Search

Your search keyword '"Nicolas, Clementy"' showing total 8 results
Start Over Author "Nicolas, Clementy" Publisher hal ccsd
8 results on '"Nicolas, Clementy"'

1. Outcomes associated with pacemaker implantation following transcatheter aortic valve replacement: A nationwide cohort study

Author

Nicolas Clementy, Dominique Babuty, Alexandre Bodin, Julien Herbert, Arnaud Bisson, Laurent Fauchier, Bertrand Pierre, Christophe Saint Etienne, Pierre Deharo, Thibaud Lacour, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), and Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Heart failure, 030204 cardiovascular system & hematology, Patient Readmission, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Valve replacement, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, education, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Outcome, Aged, 80 and over, education.field_of_study, business.industry, Incidence (epidemiology), Incidence, Aortic stenosis, Hazard ratio, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, Aortic Valve Stenosis, medicine.disease, Transcatheter aortic valve replacement, Confidence interval, Pacing-induced cardiomyopathy, Pacemaker, Stenosis, Heart Valve Prosthesis, Cardiology, Female, France, Cardiology and Cardiovascular Medicine, business, Cohort study, Follow-Up Studies
Abstract

International audience; BACKGROUND Conduction abnormalities following transcatheter aortic valve replacement (TAVR) often may require permanent pacemaker implantation (PPM).OBJECTIVE The purpose of this study was to evaluate outcomes associated with PPM after a TAVR procedure in a large, nationwide-level population.METHODS Based on the administrative hospital discharge database, the incidence of all-cause death, cardiovascular death, and hospitalization for heart failure (HF) were retrospectively collected, based on the presence or absence of PPM, in the first 30 days following all TAVRs in France from 2010 to 2019.RESULTS Among 520,662 patients hospitalized for aortic stenosis, 49,201 were treated with TAVR. A total of 29,422 patients had follow-up >= 6 months (median 1.7 years), 22% already had PPM at baseline, and 22% underwent PPM within the first 30 days post-TAVR. Adjusted hazard ratios for the combined risk of all-cause death and hospitalization for HF, during the whole follow-up, were higher in both patients with a previous PPM and in those implanted within 30 days (hazard ratio [95% confidence interval] 1.12 [1.07-1.17] and 1.11 [1.06-1.16], respectively).CONCLUSION PPM at baseline and within 30 days post-TAVR are independently associated with higher mortality and HF hospitalization during follow-up.

Published
2021
Full Text
View/download PDF

2. Leadless pacemakers in critically ill patients requiring prolonged cardiac pacing: A multicenter international study

Author

Christian Veltmann, Sylvain Ploux, Philippe Ritter, Clemens Steinwender, Raphaël P. Martins, José María Tolosana, Vincent Galand, Eloi Marijon, Edouard Simeon, Margarida Pujol-López, Romain Eschalier, Johanna Mueller-Leisse, Roxane Coelho, Hermann Blessberger, Dominique Babuty, Nicolas Clementy, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hannover Medical School [Hannover] (MHH), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), University of Barcelona, CHU Pontchaillou [Rennes], CHU Pessac, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Kepler University Hospital, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Jonchère, Laurent

Subjects
Pacemaker, Artificial, leadless, Critical Illness, [SDV]Life Sciences [q-bio], Population, 030204 cardiovascular system & hematology, Intracardiac injection, temporary pacing, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Physiology (medical), Intensive care, Medicine, Humans, 030212 general & internal medicine, education, Aged, Retrospective Studies, intensive care, education.field_of_study, business.industry, Mortality rate, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, Equipment Design, medicine.disease, Intensive care unit, pacemaker, 3. Good health, Transvenous pacing, [SDV] Life Sciences [q-bio], Treatment Outcome, Bacteremia, Anesthesia, Cardiology and Cardiovascular Medicine, business, Complication
Abstract

Background Temporary transvenous pacing in critically ill patients requiring prolonged cardiac pacing is associated with a high risk of complications. We sought to evaluate the safety and efficacy of self-contained intracardiac leadless pacemaker (LPM) implantation in this population. Methods and results Consecutive patients implanted with a Micra LPM during the hospitalization in an intensive care unit were retrospectively included. Inclusion criteria were: ≥1 supracaval central venous, or a ventilation tube, or intravenous antibiotic therapy for ongoing sepsis or bacteremia. Patients with a history of previous implantation of a pacemaker were excluded. Out of 1,016 patients implanted with an LPM, 99 met the inclusion criteria. Mean age was 75 years and Charlson comorbidity index 7. LPM implantation was successfully performed in 98% of cases, with a peri-operative complication rate of 5%, mainly cardiac injuries. In-hospital mortality rate was 6%. No late (>30 days) device-related complication occurred, especially no infection. Conclusions LPM appears as an acceptable alternative to conventional temporary transvenous pacing in selected critically ill patients requiring prolonged cardiac pacing, especially regarding the risk of infection. This article is protected by copyright. All rights reserved.

Published
2021
Full Text
View/download PDF

3. Pacemaker Implantation After Balloon-or Self-Expandable Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis

Author

Julien Herbert, Alexandre Bodin, Thibaud Lacour, Dominique Babuty, Christophe Saint Etienne, Arnaud Bisson, Bertrand Pierre, Laurent Fauchier, Pierre Deharo, Nicolas Clementy, Guieu, régis, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)

Subjects
medicine.medical_specialty, Transcatheter aortic, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Balloon, Pacemaker implantation, 03 medical and health sciences, 0302 clinical medicine, Valve replacement, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, In patient, 030212 general & internal medicine, PREDICTORS, transcatheter aortic valve implantation, OUTCOMES, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Self expandable, business.industry, aortic stenosis, medicine.disease, pacemaker, 3. Good health, Surgery, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV] Life Sciences [q-bio], Stenosis, Cardiology, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background The incidence of conduction abnormalities requiring permanent pacemaker implantation ( PPI ) after transcatheter aortic valve replacement ( TAVR ) with early and later generation prostheses remains debated. Methods and Results Based on the administrative hospital‐discharge database, we collected information for all patients treated with TAVR between 2010 and 2019 in France. We compared the incidence of PPI after TAVR according to the type and generation of valve implanted. A total of 49 201 patients with aortic stenosis treated with TAVR using the balloon‐expandable ( BE ) Edwards SAPIEN valve (early Sapien XT and latest Sapien 3) or the self‐expanding ( SE ) Medtronic CoreValve (early CoreValve and latest Evolut R) were found in the database. Mean ( SD ) follow‐up was 1.2 (1.5 years) (median [interquartile range] 0.6 [0.1–2.0] years). PPI after the procedure was reported in 13 289 patients, among whom 11 010 (22.4%) had implantation during the first 30 days. In multivariable analysis, using early BE TAVR as reference, adjusted odds ratio (95% CI ) for PPI during the first 30 days was 0.88 (0.81–0.95) for latest BE TAVR , 1.40 (1.27–1.55) for early SE TAVR , and 1.17 (1.07–1.27) for latest SE TAVR . Compared with early BE TAVR , the adjusted hazard ratio for PPI during the whole follow‐up was 1.01 (0.95–1.08) for latest BE TAVR , 1.30 (1.21–1.40) for early SE TAVR , and 1.25 (1.18–1.34) for latest SE TAVR . Conclusions In patients with aortic stenosis treated with TAVR , our systematic analysis at a nationwide level found higher rates of PPI than previously reported. BE technology was independently associated with lower incidence rates of PPI both at the acute and chronic phases than SE technology. Recent generations of TAVR were not independently associated with different rates of PPI than early generations during the overall follow‐up.

Published
2020
Full Text
View/download PDF

4. Localization of Left Ventricular Lead Electrodes in Relation to Myocardial Scar in Patients Undergoing Cardiac Resynchronization Therapy

Author

Dominique Babuty, Anne Bernard, Laurent Fauchier, Arnaud Bisson, Clémentine André, Nicolas Clementy, Julien Pucheux, Bertrand Pierre, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Griset SA, Diehl - Griset, Service de Cardiologie B, Service de Cardiologie (CHU Trousseau, Tours), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Department of Radiology, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP]

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Heart Ventricles, Cardiac resynchronization therapy, cardiac resynchronization therapy, 030204 cardiovascular system & hematology, image fusion, [SHS]Humanities and Social Sciences, 03 medical and health sciences, QRS complex, Cicatrix, 0302 clinical medicine, Fibrosis, Internal medicine, medicine, Humans, 030212 general & internal medicine, Lead (electronics), Electrodes, Aged, Original Research, Heart Failure, Ischemic cardiomyopathy, Cardiovascular Surgery, medicine.diagnostic_test, business.industry, Left bundle branch block, Myocardium, left ventricular lead, fibrosis, Magnetic resonance imaging, medicine.disease, Pacemaker, Cardiology, Myocardial fibrosis, Female, Cardiology and Cardiovascular Medicine, business, Cardiomyopathies
Abstract

Background The efficacy of cardiac resynchronization therapy may be reduced in the event of pacing within myocardial fibrosis. We aimed to develop a method to determine the anatomical relationships between the left ventricular ( LV ) lead and myocardial fibrosis. Methods and Results In consecutive patients indicated for cardiac resynchronization therapy, cardiovascular magnetic resonance imaging with late gadolinium enhancement assessment was performed before implantation. After implantation, an injected computed tomography scanner ( CT scan) was performed. The 2 imaging techniques were fused to assess the LV lead position relative to myocardial scar. A total of 68 patients were included. Myocardial scar was found in 29 (43%) and was localized in lateral segments in 14 (21%). Scar was significantly associated with male sex, ischemic cardiomyopathy, a Selvester score adapted to left bundle branch block ( LBBB Selvester), and Selvester criteria for localizing lateral fibrosis (V2 S/S′ ratio). Image fusion was feasible in all patients. Position within myocardial scar was confirmed for 6 electrodes in 3 patients. Prolonged QRS duration during LV pacing ≥139% predicted electrode positioning within scar tissue (sensitivity, 83%; specificity, 91%; P =0.002). Conclusions In cardiac resynchronization therapy patients, fusion between preimplantation cardiovascular magnetic resonance and a postimplantation injected computed tomography scan is a feasible technique. Prolongation of the QRS duration during LV pacing predicts pacing within myocardial scar. Accurate location of LV lead pacing electrodes on the epicardial surface relative to myocardial scar, either by imaging or ECG analyses, may help improve cardiac resynchronization therapy response in selected patients.

Published
2018
Full Text
View/download PDF

5. Stroke, thromboembolism and bleeding in patients with atrial fibrillation according to the EHRA valvular heart disease classification

Author

Arnaud Bisson, Laurent Fauchier, Dominique Babuty, Gregory Y.H. Lip, Nicolas Clementy, Alexandre Bodin, Anne Bernard, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie B, University of Liverpool, Aalborg University [Denmark] (AAU), Service de Cardiologie (CHU Trousseau, Tours), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut Français du Cheval et de l'Equitation [Saumur] (IFCE)-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Male, medicine.medical_specialty, Heart Valve Diseases, Hemorrhage, Valve prosthesis, 030204 cardiovascular system & hematology, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Mitral valve stenosis, Internal medicine, Thromboembolism, Medicine, Humans, Mitral Valve Stenosis, In patient, 030212 general & internal medicine, Stroke, ComputingMilieux_MISCELLANEOUS, Prosthetic heart, Aged, Retrospective Studies, Aged, 80 and over, Ischemic stroke, business.industry, valvular heart disease, Rheumatic Heart Disease, Atrial fibrillation, Middle Aged, medicine.disease, Valvular heart disease, Clinical Practice, Heart Valve Prosthesis, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Valve disease
Abstract

Aims We compared thromboembolic (TE) and bleeding risks in patients with atrial fibrillation (AF) according to the new ‘Evaluated Heartvalves, Rheumatic or Artificial' (EHRA) valve classification. Methods Patients were divided into 3 categories: (i) EHRA type 1 corresponds to the previous ‘valvular' AF patients, with either rheumatic mitral valve stenosis or mechanical prosthetic heart valves; (ii) EHRA type 2 includes AF patients with other valvular heart disease (VHD) and valve bioprosthesis or repair; and (iii) ‘non-VHD controls' i.e. all AF patients with neither VHD nor post-surgical valve disease. Results Among 8962 AF patients seen between 2000 and 2010, 357 (4%) were EHRA type 1, 1754 (20%) were EHRA type 2 and 6851 (76%) non-VHD controls. EHRA type 2 patients were older and had a higher CHA 2 DS 2 -VASc and HAS-BLED scores than either type 1 and non-VHD patients. After a mean follow-up of 1264 ± 1160 days, the occurrence of TE events was higher in EHRA type 2 than non-VHD patients (HR (95%CI): 1.30 1.09–1.54), p = 0.003; also, p = 0.31 for type 1 vs 2, p = 0.68 for type 1 vs non-VHD controls). The rate of major BARC bleeding events for AF patients was higher in either EHRA type 1 (HR (95%CI): 3.16(2.11–4.72), p p Conclusion The EHRA valve classification of AF patients with VHD appears useful in categorizing these patients, in terms of TE and bleeding risks. This classification can be used in clinical practice for appropriate choices of oral anticoagulation therapy and follow-up.

Published
2018
Full Text
View/download PDF

6. Very high rate programming in primary prevention patients with reduced ejection fraction implanted with a defibrillator: Results from a large multicenter controlled study

Author

Christophe Leclercq, Vincent Algalarrondo, Pascal Defaye, Nicolas Sadoul, Jean-Claude Deharo, Dominique Babuty, Daniel Gras, Laurent Fauchier, Serge Boveda, Farid Challal, Pierre Bordachar, Olivier Piot, Didier Klug, Nicolas Clementy, Eloi Marijon, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Cardiac Stimulation and Rhythmology, CHU Grenoble, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre cardiologique du Nord (CCN), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes (UN), CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Aix Marseille Université ( AMU ), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques ( DS-ACI / UMR MD2 ), Aix Marseille Université ( AMU ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital de la Timone [CHU - APHM] ( TIMONE ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre cardiologique du Nord, Cardiopathies et mort subite, Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), and CHU de Tours

Subjects
Male, Inappropriate, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Cardiomyopathy, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Sudden cardiac death, Cohort Studies, Ventricular Dysfunction, Left, 0302 clinical medicine, Heart Rate, Risk Factors, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Outcome, Ejection fraction, Primary prevention, Hazard ratio, Antitachycardia pacing, Atrial fibrillation, Appropriate, Shock, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, 3. Good health, Outcome and Process Assessment, Health Care, High rate, Cardiology, Programming, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Electric Countershock, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, Humans, Aged, Proportional Hazards Models, [ SDV ] Life Sciences [q-bio], business.industry, Stroke Volume, medicine.disease, Confidence interval, Death, Sudden, Cardiac, Ventricular fibrillation, Tachycardia, Ventricular, business, Follow-Up Studies
Abstract

International audience; BACKGROUND: Programming implantable cardioverter-defibrillators (ICDs) with a high-rate therapy strategy has proven to be effective in reducing shocks and is associated with a reduced mortality. OBJECTIVE: We sought to determine the impact of a very high rate cutoff programming strategy on outcomes in patients with a primary indication for an ICD due to reduced left ventricular ejection fraction. METHODS: Using data from the multicenter French DAI-PP registry, this cohort-controlled study compared outcomes in 500 patients programmed with a very high rate cutoff (VH-RATE group: monitor zone 170-219 beats/min; ventricular fibrillation zone ≥220 beats/min with 13 ± 4 detection intervals) with 1500 matched control patients programmed with 1 or 2 therapy zone. All ICDs were implanted for primary prevention in patients with systolic dysfunction. Risks of events were compared after propensity score matching of sex, age, ejection fraction, New York Heart Association class, cardiomyopathy, atrial fibrillation, and type of device. RESULTS: After a mean follow-up of 3.6 ± 2.3 years, VH-RATE programming was associated with a reduction of appropriate therapy risk (hazard ratio [HR] 0.40; 95% confidence interval [CI] 0.31-0.51; P < .0001) and inappropriate shock (HR 0.42; 95% CI 0.27-0.63; P < .0001). It was also associated with a decreased risk of sudden cardiac death (HR 0.43; 95% CI 0.17-0.99; P = .04) as compared with patients programmed with 2 therapy zones. There was no significant difference in overall survival between the groups. CONCLUSION: In patients implanted with an ICD in primary prevention with left ventricular dysfunction, very high rate cutoff programming (single therapy zone ≥220 beats/min) was associated with a 60% reduction of appropriate therapies as well as inappropriate shocks, without affecting mortality.

Published
2017
Full Text
View/download PDF

7. Position paper for management of elderly patients with pacemakers and implantable cardiac defibrillators Groupe de rythmologie et stimulation cardiaque de la Société française de cardiologie et Société française de gériatrie et gérontologie

Author

Patrick Friocourt, Jean-Luc Pasquié, Jacques Mansourati, Christine Alonso, Hugues Blangy, Dominique Pavin, Olivier Piot, Jérôme Taieb, Olivier Hanon, Nicolas Sadoul, Nicolas Clementy, Serge Boveda, Frédéric Anselme, Pierre Bordachar, Franck Halimi, Benjamin Obadia, Jean-Claude Deharo, Pascal Defaye, Didier Klug, Daniel Gras, Laurent Fauchier, Herrada, Anthony, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Tours (UT), Clinique Ambroise Paré, CHU Rouen, Normandie Université (NU), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Clinique Pasteur [Toulouse], CHU Grenoble, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier de Blois (CHB), Nouvelles Cliniques Nantaises, Hôpital privé de Parly-2, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes], Centre Hospitalier du Pays d'Aix, Centre cardiologique du Nord (CCN), Groupe hospitalier Broca, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Tours, and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_specialty, Pacemaker, Artificial, implantable cardioverter defibrillator, Heart Diseases, medicine.medical_treatment, [SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cardiac resynchronization therapy, Psychological intervention, cardiac resynchronization therapy, Disease, elderly, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, Biological Psychiatry, Aged, High rate, Aged, 80 and over, business.industry, Mortality rate, cardiac pacing, Geriatric assessment, Implantable cardioverter-defibrillator, Icd therapy, 3. Good health, Defibrillators, Implantable, Patient Care Management, Neuropsychology and Physiological Psychology, 030220 oncology & carcinogenesis, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Cardiology, Female, Neurology (clinical), France, Geriatrics and Gerontology, business
Abstract

International audience; Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group. In older patients with sinus node disease, a general consensus is that dual chamber pacing, along with the programming of an algorithm to minimise ventricular pacing is preferred. In very old patients presenting with intermittent or suspected AV block, VVI pacing may be appropriate. In terms of correcting potentially life-threatening arrhythmias, the effectiveness of ICD therapy is comparable in older and younger individuals. However, the assumption of persistent ICD benefit in the elderly population is questionable, as any advantage of the device on arrhythmic death may be attenuated by a higher total non-arrhythmic mortality. While septuagenarians and octogenarians have higher annual all-cause mortality rates, ICD therapy may remain effective in selected patients at high risk of arrhythmic death and with minimum comorbidities despite advanced age. ICD implantation among the elderly, as a group, may not be cost-effective, but the procedure may reach cost-effectiveness in those expected to live >5-7 years after implantation. The elderly patients usually experience a significant functional improvement after CRT, similar to that observed in middle-aged patients. Management of CRT non responders remains globally the same, while considering a less aggressive approach in terms of re interventions (revision of LV lead placement, addition of a RV or LV lead, LV endocardial pacing configuration). Overall, age, comorbidities and comprehensive geriatric assessment should be the decisive factor in making a decision on device implantation selection for survival and well-being benefit in elderly patients.

Published
2016
Full Text
View/download PDF

8. Assessment of cardiac resynchronisation therapy in patients with wide QRS and non-specific intraventricular conduction delay: rationale and design of the multicentre randomised NICD-CRT study

Author

Stéphane Garrigue, Pierre Bordachar, Romain Eschalier, Antoine Da Costa, Bruno Pereira, Benoit Guy-Moyat, Sylvain Ploux, Jean-Baptiste Gourraud, Pierre Mondoly, Christophe Leclercq, Pascal Defaye, Daniel Gras, Nicolas Clementy, Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], CHU Clermont-Ferrand, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU St Etienne, Centre Hospitalier Universitaire [Grenoble] (CHU), Clinique Saint Augustin, Centre hospitalier universitaire de Nantes (CHU Nantes), Nouvelles Cliniques Nantaises, CHU Limoges, CHU Pontchaillou [Rennes], Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
Male, Pacemaker, Artificial, medicine.medical_treatment, efficacy, 030204 cardiovascular system & hematology, Cardiovascular Medicine, Cardiac Resynchronization Therapy, Electrocardiography, Ventricular Dysfunction, Left, 0302 clinical medicine, Clinical Protocols, Clinical endpoint, Protocol, Medicine, 030212 general & internal medicine, Prospective Studies, Ejection fraction, medicine.diagnostic_test, Left bundle branch block, General Medicine, Middle Aged, QRS morphology, 3. Good health, Defibrillators, Implantable, Treatment Outcome, Research Design, Cardiology, cardiovascular system, Female, Adult, medicine.medical_specialty, Bundle-Branch Block, Cardiac resynchronization therapy, 03 medical and health sciences, QRS complex, Double-Blind Method, Internal medicine, bundle branch block, Humans, cardiovascular diseases, Aged, Heart Failure, Bundle branch block, business.industry, Patient Selection, Arrhythmias, Cardiac, Stroke Volume, medicine.disease, Surgery, Heart failure, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Introduction Cardiac resynchronisation therapy (CRT) was initially developed to treat patients with left bundle branch block (LBBB). However, many patients with heart failure have a widened QRS but neither left-BBB nor right-BBB; this is called non-specific intraventricular conduction delay (NICD). It is unclear whether CRT is effective in this subgroup of patients. Methods and analysis The NICD-CRT study is a prospective, double-blind, randomised (1:1), parallel-arm, multicentre trial comparing the effects of CRT in patients with heart failure, a reduced left ventricular ejection fraction (LVEF

Published
2016
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results