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177 results on '"Zanon, F"'

5. Assessment of Reed Grasses (Phragmites australis) Performance in PFAS Removal from Water: A Phytoremediation Pilot Plant Study

Author

Ferrario, C, Peruzzi, C, Cislaghi, A, Polesello, S, Valsecchi, S, Lava, R, Zanon, F, Santovito, G, Barausse, A, Bonato, M, Ferrario C., Peruzzi C., Cislaghi A., Polesello S., Valsecchi S., Lava R., Zanon F., Santovito G., Barausse A., Bonato M., Ferrario, C, Peruzzi, C, Cislaghi, A, Polesello, S, Valsecchi, S, Lava, R, Zanon, F, Santovito, G, Barausse, A, Bonato, M, Ferrario C., Peruzzi C., Cislaghi A., Polesello S., Valsecchi S., Lava R., Zanon F., Santovito G., Barausse A., and Bonato M.

Abstract

Per-and polyfluoroalkyl substances (PFASs) have multiple emission sources, from industrial to domestic, and their high persistence and mobility help them to spread in all the networks of watercourses. Diffuse pollution of these compounds can be potentially mitigated by the application of green infrastructures, which are a pillar of the EU Green Deal. In this context, a phytoremediation pilot plant was realised and supplied by a contaminated well-located in Lonigo (Veneto Region, Italy) where surface and groundwaters were significantly impacted by perfluoroalkyl acids (PFAAs) discharges from a fluorochemical factory. The investigation involved the detection of perfluorobutanoic acid (PFBA), perfluorooctanoic acid (PFOA), perfluorobutanesulfonic acid (PFBS) and perfluorooctanesulfonic acid (PFOS) inside the inlet and outlet waters of the phytoremediation pilot plant as well as in reed grasses grown into its main tank. The obtained results demonstrate that the pilot plant is able to reduce up to 50% of considered PFAAs in terms of mass flow without an evident dependence on physico-chemical characteristics of these contaminants. Moreover, PFAAs were found in the exposed reed grasses at concentrations up to 13 ng g−1 ww. A positive correlation between PFAA concentration in plants and exposure time was also observed. In conclusion, this paper highlights the potential efficiency of phytodepuration in PFAS removal and recommends improving the knowledge about its application in constructed wetlands as a highly sustainable choice in wastewater remediation.

Published
2022

8. His bundle pacing: 10-years follow-up

Author

Marcantoni, L, primary, Deluca, F, additional, Pastore, G, additional, Baracca, E, additional, Marsiglia, S, additional, Fornasaro, M, additional, Cappato, E, additional, Pigaiani, C, additional, Manzato, E, additional, Tiribello, A, additional, Raffagnato, P, additional, and Zanon, F, additional

Published
2023
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9. Multi-Sensor Quench Detection System for an HTS Slotted Superconducting Cable

Author

Adibi, S. A., Colombo, G., Breschi, M., Caponero, M. A., Castaldo, A., Celentano, G., Marchetti, M., Masi, A., Mazzotta, C., Polimadei, A., Savoldi, L., Trotta, A., Zanon, F., and De Marzi, G.

Abstract

Quench caused by electromechanical instabilities is a major concern in high-temperature superconducting (HTS) magnets, and quench detection methods, alternative to common voltage-based systems, are currently under study. In this work, we describe the experimental design and set-up, and we report the results of studies carried out on a cable equipped with bismuth strontium calcium copper oxide (BSCCO) tapes. The sample layout comprises an aluminum slotted core, cooled via a forced flow of liquid nitrogen in the central channel, and liquid nitrogen cooled termination. To trigger a quench in a well-defined position within the stack, a localized small magnetic field is employed to reduce the critical current density in the central zone of the cable. Various configuration of sensors including temperature sensors, voltage taps, and fiber Bragg grating (FBG) are installed, with the final aim of developing a fast and reliable quench detection set-up for the stacked-tapes HTS cable. It is shown that the response for both temperature and FBG signals are comparable for what concerns sensitivity and velocity, and both follow the voltage evolution in time. All in all, the developed setup with the multi-sensor allowed characterizing the electrical and thermal aspects of an HTS slotted-core superconducting cable during a localized magneto-thermal quench.

Published
2024
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10. Multi-Sensor Quench Detection System for an HTS Slotted Superconducting Cable

Author

Adibi, S. A., primary, Colombo, G., additional, Breschi, M., additional, Caponero, M. A., additional, Castaldo, A., additional, Celentano, G., additional, Marchetti, M., additional, Masi, A., additional, Mazzotta, C., additional, Polimadei, A., additional, Savoldi, L., additional, Trotta, A., additional, Zanon, F., additional, and De Marzi, G., additional

Published
2023
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11. One year after on Tyrrhenian coasts: The ban of cotton buds does not reduce their dominance in beach litter composition

Author

Poeta, G., primary, Bazzichetto, M., additional, Gallitelli, L., additional, Garzia, M., additional, Aprea, F., additional, Bartoli, F., additional, Battisti, C., additional, Cascone, S., additional, Corradi, A., additional, D’Amelia, D., additional, D’Amico, E., additional, De Luca, J., additional, Del Grosso, F., additional, Iacobelli, L., additional, Langone, S., additional, Lembo Fazio, C., additional, Locchi, G., additional, Perrone, M., additional, Petroni, F., additional, Raimondi, D., additional, Romiti, F., additional, Secco, S., additional, Sonet, L., additional, Spinelli, A., additional, Toscano, S., additional, Vanadia, S., additional, Vecchi, S., additional, Zanon, F., additional, and Malavasi, M., additional

Published
2022
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12. One year after on Tyrrhenian coasts: The ban of cotton buds does not reduce their dominance in beach litter composition

Author

Poeta, G., Bazzichetto, Manuele, Gallitelli, L., Garzia, M., Aprea, F., Bartoli, F., Battisti, C., Cascone, Silvia, Corradi, A., D’Amelia, D., D’Amico, E., Luca, J. De, Grosso, F. Del, Iacobelli, L., Langone, S., Lembo Fazio, C., Locchi, G., Perrone, M., Petroni, F., Raimondi, D., Romiti, F., Secco, S., Sonet, L., Spinelli, A., Toscano, S., Vanadia, S., Vecchi, S., Zanon, F., Malavasi, Marco, Poeta, G., Bazzichetto, Manuele, Gallitelli, L., Garzia, M., Aprea, F., Bartoli, F., Battisti, C., Cascone, Silvia, Corradi, A., D’Amelia, D., D’Amico, E., Luca, J. De, Grosso, F. Del, Iacobelli, L., Langone, S., Lembo Fazio, C., Locchi, G., Perrone, M., Petroni, F., Raimondi, D., Romiti, F., Secco, S., Sonet, L., Spinelli, A., Toscano, S., Vanadia, S., Vecchi, S., Zanon, F., and Malavasi, Marco

Abstract

In January 2019, Italy banned the sale of plastic cotton buds, which is one of the most abundant litter items entering the sea and then washing ashore. However, since the ban came into force, no studies have been carried out to assess whether the measure has actually led to the reduction of plastic cotton buds accumulating on Italian coasts. Here we aim at evaluating the effectiveness of the ban in reducing the amount of cotton buds reaching sandy beaches of the Tyrrhenian coast. Specifically, we monitored the accumulation of beach litter for one year since the ban came into force. By surveying eight coastal sites from winter 2019 to winter 2020, we collected a total of 52,824 items mostly constituted by plastic debris (97.6%). We found that cotton buds were the most abundant item (42.3% of total litter), followed by plastic (28.5%) and polystyrene (5.43%) fragments. Our preliminary assessment suggests that the ban has so far not led to a sensible reduction in the amount of cotton buds entering the marine ecosystem. This was to be expected since implementation strategies are still lacking (i.e. no economic sanctions can be imposed in case of non-compliance) and bans are differently implemented among countries facing the Mediterranean Sea, calling for law enforcement and implementation at the national and international levels.

Published
2022

17. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Guerra, F., De Ponti, R., D'Onofrio, A., Accogli, M., Bertini, M., Bisignani, G., Forleo, G. B., Landolina, M., Lavalle, C., Notarstefano, P., Ricci, R. P., Zanotto, G., Palmisano, P., Luise, R., De Bonis, S., Pangallo, A., Talarico, A., Maglia, G., Aspromonte, V., Nigro, G., Bianchi, V., Rapacciuolo, A., Ammendola, E., Solimene, F., Stabile, G., Biffi, M., Ziacchi, M., Malpighi, P. S. O., Saporito, D., Casali, E., Turco, V., Malavasi, V. L., Vitolo, M., Imberti, J. F., Anna, A. S., Zardini, M., Placci, A., Quartieri, F., Bottoni, N., Carinci, V., Barbato, G., De Maria, E., Borghi, A., Ramazzini, O. B., Bronzetti, G., Tomasi, C., Boggian, G., Virzi, S., Sassone, B., Corzani, A., Sabbatani, P., Pastori, P., Ciccaglioni, A., Adamo, F., Scaccia, A., Spampinato, A., Patruno, N., Biscione, F., Cinti, C., Pignalberi, C., Calo, L., Tancredi, M., Di Belardino, N., Ricciardi, D., Cauti, F., Rossi, P., Cardinale, M., Ansalone, G., Narducci, M. L., Pelargonio, G., Silvetti, M., Drago, F., Santini, L., Pentimalli, F., Pepi, P., Caravati, F., Taravelli, E., Belotti, G., Rordorf, R., Mazzone, P., Bella, P. D., Rossi, S., Canevese, L. F., Cilloni, S., Doni, L. A., Vergara, P., Baroni, M., Perna, E., Gardini, A., Negro, R., Perego, G. B., Curnis, A., Arabia, G., Russo, A. D., Marchese, P., Dell'Era, G., Occhetta, E., Pizzetti, F., Amellone, C., Giammaria, M., Devecchi, C., Coppolino, A., Tommasi, S., Anselmino, M., Coluccia, G., Guido, A., Rillo, M., Palama, Z., Luzzi, G., Pellegrino, P. L., Grimaldi, M., Grandinetti, G., Vilei, E., Potenza, D., Scicchitano, P., Favale, S., Santobuono, V. E., Sai, R., Melissano, D., Candida, T. R., Bonfantino, V. M., Di Canda, D., Gianfrancesco, D., Carretta, D., Pisano, E. C. L., Medico, A., Giaccari, R., Aste, R., Murgia, C., Nissardi, V., Sanna, G. D., Firetto, G., Crea, P., Ciotta, E., Sgarito, G., Caramanno, G., Ciaramitaro, G., Faraci, A., Fasheri, A., Di Gregorio, L., Campsi, G., Muscio, G., Giannola, G., Padeletti, M., Del Rosso, A., Nesti, M., Miracapillo, G., Giovannini, T., Pieragnoli, P., Rauhe, W., Marini, M., Guarracini, F., Ridarelli, M., Fedeli, F., Mazza, A., Zingarini, G., Andreoli, C., Carreras, G., Zorzi, A., Rossillo, A., Ignatuk, B., Zerbo, F., Molon, G., Fantinel, M., Zanon, F., Marcantoni, L., Zadro, M., and Bevilacqua, M.

Subjects
Cardiac resynchronization therapy, Remote monitoring, Emergency Medicine, Internal Medicine, Ablation, Arrhythmia, Atrial fibrillation, COVID-19, Implantable cardioverter defibrillators, Pacemakers
Abstract

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.

Published
2022

22. Left bundle branch pacing: 2 year single-centre experience

Author

Marcantoni, L, primary, Pastore, G, additional, Baracca, E, additional, Bartolomei, M, additional, Centioni, M, additional, Andreaggi, S, additional, Pellegrini, N, additional, Galuppi, E, additional, Rigatelli, G, additional, Roncon, L, additional, and Zanon, F, additional

Published
2021
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23. EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators: endorsed by the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS), and the Latin-American Heart Rhythm Society (LAHRS)

Author

Burri, H., Starck, C., Auricchio, A., Biffi, M., Burri, M., D'Avila, A., Deharo, J.C., Glikson, M., Israel, C., Lau, C.P., Leclercq, C., Love, C.J., Nielsen, J.C., Vernooy, K., Dagres, N., Boveda, S., Butter, C., Marijon, E., Braunschweig, F., Mairesse, G.H., Gleva, M., Defaye, P., Zanon, F., Lopez-Cabanillas, N., Guerra, J.M., Vassilikos, V.P., Martins Oliveira, M., Burri, H., Starck, C., Auricchio, A., Biffi, M., Burri, M., D'Avila, A., Deharo, J.C., Glikson, M., Israel, C., Lau, C.P., Leclercq, C., Love, C.J., Nielsen, J.C., Vernooy, K., Dagres, N., Boveda, S., Butter, C., Marijon, E., Braunschweig, F., Mairesse, G.H., Gleva, M., Defaye, P., Zanon, F., Lopez-Cabanillas, N., Guerra, J.M., Vassilikos, V.P., and Martins Oliveira, M.

Abstract

Contains fulltext : 238765.pdf (Publisher’s version ) (Closed access), With the global increase in device implantations, there is a growing need to train physicians to implant pacemakers and implantable cardioverter-defibrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to fill the gap by setting standards for device implantation.

Published
2021

24. Evaluation of Short-Term Pacing Effect to Predict Long-Term Response to Cardiac Resynchronization Therapy: The TRAJECTORIES Study

Author

Santarelli G., Severi S., Tomasi C., Corsi C., Ciccotelli R., Molon G., Zanon F., Corzani A., Rossillo A., Biffi M., Zanotto G., Lanzoni L., Santarelli G., Severi S., Tomasi C., Corsi C., Ciccotelli R., Molon G., Zanon F., Corzani A., Rossillo A., Biffi M., Zanotto G., and Lanzoni L.

Subjects
Cardiac Resynchronization Therapy
Abstract

Cardiac resynchronization therapy (CRT) is an effective treatment for chronic symptomatic systolic heart failure with cardiac dyssynchrony, but about 1/3 of patients do not respond favorably to the therapy. We hypothesized that acute modifications of the coronary sinus (CS) pacing cathode movements induced by biventricular pacing may be related to resynchronization process and consequently may carry predictive power on CRT response. A method for the 3D reconstruction of CS lead's pacing cathode trajectory (3DTJ) throughout a cardiac cycle showed that trajectory's geometry suddenly changed in responders (R) upon starting of biventricular pacing, becoming less eccentric and more multi-directional. Our multicenter observational study aimed at evaluating the clinical value of 3DTJ. Out of 119 patients enrolled, 50 have ended follow-up and have been analyzed. Concordance between 3DTJ metrics and response was 82% overall (41/50), 91% in R (31/34), 62% in NR (10/16). The proposed 3DTJ metric showed high sensitivity (91%) with specificity=62%; PPV=84%, NPV=77%. From our data, 3DTJ seems a promising tool to acutely predict CS pacing site-specific response to CRT. Its investigational use as an intra-operatory, real-time guidance for selecting LV pacing sites may open new opportunities for CRT patients' selection and therapy delivery.

Published
2019

26. Indicazioni metodologiche

Author

Cottini, L, Mangiatordi, A, Pascoletti, S, Vivanet, G, Zanon, F, Calvani, A, Cottini, L, Mangiatordi, A, Pascoletti, S, Vivanet, G, Zanon, F, and Calvani, A

Published
2020

28. Indicazioni tecnologiche

Author

Cottini, L, Mangiatordi, A, Pascoletti, S, Vivanet, G, Zanon, F, Calvani, A, Cottini, L, Mangiatordi, A, Pascoletti, S, Vivanet, G, Zanon, F, and Calvani, A

Published
2020

32. P544Evaluation of three-dimensional trajectory of pacing cathode pole in coronary sinus to predict long-term response to cardiac resynchronization therapy

Author

Tomasi, C, primary, Severi, S, additional, Zanon, F, additional, Molon, G, additional, Corzani, A, additional, Rossillo, A, additional, Biffi, M, additional, Marcantoni, L, additional, Costa, A, additional, Dal Monte, A, additional, Santarelli, G, additional, Lanzoni, L, additional, and Corsi, C, additional

Published
2020
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34. A CASE OF PULMONARY HYPERTENSION ASSOCIATED WITH MYELOFIBROSIS: THERAPEUTICAL CHALLENGES FROM ACUTE TO CHRONIC SETTING

Author

Bignami, L, Picariello, C, Diaferio, A, Porcelli, G, Deluca, F, Marcantoni, L, Maddalozzo, A, Ribichini, F, and Zanon, F

Abstract

A 85–year–old female was transferred to our ICCU for acute heart failure from one of our spoke hospitals. The patient had a long history of chronic myelofibrosis, treated with fedratinib as a second–line agent after ruxolitinib failure. During a recent hospital admission, transthoracic echocardiography already showed signs of severe pulmonary hypertension (PH) with right ventricular (RV) dysfunction, so diuretic was started. On admission the patient presented showed consistent with acute on chronic kidney injury (serum Cr 3.2 mg/dl), stable anemia (Hb 9.2 mg/dl) and markedly elevated Nt–proBNP. A pulmonary CT–scan excluded acute pulmonary embolism and lung parenchymal alterations, with a clear dilation of main pulmonary artery. Transthoracic echocardiography (figure 1) confirmed precapillary PH phenotype diagnosis. Electrocardiogram (figure 2) showed sinus rhythm; incomplete RBBB, T wave inversion in V2 to V4. The patient was initially treated with high dose furosemide, low flow oxygen; but later she needed multiple cycles of inotropes, vasopressors and combined diuretic therapy (metolazone and acetazolamide) to stabilize the clinical setting. The patient also experienced episodes of paroxysmal high ventricular rate atrial flutter. After resolution of volume overload, a right heart catheterization was performed and findings were consistent with severe precapillary pulmonary hypertension: PA pressure 90/58/40 mmHg, normal PCWP, high PVR, mild cardiac index reduction. Due to critical clinical situation, Sildenafil 20 mg was started as an off–label therapy for PH (group 5). Subsequently, the patient experienced gradual but constant hemodynamic and clinical improvement and was discharged in NYHA class II. At 1 month control, patient was stable, echocardiogram revealed improvement in right ventricle dimension, systolic function and right atrial enlargement. At three months, patient is still in an intermediate risk class for PH, so we are evaluating a combination therapy (either endothelin receptor antagonist or prostanoids), taking into account anemia and thrombocytopenia. Take home message: PH can be a complication of hematological disorders as myelofibrosis, included in “mixed” forms (group 5) of PH. In our patient, after a challenging management for acute right heart failure, an off–label PDE–5 inhibitor stabilized the clinical scenario: more data are needed on PH drugs use in this setting where up to now therapeutic strategies are lacking.

Published
2024
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35. THROW YOUR LEAD OVER THE OBSTACLE: A CHALLENGING CRT UPGRADING

Author

Valenza, S, Pastore, G, Marcantoni, L, Deluca, F, Porcelli, G, and Zanon, F

Abstract

High percentage of right ventricular pacing could lead to pacing induced cardiomyopathy in a non–negligible proportion of patients. Cardiac resynchronization therapy upgrading could represent an option to improve ventricular function, reducing heart failure hospitalizations. A 82 yo male was admitted to hospital with symptomatic heart failure. He had history of complete AV block treated with dual chamber pacemaker implantation five years earlier following coronary artery bypass graft surgery, bioprosthetic aortic valve replacement and septal myectomy. He had also history of cardiac arrest occurred in the context of acute coronary syndrome treated with PCI so that ICD implant was not considered at that time, and two more HF hospitalizations in previous years. Progressive LVEF decline was documented since PM impantation until last echo showed severe left ventricular dysfunction (EF 20% from baseline EF 60%). The ECG showed sinus rhythm and wide paced QRS (206 ms) with 100% pacing percentage. A CRT device upgrading was planned. Baseline venography initially showed pervious axillary–subclavian left axis, but unfortunately the guidewire encountered a complete occlusion before entering the superior vena cava. Nevertheless, dye contrast injection documented the presence of a proximal collateral branch (fig A) having a vertical course in the thorax and reaching the lateral wall of the left ventricle with an extrapericardic course then entering the right heart through inferior vena cava. Using a IM 5Fr sheath (usually used by interventional cardiologists to cannulate internal mammary artery) we could reach this branch, inserting a guidewire and finally advancing a quadripolar lead (Fig B–C) which reached the lateral left ventricular wall. LV capture was confirmed when pacing from the three proximal poles, while the distal one caused phrenic nerve capture. The quadripolar lead was connected to the LV port of a three chamber PM along with previous implanted leads thus obtaining biventricular pacing. QRS paced was 50 ms shorter than baseline. No peri–procedural complications occurred. Lead–related venous occlusion might represent an obstacle to CRT upgrade requiring high technical expertise. The presence of a complete venous occlusion might cause procedural failure, particularly in hospitals without surgical facility. In this case, the presence of a collateral branch reaching the lateral wall of the left ventricle allowed to successfully complete the CRT upgrade.

Published
2024
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36. P6547The energy cost of His bundle pacing can be curtailed

Author

Zanon, F, primary, Marcantoni, L, additional, Pastore, G, additional, Baracca, E, additional, Picariello, C, additional, Lanza, D, additional, Maddalozzo, A, additional, Giatti, S, additional, Carraro, M, additional, Roncon, L, additional, Barbetta, A, additional, and Di Gregorio, F, additional

Published
2019
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37. P2871Attenuated clinical benefit after ICD replacement over long term follow-up in a contemporary large world population: insight to the DECODE registry

Author

Zanon, F, primary, Menardi, E, additional, Ammendola, E, additional, De Filippo, P, additional, Manzo, M, additional, Stabile, G, additional, Potenza, D R, additional, Zaca', V, additional, Bertini, M, additional, Lissoni, F, additional, Bandini, A, additional, Calzolari, V, additional, Zingarini, G, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2019
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38. P5238Rate, cause and costs of Heart Failure hospitalizations following ICD/CRT-D replacement: preliminary data from an Italian multicenter registry

Author

Zaca', V, primary, Narducci, M L, additional, Parisi, Q, additional, Quartieri, F, additional, Zanon, F, additional, Zoni Berisso, M, additional, Saporito, D, additional, Notarstefano, P, additional, Miracapillo, G, additional, Ferretti, C, additional, Calo', L, additional, Del Rosso, A, additional, Carinci, V, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2019
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39. Improved acute haemodynamic response to cardiac resynchronization therapy using multipoint pacing cannot solely be explained by better resynchronization

Author

Engels, E.B., Vis, A., Rees, B.D. van, Marcantoni, L., Zanon, F., Vernooy, K., Prinzen, F.W., Engels, E.B., Vis, A., Rees, B.D. van, Marcantoni, L., Zanon, F., Vernooy, K., and Prinzen, F.W.

Abstract

Contains fulltext : 200177.pdf (Publisher’s version ) (Open Access), BACKGROUND: The recently developed quadripolar left ventricular (LV) leads have been developed to increase the benefit of cardiac resynchronization therapy (CRT). These leads offer the option to stimulate the LV on multiple sites (multipoint pacing, MPP). Invasive haemodynamic measurements have shown that MPP increases haemodynamic response. PURPOSE: To investigate whether the beneficial effect of MPP can be explained by better electrical resynchronization. METHODS: Different LV lead locations were tested during biventricular (BiV) pacing and MPP in 29 CRT candidates. The 12-lead electrocardiogram (ECG) and the invasive LV pressure curves were measured simultaneously. The Kors matrix was used to convert the ECG into a vectorcardiogram (VCG). The acute haemodynamic benefit of MPP was compared with the reduction in QRS duration and VCG-derived QRS area. RESULTS: Out of the 29 patients, three patients were excluded due to missing LV pressures or ECG measurements. In the remaining 26 patients MPP resulted in a significant haemodynamic improvement compared to BiV pacing without a significant change in QRS duration and QRS area. In only 5 out of the 26 patients the QRS area decreased during MPP compared to BiV pacing. In 17 patients MPP did not change QRS duration and significantly increased QRS area but moved the direction of the maximal QRS vector (azimuth) more opposite from baseline compared to BiV pacing. In 4 patients the QRS area was small during baseline, indicating limited electrical dyssynchrony. CONCLUSION: The acute haemodynamic benefit of MPP over BiV pacing is achieved by either electrical resynchronization (reduction in QRS area) or by a rotation of the maximal QRS vector, indicating a more LV dominated activation sequence. The latter property was found in two-thirds of the cohort studied.

Published
2018

40. Appropriate implantable cardioverter-defibrillator interventions in cardiac resynchronization therapy-defibrillator (CRT-D) patients undergoing device replacement: time to downgrade from CRT-D to CRT-pacemaker? Insights from real-world clinical practice in the DECODE CRT-D analysis

Author

Narducci, Ml, Biffi, M, Ammendola, E, Vado, A, Campana, A, Potenza, Dr, Iori, M, Zanon, F, Zacà, V, Zoni Berisso, M, Bertini, M, Lissoni, F, Bandini, A, Malacrida, M, Crea, F, Narducci ML, Crea F (ORCID:0000-0001-9404-8846), Narducci, Ml, Biffi, M, Ammendola, E, Vado, A, Campana, A, Potenza, Dr, Iori, M, Zanon, F, Zacà, V, Zoni Berisso, M, Bertini, M, Lissoni, F, Bandini, A, Malacrida, M, Crea, F, Narducci ML, and Crea F (ORCID:0000-0001-9404-8846)

Abstract

AIM: Ventricular tachycardia (VT)/ventricular fibrillation (VF) occurrence after cardiac resynchronization therapy-defibrillator (CRT-D) replacement is unknown; hence, there is no practical guideline to recommend either CRT-D or CRT-pacemaker at the time of device replacement. We observed the 1-year VT/VF occurrence after CRT-D replacement in a subanalysis of the Detect Long-term Complications after ICD Replacement (DECODE) registry. METHODS AND RESULTS: A total of 332 consecutive patients who had undergone CRT-D replacement from 2013 to 2015 were enrolled in 36 Italian centres. The primary endpoint was the number of patients with any appropriate implantable cardioverter-defibrillator (ICD) interventions during 12-month follow-up. The secondary endpoint comprised death from any cause and appropriate ICD interventions. At replacement, 214 (64.5%) patients had a left ventricular ejection fraction ≤ 35% and 138 (41.6%) patients had a secondary prevention indication for ICD. Seventy (21.1%) patients had no longer indication to ICD therapy. During a median follow-up period of 406.5 (362-533) days, VT/VF requiring therapy delivery occurred in 57 (17%) patients, specifically in 7% of those who no longer had an ICD indication. On multivariate analysis, number of criteria for ICD replacement independently predicted appropriate ICD intervention during follow-up [hazard ratio (HR) = 1.62, 95% confidence interval (CI) 1.07-2.46; log-rank P = 0.02]. The combined endpoint of death from any cause or appropriate ICD therapy occurred in 76 (23%) patients. Only NYHA class remained associated with this combined endpoint (HR = 1.97, 95% CI 1.23-3.14; P = 0.005). CONCLUSIONS: The DECODE registry showed the 'real-world' experience of CRT-D recipients approaching device replacement, in which 7% of patients who no longer had an indication for ICD therapy experienced appropriate ICD interventions.

Published
2018

42. HALF DOSE THROMBOLYSIS IN INTERMEDIATE – HIGH RISK PULMONARY EMBOLISM WITH TRICUSPID VALVE MOBILE MASS: A BAIL OUT STRATEGY

Author

Roccabruna, A, Giatti, S, Pastore, G, D’Elia, K, Carraro, M, Conte, L, Marcantoni, L, Aggio, S, Ribichini, F, Picariello, C, and Zanon, F

Abstract

A 82–year–old previously healthy male was referred to the emergency department complaining sudden onset dyspnea and witnessed syncope complicated by head trauma. Recurrent dizziness occurred previously. No history or drug consumption noted. On admission: heart rate 90 beats/min, blood pressure 110/60 mmHg, respiratory rate 25 breaths/min, oxygen saturation 87% in room air, normal body temperature. No lower extremities tenderness or swelling reported. Consistent with peripheral blood oxygen saturation levels, arterial blood gas analysis showed hypoxemia and respiratory alkalosis. Laboratory exams were significant for thrombocytopenia (89.000 cells/L), elevated cardiac troponin T levels (222 ng/L) and natriuretic peptide (NT pro–BNP 3944 pg/mL). Head CT excluded acute cerebral hemorrhage. At the electrocardiogram, signs of RV strain were present (biphasic T–waves in V1–V3 leads, S1–Q3–T3). Transthoracic echocardiography (TTE) showed dilated RV with hypokinetic free wall, “D–shaped” LV, “60/60” sign and a mobile filiform mass crossing the tricuspid valve plan in the right atrium (fig. 1). The patient did not present structural valvular abnormalities or endocarditis–related risk factors. CT pulmonary angiography detected a “saddle” PE and extensive thrombosis in inferior vena cava. After unfractioned heparin (UFH) bolus, the patient was transferred to our intensive care unit and balancing risks and benefits the chosen treatment option consisted in half dose systemic thrombolysis (50 mg rtPA in 60’’; 10 mg as loading dose in 2’). Because of potential harmful effects in thrombocytopenia and recent head trauma, UFH was temporarily withheld and started again after 1 hour. The day after, a beside TTE showed complete tricuspid thrombus resolution, a significant decrease in RV/LV ratio and systolic pulmonary artery pressure (fig. 2). Apart from small hematomas, no bleedings were reported. The patient was shifted to the ward on the next day and following course was uneventful. On day 4 a direct oral anticoagulant (Dabigatran 110 mg) was started. Abdominal and inferior limb–deep–venous ultrasound were both negative for pathological reports. A total body CT was scheduled to exclude silent malignancies at discharge. Take home message: in intermediate–high risk PE, half dose systemic fibrinolysis strategy is controversial since its potential benefit is counterbalanced by concerns about major bleedings, but increasing data suggest its efficacy with low risk profile.

Published
2024
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44. 5305Heart failure-related hospitalizations in ICD/CRT-D recipients following device replacement or upgrade: insights from the DECODE registry

Author

Zaca', V, primary, Narducci, M L, additional, Nigro, G, additional, Menardi, E, additional, Zanon, F, additional, Zoni Berisso, M, additional, Bertini, M, additional, Lissoni, F, additional, Calzolari, V, additional, Bandini, A, additional, Tomasi, C, additional, Carinci, V, additional, Ferretti, C, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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46. P5744Long-term response prediction to cardiac resynchronization therapy by acute pacing-induced changes in 3D trajectory of pacing cathode pole in coronary sinus: preliminary results of TRAJECTORIES study

Author

Tomasi, C, primary, Molon, G, additional, Marcantoni, L, additional, Zanon, F, additional, Corzani, A, additional, Rossillo, A, additional, Biffi, M, additional, Zanotto, G, additional, Severi, S, additional, Lanzoni, L, additional, and Corsi, C, additional

Published
2018
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47. P3158Health care consumption after ICD/CRT-D replacement: preliminary results from the DECODE registry

Author

Zaca', V, primary, Menardi, E, additional, Zanon, F, additional, Ammendola, E, additional, Narducci, M L, additional, Giofre', F, additional, Zoni Berisso, M, additional, Bertini, M, additional, Tomasi, C, additional, Lissoni, F, additional, Pierantozzi, A, additional, Zingarini, G, additional, Carinci, V, additional, Malacrida, M, additional, and Biffi, M, additional

Published
2018
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