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Tainta M, Ecay-Torres M, de Arriba M, Barandiaran M, Otaegui-Arrazola A, Iriondo A, Garcia-Sebastian M, Estanga A, Saldias J, Clerigue M, Gabilondo A, Ros N, Mugica J, Barandiaran A, Mangialasche F, Kivipelto M, Arrospide A, Mar J, Martinez-Lage P. GOIZ ZAINDU study: a FINGER-like multidomain lifestyle intervention feasibility randomized trial to prevent dementia in Southern Europe. Alzheimers Res Ther 2024; 16:44. [PMID: 38413990 PMCID: PMC10898038 DOI: 10.1186/s13195-024-01393-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/16/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND GOIZ ZAINDU ("caring early" in Basque) is a pilot study to adapt the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) methodology to the Basque population and evaluate the feasibility and adherence to a FINGER-like multidomain intervention program. Additional aims included the assessment of efficacy on cognition and data collection to design a large efficacy trial. METHOD GOIZ ZAINDU is a 1-year, randomized, controlled trial of a multidomain intervention in persons aged 60+ years, with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥ 6, no diagnosis of dementia, and below-than-expected performance in at least one of three cognitive screening tests. Randomization to a multidomain intervention (MD-Int) or regular health advice (RHA) was stratified by sex, age (>/≤ 75), and cognitive status (mild cognitive impairment (MCI)/normal cognition). MD-Int included cardiovascular risk factor control, nutritional counseling, physical activity, and cognitive training. The primary outcomes were retention rate and adherence to the intervention program. Exploratory cognitive outcomes included changes in the Neuropsychological Test Battery z-scores. Analyses were performed according to the intention to treat. RESULTS One hundred twenty-five participants were recruited (mean age: 75.64 (± 6.46); 58% women). The MD-Int (n = 61) and RHA (n = 64) groups were balanced in terms of their demographics and cognition. Fifty-two (85%) participants from the RHA group and 56 (88%) from the MD-Int group completed the study. More than 70% of the participants had high overall adherence to the intervention activities. The risk of cognitive decline was higher in the RHA group than in the MD-Int group in terms of executive function (p =.019) and processing speed scores (p =.026). CONCLUSIONS The GOIZ-ZAINDU study proved that the FINGER methodology is adaptable and feasible in a different socio-cultural environment. The exploratory efficacy results showed a lower risk of decline in executive function and processing speed in the intervention group. These results support the design of a large-scale efficacy trial. TRIAL REGISTRATION GOIZ ZAINDU feasibility trial was approved and registered by the Euskadi Drug Research Ethics Committee (ID: PI2017134) on 23 January 2018. Retrospectively registered in ClinicalTrials.gov (NCT06163716) on 8 December 2023.
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Affiliation(s)
- Mikel Tainta
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Maria de Arriba
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Myriam Barandiaran
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | | | - Ane Iriondo
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Ainara Estanga
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | - Jon Saldias
- CITA-alzheimer Foundation, Donostia-San Sebastián, País Vasco, Spain
| | | | - Alazne Gabilondo
- Osakidetza, Organización Sanitaria Integrada (OSI) Donostialdea, País Vasco, Spain
- Osakidetza, Organización Sanitaria Integrada (OSI) Bidasoa, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Naia Ros
- University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain
| | - Justo Mugica
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Aitziber Barandiaran
- Osakidetza, Organización Sanitaria Integrada (OSI) Goierri-Urola Garaia, País Vasco, Spain
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Arantzazu Arrospide
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
| | - Javier Mar
- Osakidetza, Organización Sanitaria Integrada (OSI) Debagoiena, País Vasco, Spain
- Instituto de Investigación Sanitaria Biodonostia, Donostia-San Sebastián, Spain
- Instituto de Investigación en Servicios Sanitarios Kronikgune, Barakaldo, Spain
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Tainta M, Ecay M, Iriondo A, Estanga A, Clerigue M, Saldias J, de Arriba M, Garcia‐Sebastian M, Aurtenetxe S, Barandiaran M, Gabilondo A, Mar J, Arrospide A, Vergara I, Mugica J, Mangialasche F, Ngandu T, Kivipelto M, Martinez‐Lage P. Adopting the FINGER multimodal intervention methodology to prevent cognitive decline in Southern Europe: The GOIZ ZAINDU pilot study. Alzheimers Dement 2021. [DOI: 10.1002/alz.056022] [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: 11/08/2022]
Affiliation(s)
- Mikel Tainta
- Organización Sanitaria Integrada Goierri Alto Urola Zumárraga Spain
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | - Mirian Ecay
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | - Ane Iriondo
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | | | - Jon Saldias
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | | | | | - Myriam Barandiaran
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
- Organización Sanitaria Integrada Donostialdea Donostia‐San Sebastian Spain
| | - Alazne Gabilondo
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
- Organización Sanitaria Integrada Bidasoa Irun Spain
| | - Javier Mar
- Biodonostia Health Research Institute Donostia‐San Sebastian Spain
- Gipuzkoa Primary Care – Integrated Health Care Organizations Research Unit, Alto Deba Arrasate Spain
| | - Arantzazu Arrospide
- Biodonostia Health Research Institute Donostia‐San Sebastian Spain
- Gipuzkoa Primary Care – Integrated Health Care Organizations Research Unit, Alto Deba Arrasate Spain
| | - Itziar Vergara
- Biodonostia Health Research Institute Donostia‐San Sebastian Spain
| | - Justo Mugica
- Organización Sanitaria Integrada Goierri‐Alto Urola Beasain Spain
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Ecay M, Tainta M, Mugica J, Arriba M, Ros N, Barandiaran M, Iriondo A, Garcia‐Sebastian M, Estanga A, Aurtenetxe S, Saldias J, Clerigue M, Otaegui A, Gabilondo A, Arrospide A, Martinez‐Lage P. Cognitive results after a FINGER‐like one‐year randomized controlled multidomain intervention: The GOIZ ZAINDU pilot project. Alzheimers Dement 2020. [DOI: 10.1002/alz.042440] [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: 11/10/2022]
Affiliation(s)
- Mirian Ecay
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | - Justo Mugica
- Organización Sanitaria Integrada Goierri‐Alto Urola Beasain Spain
| | - Maria Arriba
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | - Naia Ros
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | - Ane Iriondo
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | | | | | - Jon Saldias
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
| | | | - Ane Otaegui
- CITA Alzheimer Foundation Donostia‐San Sebastian Spain
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Tainta M, de Arriba M, Mugica J, Barandiaran M, Ecay M, Iriondo A, Garcia-Sebastian M, Estanga A, Aurtenetxe S, Saldias J, Clerigue M, Gabilondo A, Martinez-Lage P. P4-005: GOIZ ZAINDU: A FINGER-ADAPTED MULTIDOMAIN LIFESTYLE INTERVENTION TO PREVENT DEMENTIA IN THE BASQUE COUNTRY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3664] [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: 11/29/2022]
Affiliation(s)
- Mikel Tainta
- Fundación CITA-Alzhéimer Fundazioa; San Sebastian Spain
- Organización Sanitaria Integrada Goierri Alto Urola; Zumárraga Spain
| | - Maria de Arriba
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
| | - Justo Mugica
- Organización Sanitaria Integrada Goierri-Alto Urola; Beasain Spain
| | - Myriam Barandiaran
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
- Organización Sanitaria Integrada Donostialdea; Donostia-San Sebastian Spain
| | - Mirian Ecay
- Fundación CITA-Alzheimer Fundazioa; San Sebastian Spain
| | - Ane Iriondo
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
| | | | | | - Sara Aurtenetxe
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
| | - Jon Saldias
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
| | | | - Alazne Gabilondo
- Fundación CITA-Alzheimer Fundazioa, Donostia-San; Sebastian Spain
- Organización Sanitaria Integrada Bidasoa; Irun Spain
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Grandes G, Sanchez A, Cortada JM, Pombo H, Martinez C, Balagué L, Corrales MH, de la Peña E, Mugica J, Gorostiza E. Collaborative modeling of an implementation strategy: a case study to integrate health promotion in primary and community care. BMC Res Notes 2017; 10:699. [PMID: 29208052 PMCID: PMC5717849 DOI: 10.1186/s13104-017-3040-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 08/22/2016] [Accepted: 11/30/2017] [Indexed: 02/08/2023] Open
Abstract
Background Evidence-based interventions are more likely to be adopted if practitioners collaborate with researchers to develop an implementation strategy. This paper describes the steps to plan and execute a strategy, including the development of structure and supports needed for implementing proven health promotion interventions in primary and community care. Results Between 10 and 13 discussion and consensus sessions were performed in four highly-motivated primary health care centers involving 80% of the primary care staff and 21 community-based organizations. All four centers chose to address physical activity, diet, and smoking. They selected the 5 A’s evidence-based clinical intervention to be adapted to the context of the health centers. The planned implementation strategy worked at multiple levels: bottom-up primary care organizational change, top-down support from managers, community involvement, and the development of innovative e-health information and communication tools. Shared decision making and practice facilitation were perceived as the most positive aspects of the collaborative modeling process, which took more time than expected, especially the development of the new e-health tools integrated into electronic health records. Conclusions Collaborative modeling of an implementation strategy for the integration of health promotion in primary and community care was feasible in motivated centers. However, it was difficult, being hindered by the heavy workload in primary care and generating uncertainty inherent to a bottom-up decision making processes. Lessons from this experience could be useful in diverse settings and for other clinical interventions. Two companion papers report the evaluation of its feasibility and assess quantitatively and qualitatively the implementation process.
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Affiliation(s)
- Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service-Osakidetza, BioCruces Health Research Institute, Luis Power 18, 48014, Bilbao, Spain.
| | - Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service-Osakidetza, BioCruces Health Research Institute, Luis Power 18, 48014, Bilbao, Spain
| | - Josep M Cortada
- Deusto Primary Health Care Center, Bilbao-Basurto Integrated Care Organization-Osakidetza, BioCruces Health Research Institute, Luis Power 18, 48014, Bilbao, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service-Osakidetza, BioCruces Health Research Institute, Luis Power 18, 48014, Bilbao, Spain
| | - Catalina Martinez
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service-Osakidetza, BioCruces Health Research Institute, Luis Power 18, 48014, Bilbao, Spain
| | - Laura Balagué
- Iztieta Primary Care Center, Donostialdea Integrated Care Organization-Osakidetza, Avenida de Lezo, s/n, 20100, Renteria, Spain
| | - Mary Helen Corrales
- La Merced Primary Health Care Center, Bilbao-Basurto Integrated Care Organization-Osakidetza, Luis Iraurrizaga 1, 48003, Bilbao, Spain
| | - Enrique de la Peña
- Sondika Primary Health Care Center, Uribe Integrated Care Organization-Osakidetza, Lehendakari Agirre 41, 48160, Sondika, Spain
| | - Justo Mugica
- Beasain Primary Health Care Center, Goieri-Alto Urola Integrated Care Organization-Osakidetza, Bernedo s/n, 20200, Beasain, Spain
| | - Esther Gorostiza
- Matiena Primary Health Care Center, Barrualde-Galdakao Integrated Care Organization-Osakidetza, BioCruces Health Research Institute, Trañabarren 13-Bajo, 48220, Abadiño, Spain
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Sanchez A, Grandes G, Cortada JM, Pombo H, Martinez C, Corrales MH, de la Peña E, Mugica J, Gorostiza E. Feasibility of an implementation strategy for the integration of health promotion in routine primary care: a quantitative process evaluation. BMC Fam Pract 2017; 18:24. [PMID: 28212621 PMCID: PMC5316192 DOI: 10.1186/s12875-017-0585-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 01/19/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Process evaluation is recommended to improve the understanding of underlying mechanisms related to clinicians, patients, context and intervention delivery that may impact on trial or program results, feasibility and transferability to practice. The aim of this study was to assess the feasibility of the Prescribe Healthy Life (PVS from the Spanish "Prescribe Vida Saludable") implementation strategy for enhancing the adoption and implementation of an evidence-based health promotion intervention in primary health care. METHODS A descriptive study of 2-year implementation indicators for the PVS clinical intervention was conducted in four primary health care centers. A multifaceted collaborative modeling implementation strategy was developed to enhance the integration of a clinical intervention to promote healthy lifestyles into clinical practice. Process indicators were assessed for intervention reach, adoption, implementation, sustainability and their variability at center, practice, and patient levels. RESULTS Mean rates of adoption by means of active collaboration among the three main professional categories (family physicians, nurses and administrative personnel) were 75% in all centers. Just over half of the patients that attended (n = 11650; 51.9%) were reached in terms of having their lifestyle habits assessed, while more than a third (33.7%; n = 7433) and almost 10% (n = 2175) received advice or a printed prescription for at least one lifestyle change, respectively. Only 3.7% of the target population received a repeat prescription. These process indicators significantly (p < 0.001) varied by center, lifestyle habit and patient characteristics. Sustainability of intervention components changed thorough the implementation period within centers. CONCLUSIONS The implementation strategy used showed moderate-to-good performance on process indicators related to adoption, reach, and implementation of the evidence-based healthy lifestyle promotion intervention in the context of routine primary care. Sources of heterogeneity and instability in these indicators may improve our understanding of factors required to attain adequate program adoption and implementation through improved implementation strategies.
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Affiliation(s)
- Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, 4ª planta, E48014 Bilbao, Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, 4ª planta, E48014 Bilbao, Spain
| | - Josep M. Cortada
- Deusto Primary Health Care Center, Bilbao-Basurto Integrated Care Organization– Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014 Bilbao, Spain
| | - Haizea Pombo
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, 4ª planta, E48014 Bilbao, Spain
| | - Catalina Martinez
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, 4ª planta, E48014 Bilbao, Spain
| | - Mary Helen Corrales
- La Merced Primary Health Care Center, Bilbao-Basurto Integrated Care Organization – Osakidetza, Luis Iraurrizaga 1, 48003 Bilbao, Spain
| | - Enrique de la Peña
- Sondika Primary Health Care Center, Uribe Integrated Care Organization – Osakidetza, Lehendakari Agirre 41, 48160 Sondika, Spain
| | - Justo Mugica
- Beasain Primary Health Care Center, Goieri-Alto Urola Integrated Care Organization – Osakidetza, Bernedo s/n, 20200 Beasain, Spain
| | - Esther Gorostiza
- Matiena Primary Health Care Center, Barrualde-Galdakao Integrated Care Organization – Osakidetza, BioCruces Health Research Institute, Trañabarren 13-Bajo, 48220 Abadiño, Spain
| | - on behalf of the PVS group
- Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, BioCruces Health Research Institute, Luis Power 18, 4ª planta, E48014 Bilbao, Spain
- Deusto Primary Health Care Center, Bilbao-Basurto Integrated Care Organization– Osakidetza, BioCruces Health Research Institute, Luis Power 18, E48014 Bilbao, Spain
- La Merced Primary Health Care Center, Bilbao-Basurto Integrated Care Organization – Osakidetza, Luis Iraurrizaga 1, 48003 Bilbao, Spain
- Sondika Primary Health Care Center, Uribe Integrated Care Organization – Osakidetza, Lehendakari Agirre 41, 48160 Sondika, Spain
- Beasain Primary Health Care Center, Goieri-Alto Urola Integrated Care Organization – Osakidetza, Bernedo s/n, 20200 Beasain, Spain
- Matiena Primary Health Care Center, Barrualde-Galdakao Integrated Care Organization – Osakidetza, BioCruces Health Research Institute, Trañabarren 13-Bajo, 48220 Abadiño, Spain
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Matorras R, Meabe A, Mendoza R, Prieto B, Ramón O, Mugica J, Aspichueta F, Exposito A. Human chorionic gonadotropin (hCG) plasma levels at oocyte retrieval and IVF outcomes. J Assist Reprod Genet 2012; 29:1067-71. [PMID: 22815004 DOI: 10.1007/s10815-012-9826-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 06/26/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE The aim of our study was to ascertain the influence of hCG levels at oocyte pick-up on IVF outcomes, and their relationship with clinical parameters. METHODS A prospective study was performed including 473 women undergoing IVF, aged under 40 years. Blood samples to analyze hCG levels were obtained at the time of follicular aspiration, 36 h after the administration of 250 μg of recombinant hCG. RESULTS Neither the numbers of oocytes obtained or fertilized, nor the pregnancy rate, were correlated with hCG levels. Moreover, hCG values were very similar in women who did and did not become pregnant (123.3 ± 48.7 and 117.5 ± 44.7 mUI/mL). Cases in which no oocytes were recovered after follicular aspiration had similar hCG levels to those in which more than 1 oocyte was obtained. On the other hand, hCG levels were negatively related to body mass index, weight, and age. CONCLUSIONS These data indicate that after the administration of 250 μg of recombinant hCG, hCG levels are not responsible for failure to recover oocytes. Specifically, there was no correlation between plasma hCG levels and the number of oocytes obtained or other markers of IVF outcome. There was, however, an inverse relationship with BMI, body weight and age.
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Affiliation(s)
- R Matorras
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Cruces University Hospital, C/Plaza de Cruces S/N. 48903 Baracaldo, Vizcaya, Spain.
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Dul EC, van Ravenswaaij-Arts CMA, Groen H, van Echten-Arends J, Land JA, Tyulenev Y, Naumenko V, Kurilo L, Shileiko L, Segal A, Klimova R, Kushch A, Ribas-Maynou J, Garcia-Peiro A, Abad C, Amengual MJ, Benet J, Navarro J, Colasante A, Lobascio AM, Scarselli F, Minasi MG, Alviggi E, Rubino P, Casciani V, Pena R, Varricchio MT, Litwicka K, Ferrero S, Zavaglia D, Franco G, Nagy ZP, Greco E, Romany L, Meseguer M, Garcia-Herrero S, Pellicer A, Garrido N, Dam A, Pijnenburg A, Hendriks JC, Westphal JR, Ramos L, Kremer JAM, Eertmans F, Bogaert V, Puype B, Geisler W, Clusmann C, Klopsch I, Strowitzki T, Eggert-Kruse W, Maettner R, Isachenko E, Isachenko V, Strehler E, Sterzik K, Band G, Madgar I, Brietbart H, Naor Z, Cunha-Filho JS, Souza CA, Krebs VG, Santos KD, Koff WJ, Stein A, Hammoud I, Albert M, Bergere M, Bailly M, Boitrelle F, Vialard F, Wainer R, Izard V, Selva J, Cohen - Bacrie P, Belloc S, de mouzon J, Cohen-Bacrie M, Alvarez S, Junca AM, Dumont M, Douard S, Prisant N, Tomita K, Hashimoto S, Akamatsu Y, Satoh M, Mori R, Inoue T, Ohnishi Y, Ito K, Nakaoka Y, Morimoto Y, Smith VJH, Ahuja KK, Atig F, Raffa M, Sfar MT, Saad A, Ajina M, Braga DPAF, Halpern G, Figueira RCS, Setti AS, Iaconelli Jr. A, Borges Jr. E, Medeiros GS, Borges Jr. E, Pasqualotto EB, Pasqualotto FF, Nadalini M, Tarozzi N, Di Santo M, Borini A, Lopez-Fernandez C, Arroyo F, Caballero P, Nunez-Calonge R, Fernandez JL, Gosalvez J, Gosalvez J, Lopez-Fernandez C, Gosalbez A, Cortes S, Caballero P, Nunez-Calonge R, Zikopoulos K, Lazaros L, Vartholomatos G, Kaponis A, Makrydimas G, Plachouras N, Sofikitis N, Kalantaridou S, Hatzi E, Georgiou I, Belloc S, de Mouzon J, Cohen-Bacrie M, Junca AM, Dumont M, Amar E, Cohen-Bacrie P, Vuillaume ML, Brugnon F, Artonne C, Janny L, Pons-Rejraji H, Fedder J, Bosco L, Ruvolo G, Bruccoleri AM, Manno M, Roccheri MC, Cittadini E, Bochev I, Gavrilov P, Kyurkchiev S, Shterev A, Carlomagno G, Colone M, Condorelli RA, Stringaro A, Calogero AE, Zakova J, Kralikova M, Crha I, Ventruba P, Melounova J, Matejovicova M, Vodova M, Lousova E, Sanchez Toledo M, Alvarez LLeo C, Garcia Garrido C, Resta Serra M, Belmonte Andujar LL, Gonzalez de Merlo G, Crha I, Zakova J, Ventruba P, Lousova E, Pohanka M, Huser M, Amiri I, Karimi J, Goodarzi MT, Tavilani H, Filannino A, Magli MC, Boudjema E, Crippa A, Ferraretti AP, Gianaroli L, Robles F, Magli MC, Crippa A, Filannino A, Ferraretti AP, Gianaroli L, Huang H, Yao DJ, Huang HJ, Li JR, Fan SK, Wang ML, Yung-Kuei S, Amer S, Mahran A, Darne J, Shaw R, Boudjema E, Magli MC, Borghi E, Cetera C, Ferraretti AP, Gianaroli L, Shukla U, Ogutu D, Deval B, Jansa M, Savvas M, Narvekar N, Houska P, Dackland AL, Bjorndahl L, Kvist U, Crippa A, Magli MC, Muzii L, Barboni B, Ferraretti AP, Gianaroli L, Samanta L, Kar S, Yakovenko SA, Troshina MN, Rutman BK, Dyakonov SA, Holmes E, Bjorndahl L, Kvist U, Feijo C, Verza Junior S, Esteves SC, Berta CL, Caille AM, Ghersevich SA, Zumoffen C, Munuce MJ, San Celestino M, Agudo D, Alonso M, Sanjurjo P, Becerra D, Bronet F, Garcia-Velasco JA, Pacheco A, Lafuente R, Lopez G, Checa MA, Carreras R, Brassesco M, Oneta M, Savasi V, Parrilla B, Guarneri D, Laureti A, Pagano F, Cetin I, Ekwurtzel E, Bjorndahl L, Kvist U, Morgante G, Piomboni P, Stendardi A, Serafini F, De Leo V, Focarelli R, Dumont M, Belloc S, Junca AM, Benkhalifa M, Cohen-Bacrie M, De Mouzon J, Entezami F, Cohen-Bacrie P, Junca A, Belloc S, Dumont M, Cohen-Bacrie M, Benkhalifa M, De Mouzon JJ, Entezami F, Cohen-Bacrie P, Mangiarini A, Capitanio E, Paffoni A, Restelli L, Guarneri C, Scarduelli C, Ragni G, Harrison K, Irving J, Martin N, Sherrin D, Yazdani A, Almeida C, Correia S, Rocha E, Alves A, Cunha M, Ferraz L, Silva S, Sousa M, Barros A, Perdrix A, Travers A, Milazzo JP, Clatot F, Mousset-Simeon N, Mace B, Rives N, Clarke HS, Callow A, Saxton D, Pacey AA, Sapir O, Oron G, Ben-Haroush A, Garor R, Feldberg D, Pinkas H, Stein A, Wertheimer A, Fisch B, Palacios E, Gonzalvo MC, Clavero A, Ramirez JP, Rosales A, Mozas J, Bjorndahl L, Castilla JA, Mugica J, Ramon O, Valdivia A, Exposito A, Casis L, Matorras R, Bongers R, Gottardo F, Zitzmann M, Kliesch S, Cordes T, Kamischke A, Schultze-Mosgau A, Buendgen N, Diedrich K, Griesinger G, Crisol L, Aspichueta F, Exposito A, Hernandez ML, Ruiz-Sanz JI, Mendoza R, Matorras R, Sanchez-Tusie AA, Bermudez A, Lopez P, Churchill GC, Trevino CL, Maldonado I, Dabbah J. POSTER VIEWING SESSION - ANDROLOGY. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Caballero Peregrin P, Nunez-Calonge R, Guijarro JA, Ortega L, Cortes S, Gosalvez J, Palini S, De Stefani S, Scala V, Benedetti S, Tagliamonte MC, Catalani S, Primiterra MA, Polli V, Rocchi P, Tiezzi A, Donati L, Pelosi E, Canestrari F, Bulletti C, Garcia-Herrero S, Meseguer M, Martinez-Conejero JA, Romany L, Ruiz M, Horcajadas JA, Pellicer A, Garrido N, Ramon O, Corcostegui B, Crisol L, Exposito A, Mugica J, Matorras R, Kyurkchiev S, Dyulgerova-Nikolova D, Milachich T, Shterev A, Pons Mallol I, Cercas Duque R, Villas Martin C, Brana Pelayo C, Fernandez Shaw S, Arts EGJM, Wester NE, Groen H, van Echten-Arends J, Land JA. SELECTED ORAL COMMUNICATION SESSION, SESSION 70: ANDROLOGY AND SEMINAL FACTORS Wednesday 6 July 2011 14:00 - 15:45. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.70] [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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Fujii R, Fujita S, Waseda T, Oka Y, Takagi H, Tomizawa H, Sasagawa T, Makinoda S, Cavagna M, Braga DPAF, Figueira RCS, Aoki T, Maldonado LGL, Iaconelli A, Borges E, Prabhakar S, Dittrich R, Beckmann MW, Hoffmann I, Mueller A, Kjotrod S, Carlsen SM, Rasmussen PE, Holst-Larsen T, Mellembakken J, Thurin-Kjellberg A, Haapaniemi Kouru K, Morin Papunen L, Humaidan P, Sunde A, von During V, Pappalardo S, Valeri C, Crescenzi F, Manna C, Sallam HN, Polec A, Raki M, Tanbo T, Abyholm T, Fedorcsak P, Tabanelli C, Ferraretti AP, Feliciani E, Magli MC, Fasolino C, Gianaroli L, Wang T, Feng C, Song Y, Dong MY, Sheng JZ, Huang HF, Sayyah Melli M, Kazemi-shishvan M, Snajderova M, Zemkova D, Pechova M, Teslik L, Lanska V, Ketel I, Serne E, Stehouwer C, Korsen T, Hompes P, Smulders Y, Voorstemans L, Homburg R, Lambalk C, Bellver J, Martinez-Conejero JA, Pellicer A, Labarta E, Alama P, Melo MAB, Horcajadas JA, Agirregoitia N, Peralta L, Mendoza R, Exposito A, Matorras R, Agirregoitia E, Ajina M, Chaouache N, Gaddas M, Souissi A, Tabka Z, Saad A, Zaouali-Ajina M, Zbidi A, Eguchi N, Jinno M, Watanabe A, Hirohama J, Hatakeyama N, Choi YM, Kim JJ, Kim DH, Yoon SH, Ku SY, Kim SH, Kim JG, Lee KS, Moon SY, Hirohama J, Jinno M, Watanabe A, Eguchi N, Hatakeyama N, Jinno M, Watanabe A, Hirohama J, Eguchi N, Hatakeyama N, Xiong Y, Liang X, Li Y, Yang X, Wei L, Makinoda S, Tomizawa H, Fujita S, Takagi H, Oka Y, Waseda T, Sasagawa T, Fujii R, Utsunomiya T, Chu S, Li P, Akarsu S, Dirican EK, Akin KO, Kormaz C, Goktolga U, Ceyhan ST, Kara C, Nadamoto K, Tarui S, Ida M, Sugihara K, Haruki A, Hukuda A, Morimoto Y, Albu A, Albu D, Sandu L, Kong G, Cheung L, Lok I, Pinto A, Teixeira L, Figueiredo H, Pires I, Silva Carvalho JL, Pereira ML, Faut M, de Zuniga I, Colaci D, Barrios E, Oubina A, Terrado Gil G, Motta A, Colaci D, de Zuniga I, Horton M, Faut M, Sobral F, Gomez Pena M, Motta A, Gleicher N, Barad DH, Li YP, Zhao HC, Spaczynski RZ, Guzik P, Banaszewska B, Krauze T, Wykretowicz A, Wysocki H, Pawelczyk L, Sarikaya E, Gulerman C, Cicek N, Mollamahmutoglu L, Venetis CA, Kolibianakis EM, Toulis K, Goulis D, Loutradi K, Chatzimeletiou K, Papadimas I, Bontis I, Tarlatzis BC, Schultze-Mosgau A, Griesinger G, Schoepper B, Cordes T, Diedrich K, Al-Hasani S, Gomez R, Jovanovic V, Sauer CM, Shawber CJ, Sauer MV, Kitajewski J, Zimmermann RC, Bungum L, Jacobsson AK, Rosen F, Becker C, Andersen CY, Guner N, Giwercman A, Kiapekou E, Zapanti E, Boukelatou D, Mavreli T, Bletsa R, Stefanidis K, Drakakis P, Mastorakos G, Loutradis D, Malhotra N, Sharma V, Kumar S, Roy KK, Sharma JB, Ferraretti A, Gianaroli L, Magli MC, Crippa A, Stanghellini I, Robles F, Serdynska-Szuster M, Spaczynski RZ, Banaszewska B, Pawelczyk L, Kristensen SL, Ernst E, Toft G, Olsen SF, Bonde JP, Vested A, Ramlau-Hansen CH, Wang FF, Qu F, Ding GL, Huang HF, Gallot V, Genro V, Roux I, Scheffer JB, Frydman R, Fanchin R, Kanta Goswami S, Banerjee S, Chakravarty BN, Kabir SN, Seeber BE, Morandell E, Kurzthaler D, Wildt L, Dieplinger H, Tutuncu L, Bodur S, Dundar O, Ron - El R, Seger R, Komarovsky D, Kasterstein E, Komsky A, Maslansky B, Strassburger D, Ben-Ami I, Zhao XM, Ni RM, Lin L, Dong M, Tu CH, He ZH, Yang DZ, Karamalegos C, Polidoropoulos N, Papanikopoulos C, Stefanis P, Argyrou M, Doriza S, Sisi V, Moschopoulou M, Karagianni T, Mentorou C, Economou K, Davies S, Mastrominas M, Gougeon A, De Los Santos MJ, Garcia-Laez V, Martinez-Conejero JA, Horcajadas JA, Esteban F, Labarta E, Crespo J, Pellicer A, Li HWR, Anderson RA, Yeung WSB, Ho PC, Ng EHY, Yang HI, Lee KE, Seo SK, Kim HY, Cho SH, Choi YS, Lee BS, Park KH, Cho DJ, Hart R, Doherty D, Mori T, Hickey M, Sloboda D, Norman R, Huang RC, Beilin L, Freiesleben N, Lossl K, Johannsen TH, Loft A, Bangsboll S, Hougaard D, Friis-Hansen L, Christiansen M, Nyboe Andersen A, Thum MY, Abdalla H, Martinez-Salazar J, De la Fuente G, Kohls G, Pellicer A, Garcia Velasco JA, Yasmin E, Kukreja S, Barth J, Balen AH, Esra T, Var T, Citil A, Dogan M, Cicek N, Messini CI, Dafopoulos K, Chalvatzas N, Georgoulias P, Anifandis G, Messinis IE, Celik O, Hascalik S, Celik N, Sahin I, Aydin S, Hanna CW, Bretherick KL, Liu CC, Stephenson MD, Robinson WP, Louwers YV, Goodarzi MO, Taylor KD, Jones MR, Cui J, Kwon S, Chen YDI, Guo X, Stolk L, Uitterlinden AG, Laven JSE, Azziz R, Navaratnarajah R, Grun B, Sinclair J, Dafou D, Gayther S, Timms JF, Hardiman PJ, Ye Y, Wu R, Ou J, Kim SD, Jee BC, Lee JY, Suh CS, Kim SH, Jung JH, Moon SY, Opmeer BC, Broeze KA, Coppus SF, Collins JA, Den Hartog JE, Land JA, Van der Linden PJ, Marianowski P, Ng E, Van der Steeg JW, Steures P, Strandell A, Mol BW, Tarlatzi TB, Kyrou D, Mertzanidou A, Fatemi HM, Tarlatzis BC, Devroey P, Batenburg TE, Konig TE, Overbeek A, Hompes P, Schats R, Lambalk CB, Carone D, Vizziello G, Vitti A, Chiappetta R, Topcu HO, Yuksel B, Islimye M, Karakaya J, ozat M, Batioglu S, Kuchenbecker WK, Groen H, Bolster JH, van Asselt S, Wolffenbuettel BH, Land JA, Hoek A, Wu Y, Pan H, Chen X, Wang T, Huang H, Zavos A, Dafopoulos K, Georgoulias P, Messini CI, Verikouki C, Messinis IE, Van Os L, Vink-Ranti CQJ, Rijnders PM, Tucker KE, Jansen CAM, Lucco F, Pozzobon C, Lara E, Galliano D, Pellicer A, Ballesteros A, Ghoshdastidar B, Maity SP, Ghoshdastidar B, Ghoshdastidar S, Luna M, Vela G, Sandler B, Barritt J, Flisser ED, Copperman AB, Nogueira D, Prat L, Degoy J, Bonald F, Montagut J, Ghoshdastidar S, Maity S, Ghoshdastidar B, Chen S, Chen X, Luo C, Zhen H, Shi X, Wu F, Ni Y, Merdassi G, Chaker A, Kacem K, Benmeftah M, Fourati S, Wahabi D, Zhioua F, Zhioua A, Saini P, Saini A, Sugiyama R, Nakagawa K, Nishi Y, Jyuen H, Kuribayashi Y, Sugiyama R, Inoue M, Jancar N, Vrtacnik Bokal E, Virant-Klun I, Lee JH, Kim SG, Cha EM, Park IH, Lee KH, Dahdouh EM, Desrosiers P, St-Michel P, Villeneuve M, Fontaine JY, Granger L, Ramon O, Matorras R, Burgos J, Abanto E, Gonzalez M, Mugica J, Corcostegui B, Exposito A, Tal J, Ziskind G, Ohel G, Paltieli Y, Paz G, Lewit N, Sendel H, Khouri S, Calderon I, van Gelder P, Al-Inany HG, Antaki R, Dean N, Lapensee L, Racicot M, Menard S, Kadoch I, Meylaerts LJ, Dreesen L, Vandersteen M, Neumann C, Zollner U, Kato K, Segawa T, Kawachiya S, Okuno T, Kobayashi T, Takehara Y, Kato O, Jayaprakasan K, Nardo L, Hopkisson J, Campbell B, Raine-Fenning N. Posters * Reproductive Endocrinology (i.e. PCOS, Menarche, Menopause etc.). Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Cazeau S, Bordachar P, Jauvert G, Lazarus A, Alonso C, Vandrell MC, Mugica J, Ritter P. Echocardiographic modeling of cardiac dyssynchrony before and during multisite stimulation: a prospective study. Pacing Clin Electrophysiol 2003; 26:137-43. [PMID: 12687799 DOI: 10.1046/j.1460-9592.2003.00003.x] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Multisite biventricular pacing therapy offers significant clinical improvement in some stimulated patients with electrocardiographic criteria of cardiac dyssynchrony. However, observational data increasingly suggest that patients suffering from congestive heart failure in presence of modest QRS widening may also derive benefit from cardiac resynchronization therapy (CRT), and that some patients can be significantly improved clinically after system implantation despite no apparent change in QRS width. This pilot study explored the value of an echocardiographic model to identify cardiac electromechanical dyssynchrony parameters (EDP) in candidates for CRT, and their potential correction after implantation. The study included 66 consecutive CRT recipients of CRT in NYHA functional class III or IV who had one or more atrioventricular, interventricular or intraventricular dyssynchrony criteria. An immediate improvement was observed in 85% of the population with a partial or total correction of their EDP. However, the modifications in EDP differed considerably between recipients of de novo CRT systems and patients with previously implanted standard pacing systems upgraded with the implantation of a left ventricular lead. EDP measurements appear to identify potential candidates for CRT, and to confirm the success of system implantation.
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Abstract
Interference of electronic antitheft systems (EASs) with pacemakers has been an object of controversy. This study was performed in 204 patients followed by our pacemaker surveillance center. The data from a total of 408-patient exposures to the EAS were analyzed. The device tested consisted of 129 DDD, 71 VVI, and 4 VDD pacemakers from seven manufacturers. The EAS studied consisted of an "acoustomagnetic" system that emits an intermittent 58-kHz signal, and a magnetic audio frequency system that emits a continuous 73-Hz signal. Complete interrogation of the pacemakers was performed before and after the consecutive exposure of the patients to both EASs. Electrocardiograms were recorded while the patients were exposed to the magnetic fields of each EAS for up to 30 seconds. One or more EAS interferences occurred in 17% of patients. EAS was observed in 26 (20%) of 129 patients with DDD, 7 (10%) of 71 patients with VVI, and 2 (50%) of 4 patients with VDD pacemakers. Over twice as many instances of EAS interference were observed with the "acoustomagnetic" system as were with the magnetic audio frequency system. Among pacemakers programmed in the DDD mode, a considerably greater prevalence of interference was observed at the atrial versus ventricular level, despite the same programmed sensing polarity in both chambers in all but one case. Sensing anomalies were the most common EAS induced disturbance, and typically lasted for the duration of exposure. In a few instances of pacing inhibition, the phenomenon was limited to 1 cycle at the onset of EAS exposure. No changes occurred in the programming of the pacemakers, and a single patient experienced palpitation during EAS induced rapid pacing. During exposure to EAS mimicking the normal use of the systems, interference with a variety of pacemakers was relatively common. However, the anomalies observed were transient and the cause of no symptom or device reprogramming. Patients should be advised to not stand unnecessarily in the close proximity of EASs.
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Affiliation(s)
- J Mugica
- Pacing and Electrophysiology Department, Surgical Center Val d'Or, Saint-Cloud, France
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Lazarus A, Taskiran M, Ritter P, Gras D, Cazeau S, Mugica J. Reduction in energy pacing thresholds by overlapping biphasic stimulation versus conventional bipolar pacing. Pacing Clin Electrophysiol 1998; 21:2166-70. [PMID: 9825312 DOI: 10.1111/j.1540-8159.1998.tb01146.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Overlapping biphasic (OLBI) stimulation is a new pacing waveform consisting of two simultaneous monophasic pulses of opposite polarities applied to a bipolar electrode. The goal of this prospective study was to compare, using conventional pacing leads, the acute energy pacing thresholds, measured at 0.5-ms pulse duration, associated with bipolar versus OLBI (mode 7 and mode 8) pulse delivery. RESULTS Thirty one leads were tested in 20 patients. Of these leads, 7 (23%) were implanted chronically, 12 (39%) were in atrial positions, and 19 (61%) in ventricular positions. Energy pacing thresholds were significantly lower (-25.6 +/- 25.6%, P = 0.005) in OLBI mode 8 (1.30 +/- 3.96 microJ) compared to bipolar (1.55 +/- 4.37 microJ) pacing, regardless of the pacing site or length of service of the leads. In contrast, OLBI mode 7, which has an anodal component, at the tip electrode was associated with higher energy pacing thresholds (3.65 +/- 6.48 microJ; +358.3 +/- 219.4%, P = 0.002). CONCLUSIONS Mode 8 OLBI pacing is associated with lower acute energy pacing thresholds when used with bipolar leads in contact with the myocardium. OLBI pacing may increase pacemaker longevity by reducing long-term energy consumption.
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Affiliation(s)
- A Lazarus
- Association Cardiologie Val d'Or, Saint Cloud, France.
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Lazarus A, Cazeau S, Ritter P, Gras D, Mugica J. Reliability of an automatic sensing test with beat-to-beat display of the signal amplitude. Pacing Clin Electrophysiol 1998; 21:1881-4. [PMID: 9793083 DOI: 10.1111/j.1540-8159.1998.tb00006.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In contrast to testing of the capture threshold, the reliability of sensing tests has been little studied. This study was performed to test the automatic sensing algorithm included in the Biotronik pacing systems. The automatic measurements made by the devices were compared with the direct manual measurements made of 271 atrial (72%) or ventricular (28%) electrograms recorded in ten patients. A high correlation (r = 0.995, P < 0.0001) was found between the two types of measurements. The use of this function should facilitate the verification of accurate sensing during the long-term follow-up of pacemaker patients, and offers a tool to analyze the variations in amplitude of intracardiac signals.
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Affiliation(s)
- A Lazarus
- Service de Cardiologie A, Centre Chirurgical Val d'Or, Saint Cloud, France.
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Daubert JC, Ritter P, Le Breton H, Gras D, Leclercq C, Lazarus A, Mugica J, Mabo P, Cazeau S. Permanent left ventricular pacing with transvenous leads inserted into the coronary veins. Pacing Clin Electrophysiol 1998; 21:239-45. [PMID: 9474680 DOI: 10.1111/j.1540-8159.1998.tb01096.x] [Citation(s) in RCA: 206] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This paper describes a preliminary experiment-conducted jointly by 2 centers-of permanent left ventricular pacing using leads inserted by the transvenous route and through the coronary sinus into the cardiac veins of the left ventricle free wall. The aim was to obtain permanent biventricular pacing in a totally endocavitary configuration in patients with severe LV dysfunction and drug-refractory heart failure. Two types of leads were used: nonspecific unipolar leads at the beginning of the experiment, followed by leads specifically designed to be used in the coronary sinus in a second step. The electrode could be fitted in an adequate location in 35 of the 47 patients (75.4%), with a 1.15 +/- 0.7 V acute pacing threshold and 11.8 +/- 5.7 mV R wave amplitude. The success rate was significantly higher with the specific electrodes (81.8% vs 53.3%, p < 0.001). The pacing and sensing thresholds upon implantation were not influenced by the type of lead or by the localization of the cardiac vein that was catheterized (great cardiac vein, lateral vein, postero-lateral or posterior vein, mid cardiac vein). In contrast, the pacing threshold was significantly lower (0.8 +/- 0.2 vs 1.8 +/- 0.8 V; p = 0.002) and the R wave amplitude tended to be greater (13.1 +/- 4.5 mV vs 9.3 +/- 6.5 mV; p = 0.07) when the tip electrode could be inserted distally into the vein, by comparison with a proximal site near the ostium. At the end of follow-up (10.2 +/- 8.7 months), 34 out of the 35 leads were still fully functional, with a chronic pacing threshold of 1.8 +/- 0.7 V and a R wave amplitude of 10.7 +/- 6 mV. To conclude, permanent LV pacing via the transvenous route is possible in most patients, with excellent safety and long-term results.
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Affiliation(s)
- J C Daubert
- Service de Cardiologie A, Hotel Dieu/CHRU 35033 Rennes, France
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Menier R, Talmud J, Kruse J, Klahr E, Mugica J. [The rehabilitation of chronic respiratory insufficiency]. Bull Acad Natl Med 1997; 181:539-52; discussion 552-4. [PMID: 9203741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Respiratory rehabilitation is defined as a medical practice including a multidisciplinary medical program fitting each individual. Personalized retraining by means of exercises, is the master part of it, its aim is to improve the physical fitness in specialised institution then to maintain it when he becomes an out patient. In both cases, this retraining complies with strict rules concerning the mode of exercises (imposed power--duration of sessions--weekly frequency--progressiveness of overloading ...). This codification rests mainly on the recommendations of the American College of Sports Medicine. The choice of intensity at the beginning of the stay will be determined either by the maximal reserve of cardiac frequency or by the ventilatory threshold. This training has to involve extensive muscular mass and must not neglect the upper limbs. Ventilatory physiotherapy also plays an important part. The other components of rehabilitation concern optimisation of bronchodilator treatment, cessation of smoking, health education, physical education and relaxation, appraisal of nutritional status, assessment of therapeutic programs, of the quality of life and a long-term program for reinforcement of acquisitions. The therapeutic programs improve ventilatory performance, maximal oxygen intake, maximal tolerated power and quality of life. An adaptation of the St. George's Respiratory Questionnaire to patients hosted at the TOKI EDER Medical Center points out that the quality of life of patients with chronic respiratory failure is improved very highly significantly by this rehabilitation.
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Affiliation(s)
- R Menier
- CHRU Dupuytren - Service d'Exploration de la Fonction Respiratoire et de la Condition Physique, Limoges
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Cazeau S, Ritter P, Lazarus A, Gras D, Bakdach H, Mundler O, Mugica J. [First experience in treatment of terminal cardiac insufficiency using multisite stimulation]. Bull Acad Natl Med 1996; 180:2065-75; discussion 2075-8. [PMID: 9181997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We hypothesized that the presence of an abnormal ventricular mechanical activation sequence and/or a delayed left ventricular (LV) contraction may have adverse hemodynamic effects in congestive heart failure (CHF) and could be improved by synchronous RV-LV pacing in a multisite (MS) configuration. 8 NYHA IV CHF patients were included with a LV delay due to 1/ preexistent pacemaker in 4 pts (2 VVI and 2 DDD); 2/ left bundle branch block in 2 pts; 3/ intraventricular conduction delays in 2 pts. An acute hemodynamic evaluation was performed. Hemodynamics were optimized in standard RV pacing by modifying RV lead position from apex to outflow tract (RVOT) in VVI for AF patients and in VDD for sinus rhythm patients at different AV delays. RV pacing did not change hemodynamics whatever the lead position. BV pacing improved CI by 25% (p < 0.006), V wave by 26% (p < 0.004) and PCWP by 17% (p < 0.01). Chronic implantation was performed in 7pts. LV lead was implanted via the coronary sinus in 2 cases and epicardial via a thoracoscopic approach in the remaining ones. 1 pt died during LV lead implantation. Hemodynamics were tested at 2 months followup (FU). Switching BV pacing off was associated with immediate deterioration. At 6 +/- 6 months Followup 4 pts are stable in Class II. 1 pt died of cardiac cause. 1 pt could be transplanted at 17 months FU. In conclusion, BV pacing through a multisite configuration is feasible and can help in CHF patients managing.
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Affiliation(s)
- S Cazeau
- Centre Chirurgical du Val d'Or, Saint-Cloud
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20
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Abstract
Our objective was to improve hemodynamics by synchronous right and left site ventricular pacing in patients with severe congestive heart failure (CHF). Previous studies reported a benefit of dual chamber pacing with a short AV delay in patients with severe CHF. Other works, however, show contradictory results. Deleterious effects due to a desynchronization of right (RV) and left ventricular (LV) contractions have been suggested. This study included eight subjects with widened QRS and end-stage heart failure despite maximal medical therapy, who refused, or were not eligible to undergo heart transplantation, Each patient underwent a baseline, invasive hemodynamic evaluation with insertion of three temporary leads to allow different pacing configurations, including RV apex and outflow tract pacing, and biventricular pacing between the RV outflow tract and LV and RV apex and LV. According to the results of this baseline study, the configuration of preexistent pacemakers was modified or new systems were implanted to allow biventricular pacing, which, in patients with sinus rhythm, was atrial triggered. Biventricular pacing increased the mean cardiac index (CI) by 25% (from a baseline of 1.83 +/- 0.30 L/min per m2, P < 0.006), decreased the mean V wave by 26% (from a baseline of 36 +/- 12 mmHg, P < 0.004), and decreased pulmonary capillary wedge pressure by 17% (from a baseline of 31 +/- 10 mmHg, P < 0.01). Four patients died (1 preoperatively, 1 intraoperatively, 2 within 3 months, and 1 of a noncardiac cause). The four surviving patients have clinically improved from New York Heart Association Functional Class IV to Class II. In these survivors, CI decreased by 15% (P < 0.007) when multisite pacing was turned off during follow-up. In patients with end-stage heart failure, multisite pacing may be associated with a rapid and sustained hemodynamic improvement.
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Affiliation(s)
- S Cazeau
- Centre Chirurgical du Val d'Or, Saint-Cloud, France
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21
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Deharo JC, Badier M, Thirion X, Ritter P, Provenier F, Graux P, Guillot C, Mugica J, Jordaens L, Djiane P. A randomized, single-blind crossover comparison of the effects of chronic DDD and dual sensor VVIR pacing mode on quality-of-life and cardiopulmonary performance in complete heart block. Pacing Clin Electrophysiol 1996; 19:1320-6. [PMID: 8880795 DOI: 10.1111/j.1540-8159.1996.tb04210.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of this study was to compare DDD and dual sensor VVIR (activity and QT) pacing modes in complete AV block (CAVB). Eighteen patients (14 men and 4 women, aged 70 +/- 6.5 years) implanted with a dual chamber, dual sensor pacemaker for CAVB with normal sinus node chronotropic function were studied. A quality-of-life and cardiovascular symptom questionnaire, and a treadmill exercise test were completed after a period of VVIR and a period of DDD pacing, each lasting 1 month. Overall quality-of-life and cardiovascular symptoms did not significantly differ, though three patients felt discomfort during VVIR mode. There was no significant statistical difference in cardiopulmonary parameters. DDD and VVIR modes yielded the following respective data: maximum heart rate = 105.7 +/- 21.8 beats/minute versus 107.6 +/- 21.6 beats/minute (NS); maximum workload = 60 +/- 33.4 W versus 59.3 +/- 37.8 W (NS); treadmill duration = 10.1 +/- 3.8 minute versus 10.1 +/- 3.6 minute (NS); oxygen consumption at anaerobic threshold = 14.6 +/- 4.1 mL/kg per minute versus 14.9 +/- 4.6 mL/kg per minute (NS); maximum minute ventilation = 49.6 +/- 9L/min versus 46 +/- 12 L/min (NS); and respiratory quotient = 1.08 +/- 0.15 versus 1.08 +/- 0.13 (NS). We conclude that, during a 1-month follow-up period, no difference was found between DDD and dual sensor VVIR (QT and activity) pacing modes in CAVB patients with regard to quality-of-life and cardiopulmonary performance, though a trend toward an increased sense of well being was noted with the DDD mode.
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Affiliation(s)
- J C Deharo
- Department of Cardiology, Hôpital Sainte-Marguerite, Marseille, France
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Garrigue S, Cazeau S, Ritter P, Lazarus A, Gras D, Mugica J. [Incidence of atrial arrhythmia in patients with long term dual-chamber pacemakers. Contribution of the Holter function of pacemakers]. Arch Mal Coeur Vaiss 1996; 89:873-881. [PMID: 8869249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The extension of the RAM memories in the latest generation of pacemakers has enabled development of Holter function allowing continuous surveillance of the cardiac rhythm. Between October 1991 and February 1995, 213 patients implanted with a Chorus 6234 or 7034 (Ela Medical) pacemaker, functioning in the DDD (R) mode, were followed up using the implanted continuous Holter function. Of the patients with no documented supraventricular arrhythmia (SVA) before implantation (n = 154), 67 (43.5%) developed SVA during an average period of one year. Male patients (p = 0.01; OR = 7.5 on multivariate analysis), high degrees of AVB (p = 0.03) and the presence of isolated or bursts of atrial extrasystoles (p = 0.004) were independent risk factors for SVA. The average time to detection of SVA was 207 days. In patients with documented SVA before implantation (n = 59), 22 (37.3%) had no recurrence during follow-up; in the other 37 cases, the average period before recurrence was 127 days. Multivariate analysis did not reveal any independent risk factor for recurrence of the arrhythmias. On the other hand, persistent but delayed atrioventricular conduction (1 degree AVB, long H-V interval or bifascicular block), seemed to protect against SVA, independently of other variables and of antiarrhythmic therapy (p = 0.008). These results suggest a high prevalence of SVA in patients on long-term pacemaker therapy, most episodes being asymptomatic. The implanted Holter function would therefore seem to be an essential tool for investigating and following up the natural history of arrhythmias in these patients.
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Affiliation(s)
- S Garrigue
- Service du Pr Clementy, hôpital cardiologique du Haut-Lévêque, Pessac
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23
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Cazeau S, Ritter P, Lazarus A, Ducongé R, Henry L, Podeur H, Lazarus B, Mugica J. Pacemaker miniaturization: a good trend? French Group of Cardiac Pacing. Pacing Clin Electrophysiol 1996; 19:1-3. [PMID: 8848364 DOI: 10.1111/j.1540-8159.1996.tb04783.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
UNLABELLED The extension of random access memory now makes it possible to store electrocardiographic (ECG) information, referred to here as Holter function (HF), in the memories of new pacemakers, which can be used as diagnostic tools during long-term follow-up. This report describes our experience in 26 consecutive patients for whom the device was used to detect episodes of atrial arrhythmias (AA). An illustrative case is also presented to describe in detail the device's analytical method. RESULTS Fourteen AA profiles were successfully recorded in 10 patients by the pacemaker HF and correlated with confirmatory simultaneous surface ECG tracings. Three additional profiles were recorded in three other patients without simultaneous ECG recordings. A diagnosis of AA is established when the following findings are combined: (1) in all cases a large number of short interatrial intervals (A INT); (2) in presence of AV block, interventricular intervals (V INT) stored between the lower programmed pacing rate and the upper rate limit or the fallback rate; (3) in absence of AV block, V INT stored between the basic rate and the AV node refractory period; (4) in case of fallback, (VVI function) no stored AV INT; and (5) in absence of fallback, great variability of AV INT (Wenckebach function). CONCLUSIONS (1) Diagnoses of AA can be made with the pacemaker HF; (2) The homogeneity of the HF profiles makes them useful for long-term follow-up and will probably contribute and clarify the natural history of AA in DDD patients; (3) HF may also serve to monitor the safety and efficacy of antiarrhythmic drug therapy during long-term follow-up.
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Affiliation(s)
- S Cazeau
- Centre Chirurgical du Val d'Or, Saint-Cloud, France
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Abstract
A 54-year-old man received a four chamber pacing system for severe congestive heart failure (NYHA functional Class IV). His ECG showed a left bundle branch block (200-msec QRS duration) with 200-msec PR interval, normal QRS axis, and 90-msec interatrial interval. An acute hemodynamic study with insertion of four temporary leads was performed prior to the implant, which demonstrated a significant increase in cardiac output and decrease of pulmonary capillary wedge pressure. A permanent pacemaker was implanted based on the encouraging results of the acute study. The right chamber leads were introduced by cephalic and subclavian approaches. The left atrium was paced with a coronary sinus lead, Medtronic SP 2188-58 model. An epicardial Medtronic 5071 lead was placed on the LV free wall. The four leads were connected to a standard bipolar DDD pacemaker, Chorus 6234. The two atrial leads were connected via a Y-connector to the atrial channel of the pacemaker with a bipolar pacing configuration. The two ventricular leads were connected in a similar fashion to the ventricular channel of the device. The right chamber leads were connected to the distal poles. The left chamber leads were connected to the proximal poles of the pacemaker. Six weeks later, the patient's clinical status improved markedly with a weight loss of 17 kg and disappearance of peripheral edema. His functional class was reduced to NYHA II. Four chamber pacing is technically feasible. In patients with evidence of interventricular dyssynchrony, this original pacing mode probably provides a mechanical activation sequence closer to the natural one.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S Cazeau
- Val d'Or Surgical Centre, St. Cloud, France
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26
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Mugica J. Importance of a systematic long-term follow-up to guide the choice of pacemaker electrodes: the experience of a single center with 18,132 leads. Pacing Clin Electrophysiol 1994; 17:1995-2000. [PMID: 7845805 DOI: 10.1111/j.1540-8159.1994.tb03787.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J Mugica
- Pacing Department, Centre Chirurgical Val d'Or, Saint-Cloud, France
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27
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Abstract
Noninvasive transcutaneous cardiac pacing has evolved from a simple stand alone unit with no ventricular sensing to a complete cardiac arrest resuscitation system combining synchronous pacing and defibrillation capabilities and using a single set of multifunction electrodes. In current instrumentation, four configurations exist including stand alone unit, modular configuration, built-in monitor and recorder, and built-in monitor, recorder and defibrillator. In present day devices, ventricular sensing, extensive programmability, and large surface electrodes are general features. Capture monitoring requires specific integrated electrocardiographic capability. Future developments are expected to involve low threshold electrode technology, integrated mechanical monitoring, and interdevice electrode compatibility.
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Affiliation(s)
- J A Trigano
- Centre Hospitalier Universitaire Marseille Nord, France
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28
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Abstract
A controversy arose some 10 years ago over the reliability of polyurethane lead insulation. On the basis of one of the longest standing and largest databanks worldwide, the authors compare the cumulative survival of several thousand polyurethane, standard silastic, and high-performance silastic electrodes as it pertains to the failure criterion described as insulation degradation. With the possible exception of the Medtronic 6972 (Medtronic, Inc.) electrode, polyurethane electrodes have a 100% reliability at 84 months, which is similar to silastic electrodes.
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Affiliation(s)
- J Mugica
- Département de Stimulation Cardiaque, Centre Chirurgical, Val d'Or, Saint-Cloud, France
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Zegelman M, Winter UJ, Alt E, Treese N, Kreuzer J, Henry L, Mugica J, Schroeder E, Klein H, Völker R. Effect of different body-exercise modes on the rate response of the temperature-controlled pacemaker Nova MR. Thorac Cardiovasc Surg 1990; 38:181-5. [PMID: 2375035 DOI: 10.1055/s-2007-1014015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In order to evaluate the effect of different modes of physical exercise on the rate response of the temperature-controlled Nova MR, parameters such as temperature behaviour and correlation of work load to pacing rate were investigated using different types and protocols of stress testing. This study considered 21 patients (age: 66 +/- 12 y). The indications for the Nova MR were AV block (n: 14) and sick sinus syndrome (n: 7). The patients performed two different types of exercise (treadmill n: 13, bicycle n: 14) based on different protocols. We registered the surface ECG, pacing rate, exercise time, and (via data transmission by the RX 2000 programmer) blood temperature and pacing rate. An adequate rate response could be achieved with all the different types of exercise and protocols using more sensitive program settings. The type of stress testing used to adjust or evaluate the Nova MR seems to be secondary, although cycling as compared with treadmill exercise resulted in a slightly weakened reaction of temperature and pacing rate. Our investigations revealed a good correlation between work load and pacing rate independent of the type of stress testing. The initial DIP (48%) is not a constant phenomenon and showed inter- and intraindividual variations. Impressive psychological influences also exhibited an effect on temperature and pacing rate, sometimes preventing a DIP response. During exercise at lower work loads (under 50 watts, shorter than 3-4 min) the rate response of the Nova MR--without any detected DIP--is often delayed due either to a decrease or to a late and flat increase in temperature. An additional fast-reacting sensor could be advantageous in triggering the initial rate response in such cases.
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Affiliation(s)
- M Zegelman
- Dept. of Thoracic and Cardiovascular Surgery, University Hospital, Franfurt a.M., FRG
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32
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De Gandarias JM, Irazusta J, Echevarria E, Mugica J, Casis L. Pre- and postnatal aminopeptidase activities in the rat brain. Int J Dev Biol 1989; 33:491-3. [PMID: 2641355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Research concerning the functional role of brain peptides is performed, in part, by studying peptidase enzymes which might be involved in brain peptide processing or inactivation. Aminopeptidase (AP) activity has been proposed as a candidate regulator of the degradation of these peptides. In this paper, changes in Lys- and Leu-aminopeptidase activities in rat brain hemispheres, cerebellum and medulla were examined in 20 day fetuses and one day postnatal subjects. Aminopeptidase activities were studied by measuring the rate of hydrolysis of the artificial substrates Lys- and Leu-2-naphthylamides (fluorimetrically detected in triplicate). Both enzyme activities increase from the last fetal stage up to the first day of birth in all the brain areas examined except for the case of Leu-AP activity in the medulla. It is suggested that these activities play a part in the neurochemical changes that take place during rat brain maturation, possibly by regulating the activity of several neuroactive peptides.
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Affiliation(s)
- J M De Gandarias
- Department of Physiology, University of the Basque Country, Leioa, Spain
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33
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Abstract
Recent developments in cardiac pacemaker electrodes have resulted in significant benefits to the group of pacemaker patients as a whole. The results of analysis of 2,818 chronic pacemaker electrodes are presented. These electrodes are divided into major categories according to their particularities: platinum iridium, elgiloy, carbon-tip, anodized platinum and granulated iridium-platinum. All leads were in the ventricular position. The results of acute and chronic threshold measurements reveal that carbon-tipped electrodes appear to have the most favorable overall characteristics. This will have a major influence on long-term pacing practices.
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Affiliation(s)
- J Mugica
- Centre Chiruigical du Val d'Or, Saint Cloud, France
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34
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Abstract
We performed atrial EP studies (atrial substrate evaluation) on 10 patients. These patients had evidence of paroxysmal, sustained, recurrent atrial arrhythmias (7 men and 3 women with a mean age of 64 +/- 15 years). All patients combined a brady-tachy syndrome; 7 patients had a sick sinus syndrome (SSS) and 3 patients a typical vagally induced atrial arrhythmia. No anti-arrhythmic drug was allowed in 3 patients with SSS, 1 drug failed in 4 patients and the combination of 2 drugs failed in 3 patients during the first to eighth years prior to pacemaker implantation. Atrial substrate evaluation was feasible in all these patients off anti-arrhythmic therapy and showed important abnormalities of atrial loco-regional conduction parameters and long refractory periods (RP). The remarkable point was, in 7 patients, a paradoxical improvement in intra-atrial conduction delay at rapid pacing rate. The DDD pacing mode was chosen in all patients. No technical problem occurred during implantation. Atrial pacing rate was programmed to be slightly higher than the mean diurnal heart rate calculated on Holter monitoring. After implantation, the mean follow-up period was 18 +/- 25 months with an average of one Holter every 4 months during the first 2 years. The 7 patients who improved intra-atrial conduction at rapid pacing rate were controlled without drugs, 2 patients were controlled with 1 drug, and 1 patient with 2 drugs. Atrial pacing in the DDD mode in a selected group of patients prevents paroxysmal and drug-resistant atrial arrhythmias. Atrial substrate evaluation is a sensitive tool for assuring the long-term benefit of atrial pacing.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Attuel
- Centre Medico-Chirurgical du Val d'Or, Saint-Cloud, France
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35
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Herbeau C, Herbeau S, Charlon D, Mugica J. [Midazolam-fentanyl for implantation of an intracavitary cardiac pacemaker]. Cah Anesthesiol 1987; 35:555-8. [PMID: 3442746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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36
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Abstract
Direct diaphragmatic stimulation is effective without discomfort to the patient and without muscular fatigue. However, some quadriplegic patients may require synchronous expiratory stimulation in order to obtain complete and permanent respiratory autonomy. Now it will be necessary to undertake further studies of the indications for direct diaphragm stimulation.
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37
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Attuel P, Rancurel G, Delgatte B, Colcher E, Chazoullieres P, Friocourt P, Mugica J, Coumel P. Importance of atrial electrophysiology in the work-up of cerebral ischemic attacks. Pacing Clin Electrophysiol 1986; 9:1121-6. [PMID: 2432519 DOI: 10.1111/j.1540-8159.1986.tb06680.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Recent data suggest that a large proportion of ischemic strokes are due to embolic phenomena from the heart. Atrial fibrillation appears to be one of the principal causes of embolization. If electrophysiologic parameters are considered as determining factors, the existence of atrial hypervulnerability in patients with embolic strokes is significant, when arrhythmia has been excluded as an etiology. This study suggests that an aggressive approach to early diagnosis and management through electrophysiologic studies might aid in preventing future neurologic attacks.
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38
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Abstract
Because of the increased complexity of modern pacemakers, pacemaker follow-up visits in specialized centers become more and more indispensable. In this study, the results of 15,000 outpatient visits to the cardiac pacing center between the years 1983-1985 are presented. In most cases (92.8%), verification of normal function was made; however, mandatory reprogramming was required in 1.2%, and hospitalization for various reasons was required in 6% of visits. Careful outpatient monitoring of pacemakers is therefore very important for detecting early or late pacemaker complications.
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39
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Abstract
This study analyzed the results of 3,701 patients implanted with cardiac pacemakers at the Centre Chirurgical du Val d'Or between 1976 and 1981. Two pacemaker populations were compared: those having a new pacemaker and those implanted with a reused pacemaker. There were no statistically significant differences between the two groups, either in terms of indications for implantation or in terms of actuarial survival of patients. In addition, there was no significant change in survival of the pulse generator. The reutilization of pacemakers appeared to be in no way detrimental to patients.
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40
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Abstract
Since 1980, we have implanted 910 carbon tip leads from three different manufacturers. The pacing thresholds from these leads were compared to those of standard polished platinum electrode configurations. Our major findings are that while acute voltage thresholds are not significantly different, two of the three carbon tip leads that we used in the study have statistically lower chronic thresholds then polished platinum leads (p less than or equal to 0.01).
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41
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Mugica J, Dejean D, Bourgeois I, Smits K, Bisson A. [Assisted respiration by stimulation of the diaphragmatic muscle. A case]. Presse Med 1985; 14:1919-20. [PMID: 2933694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Direct electrical stimulation of the diagram has resulted in physiological functioning in a quadriplegic patient. Mechanical ventilation could be partly withdrawn with 13-hour periods of "respiration". During the 2-month stay in hospital, 90 hours of respiration were obtained by stimulation. The patient died 8 weeks after the operation.
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42
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Herbeau C, Charlon D, Herbeau S, Mugica J. [Flunitrazepam-fentanyl for the intracavitary placement of pacemakers]. Cah Anesthesiol 1984; 32:69-73. [PMID: 6529698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Eight hundred pacemaker have been placed under general anaesthesia associating flunitrazepam-fentanyl, with a good comfort and safety for those patients old and often weak.
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43
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Abstract
The different possibilities for programming modern pacemakers are discussed. A pacemaker based on hardware alone provides highly reliable pacing within narrow limits. On the other hand, a totally software-based pacemaker would provide maximum flexibility in terms of programming but would remain more susceptible to errors in software. A middle solution might be one that divides the program between passive ROM and active RAM memories. This alternative may provide sophistication without sacrificing safety.
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44
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Coumel P, Attuel P, Friocourt R, Chouty F, Mugica J. ARRHYTHMOGENIC EFFECT OF VAGAL DRIVE ON THE ATRIUM. Pacing Clin Electrophysiol 1984. [DOI: 10.1111/j.1540-8159.1984.tb05712.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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45
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Coumel P, Friocourt P, Mugica J, Attuel P, Leclercq JF. Long-term prevention of vagal atrial arrhythmias by atrial pacing at 90/minute: experience with 6 cases. Pacing Clin Electrophysiol 1983; 6:552-60. [PMID: 6191292 DOI: 10.1111/j.1540-8159.1983.tb05295.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Six patients (5 men, 1 woman) with a history ranging from 3-16 years of resistant vagal atrial arrhythmias were treated by atrial pacing at a rate of 90/Min. These patients have been followed up for an average of 5.5 years (range 2-11 years) with favorable results. The arrhythmias were characterized by daily or weekly attacks of typical atrial flutter and atrial fibrillation occurring mainly or exclusively at night, at rest, or in the digestive periods in otherwise normal hearts of middle-aged patients (first attack between 25 and 54, mean 40). The arrhythmias were resistant to quinidine, and were usually aggravated by digitalis, beta-blockers and verapamil. Amiodarone is usually the only effective drug in this syndrome, but was not used before pacing in the 2 first cases, and was ineffective in the other 4 cases. Electrophysiologic studies confirmed the absence of sick sinus syndrome, and the close relationship between relative bradycardia and the onset of the arrhythmia. Atrial pacing alone totally controlled the arrhythmia in 1 patient; amiodarone was used in conjunction with pacing in 3 patients. In 1 patient the improvement was clear but incomplete, and in 1 patient permanent atrial fibrillation occurred shortly after pacemaker implantation.
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46
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Podeur H, Mugica J, Rollet M. [The daily life of the patient with a cardiac pacemaker]. Soins Chir 1983:43-44. [PMID: 6604329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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47
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Herbeau C, Herbeau M, Mugica J, Giesberger MP, Mouillard MC. [Placement of a cardiac pacemaker. General anesthesia or not?]. Soins Chir 1983:22-3. [PMID: 6604325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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48
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Henry L, Mugica J, Attuel P, Rollet M, Podeur H. [Why implant a cardiac pacemaker? Review of physiology and electrocardiography, diagnosis and indications]. Soins Chir 1983:3-8. [PMID: 6604328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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49
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Mugica J. [Ideal criteria for a center for cardiac pacing]. Soins Chir 1983:45. [PMID: 6604330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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50
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Mugica J, Rollet M, Podeur H, Henry L, Martel S. [The preoperative period in cardiac pacing (transport, arrival, admission, hospitalization)]. Soins Chir 1983:14-9. [PMID: 6604323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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