium and the other in the coronary sinus or left branch of the pulmonary artery (anode). These catheters were connected to an external defibrillator delivering biphasic 3/3 ms shocks with a voltage which could be programmed from 10 to 400 volts. The shocks were synchronised on the R wave. Sinus rhythm was restored in 44 of the 62 patients in Group I (70%), 12 of the 16 patients in Group II (75%) and 20 of the 26 patients in Group III (77%). The average voltages and energies restoring sinus rhythm were 300 +/- 68 volts and 3.5 +/- 1.5 joules respectively in Group I, 245 +/- 72 volts and 2.0 +/- 2.9 joules in Group II, and 270 +/- 67 volts and 2.6 +/- 1.2 joules in Group III. These results show that the energy required to restore sinus rhythm is significantly greater in patients with chronic atrial fibrillation than in patients with paroxysmal or induced atrial fibrillation. There were no ventricular proarrhythmic effects in the 686 shocks synchronised on the R wave. This study shows that internal cardioversion of atrial fibrillation is feasible with low energies under simple sedation. These results support the concept of an implantable atrial defibrillator.
Collapse
Affiliation(s)
- P Ricard
- Service de cardiologie, Université de Marseille, CHU Nord
| | | | | | | | | |
Collapse
|
36
|
Abstract
Recent reports have suggested that transvenous cardioversion of atrial fibrillation is feasible using low-energy shocks and a right atrium coronary sinus electrode configuration. We evaluated in a prospective study the efficacy and safety of low-energy internal cardioversion of atrial fibrillation in 104 consecutive patients. Sixty-two patients presented with chronic atrial fibrillation (group I), 16 had paroxysmal atrial fibrillation (group II), and 26 had an induced atrial fibrillation episode (group III). The mean duration of the presenting episode of atrial fibrillation was 9 +/- 19 months for group I, 4 +/- 2 days for group II, and 18 +/- 7 minutes for group III. Atrial defibrillation was performed using two intracardiac catheters: one was placed in the right atrium (cathode) and the other in the coronary sinus or in the left branch of the pulmonary artery (anode). The catheters were connected to a customized external defibrillator capable of delivering 3/3-ms biphasic waveform shocks with a voltage programmable between 10 and 400 volts. The shocks were synchronized to the R wave. Sinus rhythm was restored in 44 of the 62 patients in group I (70%), in 12 of the 16 patients in group II (75%), and in 20 of 26 patients in group III (77%). The mean voltage and energy required for cardioversion were respectively 300 +/- 68 V and 3.5 +/- 1.5 J, for group I, 245 +/- 72 V and 2.0 +/- 0.9 J for group II, and 270 +/- 67 V and 2.6 +/- 1.2 J for group III. The leading-edge voltage required for sinus rhythm restoration was significantly higher (p < 0.05) in the chronic atrial fibrillation group than in the paroxysmal or induced groups. No proarrhythmic effects occurred for the delivered 686 R-wave synchronized shocks. This study of a large group of patients confirms and extends the results of previous reports. Such findings may have clinical implications for elective cardioversion of atrial fibrillation and the development of an implantable atrial defibrillator.
Collapse
Affiliation(s)
- A G Socas
- University of Marseille, School of Medicine, Cardiology Division, France
| | | | | | | | | |
Collapse
|
37
|
Ricard P, Mansouri C, Yappo F, Guenoun M, Paganelli F, Lévy S. [Radiofrequency ablation of resistant atrial flutter: a new anatomical approach]. Arch Mal Coeur Vaiss 1997; 90:379-83. [PMID: 9232076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Several reports have suggested that radiofrequency ablation could prevent atrial flutter resistant to antiarrhythmic therapy. The usual recommendation is to apply the radiofrequency current in a zone situated between the tricuspid valve and orifice of inferior vena cava. The aim of this study was to assess the efficacy of another site of ablation of flutter extending from the tricuspid valve to the orifice of the coronary sinus, either alone or associated with a site between the coronary sinus and the lateral wall of the right atrium. Twenty patients aged 42 to 78 years (mean : 6 +/- 11 years) were included. Atrial flutter was paroxysmal in 15 patients and chronic in 5 patients. Each patients had documented failure of 1 to 5 antiarrhythmic agents (average 3.1 +/- 1.6). The site of ablation was localised by anatomical criteria alone. During follow-up of 7 +/- 5 months (range 1 to 18 months), 13 patients had no recurrence of atrial flutter after ablation, 5 patients had recurrence and 2 patients had paroxysmal atrial fibrillation alone: the success rate was 15/20 (75%). This study suggests that the zone between the tricuspid valve and coronary sinus may be a site for radiofrequency ablation of atrial flutter. It is valuable alternative to the usually recommended technique.
Collapse
Affiliation(s)
- P Ricard
- Service de cardiologie, hôpital Nord, Marseille
| | | | | | | | | | | |
Collapse
|
38
|
Chabaud R, Guenoun M, Taddei JP, Guillou J. [Abnormal movements and shaking in geriatrics (author's transl)]. Sem Hop 1979; 55:465-9. [PMID: 38513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The authors have experimented tiapride in 37 cases of abnormal movements and 20 cases of shaking anxio depresive origin. The best indication of tiapride corresponds to lingual buccal an facial dyskinesia caused by neuroleptics and senile trembling increased by alcoholism. On the other hand its anxiolytic and anti shaking properties are more limited. Finally in the case of degenerative senile trembling its action is less effective. Tolerance to tiapride seemed to be excellent even at high dose.
Collapse
|