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Article ; Online: Endocardial ablation of epicardial ganglionated plexi: history, open questions and future prospects of cardioneuroablation.

Magnano, Massimo / Bissolino, Arianna / Budano, Carlo / Occhetta, Eraldo / Rametta, Francesco

2022 Volume 71, Issue 5, Page(s) 553–563

Abstract: Neurocardiogenic syncope is the most common cause of transient loss of consciousness and considerably reduces quality of life. Pharmacological and pacing therapy may not be fully efficacious and complications related to implanted hardware must be ... ...

Abstract	Neurocardiogenic syncope is the most common cause of transient loss of consciousness and considerably reduces quality of life. Pharmacological and pacing therapy may not be fully efficacious and complications related to implanted hardware must be considered. In this context, cardioneuroablation (CNA) has been proposed to attenuate the vagal reflex with elimination of cardioinhibition. It has been shown that CNA is able to eliminate recurrences of syncope in over 90% of cases and no major complications are reported in the current literature. Despite these encouraging findings, CNA is only mentioned in current guidelines as a possible alternative treatment and has no real indication class. The diversity of mapping techniques, the absence of direct denervation control, the lack of a precise endpoint, the possible placebo effect, the short follow-up, and the question of the learning curve represent the major limitations of this promising procedure. The aim of this review was to look over the existing literature, analysing the novelties, the limitations, the unresolved issues and the outcome of CNA.
MeSH term(s)	Humans ; Quality of Life ; Endocardium ; Syncope, Vasovagal/surgery
Language	English
Publishing date	2022-10-28
Publishing country	Italy
Document type	Review ; Journal Article
ZDB-ID	3059238-0
ISSN	2724-5772
ISSN (online)	2724-5772
DOI	10.23736/S2724-5683.22.06131-2
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Article ; Online: Catheter ablation for treatment of bradycardia-tachycardia syndrome: is it time to consider it the therapy of choice? A systematic review and meta-analysis.

Magnano, Massimo / Bissolino, Arianna / Budano, Carlo / Abdirashid, Mohamed / Devecchi, Chiara / Oriente, Domenico / Matta, Mario / Occhetta, Eraldo / Gaita, Fiorenzo / Rametta, Francesco

Journal of cardiovascular medicine (Hagerstown, Md.)

2022 Volume 23, Issue 10, Page(s) 646–654

Abstract: Background: Atrial fibrillation catheter ablation (AFCA) should be considered as a strategy to avoid pacemaker (PM) implantation for patients with bradycardia-tachycardia syndrome (BTS), but lack of evidence is remarkable.: Methods: Our aim was to ... ...

Abstract	Background: Atrial fibrillation catheter ablation (AFCA) should be considered as a strategy to avoid pacemaker (PM) implantation for patients with bradycardia-tachycardia syndrome (BTS), but lack of evidence is remarkable. Methods: Our aim was to conduct a random-effects model meta-analysis on safety and efficacy data from controlled trials and observational studies. We compared atrial fibrillation (AF) recurrence, AF progression, procedural complication, additional procedure, cardiovascular death, cardiovascular hospitalization, heart failure and stroke in patients undergoing AFCA vs. PM implantation. Results: PubMed/MEDLINE, Cochrane Database and Google Scholar were screened, and four retrospective studies were selected. A total of 776 patients (371 in the AFCA group, 405 in the PM group) were included. After a median follow-up of 67.5 months, lower AF recurrence [odds ratio (OR) 0.06, confidence interval (CI) 0.02-0.18, I2 = 82.42%, P < 0.001], AF progression (OR 0.12, CI 0.06-0.26, I2 = 0%, P < 0.001), heart failure (OR 0.12, CI 0.04-0.34, I2 = 0%, P < 0.001), and stroke (OR 0.30, CI 0.15-0.61, I2 = 0%, P = 0.001) were observed in the AFCA group. No differences were observed in cardiovascular death and hospitalization (OR 0.48, CI 0.10-2.28, I2 = 0%, P = 0.358 and OR 0.43, CI 0.14-1.29, I2 = 87.52%, P = 0.134, respectively). Higher need for additional procedures in the AFCA group was highlighted (OR 3.65, CI 1.51-8.84, I2 = 53.75%, P < 0.001). PM implantation was avoided in 91% of BTS patients undergoing AFCA. Conclusions: AFCA in BTS patients seems to be more effective than PM implantation in reducing AF recurrence and PM implantation may be waived in most BTS patients treated by AFCA. Need for additional procedures in AFCA patients is balanced by long-term benefit in clinical end points.
MeSH term(s)	Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/surgery ; Bradycardia/diagnosis ; Bradycardia/therapy ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Heart Failure/complications ; Humans ; Observational Studies as Topic ; Retrospective Studies ; Sick Sinus Syndrome/complications ; Stroke/etiology ; Tachycardia
Language	English
Publishing date	2022-09-13
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000001360
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Article: Sometimes neither water nor fire are more useful than friendship-a new risk score for prediction of contrast-induced nephropathy (CIN) and long-term adverse outcomes in patients undergoing coronary angiography.

De Filippo, Ovidio / D'Ascenzo, Fabrizio / Piroli, Francesco / Budano, Carlo / De Ferrari, Gaetano Maria

Journal of thoracic disease

2019 Volume 11, Issue 7, Page(s) 2675–2679

Language	English
Publishing date	2019-08-27
Publishing country	China
Document type	Editorial ; Comment
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2019.06.51
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Article ; Online: Incidence trends and long-term outcomes of myocardial infarction in young adults: Does gender matter?

Bruno, Francesco / Moirano, Giovenale / Budano, Carlo / Lalloni, Stefania / Ciccone, Giovannino / Verardi, Roberto / Andreis, Alessandro / Montabone, Andrea / De Filippo, Ovidio / Gallone, Guglielmo / Gilardetti, Marco / D'Ascenzo, Fabrizio / De Ferrari, Gaetano Maria

International journal of cardiology

2022 Volume 357, Page(s) 134–139

Abstract: Aims: Data about long-term clinical outcomes of young patients experiencing an acute myocardial infarction (MI) and about the potential impact of gender on juvenile MI incidence and prognosis are scant.: Methods and results: Hospital Discharge ... ...

Abstract	Aims: Data about long-term clinical outcomes of young patients experiencing an acute myocardial infarction (MI) and about the potential impact of gender on juvenile MI incidence and prognosis are scant. Methods and results: Hospital Discharge Register records of Piedmont region (Italy) from 2007 to 2018 were interrogated to identify incident juvenile MI cases and MI recurrences. Patients were considered young if the first MI occurred before or at 47 years of age (5th percentile). Incidence of first juvenile MI event and overall survival were the primary outcomes. Gender differences and survival rate after an MI recurrence were secondary outcomes. Out of 114.816 hospitalizations due to MI, 4482 (3.9%) occurred in people aged ≤47. Average incidence rate of juvenile MI over the study period was 24.5 (23.8-25.2) per 100.000 person-years, with a decline among men and a stable trend among women through the years. The risk of in hospital death was higher for women (1.9% vs. 0.9%, p = 0.02), while the survival rate at 10 years after the first MI was 94.8%, without gender differences (HR 1.05: 0.69-1.60). MI recurrence occurred in 348 (7.8%) and was less common in women (HR 0.72: 0.52-0.99). After multivariate adjustment, MI recurrence was associated with a significantly higher risk of death at follow-up as compared with a single MI episode (HR 3.05: 1.9-4.80, all CI 95%). Conclusion: Among young patients with MI, women had a higher in-hospital mortality compared to men, but long-term prognosis after hospital discharge did not differ. MI recurrences were associated with increased mortality at follow up.
MeSH term(s)	Female ; Hospital Mortality ; Humans ; Incidence ; Male ; Middle Aged ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Recurrence ; Risk Factors ; Survival Rate ; Young Adult
Language	English
Publishing date	2022-03-15
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.2022.03.012
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Article ; Online: S-ICD lead dislodgement in a young isometric athlete: A rare complication.

Bissolino, Arianna / Andreis, Alessandro / Magnano, Massimo / Budano, Carlo / Castagno, Davide / Golzio, Pier Giorgio / Giustetto, Carla / De Ferrari, Gaetano Maria

Pacing and clinical electrophysiology : PACE

2020 Volume 43, Issue 8, Page(s) 898–900

Abstract: The subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD in patients who do not need cardiac pacing. We report the case of a young isometric athlete who received S-ICD for primary prevention of sudden death. ... ...

Abstract	The subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD in patients who do not need cardiac pacing. We report the case of a young isometric athlete who received S-ICD for primary prevention of sudden death. Lead dislodgement and myopotential noise oversensing during isometric training led to inappropriate shock, and a surgical revision was performed. During the procedure, strong fibrous adhesions were found, requiring polytetrafluoroethylene dilator sheaths. The S-ICD was finally reimplanted. Despite continued isometric training, no more myopotential oversensing occurred after 1-year follow-up. The present case highlights the possible higher risks of lead complication in an isometric athlete and the uncommon effort in removing an old-generation subcutaneous defibrillator lead.
MeSH term(s)	Athletes ; Brugada Syndrome/physiopathology ; Brugada Syndrome/therapy ; Death, Sudden, Cardiac/prevention & control ; Defibrillators, Implantable/adverse effects ; Electrocardiography ; Equipment Failure ; Fluoroscopy ; Humans ; Male ; Primary Prevention ; Reoperation ; Weight Lifting ; Young Adult
Language	English
Publishing date	2020-06-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	424437-0
ISSN	1540-8159 ; 0147-8389
ISSN (online)	1540-8159
ISSN	0147-8389
DOI	10.1111/pace.13965
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Zs.A 1466: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Hypnosis as an effective and inexpensive option to control pain in transcatheter ablation of cardiac arrhythmias.

Barbero, Umberto / Ferraris, Federico / Muro, Milena / Budano, Carlo / Anselmino, Matteo / Gaita, Fiorenzo

Journal of cardiovascular medicine (Hagerstown, Md.)

2018 Volume 19, Issue 1, Page(s) 18–21

Abstract: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with ... ...

Abstract	: Supportive care for pain relief and back discomfort during electrophysiology interventions is usually needed in the electrophysiology lab, especially in long-lasting procedures like atrial fibrillation ablation. Although this is usually achieved with conventional pharmacologic anesthesia, hypnosis has recently aroused interest as a reliable tool to complement and possibly enhance conscious sedation. We collected five case of percutaneous arrhythmia ablation in which, after informed consent, hypnosis was performed by nurse anesthetists in the cath lab. In each case at the end of the intervention, the patients described complete alterations of perception or memory of the pain or of the length of the study. No anesthetic drug was needed. While waiting for more robust data, we suggest hypnosis could be a reliable, inexpensive and well tolerated tool to obtain complete pain control and comfort during arrhythmia ablation.
MeSH term(s)	Adolescent ; Aged ; Arrhythmias, Cardiac/surgery ; Catheter Ablation/adverse effects ; Conscious Sedation ; Female ; Humans ; Hypnosis/methods ; Male ; Middle Aged ; Pain, Procedural/therapy
Language	English
Publishing date	2018-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000000605
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Article ; Online: Prevalence and prognosis of lead masses in patients with cardiac implantable electronic devices without infection.

Golzio, Pier Giorgio / Errigo, Daniele / Peyracchia, Mattia / Gallo, Elisa / Frea, Simone / Castagno, Davide / Budano, Carlo / Giustetto, Carla / Rinaldi, Mauro

Journal of cardiovascular medicine (Hagerstown, Md.)

2019 Volume 20, Issue 6, Page(s) 372–378

Abstract: Background: Finding of intracardiac lead masses in patients with cardiac implantable electronic devices remains controversial, as such masses have been observed in cases of exclusively local infections whereas they have not been recognized in patients ... ...

Abstract	Background: Finding of intracardiac lead masses in patients with cardiac implantable electronic devices remains controversial, as such masses have been observed in cases of exclusively local infections whereas they have not been recognized in patients with positive cultures of intravascular lead fragments. In this study, we aim to describe the prevalence of intracardiac lead masses in true asymptomatic patients with cardiac implantable electronic devices, to identify their predictive factors and to define their prognostic impact at long-term follow-up. Methods: Seventy-eight consecutive patients admitted over a 6-month period for elective generator replacement without clinical evidence of infection were evaluated by transthoracic and transesophageal echocardiography and prospectively followed at in-clinic follow-up visits. Results: Lead masses were found in 10 patients (12.8%). These patients had more frequently right ventricular dysfunction at univariate analysis (OR 2.71, P = 0.010) and after baseline variables adjustment (hazard ratio 6.25, P = 0.012). At 5-year follow-up without any specific therapy, none of the patients suffered from any cardiac device infections, or developed clinical signs of infections. Conclusion: There is an evidence of clinical lead masses in asymptomatic patients with cardiac implantable electronic devices. The value of these findings is still debated for aetiological interpretation and for therapeutic strategy, but they are not necessarily associated with an infection.
MeSH term(s)	Aged ; Aged, 80 and over ; Asymptomatic Diseases ; Cardiac Pacing, Artificial/adverse effects ; Defibrillators, Implantable/adverse effects ; Device Removal ; Echocardiography, Transesophageal ; Electric Countershock/adverse effects ; Electric Countershock/instrumentation ; Female ; Heart Diseases/diagnostic imaging ; Heart Diseases/epidemiology ; Heart Diseases/surgery ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Pacemaker, Artificial/adverse effects ; Prevalence ; Prospective Studies ; Prosthesis-Related Infections/diagnostic imaging ; Prosthesis-Related Infections/epidemiology ; Prosthesis-Related Infections/surgery ; Time Factors
Language	English
Publishing date	2019-04-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223461-5
ISSN	1558-2035 ; 1558-2027
ISSN (online)	1558-2035
ISSN	1558-2027
DOI	10.2459/JCM.0000000000000797
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Zs.A 5210: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Same-day CIED implantation and discharge: Is it possible? The E-MOTION trial (Early MObilization after pacemaker implantaTION).

Budano, Carlo / Garrone, Paolo / Castagno, Davide / Bissolino, Arianna / Andreis, Alessandro / Bertolo, Laura / Mazzini, Diana / Bergamasco, Laura / Marra, Sebastiano / Gaita, Fiorenzo

International journal of cardiology

2019 Volume 288, Page(s) 82–86

Abstract: Background: Despite the increasing number of cardiac implantable electronic devices (CIED) procedures worldwide, no guideline assessed postoperative mobilization protocols. Lacking evidences in literature, many centers require 24-hour immobilization and ...

Abstract	Background: Despite the increasing number of cardiac implantable electronic devices (CIED) procedures worldwide, no guideline assessed postoperative mobilization protocols. Lacking evidences in literature, many centers require 24-hour immobilization and bed rest to minimize the risk of pacing lead (PL) dislodgement. Prolonged immobilization may futilely delay discharge, induce pain and reduced joint mobility especially in elderly patients. We examined whether early mobilization at 3-h after CIED surgery would result in higher complication rates, compared with standard 24-hour immobilization. Methods: Consecutive patients undergoing CIED implantation were randomized to early (3-h) mobilization protocol with an arm sling support (E-motion group, EMG) vs. standard (24-h) immobilization (control group, CG). The primary end-point was 24-month PL dislodgement. Secondary safety end-point was any major intra-procedural complication (cardiac perforation, pericardial tamponade, valve damage, haemothorax, pneumothorax, myocardial infarction, peripheral embolus, TIA/stroke or death). Results: Among 200 enrolled patients, 86% underwent pacemaker implantation (28% single-chamber, 72% dual-chamber device), 14% underwent ICD implantation (75% single-chamber, 25% dual-chamber device). PL fixation was mostly passive (97% atrial PL, 88% ventricular PL), without differences between EMG and CG (p = 0.99). No differences were observed in the incidence of 24-month PL dislodgement (3% in the EMG vs. 4% in the CG, p = 0.99). No major intra-procedural complications were observed. Conclusions: Early mobilization at 3-h following CIED surgery is safe and feasible compared with standard immobilization and is not associated with an increased risk of intra-procedural complications or 24-month lead dislodgment. So, same-day implantation and discharge might be possible.
MeSH term(s)	Aged ; Arrhythmias, Cardiac/surgery ; Female ; Follow-Up Studies ; Humans ; Immobilization/methods ; Male ; Pacemaker, Artificial ; Patient Discharge/trends ; Postoperative Complications/prevention & control ; Prospective Studies ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2019-04-08
Publishing country	Netherlands
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2019.04.020
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Article ; Online: Combining electromagnetic navigation and 3-D mapping to reduce fluoroscopy time and achieve optimal CRT response.

Barbero, Umberto / Budano, Carlo / Golzio, Pier Giorgio / Castagno, Davide / Gaita, Fiorenzo

Pacing and clinical electrophysiology : PACE

2017 Volume 41, Issue 5, Page(s) 557–560

Abstract: Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and associated with high-dose x-ray exposure. We present the technique in which an electromagnetic navigation system (MediGuideTM, St. Jude Medical) and ... ...

Abstract	Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and associated with high-dose x-ray exposure. We present the technique in which an electromagnetic navigation system (MediGuideTM, St. Jude Medical) and an electroanatomical three-dimensional mapping system (EnSite NavX, St Jude Medical) are usefully combined for implanting implantable cardioverter defibrillator CRT devices with strong reduction of x-ray exposure, and for targeting the most delayed regions in the activation maps avoiding scars for optimal CRT response.
MeSH term(s)	Cardiac Resynchronization Therapy Devices ; Electrocardiography ; Electromagnetic Phenomena ; Epicardial Mapping ; Equipment Design ; Fluoroscopy ; Humans ; Prosthesis Implantation/methods ; Radiation Dosage
Language	English
Publishing date	2017-12-28
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/pace.13209
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Article ; Online: Impact of chronic kidney disease on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A long-term single-center mortality study.

Peyracchia, Mattia / Scacciatella, Paolo / Conrotto, Federico / Meynet, Ilaria / Biava, Lorenza M / Budano, Carlo / Pennone, Mauro / D'Amico, Maurizio / Gaita, Fiorenzo

Minerva cardioangiologica

2018 Volume 66, Issue 1, Page(s) 6–15

Abstract: Background: Chronic kidney disease (CKD) is associated with increased risk of mortality. We examined the impact of moderate and severe CKD at presentation on short- and long-term mortality among unselected patients with ST-segment elevation myocardial ... ...

Abstract	Background: Chronic kidney disease (CKD) is associated with increased risk of mortality. We examined the impact of moderate and severe CKD at presentation on short- and long-term mortality among unselected patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI). Methods: The study cohort consists of 501 patients (pts), enrolled from October 2005 to December 2012. The median follow-up was 46.52±25.58 months (range 8-99). A severe CKD (estimated Glomerular Filtration Rate [eGFR] <30 mL/min/1.73 m2) was detected in 16 pts (3.19%), a moderate CKD (eGFR 30-59 mL/min/1.73 m2) in 110 (21.96%) and a normal kidney function (eGFR >60 mL/min/1.73 m2) in 375 (74.85%). Results: The crude in-hospital mortality rate resulted significantly higher in pts with severe and moderate CKD compared to pts with normal renal function (50% and 19.08% versus 2.93%, P<0.0001), as well as the long-term mortality rate (57.14% and 46.34% versus 8.77%, P<0.0001). After adjustment for confounding variables, severe and moderate CKD resulted the main independent predictors of in-hospital (odds ratio [OR]=21.815, P<0.0001 for severe CKD and OR= 4.203, P=0.002 for moderate CKD) and long-term (hazard ratio [HR]= 5.272, P=0.001; HR= 1.978, P=0.006) mortality. Conclusions: CKD is a frequent condition in patients with STEMI treated with PPCI and it is associated to an excess of mortality, resulting the main independent negative prognostic predictor.
MeSH term(s)	Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention/methods ; Prognosis ; Prospective Studies ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/physiopathology ; ST Elevation Myocardial Infarction/mortality ; ST Elevation Myocardial Infarction/therapy ; Severity of Illness Index ; Time Factors
Language	English
Publishing date	2018-02
Publishing country	Italy
Document type	Journal Article
ZDB-ID	123583-7
ISSN	1827-1618 ; 0026-4725
ISSN (online)	1827-1618
ISSN	0026-4725
DOI	10.23736/S0026-4725.17.04506-6
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