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De Mattia L, Crosato M, Rebellato L, Nalli C, Calzolari V, Cernetti C. A storm in the desert: Ablation of a left atrial tachycardia in a heart transplant recipient. HeartRhythm Case Rep 2023; 9:720-722. [PMID: 38047187 PMCID: PMC10691953 DOI: 10.1016/j.hrcr.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Affiliation(s)
- Luca De Mattia
- Cardiology Department, “Ca’ Foncello” Hospital, Treviso, Italy
| | - Martino Crosato
- Cardiology Department, “Ca’ Foncello” Hospital, Treviso, Italy
| | - Luca Rebellato
- Cardiology Department, “Santa Maria della Misericordia” Hospital, Udine, Italy
| | - Chiara Nalli
- Cardiology Department, “Santa Maria della Misericordia” Hospital, Udine, Italy
| | | | - Carlo Cernetti
- Cardiology Department, “Ca’ Foncello” Hospital, Treviso, Italy
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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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Themistoclakis S, Calzolari V, De Mattia L, China P, Russo AD, Fassini G, Casella M, Caporaso I, Indiani S, Addis A, Basso C, Della Barbera M, Thiene G, Tondo C. In vivo Lesion Index (LSI) validation in percutaneous radiofrequency catheter ablation. J Cardiovasc Electrophysiol 2022; 33:874-882. [PMID: 35262242 DOI: 10.1111/jce.15442] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/06/2022] [Accepted: 01/30/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Lesion Index (LSI) has been developed to predict lesion efficacy during radiofrequency (RF) catheter ablation. However, its value in predicting lesions size has still to be established. The aim of our study was to assess the lesions size reproducibility for pre-specified values of LSI reached during RF delivery in an in vivo beating heart. METHODS Ablation lesions were created with different values of LSI in 7 domestic pigs by means of a contact force sensing catheter (TactiCathTM , Abbott). Lesions were identified during RF delivery by means of a 3D mapping system (EnSiteTM Precision, Abbott) and measured after heart explantation. Histology was carried out after gross examination on the first 3 lesions to confirm the accuracy of the macroscopic evaluation. RESULTS A total of 64 myocardial lesions were created. Thirty-nine lesions were excluded from the analysis for the following reasons: histological confirmation of macroscopic lesion measurement (n=3), transmurality (n=24), unfavorable anatomic position (n=10), not macroscopically identifiable (n=2). In a final set of 25 non-transmural lesions, injury width and depth were respectively 4.6±0.6 mm and 2.6±0.8 mm for LSI=4, 7.3±0.8 mm and 4.7±0.6 mm for LSI=5, and 8.6±1.2 mm and 7.2±1.1 mm for LSI=6. A strong linear correlation was observed between LSI and lesion width (r=0.87, p<0.00001) and depth (r=0.89, p<0.00001). Multiple linear regression analysis identified LSI as the only ablation parameter that significantly predicted lesion width (p<0.001) and depth (p<0.001). CONCLUSION In our in vivo study, LSI proved highly predictive of lesion size and depth. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | | | - Luca De Mattia
- Ospedale Ca'Foncello-ULSS2 Marca Trevigiana, Treviso, Italy
| | - Paolo China
- Ospedale dell'Angelo-ULSS3 Serenissima, Mestre-Venice, Italy
| | | | - Gaetano Fassini
- Heart Rhythm Center, Monzino Cardiac Center, IRCCS, Milan, Italy
| | - Michela Casella
- Heart Rhythm Center, Monzino Cardiac Center, IRCCS, Milan, Italy
| | - Igor Caporaso
- Abbott Medical Italia S.p.A., Sesto San Giovanni, Italy
| | | | - Alessandro Addis
- CRABCC, Biotechnology Research Center for Cardiothoracic Applications, Rivolta D'Adda, Italy
| | - Cristina Basso
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Mila Della Barbera
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Gaetano Thiene
- Cardiovascular Pathology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Claudio Tondo
- Heart Rhythm Center, Monzino Cardiac Center, IRCCS, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Savo MT, Balducci E, Calzolari V, Cernetti C. 179 ICD or not ICD? A difficult choice for a young patient presenting with palpitations in emergency department. Eur Heart J Suppl 2021. [DOI: 10.1093/eurheartj/suab127.040] [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]
Abstract
Abstract
A fit-and-well 52-year-old worker, with negative familiar story, was admitted to Emergency Department (ED) with haemodynamically unstable but well bore broad complex tachycardia of 180 b.p.m. (Figure 1). Twenty years before the patient had heart-surgery to repair atrial septal venous sinus defect with patch. The defect determined anomalous pulmonary venous return in right atrium with left to right shunt and moderate pulmonary hypertension. The surgery, 20 years before, was complicated by a single event of supraventricular tachycardia pharmacology resolved. Next follow-up was normal although at transthoracic echocardiography severe right ventricular (RV) dilation was reported. In the ED the patient had palpitation but not chest pain or dyspnoea. General clinical examination was normal but he was hypertensive (170/137 mmHg) and with heart rate of 180 b.p.m. Valsalva manoeuver was performed and adenosine (6 mg–12 mg–12 mg) was administered without benefit. Eventually, the patient was cardioverted to sinus rhythm with a single 100 J shock. His baseline ECG (Figure 2) showed sinus rhythm, normal axis, as well as right bundle branch block and T-wave inversion in leads V1–V4 and a waves with a small spike upward in lead V1 which represent characteristic epsilon waves.
Successively patient was admitted to Cardiology Department where transthoracic echocardiography showed severe RV dilation and moderate hypokinesia with a tricuspid annular plane excursion of 15 mm, TAV 9.6 cm/s, fractional area change of 29%. The right atrium was moderate dilated (volume 70 ml, indexed volume 35.53 ml/m2). Left chambers were normal. No shunts were observed. An electrophysiology study with isoprenaline infusion was performed but no arrhythmias were induced. Cardiac magnetic resonance imaging (MRI) was normal save for global RV dilatation, increased RV end diastolic volume (156 ml/m2), and global RV systolic dysfunction (reduction of RV ejection fraction 31%). Arrhythmogenic cardiomyopathy was excluded as patient’s background suggested RV dilation was due the overload caused by the history of left–right shunt. Blood tests and personal history negative initially exclude myocarditis and cardiac MRI confirmed the absence of oedema. An accurate ECG analysis excluded Brugada syndrome. Following discussion between electrophysiologists, clinical cardiologists, and the patient who first need to be informed, trans-venous ICD was implanted. 179 Figure 1ECG in ED. Figure 2 Baseline ECG. Figure 3 Cardiac MRI.
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Affiliation(s)
| | - Elisa Balducci
- Ospedale Ca’ Foncello Treviso—Marca Trevigiana ULSS 2, Italy
| | | | - Carlo Cernetti
- Ospedale Ca’ Foncello Treviso—Marca Trevigiana ULSS 2, Italy
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Genovese D, Gasparetto N, Favero L, Carrer A, Balestriero G, Calzolari V, De Mattia L, Zecchel R, Minniti G, Cernetti C. Proarrhythmic Side of Cardiac Lipoma. Circ Cardiovasc Imaging 2021; 14:e013301. [PMID: 34711078 DOI: 10.1161/circimaging.121.013301] [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)
- Davide Genovese
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy.,Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Italy (D.G.)
| | - Nicola Gasparetto
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Luca Favero
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Anna Carrer
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | | | - Vittorio Calzolari
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Luca De Mattia
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Roberto Zecchel
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Giuseppe Minniti
- Cardiac Surgery Unit (G.M.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
| | - Carlo Cernetti
- Cardiology Unit (D.G., N.G., L.F., A.C., V.C., L.D.M., R.Z., C.C.), Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy
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D'Onofrio A, Solimene F, Calò L, Calvi V, Viscusi M, Melissano D, Russo V, Rapacciuolo A, Campana A, Caravati F, Bonfanti P, Zanotto G, Gronda E, Vado A, Calzolari V, Botto GL, Zecchin M, Bontempi L, Giacopelli D, Gargaro A, Padeletti L. Combining Home Monitoring temporal trends from implanted defibrillators and baseline patient risk profile to predict heart failure hospitalizations: results from the SELENE HF study. Europace 2021; 24:234-244. [PMID: 34392336 PMCID: PMC8824514 DOI: 10.1093/europace/euab170] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/18/2021] [Indexed: 11/15/2022] Open
Abstract
AIMS We developed and validated an algorithm for prediction of heart failure (HF) hospitalizations using remote monitoring (RM) data transmitted by implanted defibrillators. METHODS AND RESULTS The SELENE HF study enrolled 918 patients (median age 69 years, 81% men, median ejection fraction 30%) with cardiac resynchronization therapy (44%), dual-chamber (38%), or single-chamber defibrillators with atrial diagnostics (18%). To develop a predictive algorithm, temporal trends of diurnal and nocturnal heart rates, ventricular extrasystoles, atrial tachyarrhythmia burden, heart rate variability, physical activity, and thoracic impedance obtained by daily automatic RM were combined with a baseline risk-stratifier (Seattle HF Model) into one index. The primary endpoint was the first post-implant adjudicated HF hospitalization. After a median follow-up of 22.5 months since enrolment, patients were randomly allocated to the algorithm derivation group (n = 457; 31 endpoints) or algorithm validation group (n = 461; 29 endpoints). In the derivation group, the index showed a C-statistics of 0.89 [95% confidence interval (CI): 0.83-0.95] with 2.73 odds ratio (CI 1.98-3.78) for first HF hospitalization per unitary increase of index value (P < 0.001). In the validation group, sensitivity of predicting primary endpoint was 65.5% (CI 45.7-82.1%), median alerting time 42 days (interquartile range 21-89), and false (or unexplained) alert rate 0.69 (CI 0.64-0.74) [or 0.63 (CI 0.58-0.68)] per patient-year. Without the baseline risk-stratifier, the sensitivity remained 65.5% and the false/unexplained alert rates increased by ≈10% to 0.76/0.71 per patient-year. CONCLUSION With the developed algorithm, two-thirds of first post-implant HF hospitalizations could be predicted timely with only 0.7 false alerts per patient-year.
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Affiliation(s)
- Antonio D'Onofrio
- Cardiology Department - Electrophysiology and Cardiac Pacing Unit A.O.R.N. V. Monaldi, Via L. Bianchi, Naples, Italy
| | - Francesco Solimene
- Electrophysiology, Montevergine Clinic, Viale S. Modestino 8, 83013 Mercogliano, Italy
| | - Leonardo Calò
- Cardiology Division, Policlinico Casilino, Via Casilina 1049, 00169 Rome, Italy
| | - Valeria Calvi
- Cardiology Department, Policlinico G. Rodolico, AOU Policlinico V. Emanuele, Via S. Sofia 78, 95125 Catania, Italy
| | - Miguel Viscusi
- Cardiology Division, Sant'Anna and San Sebastiano Hospital, Via F. Palasciano, 81100 Caserta, Italy
| | - Donato Melissano
- Cardiology Division, F. Ferrari Hospital, Viale F. Ferrari 1, 73042 Casarano (LE), Italy
| | - Vitantonio Russo
- Cardiology Division, SS. Annunziata Hospital, Via F. Bruno 1, 74121 Taranto, Italy
| | - Antonio Rapacciuolo
- Cardiology Department of Advanced Biomedical Sciences, Corso Umberto I 40, 80138 Federico II University of Naples, Italy
| | - Andrea Campana
- Cardiology Division, A.O.U. San Giovanni di Dio e Ruggi D'Aragona, Via San Leonardo 1, 84131 Salerno, Italy
| | - Fabrizio Caravati
- Division of Cardiology, ASST Settelaghi, Di Circolo Hospital, Via L. Borri 57, 21100 Varese, Italy
| | - Paolo Bonfanti
- Cardiology Division, Rho Civil Hospital, Corso Europa 250, 20017 Rho (MI), Italy
| | - Gabriele Zanotto
- Cardiology Division, Mater Salutis Hospital, Via C. Gianella 1, 37045 Legnago, Italy
| | - Edoardo Gronda
- Department of Medicine and Medical Specialties, I.R.C.C.S. Foundation Ca' Granda, Via M. Fanti 6, 20122 Milano, Italy
| | - Antonello Vado
- Cardiology Division, S. Croce e Carle Hospital, Via M. Coppino 26, 12100 Cuneo, Italy
| | - Vittorio Calzolari
- Cardiology Division, Santa Maria di Ca' Foncello Hospital, Piazzale dell'Ospedale 1, 31100 Treviso, Italy
| | - Giovanni Luca Botto
- Cardiology Division, Rho Civil Hospital, Corso Europa 250, 20017 Rho (MI), Italy
| | - Massimo Zecchin
- Cardiology Department, Cattinara University Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - Luca Bontempi
- Cardiology Division, Spedali Civili , Piazzale Spedali Civili 1, 25123 Brescia, Italy
| | | | - Alessio Gargaro
- BIOTRONIK Italia, Via delle Industrie 11, 20090 Vimodrone (MI), Italy
| | - Luigi Padeletti
- Cardiology Department, I.R.C.C.S. MultiMedica, Via Milanese 300, 20099 Sesto San Giovanni, Milano, Italy
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Zoppo F, Gagno G, Perazza L, Cocciolo A, Mugnai G, Vaccari D, Calzolari V. Electroanatomic voltage mapping for tissue characterization beyond arrhythmia definition: A systematic review. Pacing Clin Electrophysiol 2021; 44:1432-1448. [PMID: 34096635 DOI: 10.1111/pace.14288] [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] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/17/2021] [Accepted: 05/30/2021] [Indexed: 11/28/2022]
Abstract
Three-dimensional (3D) reconstruction by means of electroanatomic mapping (EAM) systems, allows for the understanding of the mechanism of focal or re-entrant arrhythmic circuits, which can be identified by means of dynamic (activation and propagation) and static (voltage) color-coded maps. However, besides this conventional use, EAM may offer helpful anatomical and functional information for tissue characterisation in several clinical settings. Today, data regarding electromechanical myocardial viability, scar detection in ischaemic and nonischaemic cardiomyopathy and arrhythmogenic right ventricle dysplasia (ARVC/D) definition are mostly consolidated, while emerging results are becoming available in contexts such as Brugada syndrome and cardiac resynchronisation therapy (CRT) implant procedures. As part of an invasive procedure, EAM has not yet been widely adopted as a stand-alone tool in the diagnostic path. We aim to review the data in the current literature regarding the use of 3D EAM systems beyond the definition of arrhythmia.
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Affiliation(s)
- Franco Zoppo
- Elettrofisiologia, U.O.C. di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy
| | - Giulia Gagno
- Dipartimento di Cardiologia, Azienda Sanitaria Universitaria Giuliano Isontina, ed Università degli Studi di Trieste, Trieste, Italy
| | - Luca Perazza
- Elettrofisiologia, U.O.C. di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy
| | - Andrea Cocciolo
- Elettrofisiologia, U.O.C. di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy
| | - Giacomo Mugnai
- Elettrofisiologia, U.O.C di Cardiologia, Ospedale Civile Arzignano, Vicenza, Italy
| | - Diego Vaccari
- Elettrofisiologia, U.O.C di Cardiologia, Ospedale Civile Feltre, Belluno, Italy
| | - Vittorio Calzolari
- Elettrofisiologia, U.O.C di Cardiologia, Ospedale Civile Treviso, Treviso, Italy
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Zoppo F, Gagno G, Perazza L, Cocciolo A, Mugnai G, Vaccari D, Calzolari V. Electroanatomic voltage mapping and characterisation imaging for "right ventricle arrhythmic syndromes" beyond the arrhythmia definition: a comprehensive review. Int J Cardiovasc Imaging 2021; 37:2347-2357. [PMID: 33761057 DOI: 10.1007/s10554-021-02221-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Abstract
Three-dimensional (3D) reconstruction by means of electroanatomic mapping (EAM) systems, allows for the understanding of the mechanism of focal or re-entrant arrhythmic circuits along with pacing techniques. However, besides this conventional use, EAM may offer helpful anatomical and functional information. Data regarding electromechanical scar detection in ischaemic (and nonischaemic) cardiomyopathy are mostly consolidated, while emerging results are becoming available in contexts such as arrhythmogenic right ventricular dysplasia (ARVC/D) definition and Brugada syndrome. As part of an invasive procedure, EAM has not yet been widely adopted as a stand-alone tool in the diagnostic path. We aim to review the current literature regarding the use of 3D EAM systems for right ventricle (RV) functional characterisation beyond the definition of arrhythmia.
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Affiliation(s)
- Franco Zoppo
- Elettrofisiologia, U.O.C. Di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy.
| | - Giulia Gagno
- Azienda Sanitaria Universitaria Giuliano Isontina - Dipartimento di Cardiologia Trieste, Trieste, Italy
| | - Luca Perazza
- Elettrofisiologia, U.O.C. Di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy
| | - Andrea Cocciolo
- Elettrofisiologia, U.O.C. Di Cardiologia, Ospedale Civile Gorizia, Gorizia, Italy
| | - Giacomo Mugnai
- Elettrofisiologia, U.O.C Di Cardiologia, Ospedale Civile Arzignano, Vicenza, Italy
| | - Diego Vaccari
- Elettrofisiologia, U.O.C Di Cardiologia, Ospedale Civile Feltre, Belluno, Italy
| | - Vittorio Calzolari
- Elettrofisiologia, U.O.C Di Cardiologia, Ospedale Civile Treviso, Treviso, Italy
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Calzolari V, De Mattia L, Basso F, Crosato M, Scalon A, Squasi PAM, Del Favero S, Cernetti C. Ablation catheter orientation: In vitro effects on lesion size and in vivo analysis during PVI for atrial fibrillation. Pacing Clin Electrophysiol 2020; 43:1554-1563. [PMID: 33111985 DOI: 10.1111/pace.14106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/08/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Catheter-delivered radiofrequency (RF) lesion formation is a complex phenomenon, and few studies have explored the effect of catheter orientation on lesion size and catheter orientation behavior during pulmonary vein isolation (PVI) procedures. We evaluated the influence of catheter orientation on lesion dimensions in an in vitro experimental setting and investigated the catheter orientation behavior during PVI. METHODS AND RESULTS 72 lesions were created in vitro on a porcine heart using a contact force catheter in a parallel, oblique, and perpendicular tip to tissue orientation. The superficial lesion length (SLL) increased shifting the catheter from perpendicular to parallel orientation. The intratissue absolute maximal lesion length (AML) was greater with an oblique catheter orientation. The lesion depth (LD) and the superficial lesion width (SLW) resulted similar with any orientation. Data from 21 PVI procedures in patients with paroxysmal atrial fibrillation using the "wide antral circumferential RF ablation" (WACA) technique were retrospectively analyzed. The mean contact angle among 1130 RF lesions was 28 ± 20°. A prevalent parallel orientation was noted in the anterior WACA segments, whereas it resulted more perpendicular in the posterior segments. Significant differences in catheter orientation between the three operators were found only in few WACA segments. CONCLUSIONS In an in vitro setting, catheter orientation affects SLL and AML, but not LD and SLW. During PVI procedures, catheter orientation resulted mostly parallel to the endocardium. Catheter orientation varied among different WACA segments, but only small differences were found between three operators when considering similar WACA segments.
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Affiliation(s)
| | - Luca De Mattia
- Department of Cardiology, Cà Foncello Hospital, Treviso, Italy
| | | | - Martino Crosato
- Department of Cardiology, Cà Foncello Hospital, Treviso, Italy
| | | | | | | | - Carlo Cernetti
- Department of Cardiology, Cà Foncello Hospital, Treviso, Italy
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Zacà V, Narducci ML, Ziacchi M, Valente S, Pelargonio G, Tomasi C, Bandini A, Zingarini G, Calzolari V, Del Rosso A, Boggian G, Sabbatani P, Bonfantino MV, Malacrida M, Biffi M. Heart failure hospitalizations and costs in ICD/CRT-D recipients following replacement or upgrade: the DECODE registry. ESC Heart Fail 2020; 7:4377-4383. [PMID: 32886455 PMCID: PMC7755025 DOI: 10.1002/ehf2.12841] [Citation(s) in RCA: 2] [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: 10/03/2019] [Revised: 05/05/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022] Open
Abstract
Aims The aim of this study is to report heart failure hospitalization (HFH) rates and associated costs within 12 months following implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy defibrillator (CRT‐D) device replacement or upgrade from ICD to CRT‐D. Methods and results The DEtect long‐term COmplications after icD rEplacement (DECODE) was a prospective, single‐arm, multicentre cohort study that explored complications in ICD/CRT‐D recipients. All clinical and survival data at 12 months were prospectively analysed. For each adjudicated HFH, admission and discharge dates and ICD‐9‐CM diagnosis and procedure codes were recorded. The reimbursement for each HFH was calculated for each diagnosis‐related group code. Between 2013 and 2015, 983 patients (mean age 71 years, male 76%, mean left ventricular ejection fraction 35%, and New York Heart Association Class I/II 75.6%) were enrolled. Patients underwent device replacement (900; 91.6%, 446 ICD/454 CRT‐D) or ICD upgrade to CRT‐D (83; 8.4%). Post‐replacement hospitalizations occurred in 220 patients, with the primary discharge diagnosis identifying cardiovascular causes in 175 patients (80%). Fifty‐five (5.6%) patients experienced at least one HFH. Overall, 91 HFH events occurred (9.6% event rate, 95% confidence interval: 7.7–11.7) in 70 patients; 66 (6.7%) patients died, 40 (60.6%) of cardiovascular causes. The HFH rate was significantly higher following upgrades, and the occurrence of HFH was associated with an 11‐fold increased mortality risk (95% confidence interval: 5.9–20.5, P < 0.0001). Medical diagnosis‐related group accounted for 91.2% of HFH; the mean cost per HFH was €5662 ± 9497, and the mean cost per patient was €9369 ± 12 687. On multivariate analysis, predictors of HFH were atrial fibrillation, chronic kidney disease, and all‐cause hospitalization within 30 days prior to the procedure. Conclusions In the DECODE registry, HFH and mortality rates in the year following ICD/CRT‐D replacement or upgrade were low. In this particular subset, underlying cardiac disease was the main driver of HFH, mortality, and higher healthcare expenditures.
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Affiliation(s)
- Valerio Zacà
- Cardiovascular and Thoracic Department, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Viale Bracci, 14, Siena, 53100, Italy
| | | | - Matteo Ziacchi
- Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola Malpighi, Bologna, Italy
| | - Serafina Valente
- Cardiovascular and Thoracic Department, Azienda Ospedaliera Universitaria Senese, Policlinico Santa Maria alle Scotte, Viale Bracci, 14, Siena, 53100, Italy
| | - Gemma Pelargonio
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | | | | | | | | | | | | | | | - Mauro Biffi
- Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola Malpighi, Bologna, Italy
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De Mattia L, Martini B, Calzolari V, Genovese D, Cernetti C, Buja G. Sudden and significant R-wave sensing variation detected on remote monitoring of ICD: What is the mechanism? Pacing Clin Electrophysiol 2020; 43:1020-1023. [PMID: 32715483 DOI: 10.1111/pace.14017] [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] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Luca De Mattia
- Department of Cardiology, Presidio Ospedaliero di Treviso, Treviso, Italy
| | - Bortolo Martini
- Department of Cardiology, Alto Vicentino Hospital, Santorso, Italy
| | - Vittorio Calzolari
- Department of Cardiology, Presidio Ospedaliero di Treviso, Treviso, Italy
| | - Davide Genovese
- Department of Cardiology, Presidio Ospedaliero di Treviso, Treviso, Italy
| | - Carlo Cernetti
- Department of Cardiology, Presidio Ospedaliero di Treviso, Treviso, Italy
| | - Gianfranco Buja
- Department of Cardiac, Thoracic and Vascular Science, University of Padova School of Medicine and Surgery, Padova, Italy
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12
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Migliore F, Zorzi A, Gregori D, Del Monte A, Falzone PV, Verlato R, Siciliano M, Themistoclakis S, China P, Marchese D, Pasquetto G, Ignatiuk B, Cernetti C, Giacomin E, Calzolari V, Bilato C, Dalla Valle C, Frigo GM, Marinaccio L, Saccà S, Lupo A, Roncon L, Marcantoni L, Tosi A, Turiano G, Folino F, Perazzolo Marra M, Cacciavillani L, Iliceto S. Urgent Pacemaker Implantation Rates in the Veneto Region of Italy After the COVID-19 Outbreak. Circ Arrhythm Electrophysiol 2020; 13:e008722. [PMID: 32434373 PMCID: PMC7299094 DOI: 10.1161/circep.120.008722] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Alvise Del Monte
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Pasquale Valerio Falzone
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Roberto Verlato
- Cardiology Division, Hospital of Cittadella, Italy (R.V., M.S., G.M.F.).,Cardiology Division, Hospital of Camposampiero, Padova, Italy (R.V.)
| | | | | | - Paolo China
- Department of Cardiology, Dell' Angelo Hospital, Mestre, Italy (S.T., P.C.)
| | - Domenico Marchese
- Cardiology Division, Hospital of Piove di Sacco, Padova, Italy (D.M., L. Marinaccio)
| | - Giampaolo Pasquetto
- Division of Cardiology, Riuniti Hospital Padova Sud, Monselice, Italy (PD) (G.P., B.I.)
| | - Barbara Ignatiuk
- Division of Cardiology, Riuniti Hospital Padova Sud, Monselice, Italy (PD) (G.P., B.I.)
| | - Carlo Cernetti
- Department of Cardiology, Hospital of Treviso, Italy (C.C., E.G., V.C.)
| | - Enrico Giacomin
- Department of Cardiology, Hospital of Treviso, Italy (C.C., E.G., V.C.)
| | | | - Claudio Bilato
- Cardiologia, Ospedali dell'Ovest Vicentino, Azienda ULSS 8 Berica, Arzignano, Vicenza, Italy (C.B., C.D.V.)
| | - Chiara Dalla Valle
- Cardiologia, Ospedali dell'Ovest Vicentino, Azienda ULSS 8 Berica, Arzignano, Vicenza, Italy (C.B., C.D.V.)
| | | | - Leonardo Marinaccio
- Cardiology Division, Hospital of Piove di Sacco, Padova, Italy (D.M., L. Marinaccio)
| | - Salvatore Saccà
- Cardiology Department, Public Hospital of Mirano, Venezia, Italy (S.S., A.L.)
| | - Antonio Lupo
- Cardiology Department, Public Hospital of Mirano, Venezia, Italy (S.S., A.L.)
| | - Loris Roncon
- Cardiology Department, Arrhythmia & Electrophysiology Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy (L.R., L. Marcantoni)
| | - Lina Marcantoni
- Cardiology Department, Arrhythmia & Electrophysiology Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy (L.R., L. Marcantoni)
| | - Alberto Tosi
- Department of Cardiology, Civil Hospital, Belluno, Italy (A.T., G.T.)
| | - Giovanni Turiano
- Department of Cardiology, Civil Hospital, Belluno, Italy (A.T., G.T.)
| | - Franco Folino
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Martina Perazzolo Marra
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Luisa Cacciavillani
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
| | - Sabino Iliceto
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Italy (F.M., A.Z., D.G., A.D.M., P.V.F., F.F., M.P.M., L.C., S.I.)
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13
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Forleo GB, Santini L, Calò L, Ricciardi D, Curnis A, Pignalberi C, Calzolari V, Giammaria M, Morani G, Bertaglia E, Ribatti V, Biffi M, Potenza D, Piro A, Covino G, Natale V, Gasperetti A, Notarstefano P, Lavalle C, Nabutovsky Y, Tondo C, Zanon F. Clinical and economic impact of multipoint left ventricular pacing: A comparative analysis from the Italian registry on multipoint pacing in cardiac resynchronization therapy (IRON‐MPP). J Cardiovasc Electrophysiol 2020; 31:1166-1174. [DOI: 10.1111/jce.14433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 01/02/2020] [Revised: 02/11/2020] [Accepted: 02/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Giovanni B. Forleo
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco” Milano Italy
| | - Luca Santini
- Division of CardiologyOspedale GB Grassi Ostia Italy
| | - Leonardo Calò
- Division of CardiologyPoliclinico Casilino Roma Italy
| | - Danilo Ricciardi
- Department of CardiologyPoliclinico Universitario Campus Bio‐Medico Italy
| | - Antonio Curnis
- Department of CardiologySpedali Civili di Brescia Brescia Italy
| | | | | | | | - Giovanni Morani
- Department of CardiologyAzienda Ospedaliera Universitaria Verona Italy
| | | | | | - Mauro Biffi
- Department of CardiologyPoliclinico S. Orsola‐Maplighi Bologna Italy
| | - Domenico Potenza
- Division of CardiologyOspedale Casa Sollievo Della Sofferenza San Giovanni Rotondo Italy
| | - Agostino Piro
- Department of CardiologyPoliclinico Universitario Umberto I Roma Italy
| | - Gregorio Covino
- Division of CardiologyOspedale San Giovanni Bosco Napoli Italy
| | - Veronica Natale
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco” Milano Italy
| | - Alessio Gasperetti
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco” Milano Italy
- Department of CardiologyCentro Cardiologico Monzino Milano Italy
| | | | - Carlo Lavalle
- Department of CardiologyPoliclinico Universitario Umberto I Roma Italy
| | | | - Claudio Tondo
- Department of CardiologyCentro Cardiologico Monzino Milano Italy
| | - Francesco Zanon
- Division of CardiologySanta Maria della Misericordia Hospital Rovigo Italy
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14
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Forleo GB, Gasperetti A, Ricciardi D, Curnis A, Bertaglia E, Calò L, Pignalberi C, Calzolari V, Ribatti V, Lavalle C, Potenza D, Tondi L, Natale V, Notarstefano P, Viecca M, Morani G, Biffi M, Giammaria M, Zanon F, Santini L. Impact of multipoint pacing on projected battery longevity in cardiac resynchronization therapy. An IRON‐MPP study sub‐analysis. J Cardiovasc Electrophysiol 2019; 30:2885-2891. [DOI: 10.1111/jce.14254] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/20/2019] [Revised: 10/11/2019] [Accepted: 10/25/2019] [Indexed: 01/24/2023]
Affiliation(s)
- Giovanni B. Forleo
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco”Milano Italy
| | - Alessio Gasperetti
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco”Milano Italy
| | - Danilo Ricciardi
- Department of CardiologyPoliclinico Universitario Campus Bio‐Medico Italy
| | - Antonio Curnis
- Department of CardiologyOspedali Civili di BresciaBrescia Italy
| | | | - Leonardo Calò
- Department of CardiologyPoliclinico CasilinoRoma Italy
| | | | | | | | - Carlo Lavalle
- Department of CardiologyPoliclinico Universitario Umberto IRoma Italy
| | - Domenico Potenza
- Department of CardiologyOspedale Casa Sollievo Della Sofferenza S.Giovanni Rotondo Italy
| | - Lara Tondi
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco”Milano Italy
| | - Veronica Natale
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco”Milano Italy
| | | | - Maurizio Viecca
- Department of CardiologyAzienda Ospedaliera‐Universitaria “Luigi Sacco”Milano Italy
| | - Giovanni Morani
- Department of CardiologyAzienda Ospedaliera Universitaria VeronaVerona Italy
| | - Mauro Biffi
- Department of CardiologyPoliclinico S. Orsola‐MaplighiBologna Italy
| | | | - Francesco Zanon
- Department of CardiologySanta Maria della Misericordia HospitalRovigo Italy
| | - Luca Santini
- Department of CardiologyOspedale GB Grassi Ostia Italy
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15
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Rordorf R, Taravelli E, Forleo GB, Giannola G, Calzolari V, Tadeo G, Rossi S, Vicentini A, Curnis A, Serra P, Santamaria M, Calò L. Performance of the Durata implantable cardioverter defibrillator lead. J Cardiovasc Med (Hagerstown) 2019; 20:676-681. [DOI: 10.2459/jcm.0000000000000843] [Citation(s) in RCA: 2] [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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16
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Zanon F, Menardi E, Ammendola E, De Filippo P, Manzo M, Stabile G, Potenza DR, Zaca' V, Bertini M, Lissoni F, Bandini A, Calzolari V, Zingarini G, Malacrida M, Biffi M. P2871Attenuated clinical benefit after ICD replacement over long term follow-up in a contemporary large world population: insight to the DECODE registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1179] [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
Cardiac Implantable Electronic Device (CIED) surgery is threatened by serious complications both during the procedure and during follow-up. The factors associated to attenuated clinical benefit over long term follow-up are poorly understood.
Purpose
To evaluate type and extent of Adverse Events (AEs) and potential predictors of major AEs over 12 months after ICD/CRT-D replacement/upgrade in a contemporary Italian population.
Methods
Detect long-term complications after ICD replacement (DECODE) was a prospective, single-arm, multicenter cohort study aimed at estimating medium- to long-term complications in a large population of patients (pts) who underwent ICD/CRT-D replacement/upgrade from 2013 to 2015. The endpoint for this analysis is death from any cause, procedure-related infection, and surgical actions/hospitalizations necessary to treat the AEs.
Results
We included 983 consecutive pts (median age 71 years, 76% male, 55% ischemic, 47% CRT-D). During a mean follow-up duration of 353±49 days, 7% of the pts died. A total of 104 AEs occurred in 70 (7.1%) pts. 43 (4.4%) pts needed at least one surgical action to treat the AEs. A total of 23 (2.3%) pts had infective AEs (CIED related in 12 pts, due to other causes in 11). Mortality was unrelated to the occurrence of overall AEs, or of CIED-related AEs, or of surgical actions/hospitalizations needed to correct AEs. The endpoint was reached by 109 (11%) pts over 12-month follow-up (97 pts had a single event, and 12 pts had two events). The median time to the endpoint was 137 [50 - 254] days. On multivariate Cox regression analysis adjusted for baseline confounders, ischemic cardiomyopathy (HR = 1.86, 95% CI: 1.18 to 2.91; p=0.0076), hospitalization prior to the procedure (2.34, 1.35 to 4.05; 0.0025) and anticoagulation (1.91, 1.25 to 2.92; 0.0032) were associated with the endpoint during follow-up.
Conclusion
Evaluation of the patient's profile may assist in predicting vulnerability and should prompt reconsideration of the procedure by deferring at a more stable clinical status, and carefully individualized in the setting of upgrades and anticoagulation management
Acknowledgement/Funding
None
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Affiliation(s)
- F Zanon
- General Hospital, Rovigo, Italy
| | - E Menardi
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | | | - M Manzo
- AOU S. Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | | | - D R Potenza
- Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - V Zaca'
- Polyclinic Santa Maria alle Scotte, Siena, Italy
| | - M Bertini
- University Hospital of Ferrara, Ferrara, Italy
| | - F Lissoni
- Presidio Ospedaliero di Lodi, Lodi, Italy
| | - A Bandini
- Morgagni-Pierantoni Hospital, Forli, Italy
| | - V Calzolari
- Hospital Santa Maria di Ca Foncello, Treviso, Italy
| | - G Zingarini
- Hospital Santa Maria Della Misericordia, Perugia, Italy
| | | | - M Biffi
- University Hospital Policlinic S. Orsola-Malpighi, Bologna, Italy
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Migliore F, Mattesi G, De Franceschi P, Allocca G, Crosato M, Calzolari V, Fantinel M, Ortis B, Facchin D, Daleffe E, Fabris T, Marras E, De Lazzari M, Zanon F, Marcantoni L, Siciliano M, Corrado D, Iliceto S, Bertaglia E, Zecchin M. Multicentre experience with the second-generation subcutaneous implantable cardioverter defibrillator and the intermuscular two-incision implantation technique. J Cardiovasc Electrophysiol 2019; 30:854-864. [PMID: 30827041 PMCID: PMC6850019 DOI: 10.1111/jce.13894] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/14/2019] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
Abstract
Introduction The recently developed second‐generation subcutaneous implantable cardioverter defibrillator (S‐ICD) and the intermuscular two‐incision implantation technique demonstrate potential favorable features that reduce inappropriate shocks and complications. However, data concerning large patient populations are lacking. The aim of this multicentre prospective study was to evaluate the safety and outcome of second‐generation S‐ICD using the intermuscular two‐incision technique in a large population study. Methods and Results The study population included 101 consecutive patients (75% male; mean age, 45 ± 13 years) who received second‐generation S‐ICD (EMBLEM; Boston Scientific, Marlborough, MA) implantation using the intermuscular two‐incision technique as an alternative to the standard implantation technique. Twenty nine (29%) patients were implanted for secondary prevention. Twenty four (24%) patients had a previously implanted transvenous ICD. All patients were implanted without any procedure‐related complications. Defibrillation testing was performed in 80 (79%) patients, and ventricular tachycardia was successfully converted at less than or equal to 65 J in 98.75% (79/80) of patients without pulse generator adjustments. During a median follow‐up of 21 ± 10 months, no complications requiring surgical revision or local or systemic device‐related infections were observed. Ten patients (9.9%) received appropriate and successful shocks for ventricular arrhythmias. Three (2.9%) patients experienced inappropriate shocks due to oversensing the cardiac signal (n = 1), noncardiac signal (n = 1), and a combination of both cardiac and noncardiac signals (n = 1), with one patient requiring device explantation. No patients required device explantation due to antitachycardia pacing indications. Conclusions According to our multicentre study, second‐generation S‐ICD implanted with the intermuscular two‐incision technique is an available safe combination and appears to be associated with a low risk of complications, such as inappropriate shocks.
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Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Giulia Mattesi
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Pietro De Franceschi
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Giuseppe Allocca
- Department of Cardiology, Hospital of Conegliano, Treviso, Italy
| | - Martino Crosato
- Department of Cardiology, Ca´ Foncello, Civil Hospital, Treviso, Italy
| | | | - Mauro Fantinel
- Department of Cardiology, Civil Hospital, Feltre, Belluno, Italy
| | - Benedetta Ortis
- Cardiovascular Department, University of Trieste, Trieste, Italy
| | - Domenico Facchin
- Cardiology Division, Azienda Sanitaria Universitaria Integrata di Udine and IRCAB Foundation, P.le Santa Maria della Misericordia, Udine, Italy
| | - Elisabetta Daleffe
- Cardiology Division, Azienda Sanitaria Universitaria Integrata di Udine and IRCAB Foundation, P.le Santa Maria della Misericordia, Udine, Italy
| | - Tommaso Fabris
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Elena Marras
- Department of Cardiology, Dell´Angelo Hospital, Mestre, Italy
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Francesco Zanon
- Cardiology Department, Arrhythmia And Electrophysiology Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | - Lina Marcantoni
- Cardiology Department, Arrhythmia And Electrophysiology Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | | | - Domenico Corrado
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Sabino Iliceto
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic And Vascular Sciences, University of Padova, Padova, Italy
| | - Massimo Zecchin
- Cardiovascular Department, University of Trieste, Trieste, Italy
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18
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Stranzinger S, Faulhammer E, Li J, Dong R, Zeitler JA, Biserni S, Calzolari V, Khinast JG, Markl D. Predicting capsule fill weight from in-situ powder density measurements using terahertz reflection technology. Int J Pharm X 2019; 1:100004. [PMID: 31517269 PMCID: PMC6733302 DOI: 10.1016/j.ijpx.2018.100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 11/07/2022]
Abstract
The manufacturing of the majority of solid oral dosage forms is based on the densification of powder. A good understanding of the powder behavior is therefore essential to assure high quality drug products. This is particularly relevant for the capsule filling process, where the powder bulk density plays an important role in controlling the fill weight and weight variability of the final product. In this study we present a novel approach to quantitatively measure bulk density variations in a rotating container by means of terahertz reflection technology. The terahertz reflection probe was used to measure the powder density using an experimental setup that mimics a lab-scale capsule filling machine including a static sampling tool. Three different grades of α-lactose monohydrate excipients specially designed for inhalation application were systematically investigated at five compression stages. Relative densities predicted from terahertz reflection measurements were correlated to off-line weight measurements of the collected filled capsules. The predictions and the measured weights of the powder in the capsules were in excellent agreement, where the relative density measurements of Lactohale 200 showed the strongest correlation with the respective fill weight (R2=0.995). We also studied how the density uniformity of the powder bed was impacted by the dosing process and the subsequent filling of the holes (with excipient powder), which were introduced in the powder bed after the dosing step. Even though the holes seemed to be filled with new powder (by visual inspection), the relative density in these specific segments were found to clearly differ from the undisturbed powder bed state prior to dosing. The results demonstrate that it is feasible to analyze powder density variations in a rotating container by means of terahertz reflection measurements and to predict the fill weight of collected capsules.
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Affiliation(s)
- Sandra Stranzinger
- Research Center Pharmaceutical Engineering (RCPE), Inffeldgasse 13, 8010 Graz, Austria.,Graz University of Technology, Institute for Process and Particle Engineering, Inffeldgasse 13, 8010 Graz, Austria
| | - Eva Faulhammer
- Research Center Pharmaceutical Engineering (RCPE), Inffeldgasse 13, 8010 Graz, Austria
| | - Jingyi Li
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Philippa Fawcett Drive, CB3 0AS Cambridge, UK
| | - Runqiao Dong
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Philippa Fawcett Drive, CB3 0AS Cambridge, UK
| | - J Axel Zeitler
- Department of Chemical Engineering and Biotechnology, University of Cambridge, Philippa Fawcett Drive, CB3 0AS Cambridge, UK
| | - Stefano Biserni
- MG2, Via del Savena, 18. I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - Vittorio Calzolari
- MG2, Via del Savena, 18. I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - Johannes G Khinast
- Research Center Pharmaceutical Engineering (RCPE), Inffeldgasse 13, 8010 Graz, Austria.,Graz University of Technology, Institute for Process and Particle Engineering, Inffeldgasse 13, 8010 Graz, Austria
| | - Daniel Markl
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, G4 0RE Glasgow, UK.,EPSRC Centre for Innovative Manufacturing in Continuous Manufacturing and Crystallisation, University of Strathclyde, 99 George Street, G1 1RD Glasgow, UK
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19
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Zaca' V, Narducci ML, Nigro G, Menardi E, Zanon F, Zoni Berisso M, Bertini M, Lissoni F, Calzolari V, Bandini A, Tomasi C, Carinci V, Ferretti C, Malacrida M, Biffi M. 5305Heart failure-related hospitalizations in ICD/CRT-D recipients following device replacement or upgrade: insights from the DECODE registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- V Zaca'
- Division of Cardiology, Cardiovascular and Thoracic Department, Santa Maria alle Scotte Hospital, Siena, Italy, Italy
| | - M L Narducci
- Catholic University of the Sacred Heart, Rome, Italy
| | - G Nigro
- Second University of Naples, Naples, Italy
| | - E Menardi
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - F Zanon
- General Hospital of Rovigo, Rovigo, Italy
| | - M Zoni Berisso
- Padre A Micone Hospital ASL3, Genoa-Sestri Ponente, Italy
| | - M Bertini
- University Hospital of Ferrara, Ferrara, Italy
| | | | - V Calzolari
- Hospital Santa Maria di Ca Foncello, Treviso, Italy
| | - A Bandini
- Morgagni-Pierantoni Hospital, Forli, Italy
| | - C Tomasi
- Santa Maria delle Croci Hospital, Ravenna, Italy
| | | | | | | | - M Biffi
- University of Bologna, Bologna, Italy
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20
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De Mattia L, Crosato M, Squasi PAM, Calzolari V. Interatrial electrical dissociation: when the left atrium does not know what the right atrium is doing. Europace 2018; 20:1757. [DOI: 10.1093/europace/euy126] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luca De Mattia
- Department of Cardiology, Ca' Foncello Hospital, Piazzale dell'Ospedale 1, Treviso, Italy
| | - Martino Crosato
- Department of Cardiology, Ca' Foncello Hospital, Piazzale dell'Ospedale 1, Treviso, Italy
| | | | - Vittorio Calzolari
- Department of Cardiology, Ca' Foncello Hospital, Piazzale dell'Ospedale 1, Treviso, Italy
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21
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Mattia LD, Crosato M, Indiani S, Causin E, Licciardello C, Maria Squasi PA, De Leo A, Calzolari V. Prospective Evaluation of Lesion Index-Guided Pulmonary Vein Isolation Technique in Patients with Paroxysmal Atrial Fibrillation: 1-year Follow-Up. J Atr Fibrillation 2018; 10:1858. [PMID: 29988268 DOI: 10.4022/jafib.1858] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 03/19/2018] [Accepted: 03/26/2018] [Indexed: 01/20/2023]
Abstract
Introduction Pulmonary vein isolation (PVI) using contact force (CF) sensing ablation catheters currently relies on CF and force-time integral (FTI) guidelines. Such measurement of lesion effectiveness still lacks information on current delivery to the tissue, influenced by system impedance and power. Lesion Index (LSI) is a multi-parametric index incorporating CF and radiofrequency current data across time. We aimed to prospectively assess the efficacy of an LSI-guided approach to PVI in patients with paroxysmal atrial fibrillation (PAF). Methods and Results The study prospectively enrolled 28 consecutive patients with PAF undergoing PVI with a CF sensing catheter (TactiCathTM, Abbott). LSI-guided ablation target was adapted according to the mean regional thickness of pulmonary vein antra (PVA): LSI range 5.5-6 was pursued in the anterior and septal portions of PVA, 5-5.5 elsewhere. Data from 32 consecutive PAF patients who underwent PVI ablation with a non-CF guided approach (NCF-group) were retrospectively collected for comparison of procedural and clinical outcome.AF-free survival rate at follow-up (17±6 months) was higher for LSI-guided group than NCF-group (89.3% vs 65.6%, p=0.037), with no increase in periprocedural complication rate (no tamponades or other major adverse events reported). Among 1126 lesions with LSI within target range (5-6), average CF was >10g and <30g for 976 lesions (86.7%). Moreover, 1015 lesions (90.1%) had FTI>400gs, but with wide distribution: 30.2% within 400-500gs, 30.0% within 501-600gs, 29.9% over 600gs. Conclusion In this first prospective study, LSI-guided PVI improved clinical outcome without any increase in complication rate when compared with standard, non-LSI-guided approach.
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Affiliation(s)
- Luca De Mattia
- Department of Cardiology, Ca' Foncello Hospital,Treviso,Italy
| | - Martino Crosato
- Department of Cardiology, Ca' Foncello Hospital,Treviso,Italy
| | | | - Elena Causin
- Department of Cardiology, Ca' Foncello Hospital,Treviso,Italy
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22
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Stranzinger S, Faulhammer E, Scheibelhofer O, Calzolari V, Biserni S, Paudel A, Khinast JG. Study of a low-dose capsule filling process by dynamic and static tests for advanced process understanding. Int J Pharm 2018; 540:22-30. [PMID: 29407875 DOI: 10.1016/j.ijpharm.2018.01.055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/26/2018] [Accepted: 01/31/2018] [Indexed: 10/18/2022]
Abstract
Precise filling of capsules with doses in the mg-range requires a good understanding of the filling process. Therefore, we investigated the various process steps of the filling process by dynamic and static mode tests. Dynamic tests refer to filling of capsules in a regular laboratory dosator filling machine. Static tests were conducted using a novel filling system developed by us. Three grades of lactose excipients were filled into size 3 capsules with different dosing chamber lengths, nozzle diameters and powder bed heights, and, in the dynamic mode, with two filling speeds (500, 3000 caps/h). The influence of the gap at the bottom of the powder container on the fill weight and variability was assessed. Different gaps resulted in a change in fill weight in all materials, although in different ways. In all cases, the fill weight of highly cohesive Lactohale 220 increased when decreasing the gap. Furthermore, experiments with the stand-alone static test tool indicated that this very challenging powder could successfully be filled without any pre-compression in the range of 5 mg-20 mg with acceptable RSDs. This finding is of great importance since for very fine lactose powders high compression ratios (dosing-chamber-length-to-powder-bed height compression ratios) may result in jamming of the piston. Moreover, it shows that the static mode setup is suitable for studying fill weight and variability. Since cohesive powders, such as Lactohale 220, are hard to fill, we investigated the impact of vibration on the process. Interestingly, we found no correlation between the reported fill weight changes in dynamic mode at 3000 cph and static mode using similar vibration. However, we could show that vibrations during sampling in the static mode dramatically reduced fill weight variability. Overall, our results indicate that by fine-tuning instrumental settings even very challenging powders can be filled with a low-dose dosator capsule filling machine. This study is a further step towards a scientific qualification of dosator nozzles for low-fill weight (1-45 mg) capsule filling.
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Affiliation(s)
- S Stranzinger
- Research Center Pharmaceutical Engineering (RCPE), Graz 8010, Austria; Graz University of Technology, Institute for Process and Particle Engineering, 8010 Graz, Austria
| | - E Faulhammer
- Research Center Pharmaceutical Engineering (RCPE), Graz 8010, Austria
| | - O Scheibelhofer
- Research Center Pharmaceutical Engineering (RCPE), Graz 8010, Austria
| | - V Calzolari
- MG2, Via del Savena, 18, I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - S Biserni
- MG2, Via del Savena, 18, I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - A Paudel
- Research Center Pharmaceutical Engineering (RCPE), Graz 8010, Austria; Graz University of Technology, Institute for Process and Particle Engineering, 8010 Graz, Austria
| | - J G Khinast
- Research Center Pharmaceutical Engineering (RCPE), Graz 8010, Austria; Graz University of Technology, Institute for Process and Particle Engineering, 8010 Graz, Austria.
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23
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Themistoclakis S, Calzolari V, De Mattia L, Dello Russo A, China P, Casella M, Indiani S, Caporaso I, Addis A, Tondo C. P287In-vivo lesion index (LSI) validation in percutaneous radiofrequency catheter ablation. Europace 2018. [DOI: 10.1093/europace/euy015.099] [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: 11/14/2022] Open
Affiliation(s)
- S Themistoclakis
- Hospital dell'Angelo, Cardiothoracic & Vascular Medicine, Unit of Electrophysiology and Cardiac Pacing, Mestre-Venice, Italy
| | - V Calzolari
- Hospital Santa Maria di Ca Foncello, Cardiology, Treviso, Italy
| | - L De Mattia
- Hospital Santa Maria di Ca Foncello, Cardiology, Treviso, Italy
| | - A Dello Russo
- Cardiology Center Monzino IRCCS, Cardiac Sciences and Community Health, University of Milan, , Milan, Italy
| | - P China
- Hospital dell'Angelo, Cardiothoracic & Vascular Medicine, Unit of Electrophysiology and Cardiac Pacing, Mestre-Venice, Italy
| | - M Casella
- Cardiology Center Monzino IRCCS, Cardiac Sciences and Community Health, University of Milan, , Milan, Italy
| | | | | | - A Addis
- Centro di Ricerche ed Applicazioni Biotecnologiche in Chirurgia Cardiovascolare, Rivolta D'Adda, Italy
| | - C Tondo
- Cardiology Center Monzino IRCCS, Cardiac Sciences and Community Health, University of Milan, , Milan, Italy
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24
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Calzolari V, De Mattia L, Indiani S, Crosato M, Furlanetto A, Licciardello C, Squasi PAM, Olivari Z. In Vitro Validation of the Lesion Size Index to Predict Lesion Width and Depth After Irrigated Radiofrequency Ablation in a Porcine Model. JACC Clin Electrophysiol 2017; 3:1126-1135. [PMID: 29759495 DOI: 10.1016/j.jacep.2017.08.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/10/2017] [Accepted: 08/31/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVES In an in vitro model, the authors tested the hypotheses that: 1) lesion dimensions correlate with lesion size index (LSI); and 2) LSI could predict lesion dimensions better than power, contact force (CF), and force-time integral (FTI). BACKGROUND When performing radiofrequency (RF) catheter ablation for cardiac arrhythmias, reliable predictors of lesion quality are lacking. The LSI is a multiparametric index incorporating time, power, CF, and impedance recorded during ablation. METHODS RF lesions were created on porcine myocardial slabs by using an open-tip irrigated catheter capable of real-time monitoring of catheter-tissue CF. Initially, 3 power settings of 20, 25, and 30 W were used with a fixed CF of 10 g. A fixed power of 20 W was then set with a CF of 20 and 30 g, thereby yielding a total of 5 ablation groups. In each group, LSI values of 5, 6, 7, and 8 were targeted. Sixty RF lesions were created by using 20 ablation protocols (3 lesions for each protocol). RESULTS Lesion width and depth were not correlated with power or CF, but the results significantly correlated with FTI (p < 0.01) and LSI (p < 0.0001). Four steam pops occurred with power set at 30 W; no pops were noted with 20 or 25 W even when high LSI values were targeted. CONCLUSIONS In this in vitro model, FTI and LSI predicted RF lesion dimensions, whereas power and CF did not. The LSI predictive value was higher than that of FTI. Steam pops occurred only using high ablation power levels, regardless of the targeted LSI.
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Affiliation(s)
| | - Luca De Mattia
- Department of Cardiology, Ca' Foncello Hospital, Treviso, Italy.
| | | | - Martino Crosato
- Department of Cardiology, Ca' Foncello Hospital, Treviso, Italy
| | - Alberto Furlanetto
- Department of Anatomical Pathology, Ca' Foncello Hospital, Treviso, Italy
| | | | | | - Zoran Olivari
- Department of Cardiology, Ca' Foncello Hospital, Treviso, Italy
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25
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Biffi M, Vado A, Nigro G, Narducci M, Ammendola E, Zingarini G, Calzolari V, Calo' L, Tomasi C, Ciaramitaro G, Boggian G, Zennaro M, Sassone B, Malacrida M, Zanon F. P6425Performance of sudden cardiac death risk score at the time of device replacement for patients with hypertrophic cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Chirillo F, Calabro' F, Boccaletto F, Mondin F, Calzolari V, Pantano P, Martire P, Benettin A, Scotton P, Polesel E, Olivari Z. P4539Assessment of the diagnostic accuracy of 18fluorodesoxyglucose positron emission tomography/computed tomography in prosthetic heart valve and cardiac implantable electronic device infection. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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De Mattia L, Calzolari V, Indiani S, Crosato M, Licciardello C, Squasi PAM, Olivari Z. P1459Lesion size index can predict total lesion dimensions after two overlapping irrigated radiofrequency lesions: an in vitro study. Europace 2017. [DOI: 10.1093/ehjci/eux158.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Biffi M, Vado A, Nigro G, Narducci ML, Ammendola E, Zingarini G, Calzolari V, Calo' L, Tomasi C, Ciaramitaro G, Boggian G, Zennaro M, Sassone B, Malacrida M, Zanon F. P1476Performance of sudden cardiac death risk score at the time of device replacement for patients with hypertrophic cardiomyopathy. Europace 2017. [DOI: 10.1093/ehjci/eux158.103] [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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29
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Folino F, Buja G, Zanotto G, Marras E, Allocca G, Vaccari D, Gasparini G, Bertaglia E, Zoppo F, Calzolari V, Suh RN, Ignatiuk B, Lanera C, Benassi A, Gregori D, Iliceto S. Association between air pollution and ventricular arrhythmias in high-risk patients (ARIA study): a multicentre longitudinal study. Lancet Planet Health 2017; 1:e58-e64. [PMID: 29851582 DOI: 10.1016/s2542-5196(17)30020-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/18/2017] [Accepted: 03/15/2017] [Indexed: 05/27/2023]
Abstract
BACKGROUND Although the effects of air pollution on mortality have been clearly shown in many epidemiological and observational studies, the pro-arrhythmic effects remain unknown. We aimed to assess the short-term effects of air pollution on ventricular arrhythmias in a population of high-risk patients with implantable cardioverter-defibrillators (ICDs) or cardiac resynchronisation therapy defibrillators (ICD-CRT). METHODS In this prospective multicentre study, we assessed 281 patients (median age 71 years) across nine centres in the Veneto region of Italy. Episodes of ventricular tachycardia and ventricular fibrillation that were recorded by the diagnostic device were considered in this analysis. Concentrations of particulate matter of less than 10 μm (PM10) and less than 2·5 μm (PM2·5) in aerodynamic diameter, carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were obtained daily from monitoring stations, and the 24 h median value was considered. Each patient was associated with exposure data from the monitoring station that was closest to their residence. Patients were followed up for 1 year and then scheduled to have a closing visit, within 1 more year. This study is registered with ClinicalTrials.gov, number NCT01723761. FINDINGS Participants were enrolled from April 1, 2011, to Sept 30, 2012, and follow-ups (completed on April 5, 2014) ranged from 637 to 1177 days (median 652 days). The incidence of episodes of ventricular tachycardia and ventricular fibrillation correlated significantly with PM2·5 (p<0·0001) but not PM10. An analysis of ventricular fibrillation episodes alone showed a significant increase in risk of higher PM2·5 (p=0·002) and PM10 values (p=0·0057). None of the gaseous pollutants were significantly linked to the occurrence of ventricular tachycardia or ventricular fibrillation. In a subgroup analysis of patients with or without a previous myocardial infarction, only the first showed a significant association between particulate matter and episodes of ventricular tachycardia or ventricular fibrillation. INTERPRETATION Particulate matter has acute pro-arrhythmic effects in a population of high-risk patients, which increase on exposure to fine particles and in patients who have experienced a previous myocardial infarction. The time sequence of the arrhythmic events suggests there is an underlying neurally mediated mechanism. From a clinical point of view, the results of our study should encourage physicians to also consider environmental risk when addressing the prevention of arrhythmic events, particularly in patients with coronary heart disease, advising them to avoid exposure to high levels of fine particulate matter. FUNDING There was no funding source for this study.
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Affiliation(s)
- Franco Folino
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
| | - Gianfranco Buja
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Gabriele Zanotto
- Department of Cardiology, Mater Salutis Hospital, Legnago, Italy
| | - Elena Marras
- Department of Cardiology, S Maria dei Battuti Hospital, Conegliano, Italy
| | - Giuseppe Allocca
- Department of Cardiology, S Maria dei Battuti Hospital, Conegliano, Italy
| | - Diego Vaccari
- Department of Cardiology, Civic Hospital, Montebelluna, Italy
| | | | - Emanuele Bertaglia
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Franco Zoppo
- Department of Cardiology, Civic Hospital, Mirano, Italy
| | | | - Rene Nangah Suh
- Department of Cardiology, Civic Hospital, Portogruaro, Italy
| | | | - Corrado Lanera
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Alessandro Benassi
- Regional Agency for Environmental Prevention and Protection of the Veneto Region, Padua, Italy
| | - Dario Gregori
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Sabino Iliceto
- Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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30
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Mazzone P, Migliore F, Bertaglia E, Facchin D, Daleffe E, Calzolari V, Crosato M, Melillo F, Peruzza F, Marzi A, Sora N, Della Bella P. Safety and efficacy of the new bidirectional rotational Evolution® mechanical lead extraction sheath: results from a multicentre Italian registry. Europace 2017; 20:829-834. [DOI: 10.1093/europace/eux020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/28/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Patrizio Mazzone
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milan, Italy
| | - Federico Migliore
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Via N. Giustiniani 2, 35121 Padova, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Via N. Giustiniani 2, 35121 Padova, Italy
| | - Domenico Facchin
- University Hospital Santa Maria della Misericordia, Udine, Italy
| | | | | | - Martino Crosato
- Department of Cardiology, Ospedale Civile Ca’Foncello, Treviso, Italy
| | - Francesco Melillo
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milan, Italy
| | - Francesco Peruzza
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Via N. Giustiniani 2, 35121 Padova, Italy
| | - Alessandra Marzi
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milan, Italy
| | - Nicoleta Sora
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milan, Italy
| | - Paolo Della Bella
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology Laboratories, Ospedale San Raffaele, Milan, Italy
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31
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Stranzinger S, Faulhammer E, Calzolari V, Biserni S, Dreu R, Šibanc R, Paudel A, Khinast JG. The effect of material attributes and process parameters on the powder bed uniformity during a low-dose dosator capsule filling process. Int J Pharm 2017; 516:9-20. [PMID: 27826028 DOI: 10.1016/j.ijpharm.2016.11.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 11/25/2022]
Abstract
The objective of this work was to assess the effect of process parameters of a dosator nozzle machine on the powder bed uniformity of inhalation powders with various characteristics during a low-dose dosator capsule filling process. Three grades of lactose excipients were extensively characterized and filled into size 3 capsules using different dosing chamber lengths (2.5, 5mm), nozzle diameters (1.9, 3.4mm), powder bed heights (5, 10mm) and filling speeds (500, 3000capsules/h). The fill weight and the weight variability of Lactohale 100 (large particles, good flowability, low cohesion) remained almost the same, regardless of the process parameters throughout the capsule filling run time. Moreover, for this powder an increase in the fill weight at a higher filling speed was observed in all cases. Fill weight variability was significantly higher for lower dosing chamber volumes at a filling speed of 3000 capsules per hour. Lactohale 220 (small particles, poor flowability, high cohesion) delivered entirely different results. After a certain run time, depending on instrumental settings, a 'steady-state' with constant fill weights and low weight variability was achieved. For this highly cohesive powder, a high dosing chamber volume requires a low filling speed in order for the powder to completely fill the dosator nozzle. Moreover, it was established that a dosing chamber length of 2.5mm and a powder bed height of 10mm were required due to the powder's high fill weight variability over time, while the dosator size had no effect on it. In summary, the layer uniformity, the fill weight and the weight variability strongly depend on the powder characteristics and the instrumental settings. The results indicate that Lactohale 220 requires special attention during low-dose capsule filling. The study presents excellent insights into the effect of material attributes and process parameters on the layer uniformity and the quality of end product.
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Affiliation(s)
- S Stranzinger
- Research Center Pharmaceutical Engineering (RCPE) GmbH, Inffeldgasse 13, 8010 Graz, Austria; Graz University of Technology, Institute for Process and Particle Engineering, Inffeldgasse 13, 8010 Graz, Austria
| | - E Faulhammer
- Research Center Pharmaceutical Engineering (RCPE) GmbH, Inffeldgasse 13, 8010 Graz, Austria
| | - V Calzolari
- MG2, Via del Savena 18, 40065 Pian di Macina di Pianoro, Bologna, Italy
| | - S Biserni
- MG2, Via del Savena 18, 40065 Pian di Macina di Pianoro, Bologna, Italy
| | - R Dreu
- University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia
| | - R Šibanc
- Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University, 40225 Düsseldorf, Germany
| | - A Paudel
- Research Center Pharmaceutical Engineering (RCPE) GmbH, Inffeldgasse 13, 8010 Graz, Austria; Graz University of Technology, Institute for Process and Particle Engineering, Inffeldgasse 13, 8010 Graz, Austria
| | - J G Khinast
- Research Center Pharmaceutical Engineering (RCPE) GmbH, Inffeldgasse 13, 8010 Graz, Austria; Graz University of Technology, Institute for Process and Particle Engineering, Inffeldgasse 13, 8010 Graz, Austria.
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Calzolari V, Barbato G, Crosato M, DE Mattia L, Daniotti A, Indiani S, Squasi PAM, Olivari Z. A Nonfluoroscopic Technique for Coronary Arteries Three-Dimensional Mapping during Epicardial Ventricular Tachycardia Ablation. Pacing Clin Electrophysiol 2016; 40:330-332. [PMID: 27943299 DOI: 10.1111/pace.12984] [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] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/02/2016] [Accepted: 11/26/2016] [Indexed: 11/30/2022]
Abstract
When performing epicardial ablation of ventricular tachycardia (VT), caution must be taken not to damage the coronary arteries. We report a case in which a new, nonfluoroscopic technique for incorporating an accurate, real-time reconstruction of the main coronary vessels into a three-dimensional electroanatomic map was used for epicardial VT ablation.
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33
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Ricci RP, Vaccari D, Morichelli L, Zanotto G, Calò L, D'Onofrio A, Curnis A, Pisanò EC, Nangah R, Brieda M, Calzolari V, Melissano D, Rovai N, Gargaro A. Stroke incidence in patients with cardiac implantable electronic devices remotely controlled with automatic alerts of atrial fibrillation. A sub-analysis of the HomeGuide study. Int J Cardiol 2016; 219:251-6. [DOI: 10.1016/j.ijcard.2016.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
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Rordorf R, Taravelli E, Forleo G, Giannola G, Calzolari V, Tadeo G, Rossi S, Vicentini A, Curnis A, Serra P, Parisi Q, Calo' L. 176-51: Performance of the St.Jude Durata ICD lead: long-term results of a multicenter study. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i130a] [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: 11/13/2022] Open
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35
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Bertini M, Giofre' F, Campana A, Rosa CL, Zanon F, Santamaria M, Attala S, Baiocchi C, Vado A, Tomasi C, Pierantozzi A, Calzolari V, Infusino T, Boggian G, Licciardello G, Lissoni F, Malacrida M, Biffi M. 56-41: Use of Remote Monitoring in the management of ICD end-of-life and the replacement strategy: preliminary data from the DECODE registry. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i42] [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: 11/13/2022] Open
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36
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Ziacchi M, Zucchelli G, Ricciardi D, Morani G, De Ruvo E, Calzolari V, Viani S, Calabrese V, Tomasi L, Calo' L, De Mattia L, Grazia Bongiorni M, Boriani G, Biffi M. 136-61: Left ventricular Attain Performa quadripolar leads: performance and clinical comparison with left ventricular bipolar leads in cardiac resynchronization therapy. Results from the multicenter JUMP Performa analysis. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i105c] [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: 11/13/2022] Open
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37
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Calzolari V, Crosato M, De Mattia L, Squasi PM, Indiani S, Pacetta D. Cardiac resynchronization therapy device implantation guided by electroanatomic mapping system when contrast medium infusion is contraindicated. HeartRhythm Case Rep 2016; 2:244-247. [PMID: 28491679 PMCID: PMC5419771 DOI: 10.1016/j.hrcr.2016.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/30/2022] Open
Affiliation(s)
- Vittorio Calzolari
- Ospedale Ca’ Foncello, Treviso, Italy
- Address reprints and correspondence: Dr Vittorio Calzolari, Arrhythmia and EP Unit, Cardiology Department, Cà Foncello Hospital, Piazzale Ospedale n 1, 31100 Treviso, ItalyArrhythmia and EP Unit, Cardiology Department, Cà Foncello Hospital, Piazzale Ospedale n 1, 31100 TrevisoItaly
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De Mattia L, Calzolari V, Crosato M. The implantable defibrillator that predicted the future. Heart 2015; 102:e2. [PMID: 26661499 DOI: 10.1136/heartjnl-2015-308608] [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: 08/26/2015] [Accepted: 11/06/2015] [Indexed: 11/04/2022] Open
Affiliation(s)
- Luca De Mattia
- Department of Cardiology, Ospedale Civile Ca'Foncello, Treviso, Italy
| | | | - Martino Crosato
- Department of Cardiology, Ospedale Civile Ca'Foncello, Treviso, Italy
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Besenhard M, Faulhammer E, Fathollahi S, Reif G, Calzolari V, Biserni S, Ferrari A, Lawrence S, Llusa M, Khinast J. Accuracy of micro powder dosing via a vibratory sieve–chute system. Eur J Pharm Biopharm 2015; 94:264-72. [DOI: 10.1016/j.ejpb.2015.04.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 04/23/2015] [Accepted: 04/29/2015] [Indexed: 11/15/2022]
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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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41
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Faulhammer E, Llusa M, Wahl PR, Paudel A, Lawrence S, Biserni S, Calzolari V, Khinast JG. Development of a design space and predictive statistical model for capsule filling of low-fill-weight inhalation products. Drug Dev Ind Pharm 2015; 42:221-30. [DOI: 10.3109/03639045.2015.1040416] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- E. Faulhammer
- Institute of Process and Particle Engineering, Graz University of Technology, Graz, Austria,
- Research Center Pharmaceutical Engineering, Graz, Austria,
| | - M. Llusa
- Research Center Pharmaceutical Engineering, Graz, Austria,
| | - P. R. Wahl
- Research Center Pharmaceutical Engineering, Graz, Austria,
| | - A. Paudel
- Research Center Pharmaceutical Engineering, Graz, Austria,
| | - S. Lawrence
- GlaxoSmithKline (GSK), New Frontiers Science Park, Harlow, Essex, UK, and
| | - S. Biserni
- MG2, Pian di Macina di Pianoro, Bologna, Italy
| | | | - J. G. Khinast
- Institute of Process and Particle Engineering, Graz University of Technology, Graz, Austria,
- Research Center Pharmaceutical Engineering, Graz, Austria,
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Faulhammer E, Fink M, Llusa M, Lawrence SM, Biserni S, Calzolari V, Khinast JG. Low-dose capsule filling of inhalation products: Critical material attributes and process parameters. Int J Pharm 2014; 473:617-26. [DOI: 10.1016/j.ijpharm.2014.07.050] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/23/2014] [Accepted: 07/26/2014] [Indexed: 11/28/2022]
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Faulhammer E, Llusa M, Radeke C, Scheibelhofer O, Lawrence S, Biserni S, Calzolari V, Khinast J. The effects of material attributes on capsule fill weight and weight variability in dosator nozzle machines. Int J Pharm 2014; 471:332-8. [DOI: 10.1016/j.ijpharm.2014.05.058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/26/2014] [Accepted: 05/29/2014] [Indexed: 10/25/2022]
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Stabile G, Bertaglia E, Pappone A, Themistoclakis S, Tondo C, Calzolari V, Bottoni N, Arena G, Rebellato L, Del Greco M, De Simone A, Corò L, Avella A, Anselmino M, Pappone C. Low incidence of permanent complications during catheter ablation for atrial fibrillation using open-irrigated catheters: a multicentre registry. Europace 2014; 16:1154-1159. [DOI: 10.1093/europace/euu002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Llusa M, Faulhammer E, Biserni S, Calzolari V, Lawrence S, Bresciani M, Khinast J. The effects of powder compressibility, speed of capsule filling and pre-compression on plug densification. Int J Pharm 2014; 471:182-8. [DOI: 10.1016/j.ijpharm.2014.04.073] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 04/30/2014] [Accepted: 04/30/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Marcos Llusa
- Research Center Pharmaceutical Engineering GmbH, A-8010 Graz, Austria
| | - Eva Faulhammer
- Research Center Pharmaceutical Engineering GmbH, A-8010 Graz, Austria
| | - Stefano Biserni
- MG2, Via del Savena 18, I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - Vittorio Calzolari
- MG2, Via del Savena 18, I-40065 Pian di Macina di Pianoro, Bologna, Italy
| | - Simon Lawrence
- GlaxoSmithKline, New Frontiers Science Park, Third Avenue, Harlow, Essex, CM19 5AW, UK
| | - Massimo Bresciani
- Research Center Pharmaceutical Engineering GmbH, A-8010 Graz, Austria
| | - Johannes Khinast
- Research Center Pharmaceutical Engineering GmbH, A-8010 Graz, Austria; Institute for Particle and Process Engineering, Graz University of Technology, A-8010 Graz, Austria.
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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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47
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Llusa M, Faulhammer E, Biserni S, Calzolari V, Lawrence S, Bresciani M, Khinast J. The effect of capsule-filling machine vibrations on average fill weight. Int J Pharm 2013; 454:381-7. [DOI: 10.1016/j.ijpharm.2013.07.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 11/30/2022]
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48
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Zanon F, Pastore G, Calzolari V, Crosato M, Zecchin M, Longaro F, Bertaglia E, Zoppo F, Neri G, Delise P. New onset of phrenic nerve stimulation during left ventricular pacing at mid-term follow up: a multicenter clinical experience. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Crosato M, Vaccari D, Calzolari V, Neri G, Olivari Z, Mantovan R. Catheter ablation of atrioventricular nodal reentrant tachycardia in patients with a prolonged PR interval at sinus rhythm. J Cardiovasc Med (Hagerstown) 2012; 13:325-9. [PMID: 22343259 DOI: 10.2459/jcm.0b013e3283511f75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Radiofrequency transcatheter ablation is an effective and safe treatment for atrioventricular node reentry tachycardia. Slow pathway ablation is considered the ablative technique of choice, but when atrioventricular nodal reentrant tachycardia is associated with a prolonged PR interval at sinus rhythm, a higher risk of delayed atrioventricular (AV) block has been reported. Studies on the subject are few, enrolling low numbers of patients with variable selection criteria and producing different results. Hence, optimal ablation strategy remains controversial. The aim of this study is to review the available knowledge on the topic. Experience from our centers is also briefly reported.
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Affiliation(s)
- Martino Crosato
- Cardiovascular Department, Treviso Hospital 'Ca' Foncello', Treviso, Italy
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50
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Macle L, Khairy P, Andrade J, Khaykin Y, Mantovan R, De Martino G, Chen J, Morillo C, Novak P, Calzolari V, Guerra P, Nair G, Torrecilla E, Rivard L, Dubuc M, Talajic M, Thibault B, Roy D, Verma A. 343 Incidence and significance of early recurrences associated with different ablation strategies for AF: Insights from the multicenter STAR-AF trial. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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