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  1. Article ; Online: Bradycardia risk stratification with implantable loop recorder after unexplained syncope.

    De Ciancio, Guillaume / Sadoul, Nicolas / Hammache, Nefissa / Pace, Nathalie / Echivard, Mathieu / Freysz, Luc / Blangy, Hugues / Sellal, Jean Marc / Olivier, Arnaud

    Archives of cardiovascular diseases

    2024  Volume 117, Issue 3, Page(s) 186–194

    Abstract: Background: An implantable loop recorder is an effective tool for diagnosing unexplained syncope. However, after a first episode in non-high-risk patients, the usefulness of implantable loop recorder implantation remains unclear.: Aims: To analyse ... ...

    Abstract Background: An implantable loop recorder is an effective tool for diagnosing unexplained syncope. However, after a first episode in non-high-risk patients, the usefulness of implantable loop recorder implantation remains unclear.
    Aims: To analyse relevant risk factors for significant bradycardia in order to identify patients who do or do not benefit from implantable loop recorder implantation. Also, to study whether implantable loop recorder implantation with remote monitoring is associated with less recurrence of traumatic syncope.
    Methods: This was a retrospective monocentric study including patients with implantable loop recorder implantation after unexplained syncope, using remote monitoring and iterative consultations.
    Results: Two hundred and thirty-seven patients were implanted for unexplained syncope. Significant bradycardia occurred in 53 patients (22.4%): 23 (43.4%) caused by paroxysmal atrioventricular block and 30 (56.6%) caused by sinus node dysfunction, leading to permanent pacemaker implantation in 48 patients. Compared with younger patients, there was a 3.46-fold increase (95% confidence interval 1.92-6.23; P<0.0001) in the risk of significant bradycardia in patients aged≥60 years. Based on multivariable analysis, only "typical syncope" was associated with significant bradycardia occurrence (hazard ratio 3.14, 95% confidence interval 1.75-5.65; P=0.0001). There was no recurrence of significant bradycardia with traumatic complications among patients implanted for traumatic syncope.
    Conclusions: This study shows that: (1) implantable loop recorders identify more significant bradycardia in patients aged≥60 presenting with a first non-high-risk typical syncope, suggesting that an implantable loop recorder should be implanted after a first episode of unexplained syncope in such conditions; and (2) after traumatic syncope, implantable loop recorder implantation is safe, and is associated with little or no recurrence of traumatic syncope.
    MeSH term(s) Humans ; Bradycardia/diagnosis ; Bradycardia/therapy ; Bradycardia/complications ; Retrospective Studies ; Syncope/diagnosis ; Syncope/etiology ; Syncope/therapy ; Electrocardiography, Ambulatory/adverse effects ; Risk Assessment ; Electrodes, Implanted/adverse effects
    Language English
    Publishing date 2024-01-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2023.12.007
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    In stock of ZB MED Cologne/Königswinter

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  2. Article ; Online: Dynamic changes in nocturnal heart rate predict short-term cardiovascular events in patients using the wearable cardioverter-defibrillator: from the WEARIT-France cohort study.

    Garcia, Rodrigue / Warming, Peder Emil / Narayanan, Kumar / Defaye, Pascal / Guedon-Moreau, Laurence / Blangy, Hugues / Piot, Olivier / Leclercq, Christophe / Marijon, Eloi

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2023  Volume 25, Issue 5

    Abstract: Aims: While elevated resting heart rate measured at a single point of time has been associated with cardiovascular outcomes, utility of continuous monitoring of nocturnal heart rate (NHR) has never been evaluated. We hypothesized that dynamic NHR ... ...

    Abstract Aims: While elevated resting heart rate measured at a single point of time has been associated with cardiovascular outcomes, utility of continuous monitoring of nocturnal heart rate (NHR) has never been evaluated. We hypothesized that dynamic NHR changes may predict, at short term, impending cardiovascular events in patients equipped with a wearable cardioverter-defibrillator (WCD).
    Methods and results: The WEARIT-France prospective cohort study enrolled heart failure patients with WCD between 2014 and 2018. Night-time was defined as midnight to 7 a.m. NHR initial trajectories were classified into four categories based on mean NHR in the first week (High/Low) and NHR evolution over the second week (Up/Down) of WCD use. The primary endpoint was a composite of cardiovascular death and heart failure hospitalization. A total of 1013 [61 (interquartile range, IQR 53-68) years, 16% women, left ventricular ejection fraction 26% (IQR 22-30)] were included. During a median WCD wear duration of 68 (IQR 44-90) days, 58 patients (6%) experienced 69 events. After considering potential confounders, High-Up NHR trajectory was significantly associated with the primary endpoint compared to Low-Down [adjusted hazard ratio (HR) 6.08, 95% confidence interval (CI) 2.56-14.45, P < 0.001]. Additionally, a rise of >5 bpm in weekly average NHR from the preceding week was associated with 2.5 higher composite event risk (HR 2.51, 95% CI 1.22-5.18, P = 0.012) as well as total mortality (HR 11.21, 95% CI 3.55-35.37, P < 0.001) and cardiovascular hospitalization (HR 2.70, 95% CI 1.51-4.82, P < 0.001).
    Conclusion: Dynamic monitoring of NHR may allow timely identification of impending cardiovascular events, with the potential for 'pre-emptive' action.
    Registration number: Clinical Trials.gov Identifier: NCT03319160.
    MeSH term(s) Humans ; Female ; Male ; Cohort Studies ; Heart Rate ; Prospective Studies ; Stroke Volume/physiology ; Ventricular Function, Left ; Heart Failure/diagnosis ; Heart Failure/therapy ; Defibrillators ; Wearable Electronic Devices
    Language English
    Publishing date 2023-04-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euad062
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    Zs.A 5434: Show issues Location:
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  3. Article ; Online: CRT-D replacement strategy: results of the BioCONTINUE study.

    Gras, Daniel / Clémenty, Nicolas / Ploux, Sylvain / Guyomar, Yves / Legallois, Damien / Segreti, Luca / Blangy, Hugues / Laurent, Gabriel / Bizeau, Olivier / Fauquembergue, Sophie / Lazarus, Arnaud

    Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

    2022  Volume 66, Issue 5, Page(s) 1201–1209

    Abstract: Background: In patients with cardiac resynchronization therapy defibrillators (CRT-Ds), the need for implantable cardioverter-defibrillator (ICD) back-up may be questionable at time of CRT-D replacement (REP) if ICD implant criteria are no longer met ... ...

    Abstract Background: In patients with cardiac resynchronization therapy defibrillators (CRT-Ds), the need for implantable cardioverter-defibrillator (ICD) back-up may be questionable at time of CRT-D replacement (REP) if ICD implant criteria are no longer met due to an improved left ventricular ejection fraction (LVEF) and if no major ventricular arrhythmic event (VAE) occurred during the CRT-D lifetime. The aim of our study was to assess the relevance of ICD back-up and predictors of VAE after REP in primary prevention CRT-D patients.
    Methods: The prospective, observational, international BioCONTINUE study investigated the rate of patients with at least 1 sustained VAE (sVAE) post-REP and searched for predictive factors of sVAE.
    Results: Two hundred seventy-six patients (70 ± 10 years, 77% men, mean LVEF 40.6 ± 12.6%) were followed for 28.4 ± 10.2 months. The rate of patients with sVAE was 8.3%, 10.3%, and 21.2% at 1, 2, and 4 years post-REP. Patients without persistent ICD indication at REP still had a sVAE rate of 5.7% (95% CI 2.3-11.5%) at 2 years. In multivariate analysis, predictive factors of subsequent sVAE were (i) persistent ICD indication (hazard ratio (HR) 3.6; 95% CI 1.6-8.3; p = 0.003); (ii) 64-72 years of age as compared to ≥ 79 years (HR 3.7; 95% CI 1.4-9.7; p = 0.008); and (iii) ischemic heart disease (HR 4.4; 95% CI 2.1-9.3; p < 0.0001).
    Conclusions: The risk of sVAE (21.2% at 4 years post-REP) depends on age, ischemic heart disease, and ICD indication at the time of REP. A non-trivial risk of sVAE remains in patients without persistent ICD indication.
    Clinical trial registration: NCT02323503.
    MeSH term(s) Aged ; Female ; Humans ; Male ; Cardiac Resynchronization Therapy/methods ; Defibrillators, Implantable ; Heart Failure/therapy ; Myocardial Ischemia/therapy ; Prospective Studies ; Risk Factors ; Stroke Volume ; Tachycardia, Ventricular ; Treatment Outcome ; Ventricular Function, Left ; Middle Aged
    Language English
    Publishing date 2022-12-02
    Publishing country Netherlands
    Document type Journal Article ; Observational Study
    ZDB-ID 1329179-8
    ISSN 1572-8595 ; 1383-875X
    ISSN (online) 1572-8595
    ISSN 1383-875X
    DOI 10.1007/s10840-022-01440-5
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5214: Show issues Location:
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  4. Article ; Online: Adherence to diagnostic and therapeutic practice guidelines for suspected cardiac implantable electronic device infections.

    De Ciancio, Guillaume / Erpelding, Marie-Line / Filippetti, Laura / Goehringer, François / Blangy, Hugues / Huttin, Olivier / Agrinier, Nelly / Juillière, Yves / Sadoul, Nicolas / Selton-Suty, Christine

    Archives of cardiovascular diseases

    2021  Volume 114, Issue 10, Page(s) 634–646

    Abstract: Background: Despite guidelines describing the optimal diagnostic and therapeutic procedures for patients with suspected cardiac implantable electronic device (CIED) infections, their management is often challenging.: Aims: To describe our diagnostic ... ...

    Abstract Background: Despite guidelines describing the optimal diagnostic and therapeutic procedures for patients with suspected cardiac implantable electronic device (CIED) infections, their management is often challenging.
    Aims: To describe our diagnostic and therapeutic practices for suspected CIED infection, and to compare them with European Heart Rhythm Association (EHRA) guidelines.
    Methods: Patients hospitalized in the tertiary care Nancy University Hospital for suspected CIED infection from 2014 to 2019 were included retrospectively. We applied the EHRA classification of CIED infection, and compared diagnostic and therapeutic management with the EHRA guidelines.
    Results: Among 184 patients (mean age 72.3±12.4 years), 137 had a proven infection of the lead (by transthoracic echocardiography/transoesophageal echocardiography,
    Conclusion: This study underlines the difficulties in following theoretical guidelines in daily practice, where both technical and human considerations interfere with their strict appliance.
    MeSH term(s) Aged ; Aged, 80 and over ; Defibrillators, Implantable/adverse effects ; Electronics ; Heart Diseases ; Humans ; Middle Aged ; Pacemaker, Artificial/adverse effects ; Prosthesis-Related Infections/diagnostic imaging ; Prosthesis-Related Infections/therapy ; Retrospective Studies
    Language English
    Publishing date 2021-11-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2021.06.010
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  5. Article ; Online: Subcutaneous Implantable Cardioverter-Defibrillator Lead Extraction: First Multicenter French Experience.

    Behar, Nathalie / Galand, Vincent / Martins, Raphaël P / Jacon, Peggy / Badenco, Nicolas / Blangy, Hugues / Alonso, Christine / Guy-Moyat, Benoit / El Bouazzaoui, Rim / Lebon, Alain / Giraudeau, Cédric / Marquie, Christelle / Leclercq, Christophe

    JACC. Clinical electrophysiology

    2020  Volume 6, Issue 7, Page(s) 863–870

    Abstract: Objectives: The aim of this multicenter study was to characterize the efficacy and safety of subcutaneous implantable cardioverter-defibrillators (S-ICDs) lead extraction procedures.: Background: S-ICDs have been developed to limit lead-related ... ...

    Abstract Objectives: The aim of this multicenter study was to characterize the efficacy and safety of subcutaneous implantable cardioverter-defibrillators (S-ICDs) lead extraction procedures.
    Background: S-ICDs have been developed to limit lead-related complications inherent to transvenous ICD devices. To date, no study has specifically investigated the safety and feasibility of S-ICD lead extraction procedures.
    Methods: Patients requiring S-ICD lead extraction between February 1, 2014, and February 28, 2019, were retrospectively included in 10 centers. The primary endpoint of the study was procedural success, defined as the removal of all the lead and lead material from the subcutaneous space. Secondary endpoints included procedural complications and the need for specific extraction tools.
    Results: S-ICD lead extraction procedures were performed in 32 patients (mean age 45.7 ± 13.8 years, 75.0% men, 65.6% in primary prevention). The median time from S-ICD lead implantation was 9.3 months (5.4 to 17.5 months). The primary endpoint, that is, complete removal of the material, was achieved in 96.9% of the patients, and only 1 procedural failure occurred (3.1%). Simple traction of the S-ICD lead was successful in 19 patients (59.4%), whereas 3 patients (9.4%) needed an additional incision and 9 patients (28.1%) required mechanical sheath to remove lead adhesions around the coil. No procedure-related complications occurred. Patients with successful simple traction extraction were implanted more recently (7.1 months [2.8 to 12.2 months] vs. 16.5 months [7.5 to 20.8 months]; p = 0.04) and had less prior history of sternotomy (2 [10.5%] vs. 5 [38.5%] patients; p = 0.09).
    Conclusions: S-ICD lead extraction is an efficient and safe procedure, but may require some specific tools like mechanical sheath, specifically when fibrotic adhesions developed around the parasternal coil.
    MeSH term(s) Defibrillators, Implantable/adverse effects ; Device Removal ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tissue Adhesions ; Treatment Outcome
    Language English
    Publishing date 2020-05-27
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2846739-5
    ISSN 2405-5018 ; 2405-500X ; 2405-500X
    ISSN (online) 2405-5018 ; 2405-500X
    ISSN 2405-500X
    DOI 10.1016/j.jacep.2020.04.012
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  6. Article: Prevalence of inducible paroxysmal supraventricular tachycardia during esophageal electrophysiologic study in patients with unexplained stroke.

    Brembilla-Perrot, Béatrice / Blangy, Hugues

    International journal of cardiology

    2006  Volume 109, Issue 3, Page(s) 344–350

    Abstract: Background: The relationships between stroke and atrial tachycardia or atrial fibrillation were previously reported. Electrophysiological study is one of the means, used to detect and evaluate these atrial tachyarrhythmias. But, some other arrhythmias ... ...

    Abstract Background: The relationships between stroke and atrial tachycardia or atrial fibrillation were previously reported. Electrophysiological study is one of the means, used to detect and evaluate these atrial tachyarrhythmias. But, some other arrhythmias as paroxysmal supraventricular tachycardia, can be induced during electrophysiologic study and their significance in stroke is unknown. The aim of the study was to assess the significance of inducible paroxysmal supraventricular tachycardia (PSVT) in stroke.
    Methods: One hundred thirty seven patients, aged 61+/-12 years had unexplained stroke (group I) and were compared to 60 subjects aged 45+/-18.5 years without stroke and history of tachycardia (group II); Holter monitoring (HM), echocardiogram and esophageal electrophysiologic study (EPS) in basal state and after isoproterenol were performed.
    Results: Heart disease was noted in 19 group I patients (14%) and 10 group II patients (17%). In group I, atrial fibrillation or tachycardia (AF-AT) was induced in 20 patients (15%) and PSVT was induced in 19 patients (14%) aged 66+/-12 years. In group II, AF/AT was induced in 3 patients (5%); no group II patient had induced PSVT. After 3+/-1 years, in group I, one of 98 patients without induced arrhythmias had new strokes and 2 had AF; 5 patients with induced AT/AF developed AF; 5 patients with induced PSVT had PSVT's, requiring ablation in 4 of them; 1 died from a new stroke; one had a second non-fatal stroke and 3 patients developed AF (16%). In group II, there were no events.
    Conclusion: In 14% of patients with unexplained stroke, PSVT was inducible during esophageal electrophysiologic study. Further studies are warranted to assess the significance of this finding in patients with unexplained stroke.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Electrocardiography, Ambulatory ; Esophagus/physiopathology ; Female ; Follow-Up Studies ; Humans ; Isoproterenol/pharmacology ; Male ; Middle Aged ; Prevalence ; Stroke/etiology ; Tachycardia, Supraventricular/epidemiology
    Chemical Substances Isoproterenol (L628TT009W)
    Language English
    Publishing date 2006-05-24
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2005.06.031
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    Zs.A 1673: Show issues Location:
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  7. Article ; Online: Incidence, indications and predicting factors of permanent pacemaker implantation after transcatheter aortic valve implantation: A retrospective study.

    Becker, Mathieu / Blangy, Hugues / Folliguet, Thierry / Villemin, Thibault / Freysz, Luc / Luc, Amandine / Maureira, Pablo / Popovic, Batric / Olivier, Arnaud / Sadoul, Nicolas

    Archives of cardiovascular diseases

    2017  Volume 110, Issue 10, Page(s) 508–516

    Abstract: Background: As the number of transcatheter aortic valve implantation (TAVI) procedures is constantly increasing, it is important to consider common complications, such as pacemaker (PM) implantation, and their specific risk factors.: Aims: ... ...

    Abstract Background: As the number of transcatheter aortic valve implantation (TAVI) procedures is constantly increasing, it is important to consider common complications, such as pacemaker (PM) implantation, and their specific risk factors.
    Aims: Echocardiographic, computed tomography and electrocardiographic data were analysed to determine the predicting factors, if any, associated with PM implantation.
    Methods: This retrospective study included patients referred to Nancy University Hospital for a TAVI procedure from January 2013 to December 2015. Both Medtronic CoreValve and Edwards SAPIEN valves were implanted. Patients with preprocedurally implanted PMs and/or referred from another institution were excluded.
    Results: Of 208 TAVI patients, 23 had a pre-existing PM and were excluded. A new PM was required in 38 patients (20.5%). Pre-existing right bundle branch block (RBBB), the use of the Medtronic CoreValve and large prostheses were identified as predictors of PM implantation (P=0.0361, P=0.0004 and P=0.0019, respectively). Using logistic regression, predictors of PM implantation included first-degree atrioventricular block (odds ratio 3.7, 95% confidence interval 1.5-9.1; P=0.0054) and large aortic annulus diameter in echocardiography (odds ratio 1.2, 95% confidence interval 1-1.4; P=0.0447), with a threshold of 24.1mm. For the combination of preTAVI PR duration >220ms and QRS duration >120ms, the positive predictive value for PM implantation reached 80%.
    Conclusion: Use of the Medtronic CoreValve, RBBB and first-degree atrioventricular block are major risk factors for post-TAVI PM implantation. In addition, large aortic annulus and large valvular prosthesis are independent risk factors for PM implantation. The combination of preTAVI prolonged PR interval and increased QRS duration could be used as a marker for periprocedural PM implantation.
    MeSH term(s) Aged ; Aged, 80 and over ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/epidemiology ; Aortic Valve Stenosis/surgery ; Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/epidemiology ; Arrhythmias, Cardiac/therapy ; Cardiac Pacing, Artificial ; Chi-Square Distribution ; Echocardiography ; Electrocardiography ; Female ; France/epidemiology ; Heart Valve Prosthesis ; Humans ; Incidence ; Logistic Models ; Male ; Multivariate Analysis ; Odds Ratio ; Pacemaker, Artificial ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Time Factors ; Tomography, X-Ray Computed ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/instrumentation ; Treatment Outcome
    Language English
    Publishing date 2017-06-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2017.03.004
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  8. Article ; Online: Predictors of Subcutaneous Implantable Cardioverter-Defibrillator Shocks and Prognostic Impact in Patients With Structural Heart Disease.

    Ninni, Sandro / Echivard, Matthieu / Marquié, Christelle / Ortmans, Staniel / Labreuche, Julien / Drumez, Elodie / Lemaire, Juliette / Cuvillier, Antoine / Arnaud, Marine / Potelle, Charlotte / Gouraud, Jean-Baptiste / Andorin, Antoine / Blangy, Hugues / Sadoul, Nicolas / Probst, Vincent / Klug, Didier

    The Canadian journal of cardiology

    2020  Volume 37, Issue 3, Page(s) 400–406

    Abstract: Background: In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses.: ... ...

    Abstract Background: In this study we aimed to assess long-term outcomes in subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients with structural heart disease by focussing especially on shock incidence, predictors, and associated prognoses.
    Methods: In this multicenter registry‒based study, we retrospectively included all patients who underwent S-ICD implantation at 3 tertiary centers. The prognostic impact of S-ICD shock was assessed with a composite outcome that included all-cause death and hospitalisation for heart failure.
    Results: A total of 351 patients with underlying cardiomyopathy were included in the investigation. Using multivariable Fine and Gray regression models, secondary prevention, left ventricular ejection fraction (LVEF), conditional shock threshold, and QRS duration appeared to be independent predictors of appropriate S-ICD shock occurrence. In the multivariate Cox regression model adjusted for age, baseline LVEF, underlying cardiomyopathy subtype, New York Heart Association class, and appropriate shocks were significantly associated with increased composite prognostic outcome risk (hazard ratio [HR], 2.61; 95% confidence interval [CI], 1.21-5.65; P = 0.014), whereas inappropriate shocks were not (HR, 1.35; 95% CI, 0.75-4.48; P = 0.18). The analysis of each component of the composite prognostic outcome highlighted that the occurrence of appropriate shocks was associated with an increased risk of hospitalisation for heart failure (HR, 3.10; 95% CI, 1.26-7.58; P = 0.013) and a trend for mortality (HR, 2.19; 95% CI, 0.78-6.16; P = 0.14).
    Conclusions: Appropriate S-ICD shocks were associated with a 3-fold increase in acute heart failure admission, whereas inappropriate shocks were not. Conditional shock threshold programming is an independent predictor of S-ICD shock, and its prognostic impact should be investigated further in patients with structural heart disease.
    MeSH term(s) Adult ; Cardiomyopathies/classification ; Cardiomyopathies/physiopathology ; Cardiomyopathies/therapy ; Death, Sudden, Cardiac/etiology ; Death, Sudden, Cardiac/prevention & control ; Defibrillators, Implantable/adverse effects ; Defibrillators, Implantable/standards ; Defibrillators, Implantable/statistics & numerical data ; Electric Countershock/instrumentation ; Electric Countershock/methods ; Electric Countershock/mortality ; Electric Countershock/statistics & numerical data ; Female ; France/epidemiology ; Heart Failure/epidemiology ; Heart Failure/etiology ; Heart Failure/therapy ; Hospitalization/statistics & numerical data ; Humans ; Male ; Prognosis ; Registries/statistics & numerical data ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Failure
    Language English
    Publishing date 2020-05-28
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/j.cjca.2020.05.032
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  9. Article: Influence of the mode of management of acute myocardial infarction on the inducibility of ventricular tachyarrhythmias with programmed ventricular stimulation after myocardial infarction.

    Brembilla-Perrot, Béatrice / Huttin, Olivier / Azman, Bérivan / Sellal, Jean M / Schwartz, Jérôme / Olivier, Arnaud / Blangy, Hugues / Sadoul, Nicolas

    The Israel Medical Association journal : IMAJ

    2014  Volume 16, Issue 6, Page(s) 352–357

    Abstract: Background: Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret.: Objectives: To investigate the ... ...

    Abstract Background: Programmed ventricular stimulation (PVS) is a technique for screening patients at risk for ventricular tachycardia (VT) after myocardial infarction (MI), but the results might be difficult to interpret.
    Objectives: To investigate the results of PVS after MI, according to date of completion.
    Methods: PVS results were interpreted according to the mode of MI management in 801 asymptomatic patients: 301 (group I) during the period 1982-1989, 315 (group II) during 1990-1999, and 185 (group III) during 2000-2010. The periods were chosen based on changes in MI management. Angiotensin-converting enzyme (ACE) inhibitors had been given since 1990; primary angioplasty was performed routinely since 2000. The PVS protocol was the same throughout the whole study period.
    Results: Group III was older (61 +/- 11 years) than groups I (56 +/- 11) and II (58 +/- 11) (P < 0.002). Left ventricular ejection fraction (LVEF) was lower in group III (36.5 +/- 11%) than in groups I (44 +/- 15) and II (41 +/- 12) (P < 0.000). Monomorphic VT < 270 beats/min was induced as frequently in group III (28%) as in group II (22.5%) but more frequently than in group I (20%) (P < 0.03). Ventricular fibrillation and flutter (VF) was induced less frequently in group III (14%) than in groups I (28%) (P < 0.0004) and II (30%) (P < 0.0000). Low left ventricular ejection fraction (LVEF) and date of inclusion (before/after 2000) were predictors of VT or VF induction on multivariate analysis.
    Conclusions: Induction of non-specific arrhythmias (ventricular flutter and fibrillation) was less frequent than before 2000, despite the indication of PVS in patients with lower LVEF. This decrease could be due to the increased use of systematic primary angioplasty for MI since 2000.
    MeSH term(s) Adult ; Age Factors ; Aged ; Aged, 80 and over ; Angioplasty/methods ; Angioplasty/trends ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/therapy ; Tachycardia, Ventricular/diagnosis ; Tachycardia, Ventricular/epidemiology ; Tachycardia, Ventricular/etiology ; Time Factors ; Ventricular Fibrillation/diagnosis ; Ventricular Fibrillation/epidemiology ; Ventricular Fibrillation/etiology ; Ventricular Flutter/diagnosis ; Ventricular Flutter/epidemiology ; Ventricular Flutter/etiology ; Ventricular Function, Left ; Young Adult
    Chemical Substances Angiotensin-Converting Enzyme Inhibitors
    Language English
    Publishing date 2014-06
    Publishing country Israel
    Document type Journal Article
    ZDB-ID 2008291-5
    ISSN 1565-1088 ; 0021-2180
    ISSN 1565-1088 ; 0021-2180
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  10. Article ; Online: Recall alerts in implantable cardioverter-defibrillator recipients: implications for patients and physicians.

    Schwartz, Jérôme / Blangy, Hugues / Zinzius, Pierre Yves / Freysz, Luc / Aliot, Etienne / Sadoul, Nicolas

    Pacing and clinical electrophysiology : PACE

    2011  Volume 34, Issue 1, Page(s) 96–103

    Abstract: Backgrounds: Implantable cardioverter-defibrillator (ICD) malfunctions sometimes need recall. Despite the increasing number of device implantation, ICD recalls and advisories' impacts have been little studied. The aim of this study was to determine the ... ...

    Abstract Backgrounds: Implantable cardioverter-defibrillator (ICD) malfunctions sometimes need recall. Despite the increasing number of device implantation, ICD recalls and advisories' impacts have been little studied. The aim of this study was to determine the rate of ICD generator advisory in our center and to examine its clinical and financial implication.
    Methods: We analyzed weekly Food and Drug Administration (FDA) Enforcement Reports issued between January 2000 and December 2008 to identify all advisories involving ICD generators and leads. We performed a retrospective analysis of all implanted patients affected by an advisory in our Cardiology department.
    Results: During the 8 years of the study period, 13 advisories were issued for generators and one for leads, leading to a total number of 278 of 1,051 (26.4%) device with recall alerts, divided into 196 generator failures and 82 lead failures. Premature generator replacement was performed in 11 patients, whereas nine patients underwent lead replacement. There was no major complications attributable to advisory device replacement, and minor complications occurred only in one patient (lead extraction failure). Recalls accounted for 593 extra outpatient visits with a mean number of 2.20 ± 2.19 per patient. The total estimated cost of the device advisories in our population was 334,528 €.
    Conclusions: ICD recalls and safety alerts frequently occur in ICD recipients and tend to increase in number and rate. Although potentially serious, they do not appear to be associated with substantial complications. Financial implications are important.
    MeSH term(s) Adolescent ; Adult ; Aged ; Defibrillators, Implantable/economics ; Defibrillators, Implantable/utilization ; Device Removal/economics ; Device Removal/utilization ; Equipment Failure/economics ; Equipment Failure/statistics & numerical data ; Equipment Safety/economics ; Female ; France/epidemiology ; Health Care Costs/statistics & numerical data ; Humans ; Male ; Medical Device Recalls ; Middle Aged ; Patients ; Workload ; Young Adult
    Language English
    Publishing date 2011-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1111/j.1540-8159.2010.02918.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 399: Show issues

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