0000000000276871
AUTHOR
Aurelio Quesada
Reliable Paroxysmal Atrial Fibrillation Substrate Assessment During Sinus Rhythm Through Optimal Estimation of Local Activation Waves Dynamics
[EN] The analysis of coronary sinus (CS) electrograms (EGMs) during catheter ablation (CA) of atrial fibrillation (AF) is highly important for AF substrate evaluation. However, channels of the CS catheter may be affected by vigorous cardiac movement and bad contact. This work investigates the most reliable channels in preserving the AF dynamics during sinus rhythm (SR). Local activation waves (LAWs) were detected in 44 bipolar CS recordings of 60-300 seconds duration in 28 paroxysmal AF patients undergoing CA. Recordings consisted of five channels: distal, mid-distal, medial, mid-proximal and proximal. LAW duration, amplitude, area and correlation between dominant morphologies of each chann…
Survival with Cardiac-Resynchronization Therapy in Mild Heart Failure
BACKGROUND The Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT) showed that early intervention with cardiac-resynchronization therapy with a defibrillator (CRT-D) in patients with an electrocardiographic pattern showing left bundle-branch block was associated with a significant reduction in heart-failure events over a median follow-up of 2.4 years, as compared with defibrillator therapy alone. METHODS We evaluated the effect of CRT-D on long-term survival in the MADIT-CRT population. Post-trial follow-up over a median period of 5.6 years was assessed among all 1691 surviving patients (phase 1) and subsequently among 854 patients who w…
Prognostic value of troponin I in atrial fibrillation
To evaluate whether circulating cardiac troponin I (cTnI) levels are associated with worst outcomes in patients with atrial fibrillation (AF).Consecutive patients visiting the emergency room (ER) with a new episode of a previously diagnosed AF or a new diagnosis of AF during ER admission between January 1st, 2010 and December 31st, 2015, were enrolled in the study (n = 2617). After applying exclusion criteria and eliminating repeated episodes, 2013 patients were finally included. Of these, 1080 patients with at least one cTnI measurement in the ER were selected and classified into 4 groups according to cTnI quartiles: Q1 (n = 147) cTnI10 ng/L (Group 1); Q2 (n = 254): 10-19 ng/L (Group 2); Q…
Managed ventricular pacing vs. conventional dual-chamber pacing for elective replacements: the PreFER MVP study: clinical background, rationale, and design
Udgivelsesdato: 2008-Mar AIMS: Several clinical studies have shown that, in patients with intact atrioventricular (AV) conduction, unnecessary chronic right ventricular (RV) pacing can be detrimental. The managed ventricular pacing (MVP) algorithm is designed to give preference to spontaneous AV conduction, thus minimizing RV pacing. The clinical outcomes of MVP are being studied in several ongoing trials in patients undergoing a first device implantation, but it is unknown to what extent MVP is beneficial in patients with a history of ventricular pacing. The purpose of the Prefer for Elective Replacement MVP (PreFER MVP) study is to assess the superiority of the MVP algorithm to convention…
Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients
OBJECTIVES The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients. BACKGROUND Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited. METHODS A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up thro…
Reliability of Local Activation Waves Features to Characterize Paroxysmal Atrial Fibrillation Substrate During Sinus Rhythm
[EN] Analysis of coronary sinus (CS) electrograms (EGMs) is vastly used for the assessment of the atrial fibrillation (AF) substrate. As a catheter consists of five dipoles (distal, mid-distal, medial, mid-proximal, proximal), results may vary upon the employed channel: myocardial contraction and bad contact are unavoidable factors affecting the recording. This work aims to specify the most reliable channels in catching AF dynamics, using 44 multichannel bipolar CS recordings in sinus rhythm (SR) of paroxysmal AF with 1-5 minutes duration. Local activation waves (LAWs) were detected and main features obtained: duration, amplitude, area and correlation between dominant morphologies of each c…
Recommendations of the European Cardiac Arrhythmia Society Committee on Device Failures and Complications
Recommendations of the European Cardiac Arrhythmia Society Committee on Device Failures and Complications MASSIMO SANTINI,* JOHANNES BRACHMANN,† RICCARDO CAPPATO,‡ WYN DAVIES,§ JERONIMO FARRE,‖ SAMUEL LEVY,¶ AURELIO QUESADA,# RENATO P. RICCI,** EDWARD ROWLAND,†† NEIL SULKE‡‡ From *San Filipo Neri Hospital, Rome, Italy, †Klinikum Coburg, Germany, ‡Policlinico S. Donato, Milan, Italy, §St. Mary Hospital, London, UK, ‖Fundacion Jimenez Diaz, Madrid, Spain, ¶Hopital Nord des Bourrellys, Marseille, France, #Hospital General University of Valencia, Spain, **San Filippo Neri Hospital, ††St. George Medical School, London, UK, ‡‡Eastbourne General Hospital, Sussex, UK