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  1. Article: Left Ventricular Lead Placement for Biventricular Pacing in a Left Lateral Vein in a Patient with Congenital Atresia of the Coronary Sinus Ostium.

    Santoro, Amato / Barilli, Maria / Sisti, Nicolò / di Florio, Alex / Baiocchi, Claudia / Muzzi, Luigi / Neri, Eugenio

    The Journal of innovations in cardiac rhythm management

    2023  Volume 14, Issue 2, Page(s) 5328–5331

    Abstract: Coronary sinus ostial atresia (CSOA) is a rare kind of congenital heart anomaly. This creates a new drainage pathway for the cardiac venous flow, with the most common being a persistent left superior vena cava (PLSVC). During the implantation of a ... ...

    Abstract Coronary sinus ostial atresia (CSOA) is a rare kind of congenital heart anomaly. This creates a new drainage pathway for the cardiac venous flow, with the most common being a persistent left superior vena cava (PLSVC). During the implantation of a cardiac resynchronization therapy defibrillator, we discovered a case of CSOA in a patient who underwent aortic valve and ascending aorta replacement. CSOA led to the research and subsequent identification of a PLSVC, which drained in the CS. The left ventricular pacing lead was appropriately placed in a left lateral vein. This case report highlights the technical aspects and procedural difficulties that characterize this specific anatomical variant.
    Language English
    Publishing date 2023-02-15
    Publishing country United States
    Document type Case Reports
    ISSN 2156-3977
    ISSN 2156-3977
    DOI 10.19102/icrm.2023.14021
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Multimodality Imaging for Selecting Candidates for CRT: Do We Have a Single Alley to Increase Responders?

    Sisti, Nicolò / Cardona, Andrea / Baldi, Enrico / Sciaccaluga, Carlotta / Notaristefano, Francesco / Santoro, Amato / Mandoli, Giulia Elena / Cameli, Matteo

    Current problems in cardiology

    2023  Volume 49, Issue 1 Pt C, Page(s) 102150

    Abstract: Cardiac resynchronization therapy has evolved in recent years to provide a reduction of morbidity and mortality for many patients with heart failure. Its application and optimization is an evolving field and its use requires a multidisciplinary approach ... ...

    Abstract Cardiac resynchronization therapy has evolved in recent years to provide a reduction of morbidity and mortality for many patients with heart failure. Its application and optimization is an evolving field and its use requires a multidisciplinary approach for patient and device selection, technical preprocedural planning, and optimization. While echocardiography has always been considered the first line for the evaluation of patients, additional imaging techniques have gained increasing evidence in recent years. Today different details about heart anatomy, function, dissynchrony can be investigated by magnetic resonance, cardiac computed tomography, nuclear imaging, and more, with the aim of obtaining clues to reach a maximal response from the electrical therapy. The purpose of this review is to provide a practical analysis of the single and combined use of different imaging techniques in the preoperative and perioperative phases of cardiac resynchronization therapy, underlining their main advantages, limitations, and information provided.
    MeSH term(s) Humans ; Cardiac Resynchronization Therapy/methods ; Echocardiography/methods ; Heart Failure/diagnostic imaging ; Heart Failure/therapy ; Multimodal Imaging/methods ; Magnetic Resonance Imaging ; Treatment Outcome
    Language English
    Publishing date 2023-10-18
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 441230-8
    ISSN 1535-6280 ; 0146-2806
    ISSN (online) 1535-6280
    ISSN 0146-2806
    DOI 10.1016/j.cpcardiol.2023.102150
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Left atrial strain in left ventricular diastolic dysfunction: have we finally found the missing piece of the puzzle?

    Mandoli, Giulia Elena / Sisti, Nicolò / Mondillo, Sergio / Cameli, Matteo

    Heart failure reviews

    2019  Volume 25, Issue 3, Page(s) 409–417

    Abstract: The noninvasive estimation of diastolic function with echocardiography as a surrogate of left ventricular filling pressure is considered an essential step in the clinical evaluation of patients with conditions predisposing to heart failure (HF). Latest ... ...

    Abstract The noninvasive estimation of diastolic function with echocardiography as a surrogate of left ventricular filling pressure is considered an essential step in the clinical evaluation of patients with conditions predisposing to heart failure (HF). Latest algorithms for the assessment of diastolic dysfunction (DD) lay on several 2D standard parameters and describe a precise grading to quantify its severity. The persistence of a "gray zone" of values in which DD quantification is not possible, together with an epidemiological increase of conditions predisposing to heart failure with preserved ejection fraction (HFpEF), has led to the search and use of parameters with higher specificity and sensitivity: one of these is left atrial (LA) longitudinal strain in the frame of speckle tracking echocardiography (STE). LA anatomy and mechanics are crucial for preserving left ventricular (LV) function and asymptomatic condition of the patient. LA longitudinal strain is angle-independent, thus overcoming Doppler limitations, and provides reproducible measures of LA deformation. This review examines the latest evidences concerning the use of LA longitudinal strain in the assessment of diastolic function and HFpEF, with a particular focus on its role in standard echocardiographic algorithms or as a lone parameter to guide diagnosis and therapeutic management.
    MeSH term(s) Diastole ; Echocardiography ; Heart Atria/diagnostic imaging ; Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/physiopathology ; Humans ; Stroke Volume ; Ventricular Dysfunction, Left/diagnosis ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left/physiology
    Language English
    Publishing date 2019-11-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1336499-6
    ISSN 1573-7322 ; 1382-4147
    ISSN (online) 1573-7322
    ISSN 1382-4147
    DOI 10.1007/s10741-019-09889-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Insight into Atrial Fibrillation in LVAD Patients: From Clinical Implications to Prognosis.

    Sisti, Nicolò / Mandoli, Giulia Elena / Sciaccaluga, Carlotta / Valente, Serafina / Mondillo, Sergio / Cameli, Matteo

    Pulse (Basel, Switzerland)

    2020  Volume 8, Issue 1-2, Page(s) 2–14

    Abstract: The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables ... ...

    Abstract The use of left ventricular assist devices (LVADs), whether for destination therapy or bridge to transplantation, has gained increasing validation in recent years in patients with advanced heart failure. Arrhythmias can be the most challenging variables in the management of such patients but the main attention has always been focused on ventricular arrhythmias given the detrimental impact on mortality. Nevertheless, atrial fibrillation (AF) is the most common rhythm disorder associated with advanced heart failure and may therefore characterize the LVADs' pre- and postimplantation periods. Indeed, the consequences of AF in the population suffering from standard heart failure may require a more comprehensive evaluation in the presence of or in sight of an LVAD, making the AF clinical management in these patients potentially complex. Several studies have been based on this subject with different and often conflicting results, leaving many questions unresolved. The purpose of this review is to summarize the main pieces of evidence about the clinical impact of AF in LVAD patients, underlining the main implications in terms of hemodynamics, thromboembolic risk, bleeding and prognosis. Therapeutic considerations about the clinical management of these patients are also made according to the latest evidence.
    Language English
    Publishing date 2020-04-28
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2707138-8
    ISSN 2235-8668 ; 2235-8676
    ISSN (online) 2235-8668
    ISSN 2235-8676
    DOI 10.1159/000506600
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Biventricular or Conduction System Pacing for Cardiac Resynchronization Therapy: A Strategy for Cardiac Resynchronization Based on a Hybrid Approach.

    Santoro, Amato / Landra, Federico / Marallo, Carmine / Taddeucci, Simone / Sisti, Nicolò / Pica, Andrea / Stefanini, Andrea / Tavera, Maria Cristina / Pagliaro, Antonio / Baiocchi, Claudia / Cameli, Matteo

    Journal of cardiovascular development and disease

    2023  Volume 10, Issue 4

    Abstract: Background: Cardiac resynchronization therapy (CRT) is usually performed with biventricular pacing (BiVP), but recently, conduction system pacing (CSP) has been proposed as an alternative in case of BiVP failure. The aim of this study is to define an ... ...

    Abstract Background: Cardiac resynchronization therapy (CRT) is usually performed with biventricular pacing (BiVP), but recently, conduction system pacing (CSP) has been proposed as an alternative in case of BiVP failure. The aim of this study is to define an algorithm to choose between BiVP and CSP resynchronization using the interventricular conduction delays (IVCD) as a guide.
    Methods: Consecutive patients from January 2018 to December 2020 with an indication for CRT were prospectively enrolled in the study group (delays-guided resynchronization group, DRG). A treatment algorithm based on IVCD was used to decide whether to leave the left ventricular (LV) lead to perform BiVP or pull it out and perform CSP. Outcomes from the DRG group were compared to a historical cohort of CRT patients who underwent CRT procedures between January 2016 and December 2017 (resynchronization standard guide group, SRG). The primary endpoint was a composite of cardiovascular mortality, heart failure (HF) hospitalization, or HF event at 1 year after the date of intervention.
    Results: The study population consisted of 292 patients, of which 160 (54.8%) were in the DRG and 132 (45.2%) in the SRG. In the DRG, 41 of 160 patients underwent CSP based on the treatment algorithm (25.6%). The primary endpoint was significantly higher in the SRG (48/132, 36.4%) compared to the DRG (35/160, 21.8%) (hazard ratio (HR): 1.72; 95% confidence interval (CI): 1.12-2.65;
    Conclusions: A treatment algorithm based on IVCD shifted one patient out of every four from BiVP to CSP, with consequent reduction in the primary endpoint after implantation. Therefore, its application could be useful to determine whether to perform BiVP or CSP.
    Language English
    Publishing date 2023-04-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2777082-5
    ISSN 2308-3425 ; 2308-3425
    ISSN (online) 2308-3425
    ISSN 2308-3425
    DOI 10.3390/jcdd10040169
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Ablation therapy for ventricular arrhythmias in patients with LVAD: Multiple faces of an electrophysiological challenge.

    Sisti, Nicolò / Santoro, Amato / Carreras, Giovanni / Valente, Serafina / Donzelli, Stefano / Mandoli, Giulia Elena / Sciaccaluga, Carlotta / Cameli, Matteo

    Journal of arrhythmia

    2021  Volume 37, Issue 3, Page(s) 535–543

    Abstract: Left ventricular assist device implantation is a recognized treatment option for patients with advanced heart failure refractory to medical therapy and can be used both as bridge to transplantation and as destination therapy. The risk of ventricular ... ...

    Abstract Left ventricular assist device implantation is a recognized treatment option for patients with advanced heart failure refractory to medical therapy and can be used both as bridge to transplantation and as destination therapy. The risk of ventricular arrhythmias is common after left ventricular assist device implantation and is influenced by pre-, peri and post-operative determinants. The management of ventricular arrhythmias can be a challenge when they become refractory to medication or to device therapy and their impact on prognosis can be detrimental despite the mechanical support. In this setting, catheter ablation is being increasingly recognized as a feasible option for patients in which standard therapeutic strategies fail, but also with preventive purpose. Catheter ablation is being increasingly considered for the management of ventricular arrhythmias in patients with left ventricular assist device despite complex clinical and technical peculiarities due to the characteristics of the mechanical support. Much conflicting data exist regarding the predictors of success of the procedure and the rate of recurrence. In this review we discuss the latest evidences regarding catheter ablation of ventricular arrhythmias in this subset of patients, focusing on clinical characteristics, arrhythmia etiology, technical aspects and postprocedural features which must be considered by the electrophysiologist.
    Language English
    Publishing date 2021-05-05
    Publishing country Japan
    Document type Journal Article ; Review
    ZDB-ID 2696593-8
    ISSN 1883-2148 ; 1880-4276
    ISSN (online) 1883-2148
    ISSN 1880-4276
    DOI 10.1002/joa3.12542
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Catheter inversion during cavotricuspid isthmus catheter ablation: The new shaft visualization catheter reduces fluoroscopy use.

    Santoro, Amato / Baiocchi, Claudia / Sisti, Nicolò / Zacà, Valerio / Pondrelli, Carlo Renato / Falciani, Francesca / Lamberti, Filippo

    Journal of arrhythmia

    2021  Volume 37, Issue 5, Page(s) 1311–1317

    Abstract: Aims: Catheter ablation (CA) is the choice therapy of cavotricuspid isthmus (CTI) atrial flutter. The aim of this study was to describe our approach to improve the CTI ablation using a zero-fluoroscopy (ZF). The procedural difficulties could be related ... ...

    Abstract Aims: Catheter ablation (CA) is the choice therapy of cavotricuspid isthmus (CTI) atrial flutter. The aim of this study was to describe our approach to improve the CTI ablation using a zero-fluoroscopy (ZF). The procedural difficulties could be related to anatomical characteristics of the CTI.
    Methods: One hundred eighty-eight patients that performed CA of CTI were retrospectively and consecutively evaluated between 2017 and 2019. The studied population was divided into two groups. Eighty-eight patients who were undergone CA using ablation catheter without shaft visualization catheter (NSV) were Group 1. One hundred patients were undergone CA using ablation catheter with a shaft visualization (SV); they were Group 2. The catheter was looped at the Eustachian ridge after 200 seconds of radiofrequencies (RF) without elimination of local electrogram.
    Results: A conduction line block of CTI was obtained in all patients of Group 2 using a ZF approach. In 16 patients of Group 1, the catheter inversion was obtained using fluoroscopy to avoid damages during its loop. In Group 2, a complete CTI block was obtained with a catheter inversion approach in ten patients without fluoroscopy, visualizing the shaft and the tip of the ablation catheter on the electroanatomic (EAM) map. In the overall population studied the use of SV had a linear correlation with the ZF approach (
    Conclusions: The visualization of the shaft's catheter on the EAM permitted the catheter inversion safely in order to overcome some complex CTI anatomy and obtain bidirectional block. The SV reduced procedure time, RF applications and fluoroscopy exposition during CTI ablation.
    Language English
    Publishing date 2021-07-11
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 2696593-8
    ISSN 1883-2148 ; 1880-4276
    ISSN (online) 1883-2148
    ISSN 1880-4276
    DOI 10.1002/joa3.12596
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  8. Article ; Online: Echocardiography for left ventricular assist device implantation and evaluation: an indispensable tool.

    Sciaccaluga, Carlotta / Soliman-Aboumarie, Hatem / Sisti, Nicolò / Mandoli, Giulia Elena / Cameli, Paolo / Bigio, Elisa / Valente, Serafina / Mondillo, Sergio / Cameli, Matteo

    Heart failure reviews

    2021  Volume 27, Issue 3, Page(s) 891–902

    Abstract: Echocardiography is an indispensable tool in the evaluation, placement, management and follow-up of patients with left ventricular assist devices (LVAD). While transoesophageal echocardiography is the ideal tool in guiding the implantation procedure, ... ...

    Abstract Echocardiography is an indispensable tool in the evaluation, placement, management and follow-up of patients with left ventricular assist devices (LVAD). While transoesophageal echocardiography is the ideal tool in guiding the implantation procedure, transthoracic echocardiography is essential during the initial evaluation, patient selection and in the post-operative follow-up. This review attempts to summarize which parameters the echocardiographic assessment should focused on during each step. In particular, during the pre-operative assessment, it is of paramount importance to assess the presence of aortic regurgitation and most importantly to evaluate right ventricular function, since it is one of the strongest predictor of post-implant right ventricular failure. During the procedure, through transoesophageal echocardiography, it is possible to confirm the correct placement of the inflow cannula, to assess right ventricular function and to guide the choice of the right pump speed. Transthoracic echocardiographic is an essential part in the patient's follow-up once the LVAD has been implanted, in order to attest the onset of possible complications.
    MeSH term(s) Echocardiography/methods ; Heart Failure/surgery ; Heart-Assist Devices ; Humans ; Retrospective Studies ; Ventricular Function, Right
    Language English
    Publishing date 2021-01-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1336499-6
    ISSN 1573-7322 ; 1382-4147
    ISSN (online) 1573-7322
    ISSN 1382-4147
    DOI 10.1007/s10741-021-10073-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Heart transplantation and anti-HLA antibodY: myocardial dysfunction and prognosis - HeartLAy study.

    Sciaccaluga, Carlotta / Natali, Benedetta Maria / Righini, Francesca Maria / Sorini Dini, Carlotta / Landra, Federico / Mandoli, Giulia Elena / Sisti, Nicolò / Menci, Daniele / D'Errico, Antonio / D'Ascenzi, Flavio / Focardi, Marta / Bernazzali, Sonia / Maccherini, Massimo / Valente, Serafina / Cameli, Matteo

    ESC heart failure

    2023  Volume 10, Issue 5, Page(s) 2853–2864

    Abstract: Aims: The presence of anti-human leucocyte antigen (HLA) antibodies has been implicated in a higher incidence of complications as well as mortality rate in heart transplantation. The aim of the study was to identify through non-invasive parameters early ...

    Abstract Aims: The presence of anti-human leucocyte antigen (HLA) antibodies has been implicated in a higher incidence of complications as well as mortality rate in heart transplantation. The aim of the study was to identify through non-invasive parameters early signs of myocardial dysfunction in the presence of anti-HLA antibodies but without evidence of antibody-mediated rejection (AMR) and its possible prognostic impact.
    Methods and results: A total of 113 heart-transplanted patients without acute cellular rejection (ACR) and AMR or cardiac allograft vasculopathy (CAV) were prospectively enrolled and divided into two groups ['HLA+' (50 patients) and 'HLA-' (63 patients)], based on the presence of anti-HLA antibodies. Each patient was followed for 2 years after the enrolment, recording episodes of AMR, ACR, CAV, and mortality. Clinical characteristics were similar between the two groups. Among laboratory data, N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin values were significantly higher in the presence of anti-HLA antibodies (P < 0.001 and P = 0.003, respectively). The echocardiographic parameters that showed a statistically significant difference between the two groups were deceleration time of E wave (DecT E, P < 0.001), left ventricular global longitudinal strain (P < 0.001), tricuspid annular plane systolic excursion (P = 0.011), tricuspid S' wave (P = 0.002), and free wall right ventricular longitudinal strain (fwRVLS, P = 0.027), whereas left atrial strain did not differ significantly (P = 0.408). Univariate analysis showed that anti-HLA antibodies were associated with the development of CAV at both 1 and 2 year follow-up [odds ratio (OR) 11.90, 95% confidence interval (CI) 1.43-90.79, P = 0.022 and OR 3.37, 95% CI 1.78-9.67, P = 0.024, respectively]. Bivariate analysis demonstrated that both fwRVLS and DecT E were predictors of CAV development independently from HLA status.
    Conclusions: The presence of circulating anti-HLA antibodies is correlated with a mild cardiac dysfunction, even in the absence of AMR, and CAV development. Interestingly, reduced values of DecT E and fwRVLS were predictors of future development of CAV, independently from anti-HLA antibody.
    MeSH term(s) Humans ; Heart Transplantation/adverse effects ; Heart Transplantation/methods ; Antibodies ; Prognosis ; Graft Rejection/diagnosis ; Echocardiography
    Chemical Substances Antibodies
    Language English
    Publishing date 2023-07-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 2814355-3
    ISSN 2055-5822 ; 2055-5822
    ISSN (online) 2055-5822
    ISSN 2055-5822
    DOI 10.1002/ehf2.14442
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Combined Use of Voltage Mapping and Speckle-tracking Analysis for the Characterization of Arrhythmogenic Right Ventricular Cardiomyopathy: A Case Report.

    Santoro, Amato / Sisti, Nicolò / Baiocchi, Claudia / Mandoli, Giulia Elena / Biancofiore, Antonio / Pistoresi, Simone / Zacà, Valerio / Carbone, Salvatore Francesco / Focardi, Marta / D'Ascenzi, Flavio / Cameli, Matteo

    The Journal of innovations in cardiac rhythm management

    2022  Volume 13, Issue 5, Page(s) 4981–4986

    Abstract: A 38-year-old man was admitted to our hospital after ventricular tachycardia. Endocardial bipolar and unipolar voltage mapping were performed and findings were integrated with data from intracardiac echocardiography (ICE) right ventricular (RV) speckle- ... ...

    Abstract A 38-year-old man was admitted to our hospital after ventricular tachycardia. Endocardial bipolar and unipolar voltage mapping were performed and findings were integrated with data from intracardiac echocardiography (ICE) right ventricular (RV) speckle-tracking analysis. A reduction in the strain analysis was stored in correspondence of the fragmented electrogram area. The definitive diagnosis was arrhythmogenic RV cardiomyopathy (ARVC). The integration of ICE-derived RV strain and voltage mapping could represent a successful strategy to improve the results of ablation in ARVC.
    Language English
    Publishing date 2022-05-15
    Publishing country United States
    Document type Case Reports
    ISSN 2156-3977
    ISSN 2156-3977
    DOI 10.19102/icrm.2022.130501
    Database MEDical Literature Analysis and Retrieval System OnLINE

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