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Bulian F, Russo M, Cinquetti M, Macor F, Mantovan R. A case of position dependent dynamic infero-posterior ST-segment elevation mimicking a myocardial infarction. Eur Heart J Cardiovasc Imaging 2024:jeae061. [PMID: 38412138 DOI: 10.1093/ehjci/jeae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Francesca Bulian
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Michele Russo
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Martino Cinquetti
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Franco Macor
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Roberto Mantovan
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
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2
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Russo M, Coccato M, Preti G, Cinquetti M, Macor F, Sitta N, Carchesio F, Cattarin S, Piccoli G, Mantovan R. Coronary computed tomography angiography and optical coherence tomography imaging of an intraplaque hemorrhage. J Cardiovasc Med (Hagerstown) 2023; 24:850-851. [PMID: 37756215 DOI: 10.2459/jcm.0000000000001564] [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: 09/29/2023]
Affiliation(s)
| | | | | | | | | | | | - Francesca Carchesio
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Simone Cattarin
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Gianluca Piccoli
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
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3
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Longo E, Locatelli L, Tsipas P, Lintzeris A, Dimoulas A, Fanciulli M, Longo M, Mantovan R. Exploiting the Close-to-Dirac Point Shift of the Fermi Level in the Sb 2Te 3/Bi 2Te 3 Topological Insulator Heterostructure for Spin-Charge Conversion. ACS Appl Mater Interfaces 2023; 15:50237-50245. [PMID: 37862590 PMCID: PMC10623560 DOI: 10.1021/acsami.3c08830] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023]
Abstract
Properly tuning the Fermi level position in topological insulators is of vital importance to tailor their spin-polarized electronic transport and to improve the efficiency of any functional device based on them. Here, we report the full in situ metal organic chemical vapor deposition (MOCVD) and study of a highly crystalline Bi2Te3/Sb2Te3 topological insulator heterostructure on top of large area (4″) Si(111) substrates. The bottom Sb2Te3 layer serves as an ideal seed layer for the growth of highly crystalline Bi2Te3 on top, also inducing a remarkable shift of the Fermi level to place it very close to the Dirac point, as visualized by angle-resolved photoemission spectroscopy. To exploit such ideal topologically protected surface states, we fabricate the simple spin-charge converter Si(111)/Sb2Te3/Bi2Te3/Au/Co/Au and probe the spin-charge conversion (SCC) by spin pumping ferromagnetic resonance. A large SCC is measured at room temperature and is interpreted within the inverse Edelstein effect, thus resulting in a conversion efficiency of λIEEE ∼ 0.44 nm. Our results demonstrate the successful tuning of the surface Fermi level of Bi2Te3 when grown on top of Sb2Te3 with a full in situ MOCVD process, which is highly interesting in view of its future technology transfer.
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Affiliation(s)
- Emanuele Longo
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, Agrate
Brianza 20864, Italy
| | - Lorenzo Locatelli
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, Agrate
Brianza 20864, Italy
| | - Polychronis Tsipas
- National
Centre for Scientific Research “Demokritos”, Institute of Nanoscience and Nanotechnology, Agia Paraskevi 15341, Athens, Greece
| | - Akylas Lintzeris
- National
Centre for Scientific Research “Demokritos”, Institute of Nanoscience and Nanotechnology, Agia Paraskevi 15341, Athens, Greece
- Department
of Physics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Athens 10682, Greece
| | - Athanasios Dimoulas
- National
Centre for Scientific Research “Demokritos”, Institute of Nanoscience and Nanotechnology, Agia Paraskevi 15341, Athens, Greece
| | - Marco Fanciulli
- Department
of Material Science, University of Milano
Bicocca, Via R. Cozzi 55, Milan 20125, Italy
| | - Massimo Longo
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, Agrate
Brianza 20864, Italy
- Department
of Chemical Science and Technologies, University
of Rome Tor Vergata, Via della Ricerca Scientifica, Rome 100133, Italy
| | - Roberto Mantovan
- CNR-IMM, Unit of Agrate Brianza, Via C. Olivetti 2, Agrate
Brianza 20864, Italy
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4
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Russo M, Carchesio F, Cercato C, Medeot A, Coss M, Coccato M, Mantovan R, Piccoli G. Superior mesenteric artery terminal branch stent failure studied by optical coherence tomography. J Cardiovasc Med (Hagerstown) 2023; 24:269-270. [PMID: 36724397 DOI: 10.2459/jcm.0000000000001429] [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: 02/03/2023]
Affiliation(s)
| | - Francesca Carchesio
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Cristina Cercato
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Alessandro Medeot
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Matteo Coss
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | | | | | - Gianluca Piccoli
- Department of Radiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
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5
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Georgopoulou-Kotsaki E, Pappas P, Lintzeris A, Tsipas P, Fragkos S, Markou A, Felser C, Longo E, Fanciulli M, Mantovan R, Mahfouzi F, Kioussis N, Dimoulas A. Significant enhancement of ferromagnetism above room temperature in epitaxial 2D van der Waals ferromagnet Fe 5-δGeTe 2/Bi 2Te 3 heterostructures. Nanoscale 2023; 15:2223-2233. [PMID: 36625389 DOI: 10.1039/d2nr04820e] [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] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Two-dimensional (2D) van der Waals (vdW) ferromagnetic metals FexGeTe2 with x = 3-5 have raised significant interest in the scientific community. Fe5GeTe2 shows prospects for spintronic applications since the Curie temperature Tc has been reported near or higher than 300 K. In the present work, epitaxial Fe5-δGeTe2 (FGT) heterostructures were grown by Molecular Beam Epitaxy (MBE) on insulating crystalline substrates. The FGT films were combined with Bi2Te3 topological insulator (TI) aiming to investigate the possible beneficial effect of the TI on the magnetic properties of FGT. FGT/Bi2Te3 films were compared to FGT capped only with AlOx to prevent oxidation. SQUID and MOKE measurements revealed that the growth of Bi2Te3 TI on FGT films significantly enhances the saturation magnetization of FGT as well as the Tc well above room temperature (RT) reaching record values of 570 K. First-principles calculations predict a shift of the Fermi level and an associated enhancement of the majority spin (primarily) as well as the total density of states at the Fermi level suggesting that effective doping of FGT from Bi2Te3 could explain the enhancement of ferromagnetism in FGT. It is also predicted that strain induced stabilization of a high magnetic moment phase in FGT/Bi2Te3 could be an alternative explanation of magnetization and Tc enhancement. Ferromagnetic resonance measurements evidence an enhanced broadening in the FGT/Bi2Te3 heterostructure when compared to FGT. We obtain a large spin mixing conductance of g↑↓eff = 4.4 × 1020 m-2, which demonstrates the great potential of FGT/Bi2Te3 systems for spin-charge conversion applications at room temperature.
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Affiliation(s)
- E Georgopoulou-Kotsaki
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
- Section of Condensed Matter Physics, Department of Physics, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15784, Athens, Greece
| | - P Pappas
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
| | - A Lintzeris
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
- Department of Physics, National Technical University of Athens, School of Applied Mathematical and Physical Sciences, 15780, Athens, Greece
| | - P Tsipas
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
| | - S Fragkos
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
- Department of Mechanical Engineering, University of West Attica, 12241 Athens, Greece
| | - A Markou
- Max Planck Institute for Chemical Physics of Solids, 01187, Dresden, Germany
| | - C Felser
- Max Planck Institute for Chemical Physics of Solids, 01187, Dresden, Germany
| | - E Longo
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza, Via C. Olivetti 2, 20864 Agrate Brianza, Italy
| | - M Fanciulli
- Department of Material Science, University of Milano Bicocca, Via R. Cozzi 55, Milan 20125, Italy
| | - R Mantovan
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza, Via C. Olivetti 2, 20864 Agrate Brianza, Italy
| | - F Mahfouzi
- Department of Physics and Astronomy, California State University Northridge, Northridge, CA 91330-8268, USA
| | - N Kioussis
- Department of Physics and Astronomy, California State University Northridge, Northridge, CA 91330-8268, USA
| | - A Dimoulas
- National Centre for Scientific Research "Demokritos", Institute of Nanoscience and Nanotechnology, Agia Paraskevi, 15341, Athens, Greece.
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6
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De Gaspari M, Finato N, Marinigh R, Livi U, Basso C, Mantovan R. Recurrent arrhythmic storms and unsuccessful catheter ablation in chronic ischemic heart disease. Cardiovasc Pathol 2023; 62:107491. [PMID: 36306970 DOI: 10.1016/j.carpath.2022.107491] [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: 07/11/2022] [Revised: 10/02/2022] [Accepted: 10/20/2022] [Indexed: 12/13/2022] Open
Abstract
The prototypical substrate for reentrant ventricular tachycardia (VT) is post-myocardial infarction (MI) scar. Catheter ablation is an important therapeutic option for recurrent VT but sometimes it is not effective despite the technical advances. Here we describe the case of a 60-year-old man who suffered a MI in 1998 and presented with recurrent arrhythmic storms during his long-term follow-up. Twenty years later, he underwent two catheter ablations with bipolar electroanatomic voltage mapping (EVM) demonstrating only an area of low voltages in the lateral left ventricular free wall. Both procedures were unsuccessful and the patient eventually underwent cardiac transplantation in 2019. Pathology examination revealed circumferential subendocardial scar with hypertrabeculation, so that the reentry substrate was unreachable by ablation with the use of standard techniques. The comparison of EVM findings with the morphologic ones in patients with chronic ischemic heart disease can help to better understand the feasibility and effectiveness of VT substrate ablation.
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Affiliation(s)
- Monica De Gaspari
- Department of Medical Area (DAME), University of Udine, Udine, Italy; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua - Azienda Ospedaliera, Padova, Italy
| | - Nicoletta Finato
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Ricarda Marinigh
- Department of Cardiology, "S. Maria dei Battuti" Hospital, Conegliano, Treviso, Italy
| | - Ugolino Livi
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua - Azienda Ospedaliera, Padova, Italy.
| | - Roberto Mantovan
- Department of Cardiology, "S. Maria dei Battuti" Hospital, Conegliano, Treviso, Italy
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7
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Radinovic A, Peretto G, Sgarito G, Cauti FM, Castro A, Narducci ML, Mantovan R, Scaglione M, Solimene F, Scopinaro A, Tondo C, Filippini G, Bianco E, Bonso A, Calzolari V, Ferraris F, Zardini M, Piacenti M, D'Angelo G, Bosica F, Della Bella P. Matching Ablation Endpoints to Long-Term Outcome: The Prospective Multicenter Italian Ventricular Tachycardia Ablation Registry. JACC Clin Electrophysiol 2022:S2405-500X(22)01046-5. [PMID: 36752462 DOI: 10.1016/j.jacep.2022.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/06/2022] [Accepted: 10/19/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Multicenter ventricular tachycardia (VT) ablation studies have shown poorer outcomes compared with single-center experiences. This difference could be related to heterogeneous mapping and ablation strategies. OBJECTIVES This study evaluated a homogenous simplified catheter ablation strategy for different substrates and compared the results with those of a single referral center. METHODS This was a multicenter prospective VT ablation registry of patients with the following 4 causes of VT: previous myocardial infarction; previous myocarditis; arrhythmogenic right ventricular dysplasia; or idiopathic dilated cardiomyopathy. The procedural protocol included precise mapping and ablation steps with the combined endpoint of late potential (LP) abolition and noninducibility of VT. The long-term primary efficacy endpoint was freedom from VT. RESULTS A total of 309 patients were enrolled. LPs were present in 70% of patients and were abolished in 83%. At the end of the procedure 74% of LPs were noninducible. The primary combined endpoint of LP abolition and noninducibility was achieved in 64% of patients with LPs at baseline. Freedom from VT at 12 months was observed in 67% of patients. In the overall study group, VT inducibility was the only predictor of freedom from VT (P = 0.013). In patients with LPs, the VT recurrence rate was lower both for patients with complete LP abolition (P = 0.040) and for patients meeting the composite endpoint (P = 0.035). CONCLUSIONS A standardized VT mapping and ablation technique reproduced the procedural outcomes of a single referral center in a multicenter prospective study. LP abolition and noninducibility were effective in reducing VT recurrences in patients with 4 causes of cardiomyopathy. (Ventricular Tachycardia Ablation Registry; NCT03649022).
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Affiliation(s)
- Andrea Radinovic
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Giovanni Peretto
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Antonello Castro
- Cardiology unit Pertini Hospital- Azienda USL Roma B, Rome, Italy
| | | | | | | | | | - Alice Scopinaro
- Alessandria Hospital - SS. Antonio, Biagio, Cesare Arrigo, Alessandria, Italy
| | - Claudio Tondo
- Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche Università degli Studi di Miano, Milan, Italy
| | | | | | | | - Vittorio Calzolari
- Electrophysiology, Division of Cardiology, Neuro-Cardio-Vascular Department, Hospital of Treviso, ULSS 2 "Marca Trevigiana," Treviso, Italy
| | | | - Marco Zardini
- Cardiac Electrophysiology Section, Zenda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Marcello Piacenti
- CNR - Area della Ricerca di Pisa Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Giuseppe D'Angelo
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Francesco Bosica
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paolo Della Bella
- Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Hospital, Milan, Italy
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8
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Migliore F, Martini N, Calo' L, Martino A, Winnicki G, Vio R, Condello C, Rizzo A, Zorzi A, Pannone L, Miraglia V, Sieira J, Chierchia GB, Curcio A, Allocca G, Mantovan R, Salghetti F, Curnis A, Bertaglia E, De Lazzari M, de Asmundis C, Corrado D. Corrigendum: Predictors of late arrhythmic events after generator replacement in Brugada syndrome treated with prophylactic ICD. Front Cardiovasc Med 2022; 9:1076294. [DOI: 10.3389/fcvm.2022.1076294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
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9
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Migliore F, Martini N, Calo' L, Martino A, Winnicki G, Vio R, Condello C, Rizzo A, Zorzi A, Pannone L, Miraglia V, Sieira J, Chierchia GB, Curcio A, Allocca G, Mantovan R, Salghetti F, Curnis A, Bertaglia E, De Lazzari M, de Asmundis C, Corrado D. Predictors of late arrhythmic events after generator replacement in Brugada syndrome treated with prophylactic ICD. Front Cardiovasc Med 2022; 9:964694. [PMID: 35935654 PMCID: PMC9355272 DOI: 10.3389/fcvm.2022.964694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Predictors of late life-threatening arrhythmic events in Brugada syndrome (BrS) patients who received a prophylactic ICD implantation remain to be evaluated. The aim of the present long-term multicenter study was to assess the incidence and clinical-electrocardiographic predictors of late life-threatening arrhythmic events in BrS patients with a prophylactic implantable cardioverter defibrillator (ICD) and undergoing generator replacement (GR). Methods The study population included 105 patients (75% males; mean age 45 ± 14years) who received a prophylactic ICD and had no arrhythmic event up to first GR. Results The median period from first ICD implantation to last follow-up was 155 (128-181) months and from first ICD Implantation to the GR was 84 (61-102) months. During a median follow-up of 57 (38-102) months after GR, 10 patients (9%) received successful appropriate ICD intervention (1.6%/year). ICD interventions included shock on ventricular fibrillation (n = 8 patients), shock on ventricular tachycardia (n = 1 patient), and antitachycardia pacing on ventricular tachycardia (n = 1 patient). At survival analysis, history of atrial fibrillation (log-rank test; P = 0.02), conduction disturbances (log-rank test; P < 0.01), S wave in lead I (log-rank test; P = 0.01) and first-degree atrioventricular block (log-rank test; P = 0.04) were significantly associated with the occurrence of late appropriate ICD intervention. At Cox-regression multivariate analysis, S-wave in lead I was the only independent predictor of late appropriate ICD intervention (HR: 9.17; 95%CI: 1.15-73.07; P = 0.03). Conclusions The present study indicates that BrS patient receiving a prophylactic ICD may experience late appropriate intervention after GR in a clinically relevant proportion of cases. S-wave in lead I at the time of first clinical evaluation was the only independent predictor of persistent risk of life-threatening arrhythmic events. These findings support the need for GR at the end of service regardless of previous appropriate intervention, mostly in BrS patients with conduction abnormalities.
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Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Nicolò Martini
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Leonardo Calo'
- Department of Cardiology, Policlinico Casilino, Rome, Italy
| | | | - Giulia Winnicki
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Riccardo Vio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Chiara Condello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Rizzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Luigi Pannone
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Vincenzo Miraglia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Juan Sieira
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Gian-Battista Chierchia
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Antonio Curcio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Allocca
- Department of Cardiology, S.Maria dei Battuti Hospital, Conegliano, Italy
| | - Roberto Mantovan
- Department of Cardiology, S.Maria dei Battuti Hospital, Conegliano, Italy
| | | | - Antonio Curnis
- Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Carlo de Asmundis
- Heart Rhythm Management Centre, Postgraduate Program in Cardiac Electrophysiology and Pacing, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, European Reference Networks Guard-Heart, Brussels, Belgium
| | - Domenico Corrado
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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10
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Mantovan R, Solimene F, Pelargonio G, Cauti F, Marinigh R, Schillaci V, Narducci ML, Rossi P, Aloia A, Di Donna P, Grifoni G, Carbone A, Maglia G, Malacrida M, Allocca G. Detectable reentrant circuits in localized microreentrant tachycardias in the era of ultra high-density mapping. Europace 2022. [DOI: 10.1093/europace/euac053.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Optimal criteria in clinical practice differentiating microreentrant atrial tachycardias (mAT) from macroreentrant atrial arrhythmias (MAT) have not yet been clarified. The use of multielectrode catheters and the recent development of ultra high-density mapping (UHDM) with automated features has improved our knowledge of mAT circuits and foci location.
Purpose
In the present study, we systematically evaluated AT mechanisms in a large consecutive cohort of patients with MAT identifying the precise mAT circuits using the Rhythmia mapping system.
Methods
Consecutive patients indicated for MAT ablation from January 2021 to November 2021 at 33 centers were prospectively included. All MATs were completely mapped in the left or right atrium by means of the Rhythmia mapping system and the 64-poles Orion basket catheter. For study purpose, a mAT was defined as an AT with slow continuous low fragmented potentials covering at least 50% of tachycardia cycle length (CL) in a small area (set as a circuit within < 1 cm2) and in a couple of closed splines of the Orion catheter and a centrifugal activation pattern to the remainder of the atria. The Lumipoint tool was systematically used to confirm EGM fragmentation inside this area. Data are reported as mean±SD.
Results
One-hundred eighty-seven MATs were analyzed: 100 (53.7%) atypical left atrial flutter, 27 (14.3%) left AT and 60 (32%) right AT. A total of 7 MAT (prevalence of 3.7%) was identified as mATs (6 atypical left atrial flutter and 1 AT), with 5 out 7 with a previous history of AF ablation procedure. The percentage of atrial surface with a voltage level below 0.1 mV was 19±17%. The CL was 329±78ms. The electrical activity spanning the whole CL was detected by 2±0.6 pairs of close bipoles of the Orion catheter, and was actually confined to a region of 0.4±0.2cm2 with continuous highly fractionated potential covering 68±10% of the CL (longest component of fractionated EGM per spline=74±18% of the CL). Voltage level was 0.3±0.1mV at RF delivery site and 0.2±0.1mV at the site of longest duration of the fragmented potential, respectively. Targeted mAT activity was identified closer to PVs in three cases and at the mid portion of the anterior wall and at the roof in two cases each, respectively. In all cases a single shot RF delivery terminated each arrhythmia at targeted location. Consolidative RF ablations were then delivered in the adjacent area. No complication occurred. At three months follow-up all patients remained free from any AT recurrence.
Conclusions
In this standard of care clinical experience with UHDM system, the prevalence of mAT seems to be higher than previously reported in literature. A technique based on mAT identification through a novel automated algorithm and matched area of electrogram fractionation captured by the Orion catheter may limit the extent of ablation needed.
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Affiliation(s)
| | | | - G Pelargonio
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - F Cauti
- San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | | | | | - ML Narducci
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - P Rossi
- San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - A Aloia
- S.Luca Vallo Lucania Hospital, Vallo Della Lucania, Italy
| | | | - G Grifoni
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - A Carbone
- Maria SS. Addolorata Eboli Hospital, Eboli, Italy
| | - G Maglia
- Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy
| | | | - G Allocca
- Conegliano Hospital, Conegliano, Italy
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11
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Meynet I, Stabile G, Mantica M, Ferraro A, D’ammando M, Scaglione M, Di Cori A, Schillaci V, Ottaviano L, Mantovan R, Ferrari F, Bianchi S, Solimene F, Malacrida M, De Sanctis V. The impact of RF wattage level on local impedance and procedural parameters in AF ablation cases. Europace 2022. [DOI: 10.1093/europace/euac053.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Local impedance (LI) measurement can provide information on catheter tip contact, but also changes in LI during ablation can inform the extent and effectiveness of RF energy delivery. To date the relationship between highly LI measurements and contact force (CF) during atrial fibrillation (AF) ablation at different levels of energy delivery is still lacking.
Purpose
We aimed to evaluate the impact of power setting on LI and key procedural parameters in AF ablation cases.
Methods
A novel CF ablation catheter equipped with dedicated algorithm was used to measure LI at the distal electrode of this catheter. Radiofrequency (RF) catheter applications ≥45 watts were categorized as high power (HP) and applications <45w as standard power (SP). Ablations were also grouped according to different levels of CF (<5g, 5-14g, 15-24g and ≥25g). Data are reported as mean±SD.
Results
Sixty-two consecutive pts undergoing RF catheter ablation of AF from the CHARISMA registry were included A total of 4619 ablation spots performed around PVs were analyzed (58% paroxysmal, 84% de novo, RF deliveries per pt=76±27, RF delivery time=9.1±5s, CF=12.3±8g). The majority of these were HP applications (n=4192, 91%). The mean LI was 158±17Ω prior to ablation and 138±14Ω after ablation (p<0.0001, absolute LI drop of 21.9±8Ω) with a LI drop rate equal to 4.4±3Ω/s. HP ablations had significantly shorter RF delivery times, 8.8±4s vs 12±7s (p<0.0001), larger LI drops (22.2±8Ω vs 19.3±9Ω, p<0.0001) and higher LI drop rates (4.5±3Ω/s vs 3.6±2Ω/s, p<0.0001) than SP, respectively. For both HP and SP settings, the magnitude of LI drop increased and RF delivery time decreased with increasing amounts of CF. The largest differences between HP and SP were found when CF was <15g (RF delivery time: 9±5s at HP vs 12.9±7s at SP, percentage of difference 26.3%, p<0.0001; LI drop: 21.2±8Ω at HP vs 18.6±9Ω, percentage of difference -14.3%, p<0.0001). No major complications occurred during the procedures. All PVs were successfully isolated.
Conclusions
This preliminary experience suggests that, HP ablation is effective and safe and resulting in shorter RF delivery times and larger LI drops than SP ablation.
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Affiliation(s)
| | - G Stabile
- Montevergine Clinic, Mercogliano, Italy
| | - M Mantica
- Clinical Institute Saint Ambrogio, Milan, Italy
| | | | - M D’ammando
- Hospital Santa Maria Della Misericordia, Perugia, Italy
| | | | - A Di Cori
- University Hospital of Pisa, Pisa, Italy
| | | | - L Ottaviano
- Clinical Institute Saint Ambrogio, Milan, Italy
| | - R Mantovan
- Conegliano General Hospital, Conegliano, Italy
| | - F Ferrari
- Hospital Molinette of the University Hospital S. Giovanni Battista, Turin, Italy
| | - S Bianchi
- Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
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12
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Parreira L, Rossillo A, Del Greco M, Mantovan R, Fantinel M, Bottoni N, Bianco E, Bacchiega E, Tao C, Rossi P. Visualization of pulmonary vein reconnections using dynamic mapping in redo procedures for patients with atrial fibrillation. Europace 2022. [DOI: 10.1093/europace/euac053.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/Introduction
Pulmonary vein (PV) reconnection is commonly associated with recurrence of atrial fibrillation (AF) after the initial catheter ablation procedure. Visualization and identification of PV reconnections are critical during repeat procedures.
Purpose
To examine the use of dynamic mapping (LiveView) in combination with a high-density mapping catheter (HD Grid) in the recognition of PV reconnections in redo AF ablation procedures.
Methods
Acute procedure data from 81 patients were prospectively collected. Mapping catheter selection and the use of LiveView was determined at the physician’s discretion. For cases where LiveView was used, the location and number of gaps from the previous procedure were identified using both standard mapping and dynamic mapping separately.
Results
Most of the patients included in the analysis were treated for paroxysmal AF (PAF: n=63/81, 77.8%). Dynamic mapping data was incorporated in 50 PAF cases and 15 persistent AF cases. Within these 65 cases, standard mapping identified a total of 120 PV gaps whereas LiveView identified a total of 138 PV gaps; gaps were most frequently identified on the right PVs, especially in the anterior region (Table1). A contact force-sensing ablation catheter was commonly (n=64/81, 79%) used by the operators. The right anterior region was ablated with an average contact force of 13.8±3.1g and Lesion index (LSI) of 5.2±0.7 at a power of 35.8±8.4W. Non-PV ablation was performed in 38 (46.9%) patients; the most common lesion sets were roofline, cavotricuspid isthmus (CTI) line, and mitral isthmus line. Acute PV isolation was achieved in all patients at the end of the procedure.
Conclusion
Data from this analysis suggest the incorporation of dynamic mapping data may help reveal more PV reconnections compared to standard mapping. Additional study is needed to assess the long-term clinical outcomes when regional dynamic mapping data is used to identify PV reconnections in repeat procedures.
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Affiliation(s)
- L Parreira
- Centro Hospitalar Setubal, Setubal, Portugal
| | | | | | - R Mantovan
- Ospedale S. Maria dei Battuti, Conegliano, Italy
| | | | - N Bottoni
- Santa Maria Nuova, Reggio Emilia, Italy
| | - E Bianco
- Ospedale Cattinara di Trieste, Azienda Ospedaliero Universitaria dell’Area Giuliano Isontina, Cardiologia, Trieste, Italy
| | | | - C Tao
- Abbott, Plymouth, United States of America
| | - P Rossi
- S. Giovanni Calibita Hospital, Isola Tiberina, Roma, Italy
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13
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Battaglia A, Calvanese R, Pandozi C, Tola G, Solimene F, Rossi L, Cauti F, Pedretti S, Mantovan R, Pelargonio G, Castro A, Gagliardi M, Izzo G, Malacrida M, Scaglione M. Ventricular tachycardia channels ablation incorporating automated high-density mapping guidance: data from the CHARISMA registry. Europace 2022. [DOI: 10.1093/europace/euac053.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Ventricular tachycardia (VT) ablation targeting conducting channels (CC)s based on timing of late potentials (LPs) during sinus rhythm (dechanneling) may facilitate a scar homogenization strategy without the need for extensive ablation and possibly lead to higher successful rate.
Purpose
We evaluated the feasibility and safety of a CC identification and ablation approach by means of an ultra-high density mapping system with a novel automated algorithm in ischemic VT procedures.
Methods
Consecutive patients indicated for ischemic VT ablation were prospectively included. A complete map of the left ventricle was performed prior and after ablation through the Rhythmia mapping system. Channels were defined as any signal activity bounded by anatomic and functional barriers and characterized through the Lumipoint (LM) tool and continuous activation was used on the whole ventricular substrate. Procedural end point was the elimination of all identified CCs by ablation at the CC entrance and exit followed by abolition of any residual LPs inside the CC. The ablation endpoint was noninducibility. Data are reported as mean±SD.
Results
A total of 36 channels were identified through LM from 28 patients (1.2±0.5 per patient): 21 (75%) patients had 1 CC, 6 (21.4%) had 2 CCs and 1 (3.6%) had 3 CCs. LPs were identified inside CCs in 19 cases (67.9%). In 8 cases (28.6%) LPs were present both inside and outside and in 1 (3.6%) case LPs were present only outside the CC. LPs inside channels covered an area of 7.6±5 mm2 with a ratio between LPs area and CCs’ area of 67.4±31.8%. In 12 (43%) cases LPs area covered more than 90% of the CCs’ area. At voltage map analysis a total of 34 CC were identified: 1 CC was present in 75% of the cases, 2 CCs in 17.9% and 3 CCs in 3.6%. LPs were identified only inside CCs in 46.4% of the cases, both inside and outside in 42.9% and only outside in 10.7%. Healthy tissue (voltage level≥0.5mV) was prevalent (68.2±17%), followed by intermediate voltage areas (0.5-0.05 mV; 31.1±17%) and very low voltage areas (<0.05mV; 0.7±1%). LPs were found mostly at intermediate voltage areas (57.0±34% of the covered area; 39.1±33% at healthy tissue and 3.4±13% at very low voltage areas). LM was more accurate than traditional voltage mapping in identifying CCs: in 6 (21.4%) cases voltage map overestimated LPs areas, in 2 (7.1%) cases failed to fully identify LPs and only in 19 out 28 (67.8%) LM and voltage map had a complete agreement. All CCs’ entrance and exit were successfully ablated and abolition of any residual LPs inside the CC was achieved in all patients. No complication occurred. Noninducibility was achieved in all (100%) the cases.
Conclusions
In this experience, a channel identification approach through the advanced Lumipoint tool was more accurate than traditional voltage mapping and seems to be safe, feasible, and effective at least in the acute setting of ischemic VT ablation.
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Affiliation(s)
| | | | - C Pandozi
- San Filippo Neri Hospital, Rome, Italy
| | - G Tola
- AO Brotzu Hospital, Cagliari, Italy
| | | | - L Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - F Cauti
- Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | | | | | - G Pelargonio
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - A Castro
- Sandro Pertini Hospital, Rome, Italy
| | | | - G Izzo
- Ospedale Del Mare, Naples, Italy
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14
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Tovia-Brodie O, Rav Acha M, Belhassen B, Gasperetti A, Schiavone M, Forleo GB, Guevara-Valdivia ME, Ruiz DV, Lellouche N, Hamon D, Castagno D, Bellettini M, De Ferrari GM, Laredo M, Carvès JB, Ignatiuk B, Pasquetto G, De Filippo P, Malanchini G, Pavri BB, Raphael C, Rivetti L, Mantovan R, Chinitz J, Harding M, Boriani G, Casali E, Wan EY, Biviano A, Macias C, Havranek S, Lazzerini PE, Canu AM, Zardini M, Conte G, Cano Ó, Casella M, Rudic B, Omelchenko A, Mathuria N, Upadhyay GA, Danon A, Schwartz AL, Maury P, Nakahara S, Goldenberg G, Schaerli N, Bereza S, Auricchio A, Glikson M, Michowitz Y. Implantation of cardiac electronic devices in active COVID-19 patients: Results from an international survey. Heart Rhythm 2022; 19:206-216. [PMID: 34710561 PMCID: PMC8547796 DOI: 10.1016/j.hrthm.2021.10.020] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/16/2021] [Accepted: 10/20/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cardiac implantable electronic device (CIED) implantation rates as well as the clinical and procedural characteristics and outcomes in patients with known active coronavirus disease 2019 (COVID-19) are unknown. OBJECTIVE The purpose of this study was to gather information regarding CIED procedures during active COVID-19, performed with personal protective equipment, based on an international survey. METHODS Fifty-three centers from 13 countries across 4 continents provided information on 166 patients with known active COVID-19 who underwent a CIED procedure. RESULTS The CIED procedure rate in 133,655 hospitalized COVID-19 patients ranged from 0 to 16.2 per 1000 patients (P <.001). Most devices were implanted due to high-degree/complete atrioventricular block (112 [67.5%]) or sick sinus syndrome (31 [18.7%]). Of the 166 patients in the study survey, the 30-day complication rate was 13.9% and the 180-day mortality rate was 9.6%. One patient had a fatal outcome as a direct result of the procedure. Differences in patient and procedural characteristics and outcomes were found between Europe and North America. An older population (76.6 vs 66 years; P <.001) with a nonsignificant higher complication rate (16.5% vs 7.7%; P = .2) was observed in Europe vs North America, whereas higher rates of critically ill patients (33.3% vs 3.3%; P <.001) and mortality (26.9% vs 5%; P = .002) were observed in North America vs Europe. CONCLUSION CIED procedure rates during known active COVID-19 disease varied greatly, from 0 to 16.2 per 1000 hospitalized COVID-19 patients worldwide. Patients with active COVID-19 infection who underwent CIED implantation had high complication and mortality rates. Operators should take these risks into consideration before proceeding with CIED implantation in active COVID-19 patients.
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Affiliation(s)
- Oholi Tovia-Brodie
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel.
| | - Moshe Rav Acha
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University, Jerusalem, Israel
| | - Bernard Belhassen
- Heart Institute, Hadassah University Hospital, Jerusalem, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alessio Gasperetti
- Cardiology Unit, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Marco Schiavone
- Cardiology Unit, ASST Fatebenefratelli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | | | - Milton E Guevara-Valdivia
- UMAE Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza IMSS, CDMX, Mexico City, México
| | - David Valdeolivar Ruiz
- UMAE Hospital de Especialidades Dr. Antonio Fraga Mouret, CMN La Raza IMSS, CDMX, Mexico City, México
| | - Nicolas Lellouche
- Henri Mondor University Hospital Cardiology Unit Creteil, Paris, France
| | - David Hamon
- Henri Mondor University Hospital Cardiology Unit Creteil, Paris, France
| | - Davide Castagno
- Division of Cardiology, Department of Medical Sciences, "Città della Salute della Scienza" Hospital, University of Turin, Turin, Italy
| | - Matteo Bellettini
- Division of Cardiology, Department of Medical Sciences, "Città della Salute della Scienza" Hospital, University of Turin, Turin, Italy
| | - Gaetano M De Ferrari
- Division of Cardiology, Department of Medical Sciences, "Città della Salute della Scienza" Hospital, University of Turin, Turin, Italy
| | - Mikael Laredo
- AP. HP-Sorbonne Université, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Baptiste Carvès
- AP. HP-Sorbonne Université, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Barbara Ignatiuk
- Ospedali Riuniti Padova Sud "Madre Teresa di Calcutta", Monselice, Italy
| | | | - Paolo De Filippo
- Cardiac Electrophysiology and Pacing Unit, Papa Giovanni XXIII Hospital, Bergamo (BG), Italy
| | - Giovanni Malanchini
- Cardiac Electrophysiology and Pacing Unit, Papa Giovanni XXIII Hospital, Bergamo (BG), Italy
| | - Behzad B Pavri
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Craig Raphael
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Luigi Rivetti
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Conegliano (TV), Italy
| | - Roberto Mantovan
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Conegliano (TV), Italy
| | - Jason Chinitz
- Department of Cardiology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell Health, South Shore University Hospital, Bay Shore, New York
| | - Melissa Harding
- Department of Cardiology, Northwell Health, Zucker School of Medicine at Hofstra/Northwell Health, South Shore University Hospital, Bay Shore, New York
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Edoardo Casali
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Elaine Y Wan
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York
| | - Angelo Biviano
- Division of Cardiology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York
| | - Carlos Macias
- UCLA Cardiac Arrhythmia Center, Los Angeles, California
| | - Stepan Havranek
- 2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Pietro Enea Lazzerini
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy, and Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Antonio M Canu
- Azienda Ospedaliero-Universitaria Pisana, Cardiothoracic and Vascular Department, Cardiovascular Unit II, Pisa, Italy
| | - Marco Zardini
- Division of Cardiology, University Hospital "Ospedale Maggiore", Parma, Italy
| | - Giulio Conte
- Electrophysiology Unit, Department of Cardiology, Istituto Cardiocentro Ticino, Lugano, Switzerland
| | - Óscar Cano
- Arrhythmia Section, Department of Cardiology, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, Centro de Investigaciones Biomédicas en RED en Enfermedades Cardiovasculares (CIBERCV), Valencia, Spain
| | - Michela Casella
- Clinic of Cardiology and Arrhythmology, University Hospital "Ospedali Riuniti", Department of Clinical, Special and Dental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Boris Rudic
- 1st Department of Medicine-Cardiology, University Medical Centre Mannheim, Germany, and German Center for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | | | - Nilesh Mathuria
- Division of Cardiac Electrophysiology, Houston Methodist DeBakey Cardiology Associates, Houston, Texas
| | - Gaurav A Upadhyay
- Center for Arrhythmia Care, Division of Cardiology, Pritzker School of Medicine, University of Chicago Medicine, Chicago, Illinois
| | - Asaf Danon
- Electrophysiology Unit, Cardiology Department, Carmel Medical Center, Haifa, Israel
| | - Arie Lorin Schwartz
- Cardiology Department, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Philippe Maury
- Cardiology, University Hospital Rangueil, Toulouse, France
| | - Shiro Nakahara
- Department of Cardiology, Dokkyo Medical University, Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Gustavo Goldenberg
- Rabin Medical Center, Petach Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nicolas Schaerli
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - Sergiy Bereza
- Cardiology Department, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Angelo Auricchio
- Electrophysiology Unit, Department of Cardiology, Istituto Cardiocentro Ticino, Lugano, Switzerland
| | - Michael Glikson
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University, Jerusalem, Israel
| | - Yoav Michowitz
- Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University, Jerusalem, Israel
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15
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Sanchez-Somonte P, Jiang CY, Betts TR, Chen J, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Completeness of Linear or Fractionated Electrogram Ablation in Addition to Pulmonary Vein Isolation on Ablation Outcome: A Substudy of the STAR AF II Trial. Circ Arrhythm Electrophysiol 2021; 14:e010146. [PMID: 34488431 DOI: 10.1161/circep.121.010146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/16/2022]
Affiliation(s)
| | - Chen-Yang Jiang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China (C.-y.J.)
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals, John Radcliffe Hospital, Oxford, United Kingdom (T.R.B.)
| | - Jian Chen
- Department of Cardiology, Haukeland University Hospital, University of Bergen, Norway (J.C.)
| | - Roberto Mantovan
- Department of Cardiology, Ospedale S. Maria di Ca' Foncelli, Treviso, Italy (R.M.)
| | - Laurent Macle
- Department of Cardiology, Montreal Heart Institute (L.M.)
| | - Carlos A Morillo
- Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Canada (C.A.M.)
| | - Wilhelm Haverkamp
- Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany (W.H.)
| | - Rukshen Weerasooriya
- Department of Cardiology, Hollywood Private Hospital, Nedlands, Western Australia, Australia, University of Western Australia, Crawley (R.W.)
| | | | - Stefano Nardi
- Department of Cardiology, Pineta Grande Hospital, Castel Volturno (S.N.)
| | - Endrj Menardi
- Department of Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy (E.M.)
| | - Paul Novak
- Department of Cardiology, Royal Jubilee Hospital, Victoria, Canada (P.N.)
| | - Prashanthan Sanders
- Department of Cardiology, Centre for Heart Rhythm Disorders, University of Adelaide & Royal Adelaide Hospital, Australia (P.S.)
| | - Atul Verma
- Southlake Regional Health Centre, Newmarket, Canada (P.S.-S., A.V.)
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16
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Scaglione M, Calvanese R, Pandozi C, Pedretti S, Rossi L, Pelargonio G, Mantovan R, Solimene F, Canciello M, Fonte G, Biagi A, Caponi D, Cerrato N, Malacrida M, Battaglia A. Impact of channels identification and ablation in ventricular tachycardia patients through high-density mapping: preliminary experience from an Italian registry. Europace 2021. [DOI: 10.1093/europace/euab116.352] [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: None.
Background
Ventricular tachycardia (VT) ablation techniques in ischemic cardiomyopathy have evolved during the recent years. However, the long-term success rate remains disappointing. A technique based on channel identification and ablation through a novel automated algorithm may limit the extent of ablation needed and possibly lead to higher successful rate.
Purpose
To report preliminary data on feasibility and safety of a channel identification approach and to characterize late potentials (LPs) features using an ultra-high density mapping system with a novel analysis tool in ischemic VT procedures.
Methods
Consecutive patients (pts) indicated for ischemic VT ablation were enrolled in the CHARISMA study. A complete map of the left ventricle was performed prior and after ablation through the Rhythmia mapping system. For our purpose channels were defined as any signal activity bounded by anatomic and functional barriers and characterized through a novel map analysis tool (Lumipoint-LM-) that automatically identifies fragmented late potentials (LPs) and continuous activation was used on the whole ventricular substrate. Procedural endpoint was the elimination of all identified conducting channels (CCs) by ablation at the CC entrance and exit followed by abolition of any residual LPs inside the CC. The ablation endpoint was noninducibility.
Results
A total of 18 channels were identified through LM from 14 pts: 71.4% of the pts had 1 CC, 28.6% had 2 CCs. In the majority of the cases LPs where identified only inside CCs (57.1%), whereas in 6 cases (42.9%) LPs were present both inside and outside. The mean conduction time inside CCs was 50.3 ± 30ms, the mean CC length was 32.6 ± 17mm and the conduction velocity was 0.8 ± 0.5 mm/ms. LPs covered a mean area of 7.0 ± 5mm2 (ratio between LPs area and CCs’ area = 52.4 ± 33.7%). At voltage map analysis 1 CC was present in 78.6% of the cases (2 CCs in 21.4%). LPs were identified only inside CCs in 42.9% of the cases, both inside and outside in 50% and only outside in 7.1%. Healthy tissue (voltage level≥0.5mV) was prevalent (61.2 ± 13.8%), followed by intermediate voltage areas (0.5-0.05mV; 37.5 ± 13.7%) and very low voltage areas (<0.05mV; 1.2 ± 2%). LPs were found mostly at intermediate voltage areas (54.1 ± 31.7% of the covered area; 39.1 ± 28.4% at healthy tissue and 6.8 ± 17.8% at very low voltage areas). Agreement in CCs identification between advanced analysis through LM and voltage map was fair (9/14 with complete agreement). In 3 cases voltage map overestimated LPs areas, in 2 cases failed to fully identify LPs. All CCs’ entrance and exit were successfully ablated and abolition of any residual LPs inside the CC was achieved in all pts. No complication occurred. Noninducibility was achieved in all the cases.
Conclusions
In our preliminary experience, a new channel identification approach through the advanced Lumipoint algorithm seems to be safe, feasible and effective at least in the acute setting of ischemic VT ablation.
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Affiliation(s)
| | | | - C Pandozi
- San Filippo Neri Hospital, Rome, Italy
| | | | - L Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - G Pelargonio
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy
| | - R Mantovan
- Conegliano General Hospital, Conegliano, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Mercogliano, Italy
| | | | - G Fonte
- Sant"Anna Hospital, Como, Italy
| | - A Biagi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - D Caponi
- Cardinal Massaia Hospital, Asti, Italy
| | - N Cerrato
- Cardinal Massaia Hospital, Asti, Italy
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17
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Porterfield C, Rillo M, Wystrach A, Rossi P, Zedda AM, Mine T, Mantovan R, Favilla A, Nilsson K. Assessment and incidence of PV gaps as determined by HD Grid and circular mapping catheters. Europace 2021. [DOI: 10.1093/europace/euab116.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Many tools and techniques are utilized to assess pulmonary vein isolation (PVI), such as evaluation of entrance and exit block, voltage mapping, and use of drugs such as adenosine. It is unclear which tools and techniques may provide greater sensitivity in the identification and elimination of pulmonary vein (PV) gaps, leading to better long-term outcomes. The HD Grid simultaneously records orthogonal bipolar EGMs to reduce directional sensitivity. Previously published data suggest that the use of HD Grid may improve sensitivity for gap identification.
Purpose
To determine, in a large cohort of procedures, the rate of gap detection when using HD Grid to check for PVI as compared to circular mapping catheters (CMC).
Methods
Anonymized, acute procedural data was prospectively collected in de novo AF ablation procedures in which either a 10- or 20-pole CMC or HD Grid catheter was used to assess PVI. Procedural data including gap detection and PVI assessment method were analyzed using chi-squared test.
Results
559 cases from over 60 institutions in 8 countries were analyzed. Of the 559 cases, 47.4% (265/599) used HD Grid, and 52.6% (294/599) used a CMC. PV gaps were found in 52.5% (139/265) of HD Grid procedures and in 36.7% (108/294) of CMC procedures (p < 0.001). The most common PVI assessment method in both HD Grid and CMC groups was entrance/exit block (90.9%, 92.5%, respectively). Mapping as a post-ablation assessment method was used in 69.1% (183/265) of HD Grid procedures whereas it was only used in 42.8% (126/294) of CMC procedures (p < 0.001). Of the 183 HD Grid procedures that utilized mapping for PV assessment, 57.9% (106/183) used both voltage and activation mapping, 41.0% (75/183) used voltage only and 1.1% (2/183) used activation mapping only. Significantly more gaps were found in the HD Grid group that used both activation and voltage mapping (83.0%, 88/106) as compared to voltage mapping only (49.3%, 37/75, p < 0.001). At the end of the procedure, 95.8% of patients in the HD Grid group were in sinus rhythm, as compared to 84.7% of the CMC group.
Conclusions
While this analysis does not represent a direct comparison of the sensitivity of the two different technologies, HD Grid detected significantly more PV gaps compared to CMC in AF procedures. Previous publications have attributed similar findings to HD Grid’s ability to reduce voltage amplitude dependence on wavefront directionality. The significantly larger number of HD Grid cases that utilized mapping as a method of determining PVI could be explained by the need to maneuver the HD Grid around the circumference of the vein, which may naturally lead to map collection. This data also suggests that using both voltage and activation mapping identifies significantly more gaps as compared to only voltage mapping, however, further analysis could be warranted to better understand how these maps were collected and what map settings were used.
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Affiliation(s)
- C Porterfield
- French Hospital, San Luis Obispo, United States of America
| | - M Rillo
- Clinica Villa Verde, Taranto, Italy
| | - A Wystrach
- Sozialstiftung Klinikum Bamberg, Bamberg, Germany
| | - P Rossi
- FateBeneFratelli – Isola Tiberina, Rome, Italy
| | - AM Zedda
- Sana Herzzentrum Dresden, Dresden, Germany
| | - T Mine
- Hyogo College of Medicine, Nishinomiya, Japan
| | | | - A Favilla
- Abbott, Minneapolis, United States of America
| | - K Nilsson
- Piedmont Athens Regional Medical Center, Athens, United States of America
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18
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La Greca C, Cauti FM, Piro A, Di Belardino N, Anselmino M, Scaglione M, Pecora D, Rossi L, Di Cori A, Tola G, Pedretti S, Mantovan R, Solimene F, Rossi P, Bianchi S. Minimal fluoroscopic approaches and factors associated with radiation dose when high-definition mapping is used for supraventricular tachycardia ablation: insight from the CHARISMA registry. Europace 2021. [DOI: 10.1093/europace/euab116.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Limited data exist on factors associated with radiation exposure during ablation procedures when a high definition mapping technology is used.
Purpose
To report factors associated with radiation exposure and data on feasibility and safety of a minimal fluoroscopic approach using the Rhythmia mapping system in supraventricular tachycardia (SVT) ablation procedures.
Methods
Consecutive patients indicated for arrhythmia ablation were enrolled in the CHARISMA study at 12 centers. We included in this analysis consecutive right-side procedures performed through a minimal fluoroscopy approach with the Rhythmia mapping system were analyzed. A 3D geometry of chambers of interest was reconstructed on the basis of the electroanatomic information taken from the mapping system. Fluoroscopy was used only if deemed necessary. The effective dose (ED) was calculated using accepted formula. For our purpose high dose exposure was defined as an ED greater than the median value of ED of the population exposed to radiation.
Results
This analysis included 325 patients (mean age = 56 ± 17 years, 57% male) undergoing SVT procedures (152 AVNRT, 116 AFL, 41 AP and 16 AT). During the study, 27481 seconds of fluoroscopy was used (84.6 ± 224 seconds per procedure), resulting in a mean equivalent ED of 1.1 ± 3.7 mSv per patient. The mean reconstructed RA volume was 99 ± 54 ml in a mean mapping time of 12.2 ± 7 min. The mean number of radiofrequency ablations (RFC) to terminate each arrhythmia was 9.4 ± 9 (mean RFC delivery time equal to 6.7 ± 6 min). 192 procedures (59.1%) were completed without any use of fluoroscopy; during the remaining 133 procedures (39.9%), 206.6 ± 313.4 seconds of fluoroscopy was used (median ED = 1.2 mSv). In a minority of the cases (n = 25, 7.7%) the fluoroscopy time was higher than 5 minutes (median ED = 6.5 mSv), whereas radiologic exposure time greater than 1 minute occurred in ninety cases (27.7%, median ED = 2.1 mSv). On multivariate logistic analysis adjusted for baseline confounders the RFC application time (OR = 1.0014, 95%CI: 1.0007 to 1.0022; p = 0.0001) was independently associated to an ED greater than 1.2 mSv, whereas female gender had an inverse association (0.54, 0.29 to 0.98; p = 0.0435). Acute success was reached in 97.8% of the cases. During a mean of 290.7 ± 169.6 days follow-up, no major adverse events related to the procedure were reported. Overall, the recurrence rate of the primary arrhythmia during follow-up was 2.5%.
Conclusions
In our experience, arrhythmias ablation through minimal fluoroscopy approach with the use of a novel ablation technology is safe, feasible, and effective in common right atrial arrhythmias. High-dose exposure occurred in a very limited number of cases, without any reduction of the safety and acute and long-term effectiveness profile.
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Affiliation(s)
- C La Greca
- Poliambulanza Foundation Hospital Institute of Brescia, Cardiology, Brescia, Italy
| | - FM Cauti
- Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - A Piro
- Umberto I Polyclinic of Rome, Rome, Italy
| | | | | | | | - D Pecora
- Poliambulanza Foundation Hospital Institute of Brescia, Cardiology, Brescia, Italy
| | - L Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - A Di Cori
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - G Tola
- AO Brotzu Hospital, Cagliari, Italy
| | | | - R Mantovan
- Conegliano General Hospital, Conegliano, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Mercogliano, Italy
| | - P Rossi
- Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - S Bianchi
- Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
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19
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Cauti FM, Rossi P, La Greca C, Piro A, Di Belardino N, Battaglia A, Ferraris F, Pecora D, Lavalle C, Scalone A, Rossi L, Di Cori A, Solimene F, Mantovan R, Pedretti S, Iaia L, Bianchi S, Anselmino M. Minimal fluoroscopy approach for right-sided supraventricular tachycardia ablation with a novel ablation technology: Insights from the multicenter CHARISMA clinical registry. J Cardiovasc Electrophysiol 2021; 32:1296-1304. [PMID: 33783875 DOI: 10.1111/jce.15023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/05/2021] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND No data exist on the ability of the novel Rhythmia 3-D mapping system to minimize fluoroscopy exposure during transcatheter ablation of arrhythmias. We report data on the feasibility and safety of a minimal fluoroscopic approach using this system in supraventricular tachycardia (SVT) procedures. METHODS Consecutive patients were enrolled in the CHARISMA registry at 12 centers. All right-sided procedures performed with the Rhythmia mapping system were analyzed. The acquired electroanatomic information was used to reconstruct 3-D cardiac geometry; fluoroscopic confirmation was used whenever deemed necessary. RESULTS Three hundred twenty-five patients (mean age = 56 ± 17 years, 57% male) were included: 152 atrioventricular nodal reentrant tachycardia, 116 atrial flutter, 41 and 16 right-sided accessory pathway and atrial tachycardia, respectively. Overall, 27 481 s of fluoroscopy were used (84.6 ± 224 s per procedure, equivalent effective dose = 1.1 ± 3.7 mSv per patient). One hundred ninety-two procedures (59.1%) were completed without the use of fluoroscopy (zero fluoroscopy, ZF). In multivariate analysis, the presence of a fellow in training (OR = 0.15, 95% CI: 0.05-0.46; p = .0008), radiofrequency application (0.99, 0.99-1.00; p = .0002), and mapping times (0.99, 0.99-1.00; p = .042) were all inversely associated with ZF approach. Acute procedural success was achieved in 97.8% of the cases (98.4 vs. 97% in the ZF vs. non-ZF group; p = .4503). During a mean of 290.7 ± 169.6 days follow-up, no major adverse events were reported, and recurrence of the primary arrhythmia was 2.5% (2.1 vs. 3% in the ZF vs. non-ZF group; p = .7206). CONCLUSIONS The Rhythmia mapping system permits transcatheter ablation of right-sided SVT with minimal fluoroscopy exposure. Even more, in most cases, the system enables a ZF approach, without affecting safety and efficacy.
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Affiliation(s)
- Filippo M Cauti
- Arrhythmology Unit, S. Giovanni Calibita Hospital, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Pietro Rossi
- Arrhythmology Unit, S. Giovanni Calibita Hospital, Fatebenefratelli Isola Tiberina, Rome, Italy
| | | | | | | | | | - Federico Ferraris
- Department of Medical Sciences, "Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy
| | | | | | | | - Luca Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | | | | | | | - Luigi Iaia
- Arrhythmology Unit, S. Giovanni Calibita Hospital, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Stefano Bianchi
- Arrhythmology Unit, S. Giovanni Calibita Hospital, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Matteo Anselmino
- Department of Medical Sciences, "Città della Salute e della Scienza di Torino" Hospital, University of Turin, Turin, Italy
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20
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Conti S, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Incidence of Concurrent Atrial Fibrillation in Patients Who Present With Atrial Tachycardia and Atrial Flutter Postablation for Persistent Atrial Fibrillation: Insights From the STAR AF II Trial. Circ Arrhythm Electrophysiol 2021; 14:e008683. [PMID: 33657834 DOI: 10.1161/circep.120.008683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sergio Conti
- Department of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada (S.C., A.V.).,Department of Cardiology, University of Tor Vergata, Rome, Italy (S.C.)
| | - Chen-Yang Jiang
- Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China (C.-y.J.)
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals, John Radcliffe Hospital, United Kingdom (T.R.B.)
| | - Jian Chen
- Department of Cardiology, Haukeland University Hospital, University of Bergen, Norway (J.C.)
| | | | - Roberto Mantovan
- Department of Cardiology, Ospedale S. Maria di Ca' Foncelli, Treviso, Italy (R.M.)
| | | | - Carlos A Morillo
- Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, AL, Canada (C.A.M.)
| | - Wilhelm Haverkamp
- Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany (W.H.)
| | - Rukshen Weerasooriya
- Department of Cardiology, Hollywood Private Hospital, Nedlands, Western Australia (R.W.).,Department of Cardiology, University of Western Australia, Crawley (R.W.)
| | | | - Stefano Nardi
- Department of Cardiology, Pineta Grande Hospital, Castel Volturno, Italy (S.N.)
| | - Endrj Menardi
- Department of Cardiology, Ospedale Santa Croce e Carle, Cuneo, Italy (E.M.)
| | - Paul Novak
- Department of Cardiology, Royal Jubilee Hospital, Victoria, BC, Canada (P.N.)
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Australia (P.S.)
| | - Atul Verma
- Department of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada (S.C., A.V.).,Department of Cardiology, University of Toronto, ON, Canada (A.V.)
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21
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Gunnlaugsson HP, Masenda H, Mølholt TE, Bharuth-Ram K, Ólafsson S, Johnston K, Schell J, Gislason HP, Krastev PB, Mantovan R, Naidoo D, Qi B, Unzueta I. Annealing studies combined with low temperature emission Mössbauer spectroscopy of short-lived parent isotopes: Determination of local Debye-Waller factors. Rev Sci Instrum 2021; 92:013901. [PMID: 33514210 DOI: 10.1063/5.0020951] [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] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
An extension of the online implantation chamber used for emission Mössbauer Spectroscopy (eMS) at ISOLDE/CERN that allows for quick removal of samples for offline low temperature studies is briefly described. We demonstrate how online eMS data obtained during implantation at temperatures between 300 K and 650 K of short-lived parent isotopes combined with rapid cooling and offline eMS measurements during the decay of the parent isotope can give detailed information on the binding properties of the Mössbauer probe in the lattice. This approach has been applied to study the properties of Sn impurities in ZnO following implantation of 119In (T½ = 2.4 min). Sn in the 4+ and 2+ charge states is observed. Above T > 600 K, Sn2+ is observed and is ascribed to Sn on regular Zn sites, while Sn2+ detected at T < 600 K is due to Sn in local amorphous regions. A new annealing stage is reported at T ≈ 550 K, characterized by changes in the Sn4+ emission profile, and is attributed to the annihilation of close Frenkel pairs.
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Affiliation(s)
- H P Gunnlaugsson
- Science Institute, University of Iceland, Dunhaga 3, IS-107 Reykjavík, Iceland
| | - H Masenda
- School of Physics, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - T E Mølholt
- DTU Health Technology, Risø Campus, Frederiksborgvej 399, 4000 Roskilde, Denmark
| | - K Bharuth-Ram
- School of Chemistry and Physics, University of KwaZulu-Natal, Durban 4001, South Africa
| | - S Ólafsson
- Science Institute, University of Iceland, Dunhaga 3, IS-107 Reykjavík, Iceland
| | - K Johnston
- EP Department, ISOLDE/CERN, 1211 Geneva 23, Switzerland
| | - J Schell
- EP Department, ISOLDE/CERN, 1211 Geneva 23, Switzerland
| | - H P Gislason
- Science Institute, University of Iceland, Dunhaga 3, IS-107 Reykjavík, Iceland
| | - P B Krastev
- Institute for Nuclear Research and Nuclear Energy, Bulgarian Academy of Sciences, 72 Tsarigradsko Chaussee Boulevard, Sofia 1784, Bulgaria
| | - R Mantovan
- CNR-IMM, Unità di Agrate Brianza, Via Olivetti 2, 20864 Agrate Brianza (MB), Italy
| | - D Naidoo
- School of Physics, University of the Witwatersrand, Johannesburg 2050, South Africa
| | - B Qi
- Science Institute, University of Iceland, Dunhaga 3, IS-107 Reykjavík, Iceland
| | - I Unzueta
- Department of Applied Mathematics, University of the Basque Country (UPV/EHU), Torres Quevedo Ingeniaria Plaza 1, 48013 Bilbao, Spain
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22
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Terricabras M, Mantovan R, Jiang CY, Betts TR, Chen J, Deisenhofer I, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Association Between Quality of Life and Procedural Outcome After Catheter Ablation for Atrial Fibrillation: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2020; 3:e2025473. [PMID: 33275151 PMCID: PMC7718606 DOI: 10.1001/jamanetworkopen.2020.25473] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IMPORTANCE Catheter ablation is effective in reducing atrial fibrillation (AF), but the association of ablation for AF with quality of life is unclear. OBJECTIVE To evaluate whether the procedural outcome of ablation for AF is associated with quality of life (QOL) measures. DESIGN, SETTING, AND PARTICIPANTS This was a prespecified secondary analysis of the Substrate and Trigger Ablation for Reduction of Atrial Fibrillation-Part II (STAR AF II) prospective randomized clinical trial, which compared 3 strategies for ablation of persistent AF. This analysis included 549 of the 589 patients enrolled in the trial who underwent ablation. Enrollment occurred at 35 centers in Europe, Canada, Australia, China, and Korea from November 2010 to July 2012. Data for the current study were analyzed on December 11, 2019. INTERVENTIONS Patients underwent AF ablation with 1 of 3 ablation strategies: (1) pulmonary vein isolation (PVI), (2) PVI plus complex fractionated electrograms, or (3) PVI plus linear lesions. MAIN OUTCOMES AND MEASURES Quality of life was assessed at baseline and at 6, 12, and 18 months after ablation for AF using the 36-Item Short Form Health Survey and the EuroQol Health-Related Quality of Life 5-Dimension 3-Level questionnaire. Scores were also converted to a physical health component score (PCS) and a mental health component score (MCS). Individual AF burden was calculated by the total time with AF from Holter monitors and the percentage of transtelephonic monitor recordings showing AF. RESULTS Among the 549 patients included in this secondary analysis, QOL was assessed in 466 (85%) at baseline and at 6, 12, and 18 months after ablation for AF. The mean (SD) age of the study population was 60 (9) years; 434 (79%) individuals were men, and 417 (76%) had continuous AF for 6 months or more before ablation. The AF burden significantly decreased from a mean (SD) of 82% (36%) before ablation to 6.6% (23%) after ablation (P < .001). Significant improvements in mean (SD) PCS (68.3 [20.7] to 82.5 [18.6]) and MCS (35.3 [8.6] to 37.5 [7.6]) occurred 18 months after ablation (P < .05 for both). Significant QOL improvement occurred in all 3 study arms and regardless of AF recurrence, defined as AF episodes lasting more than 30 seconds: for no recurrence, mean (SD) PCS increased from 66.5 (20.9) to 79.1 (19.4) and MCS from 35.3 (8.7) to 37.7 (7.7); for recurrence, mean (SD) PCS increased from 70.2 (20.4) to 86.4 (16.8) and MCS from 35.3 (8.6) to 37.1 (7.4) (P < .05 for all). When outcome was defined by AF burden reduction, in patients with less than 70% reduction in AF burden, the increase in PCS was significantly less than in those with greater than 70% reduction, and only 3 of 8 subscales showed significant improvement. CONCLUSIONS AND RELEVANCE In this secondary analysis, decreases in AF burden after ablation for AF were significantly associated with improvements in QOL. Quality of life changes were significantly associated with the percentage of AF burden reduction after ablation. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01203748.
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Affiliation(s)
- Maria Terricabras
- Department of Cardiology, Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada
| | - Roberto Mantovan
- Department of Cardiology, Santa Maria dei Battuti Hospital, Conegliano, Italy
| | - Chen-yang Jiang
- Department of Cardiology, Sir Run Shaw Hospital, Hangzhou, Zhejiang, China
| | - Timothy R. Betts
- Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Jian Chen
- Department of Cardiology, Haukeland University Hospital, Bergen, Norway
| | | | | | - Carlos A. Morillo
- Department of Cardiology, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Wilhelm Haverkamp
- Department of Cardiology, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - Rukshen Weerasooriya
- Department of Cardiology, Hollywood Private Hospital, Perth, Western Australia, Australia
| | | | - Stefano Nardi
- Department of Cardiology, Pineta Grande Hospital, Castel Volturno, Italy
| | - Endrj Menardi
- Department of Cardiology, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Paul Novak
- Department of Cardiology, Royal Jubilee Hospital, Victoria, British Columbia, Canada
| | - Prashanthan Sanders
- Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Atul Verma
- Department of Cardiology, Southlake Regional Health Centre, University of Toronto, Newmarket, Ontario, Canada
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23
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Anselmino M, Cauti F, Piro A, Di Belardino N, Scaglione M, Pecora D, Rossi L, Di Cori A, Tola G, Pedretti S, Mantovan R, Solimene F, Rossi P, Iaia L, Bianchi S. Minimal fluoroscopy approach in current clinical practice with a novel ablation technology for supraventricular tachycardia: a large multicenter experience from an Italian registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Electrophysiological studies and ablation procedures expose both physicians and patients to a large amount of radiation. Most of 3-D mapping systems provide improved tracking of catheters, possibly allowing relevant reductions in radiation exposure. No data exists on the ability of the Rhythmia mapping system to minimize fluoroscopy time and dose.
Purpose
To report preliminary data on feasibility and safety of a minimal fluoroscopic approach using the Rhythmia mapping system in supraventricular tachycardia (SVT) procedures.
Methods
Consecutive patients indicated for arrhythmia ablation were enrolled in the CHARISMA study at 12 centers. For our purpose consecutive right-side procedures performed through a minimal fluoroscopy approach with the Rhythmia mapping system were analyzed. A 3D geometry of chambers of interest was reconstructed on the basis of the electroanatomic information taken from the mapping system. Fluoroscopy was used only if deemed necessary.
Results
This analysis included 266 patients (mean age = 57±17 years, 57% male) undergoing SVT procedures (120 AVNRT, 91 AFL, 32 AP, 11 AT and 12 other right atrial procedures). In all cases, diagnostic EP and ablation catheters were positioned using a low fluoroscopic electroanatomic guided approach. The mean fluoroscopy time needed for each procedure was 55±128 s. The median reconstructed RA volume was 92 [63–131] ml in a median mapping time of 11 [7–17] min. The median number of radiofrequency ablations to terminate each arrhythmia was 6 [3–12] (total RF delivery time of 291 [180–505] s). Sixty-five percent of the procedures (n=174) were completed with less than 10 s of fluoroscopy. Low fluoroscopy approach with less than 10 s (minimal fluoroscopy approach) was most frequently obtained in case of AVNRT (91, 76%) compared to other arrhythmias' ablation (83, 57%, p=0.001) Achievement of a minimal fluoroscopic approach was not affected by operator's experience (65% vs 66%, p=1.00, respectively within physician with more or less of 10 years of active practice), whereas it was affected by presence of a fellow in training during the procedure (72% without fellow vs 26% with fellow, p<0.0001). A 100% rate of acute success was observed, and no procedure-related complications occurred. At multivariate logistic regression analysis adjusted for baseline confounders, both the total number of RF ablations (OR: 0.93 (95% CI:0.88 to 0.96; p=0.0053) and the presence of a fellow in training during the procedure (OR: 0.29; 95% CI: 0.1 to 0.87; p=0.0278) had an inverse association to the achievement of a minimal fluoroscopic approach.
Conclusions
In our preliminary experience, arrhythmias' ablation through minimal fluoroscopy approach with the use of a novel ablation technology seems to be safe, feasible, and effective in common right atrial arrhythmias. Use of fluoroscopy can be dramatically reduced in most cases, without any reduction of the safety and acute effectiveness profile.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Anselmino
- A.O.U. Citta della Salute e della Scienza di Torino, Turin, Italy
| | - F.M Cauti
- Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - A Piro
- Umberto I Polyclinic of Rome, Rome, Italy
| | | | | | - D Pecora
- Poliambulanza Foundation Hospital Institute of Brescia, Brescia, Italy
| | - L Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - A Di Cori
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - G Tola
- AO Brotzu Hospital, Cagliari, Italy
| | | | - R Mantovan
- Conegliano General Hospital, Conegliano, Italy
| | - F Solimene
- Montevergine Cardiology Clinic, Mercogliano, Italy
| | - P Rossi
- Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - L Iaia
- Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy
| | - S Bianchi
- Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy
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24
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Conti S, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Effect of Postablation Monitoring Strategy on Long-Term Outcome for Catheter Ablation of Persistent Atrial Fibrillation: A Substudy of the STAR AF II Trial. Circ Arrhythm Electrophysiol 2020; 13:e008682. [PMID: 33034510 DOI: 10.1161/circep.120.008682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sergio Conti
- Southlake Regional Health Centre, Newmarket, Canada (S.C., A.V.)
- University of Tor Vergata, Rome, Italy (S.C.)
| | - Chen-Yang Jiang
- Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China (C.-y.J.)
| | - Timothy R Betts
- Department of Cardiology, Oxford University Hospitals, John Radcliffe Hospital, United Kingdom (T.R.B.)
| | - Jian Chen
- Haukeland University Hospital, University of Bergen, Norway (J.C.)
| | | | | | | | - Carlos A Morillo
- Department of Cardiac Sciences, Libin Cardiovascular Institute, University of Calgary, Canada (C.A.M.)
| | - Wilhelm Haverkamp
- Department of Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany (W.H.)
| | - Rukshen Weerasooriya
- Department of Cardiology, Hollywood Private Hospital, Nedlands, Western Australia (R.W.)
- Department of Cardiology, University of Western Australia, Crawley (R.W.)
| | | | - Stefano Nardi
- Pineta Grande Hospital, Castel Volturno, Italy (S.N.)
| | | | - Paul Novak
- Royal Jubilee Hospital, Victoria, Canada (P.N.)
| | - Prashanthan Sanders
- Centre for Heart Rhythm Disorders, University of Adelaide, Royal Adelaide Hospital, Australia (P.S.)
| | - Atul Verma
- Southlake Regional Health Centre, Newmarket, Canada (S.C., A.V.)
- Department of Surgery, University of Toronto, Canada (A.V.)
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25
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Cauti FM, Piro A, Di Belardino N, Tola G, Anselmino M, Pecora D, Scaglione M, Rossi L, Pedretti S, Solimene F, Mantovan R, Di Cori A, Rossi P, Iaia L, Bianchi S. P1452Low fluoroscopy approach with a novel ablation technology in right side procedures: a large multicenter experience from the CHARISMA registry. Europace 2020. [DOI: 10.1093/europace/euaa162.247] [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
NO FUNDING
Background
Electrophysiological studies and ablation procedures expose both physicians and patients to a significant amount of radiation. Nowadays, most of 3-D mapping systems allow for improved tracking of catheters with possible reduction in radiation exposure. No data exists on the ability to minimize fluoroscopy time and dose while using the Rhythmia mapping system.
Purpose
To report preliminary data on feasibility and safety of a low fluoroscopic approach using the Rhythmia mapping system in SVT procedures.
Methods
The CHARISMA study is a non-randomized, multicenter, prospective study in which consecutive patients indicated for arrhythmia were enrolled. For our purpose consecutive right-side procedures performed through a low fluoroscopy approach with the Rhythmia mapping system were analyzed. The mapping system was used to create the 3D geometry of chambers of interest and anatomic reference points and to visualize the catheters from the beginning to the end of the procedure. Fluoroscopy was used only if deemed necessary.
Results
204 unselected consecutive cases of SVT from 11 centers were included in the study (mean age = 55 ± 18 years, 53% male, 85 AVNRT, 75 AFL, 28 AP, 9 AT and 7 other right atrial procedures). In all the cases, diagnostic EP and ablation catheters were positioned using only the low fluoroscopic guided mapping approach. During the study, a total of 7157 s of fluoroscopy was needed in 204 patients (51 ± 137 s per procedure). One hundred fourty-one procedures (69%) were completed with less than 10 seconds of fluoroscopy, whereas in 169 (83%) of the cases the fluoroscopy time was lower than 60 seconds. Low fluoroscopy approach with less than 10 seconds was less frequently obtained in case of AFL (46, 61.3%) compared to AVNRT ablation (65, 76.5%, p = 0.041) whereas no differences were found comparing with AP (21, 75%, p = 0.248). The median reconstructed RA volume was 94[65-133] ml in a median mapping time of 11 [6-16] min. The median number of radiofrequency ablations to terminate each arrhythmia was 5 [3-12] (total RF delivery time of 293 [180-505] sec). A 100% rate of acute success was observed in our case series. No complications occurred.
Conclusions
In our preliminary experience, arrhythmias ablation through low fluoroscopy approach and the use of a novel ablation technology seems to be safe, feasible, and effective in common right atrial arrhythmias. Use of fluoroscopy can be nearly avoided in most cases, without any reduction of the safety and effectiveness profile.
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Affiliation(s)
- F M Cauti
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - A Piro
- Umberto I Polyclinic of Rome, Rome, Italy
| | | | - G Tola
- AO Brotzu Hospital, Cagliari, Italy
| | - M Anselmino
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Turin, Italy
| | - D Pecora
- Poliambulanza Foundation Hospital Institute of Brescia, Brescia, Italy
| | | | - L Rossi
- Guglielmo da Saliceto Hospital, Piacenza, Italy
| | | | - F Solimene
- Montevergine Cardiology Clinic, Mercogliano, Italy
| | - R Mantovan
- Conegliano General Hospital, Conegliano, Italy
| | - A Di Cori
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - P Rossi
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - L Iaia
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
| | - S Bianchi
- S.Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy
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26
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Rimoldi M, Cecchini R, Wiemer C, Lamperti A, Longo E, Nasi L, Lazzarini L, Mantovan R, Longo M. Epitaxial and large area Sb 2Te 3 thin films on silicon by MOCVD. RSC Adv 2020; 10:19936-19942. [PMID: 35520434 PMCID: PMC9054238 DOI: 10.1039/d0ra02567d] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 05/18/2020] [Indexed: 11/21/2022] Open
Abstract
Antimony telluride (Sb2Te3) thin films were prepared by a room temperature Metal-Organic Chemical Vapor Deposition (MOCVD) process using antimony chloride (SbCl3) and bis(trimethylsilyl)telluride (Te(SiMe3)2) as precursors. Pre-growth and post-growth treatments were found to be pivotal in favoring out-of-plane and in-plane alignment of the crystallites composing the films. A comprehensive suite of characterization techniques were used to evaluate their composition, surface roughness, as well as to assess their morphology, crystallinity, and structural features, revealing that a quick post-growth annealing triggers the formation of epitaxial-quality Sb2Te3 films on Si(111).
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Affiliation(s)
- Martino Rimoldi
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
| | - Raimondo Cecchini
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
| | - Claudia Wiemer
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
| | - Alessio Lamperti
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
| | - Emanuele Longo
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy .,University of Milano-Bicocca, Department of Material Science Via R. Cozzi 55 20126 Milan Italy
| | - Lucia Nasi
- Institute of Materials for Electronics and Magnetism, CNR-IMEM, Parma Parco Area delle Scienze, 7/A 43100 Parma Italy
| | - Laura Lazzarini
- Institute of Materials for Electronics and Magnetism, CNR-IMEM, Parma Parco Area delle Scienze, 7/A 43100 Parma Italy
| | - Roberto Mantovan
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
| | - Massimo Longo
- Institute for Microelectronics and Microsystems, CNR-IMM Unit of Agrate Brianza Via C. Olivetti 2 20864 Agrate Brianza Italy
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27
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Mantovan R, Corò L, Allocca G, Sitta N, Rivetti L, Marinigh R. How small could a detectable reentrant circuit be in a localized microreentrant tachycardia? HeartRhythm Case Rep 2020; 6:222-225. [PMID: 32322502 PMCID: PMC7157758 DOI: 10.1016/j.hrcr.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Roberto Mantovan
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Leonardo Corò
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Giuseppe Allocca
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Nadir Sitta
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Luigi Rivetti
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
| | - Ricarda Marinigh
- Department of Cardiology, S. Maria dei Battuti Hospital, AULSS 2 Veneto, Conegliano, Italy
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28
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Mantovan R, Corò L, Allocca G, Sitta N, Rivetti L. Usefulness of high-definition propagation and voltage map in atrial macro-reentrant tachycardia. Europace 2019; 21:iii15-iii16. [PMID: 31400209 PMCID: PMC6689191 DOI: 10.1093/europace/euz153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Roberto Mantovan
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Via Brigata Bisagno, Conegliano (TV), Italy
| | - Leonardo Corò
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Via Brigata Bisagno, Conegliano (TV), Italy
| | - Giuseppe Allocca
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Via Brigata Bisagno, Conegliano (TV), Italy
| | - Nadir Sitta
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Via Brigata Bisagno, Conegliano (TV), Italy
| | - Luigi Rivetti
- Department of Cardiology, "S. Maria dei Battuti" Hospital, AULSS 2 Veneto, Via Brigata Bisagno, Conegliano (TV), Italy
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29
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Rivetti L, Sitta N, Allocca G, Coro' L, Forte C, Centa M, Mantovan R. P468High resolution micro-bipolar mapping for concealed accessory pathway ablation. Europace 2018. [DOI: 10.1093/europace/euy015.277] [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)
- L Rivetti
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - N Sitta
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - G Allocca
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - L Coro'
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - C Forte
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - M Centa
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
| | - R Mantovan
- Conegliano General Hospital, Cardiologia, Conegliano, Italy
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30
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Valinoti M, Fabbri C, Turco D, Mantovan R, Pasini A, Corsi C. 3D patient-specific models for left atrium characterization to support ablation in atrial fibrillation patients. Magn Reson Imaging 2018; 45:51-57. [DOI: 10.1016/j.mri.2017.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 08/09/2017] [Accepted: 09/24/2017] [Indexed: 11/26/2022]
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Mantovan R, Fallica R, Mokhles Gerami A, Mølholt TE, Wiemer C, Longo M, Gunnlaugsson HP, Johnston K, Masenda H, Naidoo D, Ncube M, Bharuth-Ram K, Fanciulli M, Gislason HP, Langouche G, Ólafsson S, Weyer G. Atomic-scale study of the amorphous-to-crystalline phase transition mechanism in GeTe thin films. Sci Rep 2017; 7:8234. [PMID: 28811632 PMCID: PMC5558007 DOI: 10.1038/s41598-017-08275-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/10/2017] [Indexed: 11/25/2022] Open
Abstract
The underlying mechanism driving the structural amorphous-to-crystalline transition in Group VI chalcogenides is still a matter of debate even in the simplest GeTe system. We exploit the extreme sensitivity of 57Fe emission Mössbauer spectroscopy, following dilute implantation of 57Mn (T½ = 1.5 min) at ISOLDE/CERN, to study the electronic charge distribution in the immediate vicinity of the 57Fe probe substituting Ge (FeGe), and to interrogate the local environment of FeGe over the amorphous-crystalline phase transition in GeTe thin films. Our results show that the local structure of as-sputtered amorphous GeTe is a combination of tetrahedral and defect-octahedral sites. The main effect of the crystallization is the conversion from tetrahedral to defect-free octahedral sites. We discover that only the tetrahedral fraction in amorphous GeTe participates to the change of the FeGe-Te chemical bonds, with a net electronic charge density transfer of ~ 1.6 e/a0 between FeGe and neighboring Te atoms. This charge transfer accounts for a lowering of the covalent character during crystallization. The results are corroborated by theoretical calculations within the framework of density functional theory. The observed atomic-scale chemical-structural changes are directly connected to the macroscopic phase transition and resistivity switch of GeTe thin films.
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Affiliation(s)
- R Mantovan
- Laboratorio MDM, IMM-CNR, Via Olivetti 2, 20864, Agrate Brianza (MB), Italy.
| | - R Fallica
- Laboratorio MDM, IMM-CNR, Via Olivetti 2, 20864, Agrate Brianza (MB), Italy.,Laboratory for Micro- and Nanotechnology, Paul Scherrer Institute, 5232, Villigen PSI, Switzerland
| | - A Mokhles Gerami
- Physics Department, ISOLDE/CERN, Geneva 23, Switzerland.,Dept. of Physics, K. N. Toosi University of Technology, P.O. Box 15875-4416, Tehran, Iran
| | - T E Mølholt
- Physics Department, ISOLDE/CERN, Geneva 23, Switzerland
| | - C Wiemer
- Laboratorio MDM, IMM-CNR, Via Olivetti 2, 20864, Agrate Brianza (MB), Italy
| | - M Longo
- Laboratorio MDM, IMM-CNR, Via Olivetti 2, 20864, Agrate Brianza (MB), Italy.
| | - H P Gunnlaugsson
- Science Institute, University of Iceland, Dunhaga 3, 107 Reykjavík, Iceland
| | - K Johnston
- Physics Department, ISOLDE/CERN, Geneva 23, Switzerland
| | - H Masenda
- School of Physics, University of the Witwatersrand, Johannesburg, 2050, South Africa
| | - D Naidoo
- School of Physics, University of the Witwatersrand, Johannesburg, 2050, South Africa
| | - M Ncube
- School of Physics, University of the Witwatersrand, Johannesburg, 2050, South Africa
| | - K Bharuth-Ram
- Durban University of Technology, Durban, 4000, South Africa.,School of Chemistry and Physics, University of KwaZulu-Natal, Durban, 4000, South Africa
| | - M Fanciulli
- Laboratorio MDM, IMM-CNR, Via Olivetti 2, 20864, Agrate Brianza (MB), Italy.,Dipartimento di Scienza dei Materiali, Università di Milano Bicocca, Milano, Italy
| | - H P Gislason
- Science Institute, University of Iceland, Dunhaga 3, 107 Reykjavík, Iceland
| | - G Langouche
- KU Leuven, Instituut voor Kern-en Stralings Fysika, B-3001, Leuven, Belgium
| | - S Ólafsson
- Science Institute, University of Iceland, Dunhaga 3, 107 Reykjavík, Iceland
| | - G Weyer
- Department of Physics and Astronomy, Aarhus University, Aarhus C, Denmark
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32
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Valinoti M, Mantovan R, Severi S, Corsi C. P1387Developement of an independent approach to detect electrical rotors in atrial fibrillation based on the phase mapping of the electrograms. Europace 2017. [DOI: 10.1093/ehjci/eux158.015] [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
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33
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Conti S, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Effect of Different Cutpoints for Defining Success Post-Catheter Ablation for Persistent Atrial Fibrillation: A Substudy of the STAR AF II Trial. JACC Clin Electrophysiol 2017; 3:522-523. [PMID: 29759610 DOI: 10.1016/j.jacep.2016.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 11/17/2016] [Accepted: 12/02/2016] [Indexed: 11/29/2022]
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34
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Caldarola P, Gulizia MM, Gabrielli D, Sicuro M, De Gennaro L, Giammaria M, Grieco NB, Grosseto D, Mantovan R, Mazzanti M, Menotti A, Brunetti ND, Severi S, Russo G, Gensini GF. ANMCO/SIT Consensus Document: telemedicine for cardiovascular emergency networks. Eur Heart J Suppl 2017; 19:D229-D243. [PMID: 28751844 PMCID: PMC5520753 DOI: 10.1093/eurheartj/sux028] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyse the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education, and legal aspects.
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Affiliation(s)
- Pasquale Caldarola
- Cardiology Department, San Paolo Hospital, Via Caposcardicchio, 70123 Bari, Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Garibal-Nesima Hospital, Ospedale Nesima-Garibaldi, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy
| | | | - Marco Sicuro
- Cardiology and Cardiac Intensive Care, Regionale Umberto Parini Hospital, Aosta, Italy
| | - Luisa De Gennaro
- Cardiology Department, San Paolo Hospital, Via Caposcardicchio, 70123 Bari, Italy
| | | | | | | | - Roberto Mantovan
- Cardiology Unit, Ospedale Santa Maria dei Battuti, Conegliano (Treviso), Italy
| | - Marco Mazzanti
- Cardiology Hemodynamics-CCU Department, University "Ospedali Riuniti" Hospital, Ancona, Italy
| | | | | | - Silva Severi
- Cardiology Unit, Misericordia Hospital, Grosseto, Italy
| | - Giancarmine Russo
- Italian Society for Telemedicine and eHealth (Digital SIT), Rome, Italy
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35
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Di Lenarda A, Casolo G, Gulizia MM, Aspromonte N, Scalvini S, Mortara A, Alunni G, Ricci RP, Mantovan R, Russo G, Gensini GF, Romeo F. The future of telemedicine for the management of heart failure patients: a Consensus Document of the Italian Association of Hospital Cardiologists (A.N.M.C.O), the Italian Society of Cardiology (S.I.C.) and the Italian Society for Telemedicine and eHealth (Digital S.I.T.). Eur Heart J Suppl 2017; 19:D113-D129. [PMID: 28751839 PMCID: PMC5520762 DOI: 10.1093/eurheartj/sux024] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient’s prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous. Benefits seem to be substantial, with a 30–35% reduction in mortality and 15–20% decrease in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management since all modern devices can transmit technical and diagnostic data. However, telemedicine may provide benefits to heart failure patients only as part of a shared and integrated multi-disciplinary and multi-professional ‘chronic care model’. Moreover, the future development of remote telemonitoring programs in Italy will require the primary use of products certified as medical devices, validated organizational solutions as well as legislative and administrative adoption of new care methods and the widespread growth of clinical care competence to remotely manage the complexity of chronicity. Through this consensus document, Italian Cardiology reaffirms its willingness to contribute promoting a new phase of qualitative assessment, standardization of processes and testing of telemedicine-based care models in heart failure. By recognizing the relevance of telemedicine for the care of non-hospitalized patients with heart failure, its strategic importance for the design of innovative models of care, and the many challenges and opportunities it raises, ANMCO and SIC through this document report a consensus on the main directions for its widespread and sustainable clinical implementation
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Affiliation(s)
- Andrea Di Lenarda
- Cardiovascular Department, Azienda Sanitaria Universitaria Integrata, Via Slataper, 9 34125 Trieste, Italy
| | - Giancarlo Casolo
- Cardiology Department, Nuovo Ospedale Versilia, Lido di Camaiore (Lucca), Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy
| | - Nadia Aspromonte
- CCU-Cardiology Department, Presidio Ospedaliero San Filippo Neri, Roma, Italy
| | - Simonetta Scalvini
- Cardiology Department, Cardiac Rehabilitation Division, Istituti Clinici Scientifici Maugeri, IRCCS Lumezzane (Brescia), Italy
| | - Andrea Mortara
- Cardiology Department, Policlinico di Monza, Monza, Italy
| | - Gianfranco Alunni
- Cardiology Department, Integrated Heart Failure Unit, Ospedale di Assisi, Assisi (Perugia)
| | - Renato Pietro Ricci
- CCU-Cardiology Department, Presidio Ospedaliero San Filippo Neri, Roma, Italy
| | - Roberto Mantovan
- Cardiology Unit, Ospedale Santa Maria dei Battuti, Conegliano (Treviso), Italy
| | - Giancarmine Russo
- Italian Society for Telemedicine and eHealth (Digital SIT), Rome, Italy
| | | | - Francesco Romeo
- Cardiology Unit and Interventional Cardiology Department, Policlinico "Tor Vergata", Rome, Italy
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Mølholt TE, Gunnlaugsson HP, Johnston K, Mantovan R, Röder J, Adoons V, Mokhles Gerami A, Masenda H, Matveyev YA, Ncube M, Unzueta I, Bharuth-Ram K, Gislason HP, Krastev P, Langouche G, Naidoo D, Ólafsson S, Zenkevich A. Charge states and lattice sites of dilute implanted Sn in ZnO. J Phys Condens Matter 2017; 29:155701. [PMID: 28165333 DOI: 10.1088/1361-648x/aa5e95] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The common charge states of Sn are 2+ and 4+. While charge neutrality considerations favour 2+ to be the natural charge state of Sn in ZnO, there are several reports suggesting the 4+ state instead. In order to investigate the charge states, lattice sites, and the effect of the ion implantation process of dilute Sn atoms in ZnO, we have performed 119Sn emission Mössbauer spectroscopy on ZnO single crystal samples following ion implantation of radioactive 119In (T ½ = 2.4 min) at temperatures between 96 K and 762 K. Complementary perturbed angular correlation measurements on 111mCd implanted ZnO were also conducted. Our results show that the 2+ state is the natural charge state for Sn in defect free ZnO and that the 4+ charge state is stabilized by acceptor defects created in the implantation process.
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Affiliation(s)
- T E Mølholt
- EP Department, ISOLDE/CERN, 1211 Geneva 23, Switzerland
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Kochhäuser S, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P, Verma A. Impact of acute atrial fibrillation termination and prolongation of atrial fibrillation cycle length on the outcome of ablation of persistent atrial fibrillation: A substudy of the STAR AF II trial. Heart Rhythm 2017; 14:476-483. [DOI: 10.1016/j.hrthm.2016.12.033] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Indexed: 10/20/2022]
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Kaye G, Pieragnoli P, Calvi V, Mantovan R, Zanon F, Calo L, Lunati M, Padeletti L. Automatic Contractility Sensor-Guided Optimisation is Associated with Improved Outcomes in CRT Subgroups at High Risk for Non-Response. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.197] [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: 11/17/2022]
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Di Lenarda A, Casolo G, Gulizia MM, Aspromonte N, Scalvini S, Mortara A, Alunni G, Ricci RP, Mantovan R, Russo G, Gensini GF, Romeo F. [ANMCO/SIC/SIT Consensus document: The future of telemedicine in heart failure]. G Ital Cardiol (Rome) 2016; 17:491-507. [PMID: 27311090 DOI: 10.1714/2262.24354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Telemedicine applied to heart failure patients is a tool for recording, remote transmission, storage and interpretation of cardiocirculatory parameters and/or diagnostic images, useful, as emphasized by the latest guidelines, to allow for intensive home monitoring in patients with advanced heart failure or during the vulnerable post-acute phase to improve the prognosis and quality of life for patients.Recently, several meta-analyses have shown that the patterns of care supported by telemedicine are not only effective, but also economically advantageous. The benefit is unquestionable with a 30-35% reduction in mortality and a 15-20% reduction in hospitalizations. Patients implanted with cardiac devices can also benefit from an integrated remote clinical management as all modern devices can transmit technical and diagnostic data. However, telemedicine can bring benefits to the patient with heart failure only if it is part of a shared and integrated, multidisciplinary and multiprofessional "Chronic Care Model". Moreover, the future development of remote telemonitoring programs in our country goes through the primary use of products certified as medical device, field validation of organizational solutions proposed, a legislative and administrative adaptation to new care methods and the widespread growth of competence in clinical care to remotely manage the complexity of chronicity.With this consensus document the Italian Cardiology reaffirms its willingness to contribute to the government of the tumultuous and fragmented technological development, proposing a new phase of qualitative assessment, standardization of processes and testing the application of telemedicine to heart failure.
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Affiliation(s)
- Andrea Di Lenarda
- S.C. Centro Cardiovascolare, Azienda Sanitaria Universitaria Integrata, Trieste
| | - Giancarlo Casolo
- S.C. Cardiologia, Nuovo Ospedale Versilia, Lido di Camaiore (LU)
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Nadia Aspromonte
- U.O.C. Cardiologia-UTIC, Presidio Ospedaliero San Filippo Neri, Roma
| | - Simonetta Scalvini
- U.O. Cardiologia Riabilitativa, Fondazione Salvatore Maugeri, Lumezzane (BS)
| | - Andrea Mortara
- U.O. Cardiologia Clinica e Scompenso Cardiaco, Policlinico di Monza, Monza
| | | | | | | | - Giancarmine Russo
- Segretario Generale Società Italiana Telemedicina e sanità elettronica (SIT), Roma
| | - Gian Franco Gensini
- Presidente Società Italiana Telemedicina e sanità elettronica (SIT), Firenze
| | - Francesco Romeo
- U.O.C. Cardiologia e Cardiologia Interventistica, Policlinico "Tor Vergata", Roma
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Caldarola P, Gulizia MM, Gabrielli D, Sicuro M, De Gennaro L, Giammaria M, Grieco NB, Grosseto D, Mantovan R, Mazzanti M, Menotti A, Brunetti ND, Severi S, Russo G, Gensini GF. [ANMCO/SIT Consensus document: Telemedicine and the emergency/urgency care network]. G Ital Cardiol (Rome) 2016; 17:508-528. [PMID: 27311091 DOI: 10.1714/2262.24356] [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: 06/06/2023]
Abstract
Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyze the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education and legal aspects.
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Affiliation(s)
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | | | - Marco Sicuro
- U.O. Cardiologia e Cure Intensive Cardiologiche, Ospedale Regionale Umberto Parini, Aosta
| | | | | | | | | | | | - Marco Mazzanti
- S.O.D. Cardiologia Ospedaliera Emodinamica-UTIC, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona
| | | | | | - Silva Severi
- U.O. Cardiologia, Ospedale della Misericordia, Grosseto
| | - Giancarmine Russo
- Segretario Generale Società Italiana Telemedicina e sanità elettronica (SIT), Roma
| | - Gian Franco Gensini
- Presidente Società Italiana Telemedicina e sanità elettronica (SIT), Firenze
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Vangelista S, Cinquanta E, Martella C, Alia M, Longo M, Lamperti A, Mantovan R, Basset FB, Pezzoli F, Molle A. Towards a uniform and large-scale deposition of MoS2 nanosheets via sulfurization of ultra-thin Mo-based solid films. Nanotechnology 2016; 27:175703. [PMID: 26984949 DOI: 10.1088/0957-4484/27/17/175703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Large-scale integration of MoS2 in electronic devices requires the development of reliable and cost-effective deposition processes, leading to uniform MoS2 layers on a wafer scale. Here we report on the detailed study of the heterogeneous vapor-solid reaction between a pre-deposited molybdenum solid film and sulfur vapor, thus resulting in a controlled growth of MoS2 films onto SiO2/Si substrates with a tunable thickness and cm(2)-scale uniformity. Based on Raman spectroscopy and photoluminescence, we show that the degree of crystallinity in the MoS2 layers is dictated by the deposition temperature and thickness. In particular, the MoS2 structural disorder observed at low temperature (<750 °C) and low thickness (two layers) evolves to a more ordered crystalline structure at high temperature (1000 °C) and high thickness (four layers). From an atomic force microscopy investigation prior to and after sulfurization, this parametrical dependence is associated with the inherent granularity of the MoS2 nanosheet that is inherited by the pristine morphology of the pre-deposited Mo film. This work paves the way to a closer control of the synthesis of wafer-scale and atomically thin MoS2, potentially extendable to other transition metal dichalcogenides and hence targeting massive and high-volume production for electronic device manufacturing.
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Affiliation(s)
- Silvia Vangelista
- Laboratorio MDM, IMM-CNR, Via C. Olivetti 2, I-20864 Agrate Brianza (MB), Italy
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42
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Boriani G, Berti E, Belotti LMB, Biffi M, De Palma R, Malavasi VL, Bottoni N, Rossi L, De Maria E, Mantovan R, Zardini M, Casali E, Marconi M, Bandini A, Tomasi C, Boggian G, Barbato G, Toselli T, Zennaro M, Sassone B. Cardiac device therapy in patients with left ventricular dysfunction and heart failure: ‘real‐world’ data on long‐term outcomes (mortality, hospitalizations, days alive and out of hospital). Eur J Heart Fail 2016; 18:693-702. [DOI: 10.1002/ejhf.509] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 12/05/2015] [Accepted: 12/26/2015] [Indexed: 11/10/2022] Open
Affiliation(s)
- Giuseppe Boriani
- Institute of Cardiology, University of Bologna Azienda Ospedaliera S. Orsola‐Malpighi Bologna Italy
- Division of Cardiology, Modena University Hospital University of Modena and Reggio Emilia Modena Italy
| | - Elena Berti
- Agency for Health and Social Care of Emilia‐Romagna Bologna Italy
| | | | - Mauro Biffi
- Institute of Cardiology, University of Bologna Azienda Ospedaliera S. Orsola‐Malpighi Bologna Italy
| | - Rossana De Palma
- Agency for Health and Social Care of Emilia‐Romagna Bologna Italy
| | - Vincenzo L. Malavasi
- Division of Cardiology, Modena University Hospital University of Modena and Reggio Emilia Modena Italy
| | - Nicola Bottoni
- Division of Cardiology S. Maria Nuova Hospital Reggio Emilia Italy
| | - Luca Rossi
- Division of Cardiology G. da Saliceto Hospital Piacenza Italy
| | | | | | - Marco Zardini
- Division of Cardiology Parma University Hospital Parma Italy
| | - Edoardo Casali
- Division of Cardiology, Modena University Hospital University of Modena and Reggio Emilia Modena Italy
| | - Marco Marconi
- Division of Cardiology, Local Health Unit Rimini Italy
| | - Alberto Bandini
- Division of Cardiologia G.B. Morgagni‐L. Pierantoni Hospital Forlì Italy
| | - Corrado Tomasi
- Division of Cardiology S. Maria delle Croci Hospital Ravenna Italy
| | - Giulio Boggian
- Division of Cardiology Hospital of Bentivoglio Bologna Italy
| | | | - Tiziano Toselli
- Division of Cardiology Ferrara University Hospital Ferrara Italy
| | - Mauro Zennaro
- Division of Cardiology Baggiovara Hospital Modena Italy
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Valinoti M, Lozupone GV, Sabbatani P, Mantovan R, Severi S, Corsi C. Analysis of the electrical patterns and structural remodeling in atrial fibrillation. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:7035-8. [PMID: 26737912 DOI: 10.1109/embc.2015.7320012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Catheter ablation of atrial fibrillation (AF) is a promising therapy, whose success is limited by uncertainty in the knowledge of the mechanisms sustaining the arrhythmia. Many theories based on atrial electrical activation or on atrial structural remodeling have been proposed to target AF mechanisms. We hypothesized two prospective approaches could be linked and both computational analysis of atrial electrical patterns and fibrotic tissue location and extent could give further insights on the role of rotors and spatial relationship between them and atrial fibrosis. This paper presents some preliminary results aimed at the integration of information derived from electrical patterns and structural remodeling in AF patients. Electrical patterns were analyzed by applying the standard procedure based on the Hilbert transform (HT) and with sinusoidal wavelet recomposition (SR). In addition, a new technique based on the detection of maximum negative derivative of the unipolar electrograms and a modified version of signal recomposition (NDSR) was tested.A patient-specific anatomical model was derived by segmenting magnetic resonance angiographic (MRA) data applying an edge based level set approach guided by a phase-based edge detector. A multimodality affine registration was applied to register MRA and delayed-enhanced MR imaging (DE-MRI). Following this registration step, gray intensity levels from DE-MRI were used asa texture of the 3D model to visualize fibrosis location and quantify its extent.In view of a future integration of electrical activation patterns onthe patient-specific anatomical model, detected atrial activation timings (AAT) and derived parameters were validated with manual annotation performed by an expert cardiologist and the atrial model was compared with the anatomical map used to guide the ablation procedure.
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Crosato M, Calzolari V, Franceschini Grisolia E, Daniotti A, Baldessin F, Mantovan R, Olivari Z. Implanting cardiac rhythm devices during uninterrupted warfarin therapy. J Cardiovasc Med (Hagerstown) 2015; 16:503-6. [DOI: 10.2459/jcm.0000000000000011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Verma A, Jiang CY, Betts TR, Chen J, Deisenhofer I, Mantovan R, Macle L, Morillo CA, Haverkamp W, Weerasooriya R, Albenque JP, Nardi S, Menardi E, Novak P, Sanders P. Approaches to catheter ablation for persistent atrial fibrillation. N Engl J Med 2015; 372:1812-22. [PMID: 25946280 DOI: 10.1056/nejmoa1408288] [Citation(s) in RCA: 1491] [Impact Index Per Article: 165.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Catheter ablation is less successful for persistent atrial fibrillation than for paroxysmal atrial fibrillation. Guidelines suggest that adjuvant substrate modification in addition to pulmonary-vein isolation is required in persistent atrial fibrillation. METHODS We randomly assigned 589 patients with persistent atrial fibrillation in a 1:4:4 ratio to ablation with pulmonary-vein isolation alone (67 patients), pulmonary-vein isolation plus ablation of electrograms showing complex fractionated activity (263 patients), or pulmonary-vein isolation plus additional linear ablation across the left atrial roof and mitral valve isthmus (259 patients). The duration of follow-up was 18 months. The primary end point was freedom from any documented recurrence of atrial fibrillation lasting longer than 30 seconds after a single ablation procedure. RESULTS Procedure time was significantly shorter for pulmonary-vein isolation alone than for the other two procedures (P<0.001). After 18 months, 59% of patients assigned to pulmonary-vein isolation alone were free from recurrent atrial fibrillation, as compared with 49% of patients assigned to pulmonary-vein isolation plus complex electrogram ablation and 46% of patients assigned to pulmonary-vein isolation plus linear ablation (P=0.15). There were also no significant differences among the three groups for the secondary end points, including freedom from atrial fibrillation after two ablation procedures and freedom from any atrial arrhythmia. Complications included tamponade (three patients), stroke or transient ischemic attack (three patients), and atrioesophageal fistula (one patient). CONCLUSIONS Among patients with persistent atrial fibrillation, we found no reduction in the rate of recurrent atrial fibrillation when either linear ablation or ablation of complex fractionated electrograms was performed in addition to pulmonary-vein isolation. (Funded by St. Jude Medical; ClinicalTrials.gov number, NCT01203748.).
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Affiliation(s)
- Atul Verma
- From Southlake Regional Health Centre, Newmarket, ON (A.V.), Montreal Heart Institute, Montreal (L.M.), McMaster University, Hamilton, ON (C.A.M.), and Royal Jubilee Hospital, Victoria, BC (P.N.) - all in Canada; Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China (C.J.); John Radcliffe Hospital, Oxford, United Kingdom (T.R.B.); Haukeland University Hospital, Bergen, Norway (J.C.); the German Heart Center, Munich (I.D.), and Charité Campus Virchow-Klinikum, Berlin (W.H.) - both in Germany; Ospedale M. Bufalini, Cesena (R.M.), Presidio Ospedaliero Pineta Grande, Castel Volturno (S.N.), and Ospedale Santa Croce e Carle, Cuneo (E.M.) - all in Italy; Hollywood Private Hospital, Perth, WA (R.W.), and the University of Adelaide and Royal Adelaide Hospital, Adelaide, SA (P.S.) - all in Australia; and Clinique Pasteur Toulouse, Toulouse, France (J.-P.A.)
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46
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Berisso MZ, Bongiorni MG, Curnis A, Calvi V, Catanzariti D, Gaita F, Gulizia MM, Inama G, Landolina ME, La Rovere MT, Mantovan R, Mascioli G, Occhetta E, Padeletti L, Salerno-Uriarte JA, Santini M, Sassone B, Senni M, Zecchin M. [Remarks on the guideline recommendations for cardioverter-defibrillator implantation for primary prevention of sudden cardiac Death in patients with severe ventricular dysfunction. Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO)/Italian Society of Cardiology (SIC)/Italian Association of Arrhythmology and Cardiac Pacing (AIAC)]. G Ital Cardiol (Rome) 2013; 14:752-72. [PMID: 24326639 DOI: 10.1714/1360.15089] [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: 11/06/2022]
Abstract
The indications for implantable cardioverter-defibrillator (ICD) therapy for the prevention of sudden cardiac death in patients with severe left ventricular dysfunction have rapidly expanded over the last 10 years on the basis of the very satisfying results of the numerous randomized clinical trials that have provided the framework for guidelines. However, the analysis of clinical practice in the real world has highlighted some important criticisms in the complex process of selection-management of those patients candidates for ICD therapy: 1) approximately one fourth of all ICD implantations is not justified by clinical evidence, 2) approximately one half of patients with an indication for ICD therapy do not undergo implantation, 3) the benefits from ICD therapy do not apply uniformly to all patients, 4) the relationship between the lifesaving benefit and the potential for harm of ICD therapy is still scarcely known. The main reason for this clinical scenario can be ascribed to the guideline recommendations that are based only on few standard cut-off criteria and therefore too generic and insufficiently detailed. This does not help cardiologists in their decision-making process, and results in fear, uncertainty, and sometimes emotional choices. The aim of this consensus document is to discuss current guideline recommendations and to provide the Italian cardiologists with the most updated information to optimize the selection of patients with severe left ventricular dysfunction who should receive ICD therapy.
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Mantovan R, Macle L, De Martino G, Chen J, Morillo CA, Novak P, Calzolari V, Khaykin Y, Guerra PG, Nair G, Torrecilla EG, Verma A. Relationship of Quality of Life With Procedural Success of Atrial Fibrillation (AF) Ablation and Postablation AF Burden: Substudy of the STAR AF Randomized Trial. Can J Cardiol 2013; 29:1211-7. [PMID: 23988341 DOI: 10.1016/j.cjca.2013.06.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/03/2013] [Accepted: 06/03/2013] [Indexed: 11/19/2022] Open
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Mantovan R, Gunnlaugsson HP, Naidoo D, Olafsson S, Johnston K, Masenda H, Mølholt TE, Bharuth-Ram K, Fanciulli M, Gislason HP, Langouche G, Sielemann R, Weyer G. Fe charge state adjustment in ZnO upon ion implantation. J Phys Condens Matter 2012; 24:485801. [PMID: 23139235 DOI: 10.1088/0953-8984/24/48/485801] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The influence of the ion implantation process on the charge state of dilute (57)Fe impurities implanted as radioactive (57)Mn in ZnO is investigated by (57)Fe emission Mössbauer spectroscopy. One sample is additionally implanted with stable (23)Na impurities. Both Fe(2+) and Fe(3+) charge states are observed, and the Fe(3+)/Fe(2+) ratio is found to increase with the fluence of both (57)Mn/(57)Fe and (23)Na ions, demonstrating that the build-up of Fe(3+) is not related to the chemical nature of the implanted ions. The results are interpreted in terms of radiation damage induced changes of the Fermi level, and illustrate that the Fe(3+)/Fe(2+) ratio can be adjusted by ion implantation. The spin-lattice relaxation time for Fe(3+) in ZnO is found to be independent of the implantation fluence, and is evidently an intrinsic property of the system.
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Affiliation(s)
- R Mantovan
- Laboratorio MDM, IMM-CNR, Agrate Brianza (MB), Italy.
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Andrade JG, Macle L, Khairy P, Khaykin Y, Mantovan R, De Martino G, Chen J, Morillo CA, Novak P, Guerra PG, Nair G, Torrecilla EG, Verma A. Incidence and significance of early recurrences associated with different ablation strategies for AF: a STAR-AF substudy. J Cardiovasc Electrophysiol 2012; 23:1295-301. [PMID: 22897339 DOI: 10.1111/j.1540-8167.2012.02399.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early recurrences of atrial tachyarrhythmias (ERAT) are common after atrial fibrillation (AF) ablation, and predict late recurrences (LR). We sought to determine the impact of different ablation strategies on ERAT and LR. METHODS AND RESULTS The STAR-AF trial randomized 100 patients with paroxysmal or persistent AF to ablation of complex fractionated electrograms (CFAE) alone, pulmonary vein isolation (PVI) alone, or combined PVI + CFAE. Patients were followed for 12 months. ERAT was defined as any recurrence of AF, atrial tachycardia, or flutter (AT/AFL) >30 seconds during the first 3 months of follow-up. LR was defined as any recurrence of AF/AT/AFL >30 seconds 3-12 months post. Forty-nine patients experienced ERAT. The index ablation strategy was the only independent predictor of ERAT on multivariate analysis (HR 2.24 PVI vs PVI + CFAE; and HR 2.65 CFAE vs PVI + CFAE). Fifty-two patients experienced LR. The presence of ERAT (HR 3.23), the use of antiarrhythmic drug (AAD) in the first 3 months postablation (HR 2.85), and the index ablation strategy were independently associated with LR (HR 3.42 PVI vs PVI + CFAE; HR 4.72 CFAE vs PVI + CFAE). Thirty-five of 49 (71%) patients with ERAT and 17 (33%) of 51 patients without ERAT had LR (P < 0.0001). Among patients with ERAT, increased left atrium size (HR 1.08), the use of AAD in the first 3 months postablation (HR 2.86) and the index ablation strategy were independently associated with LR (HR 4.77 PVI vs PVI + CFAE; HR 4.45 CFAE vs PVI + CFAE). CONCLUSION ERAT is common following AF ablation and is strongly associated with LR. Although CFAE ablation alone results in higher rates of early and LR, the addition of CFAE to PVI results in increased long-term success without an increase in ERAT.
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Affiliation(s)
- Jason G Andrade
- Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada
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Verma A, Sanders P, Macle L, Deisenhofer I, Morillo CA, Chen J, Jiang CY, Ernst S, Mantovan R. Substrate and Trigger Ablation for Reduction of Atrial Fibrillation Trial-Part II (STAR AF II): design and rationale. Am Heart J 2012; 164:1-6.e6. [PMID: 22795275 DOI: 10.1016/j.ahj.2012.04.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 04/12/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND The optimal ablation approach for patients with persistent atrial fibrillation (AF) remains unknown. In particular, it is unclear if pulmonary vein (PV) antral isolation (PVI) is sufficient as a lone strategy for persistent AF. Furthermore, if additional substrate ablation is to be added, the ideal approach to substrate ablation is yet to be determined. OBJECTIVE The aim of this study is to determine the optimal strategy of catheter ablation of persistent AF by comparing the efficacy of 3 strategies: PVI vs PVI plus complex fractionated electrogram (CFE) ablation (PVI + CFE) vs PVI plus linear ablation (PVI + Lines). STUDY DESIGN The STAR AF II study (ClinicalTrials.gov NCT01203748) is a prospective, multicenter, randomized trial with a blinded assessment of outcomes. A total of 549 patients will be randomized in a 1:4:4 fashion to one of the investigation arms: PVI, PVI + CFE, and PVI + Lines, respectively. Patients undergoing a first-time ablation procedure for symptomatic, persistent AF that is refractory to at least 1 antiarrhythmic medication will be included. Persistent AF will be defined as a sustained episode lasting >7 days and <3 years. Patients with a left atrial parasternal size ≥60 mm will be excluded. The primary end point is freedom from documented AF >30 seconds at 18 months after 1 or 2 ablation procedures with or without antiarrhythmic medications. CONCLUSIONS The STAR AF II study is a randomized trial designed to evaluate the optimal approach for catheter ablation of persistent AF.
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Affiliation(s)
- Atul Verma
- Southlake Regional Health Centre, Newmarket, Ontario, Canada
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