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1. Letter by Benali et al Regarding Article, 'Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial'

Author: Karim Benali, Charles Guenancia, Raphaël P. Martins, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), and CHU Pontchaillou [Rennes]
Subjects: Physiology (medical), [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine
Abstract: International audience
Published: 2022
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2. Correlation between radiation dose and myocardial remodeling after stereotactic radiation therapy for ventricular tachycardia: First assessment of dose-effect relationship in human

Author: Karim Benali, Louis Rigal, Antoine Simon, Julien Bellec, Pierre Jaïs, Tsukasa Kamakura, Clifford G. Robinson, Phillip Cuculich, Renaud De Crevoisier, Raphaël P. Martins, Jonchère, Laurent, CHU Saint-Etienne, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Eugène Marquis (CRLCC), CHU Bordeaux [Bordeaux], Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), CHU Pontchaillou [Rennes], and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Subjects: Anti-arrhythmic effects, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Myocardium, Radiation dose, Cardiac SBRT, Arrhythmias, Cardiac, Ventricular tachycardia, Arrhythmias, Radiation Dosage, Radiosurgery, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Radiation therapy, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Tachycardia, Ventricular, Humans, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, Anti-Arrhythmia Agents, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2022
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3. The emergence of Staphylococcus aureus as the primary cause of cardiac device-related infective endocarditis

Author: Loren Dejoies, Sylvain Bodi, Erwan Donal, Sarrah Boukthir, François Bénézit, Christophe Camus, Pierre Tattevin, Jean-Marie Urien, Matthieu Revest, Julien Bila, Christophe Leclercq, Nathalie Behar, Philippe Mabo, Raphaël P. Martins, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), 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 Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Microbiology (medical), Male, medicine.medical_specialty, Staphylococcus aureus, Prosthesis-Related Infections, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030106 microbiology, Cardiac resynchronization therapy, Cardiac device, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, medicine, Endocarditis, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, Coagulase negative staphylococci, COPD, business.industry, cons, Hazard ratio, General Medicine, Endocarditis, Bacterial, medicine.disease, 3. Good health, Defibrillators, Implantable, Infectious Diseases, Infective endocarditis, Cohort, Female, business
Abstract: International audience; BACKGROUND: Increasing use of cardiovascular implantable electronic devices (CIED), as permanent pacemakers (PPM), implantable cardioverter defibrillators (ICD), or cardiac resynchronization therapy (CRT), is associated with the emergence of CIED-related infective endocarditis (CIED-IE). We aimed to characterize CIED-IE profile, temporal trends, and prognostic factors. METHODS: CIED-IE diagnosed at Rennes University Hospital during years 1992-2017 were identified through computerized database, and included if they presented all of the following: (1) clinical signs of infection; (2) microbiological documentation through blood and/or CIED lead cultures; (3) lead or valve vegetation, or definite IE according to Duke criteria. Data were retrospectively extracted from medical charts. The cohort was categorized in three periods: 1992-1999, 2000-2008, and 2009-2017. RESULTS: We included 199 patients (51 women, 148 men, median age 73 years [interquartile range, 64-79]), with CIED-IE: 158 PPMs (79%), 24 ICD (12%), and 17 CRT (9%). Main pathogens were coagulase-negative staphylococci (CoNS: n = 86, 43%), Staphylococcus aureus (n = 60, 30%), and other Gram-positive cocci (n = 28, 14%). Temporal trends were remarkable for the decline in CoNS (P = 0.002), and the emergence of S. aureus as the primary cause of CIED-IE (24/63 in 2009-2017, 38%). Factors independently associated with one-year mortality were chronic obstructive pulmonary disease (COPD: hazard ratio 3.84 [1.03-6.02], P = 0.03), left-sided endocarditis (HR 2.25 [1.09-4.65], P = 0.03), pathogens other than CoNS (HR 3.16 [1.19-8.39], P = 0.02), and CIED removal/reimplantation (HR 0.41 [0.20-0.83], P = 0.01). CONCLUSIONS: S. aureus has emerged as the primary cause of CIED-IE. Left-sided endocarditis, COPD, pathogens other than CoNS, and no CIED removal/reimplantation are independent risk factors for one-year mortality.
Published: 2021
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4. Cardiac stereotactic ablative radiotherapy for refractory ventricular arrhythmias: A radical alternative? A narrative review of rationale and cardiological aspects

Author: Karim Benali, Antoine Da Costa, Louis Rigal, Renaud de Crevoisier, Vincent Galand, Raphaël P. Martins, Nefissa Hammache, Antoine Simon, N. Jaksic, J. Bellec, Pierre Caille, CHU Saint-Etienne, Centre Eugène Marquis (CRLCC), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), CRLCC Eugène Marquis (CRLCC), CHU Pontchaillou [Rennes], Jonchère, Laurent, 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 Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Subjects: medicine.medical_specialty, cardiac radioablation, medicine.medical_treatment, Catheter ablation, 030204 cardiovascular system & hematology, Radiosurgery, 03 medical and health sciences, cardiac SBRT, 0302 clinical medicine, Refractory, Ablative case, catheter ablation, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, cardiovascular diseases, Cardiac disorders, Intensive care medicine, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Radiological and Ultrasound Technology, business.industry, ventricular arrhythmias, Arrhythmias, Cardiac, Heart, refractory ventricular tachycardia, 3. Good health, Radiation therapy, cardiovascular system, Narrative review, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, cardiac sterteotactic radiotherapy
Abstract: International audience; Ventricular arrhythmias are serious life-threatening cardiac disorders. Despite many technological improvements, a non-negligible number of patients present refractory ventricular tachycardias, resistant to a catheter ablation procedure, placing these patients in a therapeutic impasse. Recently, a cardiac stereotactic radioablative technique has been developed to treat patients with refractory ventricular arrhythmias, as a bail out strategy. This new therapeutic option historically brings together two fields of expertise unknown to each other, pointing out the necessity of an optimal partnership between cardiologists and radiation oncologists. As described in this narrative review, the understanding of cardiological aspects of the technique for radiation oncologists and treatment technical aspects comprehension for cardiologists represent a major challenge for the application and the future development of this promising treatment.
Published: 2021
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5. Left Ventricular Assist Device Implantation As a Bailout Strategy for the Management of Refractory Electrical Storm and Cardiogenic Shock

Author: Frederic Sacher, Raphaël P. Martins, Baptiste Maille, Christian de Chillou, Pierre Baudinaud, Jean-Baptiste Gourraud, Karim Benali, Francis Bessière, Philippe Maury, Vincent Galand, Vincent Algalarrondo, Charles Guenancia, 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), CHU Pontchaillou [Rennes], Hôpital de la Timone [CHU - APHM] (TIMONE), Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier universitaire de Nantes (CHU Nantes), 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Shock, Cardiogenic, Hemodynamics, Catheter ablation, 030204 cardiovascular system & hematology, Ventricular tachycardia, hemodynamics, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Refractory, Physiology (medical), Internal medicine, catheter ablation, medicine, Humans, 030212 general & internal medicine, hospital, ComputingMilieux_MISCELLANEOUS, business.industry, Cardiogenic shock, informed consent, Middle Aged, medicine.disease, Treatment Outcome, Ventricular assist device, Tachycardia, Ventricular, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, ventricular tachycardia, Cardiology and Cardiovascular Medicine, business, Bailout
Abstract: International audience
Published: 2021
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6. 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
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7. Distance between the descending aorta and the left inferior pulmonary vein as a determinant of biophysical parameters during paroxysmal atrial fibrillation cryoablation

Author: Jean Baptiste Guichard, Antoine Da Costa, Karim Benali, Dominique Pavin, Laurent Macle, Cécile Romeyer, Christophe Leclercq, Raphaël P. Martins, Vincent Galand, Nefissa Hammache, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Montreal Heart Institute - Institut de Cardiologie de Montréal, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Universitaire [Rennes], 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), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, cryoballoon, Aorta, Thoracic, 030204 cardiovascular system & hematology, Cryosurgery, aortic imprint, 03 medical and health sciences, 0302 clinical medicine, cryolesion, Recurrence, Physiology (medical), medicine.artery, Internal medicine, medicine, Left inferior pulmonary vein, Humans, blood flow, 030212 general & internal medicine, Aged, Retrospective Studies, Aorta, business.industry, left inferior pulmonary vein, temperature, Cryoablation, Atrial fibrillation, Blood flow, Middle Aged, medicine.disease, Ablation, Ostium, aorta, Treatment Outcome, Pulmonary Veins, cryoablation, Descending aorta, Catheter Ablation, cardiovascular system, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; INTRODUCTION: The distance from the descending aorta (DA) to the posterior wall of the left atrium (LA) is variable. We aimed to determine whether the proximity between the DA and the left inferior pulmonary vein (LIPV) ostium has an impact on biophysical parameters and cryoballoon (CB) ablation efficacy during LIPV freezing. METHODS: Patients referred for CB-ablation of atrial fibrillation (AF) in two high-volume centers were included. Cryoablation data were collected prospectively for each patient. The anatomical relationships between the LIPV and the DA (distance LIPV ostium-DA, presence of an aortic imprint on the posterior aspect of the LIPV) were then retrospectively analysed on the LA computed tomography (CT) scans realized before AF ablation. RESULTS: 350 patients were included (70% men, 59.7±11.5 yo). The decrease in the Ostium-DA distance was significantly correlated to the increase in the Time-To-Isolation (TTI) (r=-0.31; p=0.036), with less negative temperature (r=-0.11; p=0.045). Similarly, the presence of an aortic imprint on the LIPV was associated with a longer TTI (p
Published: 2021
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8. Outcomes after catheter ablation of ventricular tachycardia without implantable cardioverter-defibrillator in selected patients with arrhythmogenic right ventricular cardiomyopathy

Author: Raphaël P. Martins, Frederic Sacher, Jean-Marc Sellal, Philippe Maury, Beatriz Jáuregui, Jean-Basptiste Gourraud, Etienne Pruvot, Antonio Berruezo, Saurabh Kumar, Laurent Pison, Paolo DellaBella, Antonio Frontera, Tom Wong, Mikael Laredo, Estelle Gandjbakhch, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), 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), CHU Pontchaillou [Rennes], CHU Bordeaux [Bordeaux], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Ziekenhuis Oost-Limburg (ZOL), Lausanne University Hospital, Westmead Hospital [Sydney], Royal Brompton and Harefield NHS Foundation Trust, Franco-czech Laboratory for clinical research on obesity, Charles University [Prague] (CU)-Institut National de la Santé et de la Recherche Médicale (INSERM), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_treatment, DYSPLASIA/CARDIOMYOPATHY, 030204 cardiovascular system & hematology, Ventricular tachycardia, THERAPY, Ventricular Function, Left, Sudden cardiac death, RISK STRATIFICATION, 0302 clinical medicine, SUBSTRATE, Palpitations, Medicine, 030212 general & internal medicine, PREDICTORS, Arrhythmogenic Right Ventricular Dysplasia, Ejection fraction, Middle Aged, Implantable cardioverter-defibrillator, 3. Good health, Arrhythmogenic right ventricular dysplasia, Defibrillators, Implantable, Treatment Outcome, Cardiology, Monomorphic ventricular tachycardia, Female, Catheter ablation, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, DIAGNOSIS, Right ventricular cardiomyopathy, 03 medical and health sciences, Physiology (medical), Internal medicine, MANAGEMENT, Humans, Retrospective Studies, business.industry, Stroke Volume, medicine.disease, Tachycardia, Ventricular, business, Arrhythmogenic right ventricular cardiomyopathy, Epicardial ablation
Abstract: Aims The roles of implantable cardioverter-defibrillators (ICDs) and radiofrequency catheter ablation (RCA) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and well-tolerated monomorphic ventricular tachycardia (MVT) are debated. In this multicentre retrospective study, we aimed at reporting the outcome of selected patients with ARVC after RCA without a back-up ICD. Methods and results Patients with ARVC who underwent RCA of well-tolerated MVT at 10 tertiary centres across 5 countries, without an ICD before and 3 months after RCA, without syncope or electrical storm, and with left ventricular ejection fraction ≥50% were included. In total, 65 ARVC patients [mean age 44.5 ± 13.2 years, 78% males] underwent RCA of MVT between 2003 and 2016. Clinical presentation was palpitations in 51 (80%) patients. One (2%) patient had >1 clinical MVT. At the ablative procedure, clinical MVTs (mean rate 185 ± 32 b.p.m.) were inducible in 50 (81%) patients. Epicardial ablation was performed in 19 (29%) patients. Complete acute success was achieved in 47 (72%) patients. After a median follow-up of 52.4 months (range 12.3–171.4), there was no death or aborted cardiac arrest, and VT recurred in 19 (29%) patients. Survival without VT recurrence was estimated at 88%, 80%, and 68%, 12, 36, and 60 months after RCA, respectively, and was significantly associated with the approach and the procedural outcome. Conclusion In patients with ARVC, well-tolerated MVT without a back-up ICD did not lead to fatal arrhythmic event after RCA despite VT recurrences in some. Our data suggest that RCA may be an alternative to ICD in selected ARVC patients.
Published: 2021
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9. Poor prognosis in young patients with atrioventricular block of unknown aetiology: who is to blame? The physician or the pacemaker?

Author: Raphaël P. Martins, Jean-Claude Daubert, Alban-Elouen Baruteau, Laboratoire Traitement du Signal et de l'Image (LTSI), 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), Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de recherche de l'institut du thorax (ITX-lab), and Jonchère, Laurent
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, Pediatrics, Heart disease, business.industry, Incidence (epidemiology), Cardiomyopathy, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, Cardiac surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Etiology, Artificial cardiac pacemaker, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Sarcoidosis, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: International audience; The rate of permanent pacemaker (PPM) implantation is still growing in Europe, due in part to population ageing with an increased risk of developing conduction diseases. Although most PPM recipients are elderly patients, some young patients experience atrioventricular block (AVB) requiring PPM. In a recent study by Rudbeck-Resdal et al. evaluating AVB in young patients, the estimated incidence of developing AVB before 50 years of age was 17.7/year/million inhabitants throughout their 20-year nationwide study period.1 The aetiology of AVB was identified in only half of the patients. The most frequent causes were complications to cardiac surgery (15.3%), congenital AVB or congenital heart disease (9.0% and 4.2%, respectively), and cardioinhibitory reflex (5.0%). An underlying cardiomyopathy or sarcoidosis were uncommon causes in this specific population.
Published: 2021
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10. Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Author: Cédric Nguyen, François Jourda, Alexis Hermida, Pascal Defaye, Frederic Sacher, Yvette Bernard, Serge Boveda, Marie-Cécile Perier, Philippe Chevalier, Pierre Winum, Mikael Laredo, Abdeslam Bouzeman, C. Marquie, Raphaël P. Martins, Jean Benoit Thambo, Laurence Iserin, Maxime De Guillebon, Kévin Gardey, Antoine Da Costa, Pierre Bordachar, Benoit Guy-Moyat, Anouk Asselin, Jean Marc Sellal, Francis Bessière, Linda Koutbi, Pierre Mondoly, Victor Waldmann, Grégoire Massoulié, Jacques Mansourati, Roland Henaine, Romain Eschalier, Fabien Labombarda, Sandro Ninni, Charles Guenancia, Sylvie Di Filippo, Philippe Maury, Rodrigue Garcia, Bertrand Pierre, Magalie Ladouceur, Caroline Audinet, Amel Mathiron, Camille Walton, Philippe Lagrange, Guillaume Duthoit, Xavier Jouven, Didier Irles, Nicolas Combes, Jean Luc Pasquié, G Clerici, Frédéric Anselme, Jean-Baptiste Gourraud, Eloi Marijon, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Toulouse [Toulouse], Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Bordeaux [Bordeaux], CHU Amiens-Picardie, CHU Rouen, Normandie Université (NU), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Groupe Hospitalier Bretagne Sud (GHBS), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Clinique Pasteur [Toulouse], CHU Sud Saint Pierre [Ile de la Réunion], Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Centre hospitalier de Pau, Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Clermont-Ferrand, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Limoges, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Chalon-sur-Saône William Morey, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Clinical sciences, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), 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 Paris Cité (UPCité), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), SELLAL, Jean-Marc, and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, 030204 cardiovascular system & hematology, Sudden death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Interquartile range, Internal medicine, medicine, Humans, Implantable cardioverter defibrilator, 030212 general & internal medicine, Cardiac Surgical Procedures, education, Pulmonary Valve/surgery, ComputingMilieux_MISCELLANEOUS, Tetralogy of Fallot, Cause of death, Pulmonary Valve, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Ventriculat arrhythmia, Arrhythmias, Cardiac, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, eye diseases, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Defibrillators, Implantable, 3. Good health, Tetralogy of Fallot/surgery, Arrhythmias, Cardiac/therapy, Pulmonary valve replacement, Cohort, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Objectives: This study aimed to assess the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias burden in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs).Background: Sudden cardiac death is a major cause of death in TOF, and right ventricular overload is commonly considered to be a potential trigger for ventricular arrhythmias.Methods: Data were analyzed from a nationwide French ongoing study (DAI-T4F) including all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.Results: A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centers. Over a median follow-up period of 6.8 (interquartile range: 2.5 to 11.4) years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least 1 appropriate ICD therapy. When considering all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (HR: 0.21; 95% confidence interval [CI]: 0.08 to 0.56; p = 0.002). Respective appropriate ICD therapies rates per 100 person-years were 44.0 (95% CI: 35.7 to 52.5) before and 13.2 (95% CI: 7.7 to 20.5) after PVR (p < 0.001). In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR: 0.29 [95% CI: 0.10 to 0.89]; p = 0.031).Conclusions: In this cohort of high-risk TOF patients implanted with an ICD, the burden of appropriate ICD therapies was significantly reduced after PVR. While optimal indications and timing for PVR are debated, these findings suggest the importance of considering ventricular arrhythmias in the overall decision-making process. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574).
Published: 2021
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11. Electrophysiological Study-Guided Permanent Pacemaker Implantation In Patients With Conduction Disturbances Following Transcatheter Aortic Valve Implantation

Author: Raphaël P. Martins, Camille Pichard, Baptiste Polin, Marc Bedossa, Hamed Bourenane, Dominique Boulmier, Christophe Leclercq, Guillaume Leurent, Hervé Le Breton, Marielle Le Guellec, Vincent Auffret, Jacques Tomasi, D. Pavin, Vincent Galand, Sam Sharobeem, Erwan Donal, Jean-Philippe Verhoye, Nathalie Behar, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], No funding, Jonchère, Laurent, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Pacemaker, Artificial, Transcatheter aortic, Bundle-Branch Block, 030204 cardiovascular system & hematology, Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Cardiac Conduction System Disease, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, atrioventricular block, medicine, bundle branch block, Humans, In patient, False Positive Reactions, 030212 general & internal medicine, False Negative Reactions, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Aged, 80 and over, business.industry, Cardiac Pacing, Artificial, Aortic Valve Stenosis, Ventricular pacing, medicine.disease, Transcatheter aortic valve replacement, Optimal management, pacemaker, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Electrophysiology, Treatment Outcome, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Electrophysiological study, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business, Index hospitalization, Electrophysiologic Techniques, Cardiac, Atrioventricular block
Abstract: International audience; Conduction disturbances remain common following transcatheter aortic valve implantation (TAVI). Aside from high-degree atrioventricular block (HAVB), their optimal management remains elusive. Invasive electrophysiological studies (EPS) may help stratify patients at low or high risk of HAVB allowing for an early discharge or permanent pacemaker (PPM) implantation among patients with conduction disturbances. We evaluated the safety and diagnostic performances of an EPS-guided PPM implantation strategy among TAVI recipients with conduction disturbances not representing absolute indications for PPM. All patients who underwent TAVI at a single expert center from June 2017 to July 2020 who underwent an EPS during the index hospitalization were included in the present study. False negative outcomes were defined as patients discharged without PPM implantation who required PPM for HAVB within 6 months of the initial EPS. False positive outcomes were defined as patients discharged with a PPM with a ventricular pacing percentage < 1% at follow-up. A total of 78 patients were included (median age: 82.4 years, 38% female), among whom 35 patients (45%) received a PPM following EPS. The sensitivity, specificity, positive and negative predictive values of the EPS-guided PPM implantation strategy were 100%, 89.6%, 81.5%, and 100%, respectively. Six patients suffered a mechanical HAVB during EPS and received a PPM. These 6 patients showed PPM dependency at follow-up. In conclusion, an EPS-guided PPM implantation strategy for managing post-TAVI conduction disturbances appears effective to identify patients who can be safely discharged without PPM implantation.
Published: 2021
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12. Validation of the VT-LVAD score for prediction of late VAs in LVAD recipients

Author: Christophe Leclercq, Raphaël P. Martins, Michael Kühl, Michael A. Borger, Arash Arya, Angeliki Darma, Sandra Eifert, Gerhard Hindricks, Vincent Galand, Nikolaos Dagres, Diyar Saeed, Heart Centre Leipzig, University Hospital Coventry, CHU Pontchaillou [Rennes], 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 (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: medicine.medical_specialty, Multivariate analysis, LVAD, medicine.medical_treatment, risk stratification, 030204 cardiovascular system & hematology, late ventricular arrhythmia, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, Idiopathic dilated cardiomyopathy, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Heart Failure, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Ejection fraction, business.industry, ICD, Arrhythmias, Cardiac, Atrial fibrillation, Odds ratio, Middle Aged, medicine.disease, equipment and supplies, mortality, Defibrillators, Implantable, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Heart failure, Ventricular assist device, Cohort, Tachycardia, Ventricular, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Objectives This study sought to validate the performance of the VT-LVAD risk model in predicting late ventricular arrhythmias (VAs) in patients after left ventricular assist device (LVAD) implantation. Background The need for implantable cardioverter-defibrillator (ICD)-implantation in LVAD recipients is not well studied. A better selection of the patients with high risk for late VAs could lead to a more targeted ICD-implantation or replacement. Methods The study evaluated the performance of the VT-LVAD prognostic score (VAs prior LVAD, no ACE-inhibitor in medication, heart failure duration > 12 months, early VAs post-LVAD implantation, atrial fibrillation prior LVAD, idiopathic dilated cardiomyopathy) for the endpoint of the occurrence of late VAs in 357 LVAD patients in Heart Centre of Leipzig. Results From the initial 460 patients, 357 (age: 58 +/- 10 years; left ventricular ejection fraction: 20 +/- 6%; HeartWare: 50%; HeartMate III: 42%) were assigned to four risk groups according to their VT-LVAD score varying from low risk to very high risk. After 25 months, late VAs occurred in 130 patients. The VT-LVAD score was an independent predictor of late VAs (multivariate analysis; p = < .001; goodness-of-tip p = .347; odds ratio: 4.8). While there was no statistically significant difference between the low- and intermediate-risk group, risk stratification for patients with high risk and very high risk performed more accurately (pairwise comparison p = .005 and p < .001, respectively). Conclusions The VT-LVAD score predicted accurately the occurrence of late VAs in high-risk LVAD recipients in a large external cohort of LVAD recipients supporting its utility for more targeted ICD implantations.
Published: 2021
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13. Comparison of Outcomes and Mortality in Patients Having Left Ventricular Assist Device Implanted Early -vs- Late After Diagnosis of Cardiomyopathy

Author: Raphaël P. Martins, Matteo Pozzi, Nicolas Lellouche, Thomas Senage, Fabrice Vanhuyse, Nicolas Nesseler, Fabien Garnier, Pierre Baudinaud, Mathieu Pernot, Olivier Chavanon, Frédéric Anselme, Michel Kindo, Philippe Rouvière, Pierre-Yves Litzler, Christophe Leclercq, Marylou Para, Hugues Blangy, Constance Verdonk, Nicolas D'Ostrevy, Guillaume Baudry, Vincent Galand, André Vincentelli, Marie Bielefeld, Magali Michel, Edeline Pelcé, Vlad Gariboldi, Philippe Gaudard, Erwan Flecher, Gerard Babatasi, Katrien Blanchart, Karine Nubret, Costin Radu, Thierry Bourguignon, Céline Goéminne, Tam Hoang Minh, Aude Boignard, Thibaud Genet, Marie-Cécile Bories, Jean Porterie, Clément Delmas, Elisabeth Chen, Romain Eschalier, Laboratoire Traitement du Signal et de l'Image (LTSI), 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), CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Charles Nicolle [Rouen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Fédération Française de Cardiologie, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Population, Cardiomyopathy, 030204 cardiovascular system & hematology, Prosthesis Design, remotely diagnosed cardiomyopathy, survival, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Clinical endpoint, medicine, Humans, In patient, education, Aged, Retrospective Studies, education.field_of_study, Ischemic cardiomyopathy, LVAD implantation, business.industry, 030208 emergency & critical care medicine, Sudden cardiac arrest, Recently diagnosed cardiomyopathy, Middle Aged, Prognosis, medicine.disease, equipment and supplies, 3. Good health, Cardiac surgery, Survival Rate, Ventricular assist device, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Heart-Assist Devices, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; LVAD implantation in patients with a recently diagnosed cardiomyopathy has been poorly investigated. This work aims at describing the characteristics and outcomes of patients receiving a LVAD within 30 days following the diagnosis of cardiomyopathy. Patients from the ASSIST-ICD study was divided into recently and remotely diagnosed cardiomyopathy based on the time from initial diagnosis of cardiomyopathy to LVAD implantation using the cut point of 30 days. The primary end point of the study was all-cause mortality at 30-day and during follow-up. A total of 652 patients were included and followed during a median time of 9.1 (2.5 to 22.1) months. In this population, 117 (17.9%) had a recently diagnosed cardiomyopathy and had LVAD implantation after a median time of 15.0 (9.0 to 24.0) days following the diagnosis. This group of patients was significantly younger, with more ischemic cardiomyopathy, more sudden cardiac arrest (SCA) events at the time of the diagnosis and were more likely to receive temporary mechanical support before LVAD compared with the remotely diagnosed group. Postoperative in-hospital survival was similar in groups, but recently diagnosed patients had a better long-term survival after hospital discharge. SCA before LVAD and any cardiac surgery combined with LVAD implantation were identified as 2 independent predictors of postoperative mortality in recently diagnosed patients. In conclusion, rescue LVAD implantation for recently diagnosed severe cardiomyopathy is common in clinical practice. Such patients experience a relatively low postoperative mortality and have a better long-term survival compared with remotely diagnosed patients.
Published: 2021
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14. Simulation-based training in cardiology: State-of-the-art review from the French Commission of Simulation Teaching (Commission d’enseignement par simulation-COMSI) of the French Society of Cardiology

Author: Fabrice Ivanes, Jean Claude Deharo, Julien Adjedj, Batric Popovic, Anne Bernard, Guillaume Bonnet, Augustin Coisne, Loïc Bière, Stephane Lafitte, Théo Pezel, Raphaël P. Martins, Stéphanie Turpeau, Benoit Lattuca, Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP)-Université Sorbonne Paris Nord, Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires (RNMCD - U1011), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Laboratoire Traitement du Signal et de l'Image (LTSI), 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), CHU Pontchaillou [Rennes], Institut Arnault Tzanck, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Henri Duffaut (Avignon), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Bordeaux [Bordeaux], Hôpital de la Timone [CHU - APHM] (TIMONE), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Johns Hopkins University (JHU), Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 (RNMCD), CHU Lille, 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 Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montpellier (UM), Université de Lorraine (UL), Université de Tours (UT), and CCSD, Accord Elsevier
Subjects: medicine.medical_specialty, Communication skills, Students, Medical, Heart Diseases, media_common.quotation_subject, education, Cardiology, Commission, 030204 cardiovascular system & hematology, Cardiologie Interventionnelle, Education, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Cardiologists, Simulation-based training, Internal medicine, medicine, Humans, Quality (business), 030212 general & internal medicine, Cooperative Behavior, Simulation Training, media_common, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Patient Care Team, Teamwork, Modalities, Interventional cardiology, business.industry, Compétences en communication, Cornerstone, General Medicine, Enseignement par simulation, 3. Good health, Education, Medical, Graduate, Echocardiography, Interdisciplinary Communication, Éducation, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Curriculum, Cardiology and Cardiovascular Medicine, business, Transfer of learning, Echocardiographie, Education, Medical, Undergraduate
Abstract: International audience; In our healthcare system, mindful of patient safety and the reduction of medical errors, simulation-based training has emerged as the cornerstone of medical education, allowing quality training in complete safety for patients. Initiated by anaesthesiologists, this teaching mode effectively allows a gradual transfer of learning, and has become an essential tool in cardiology teaching. Cardiologists are embracing simulation to master complex techniques in interventional cardiology, to manage crisis situations and unusual complications and to develop medical teamwork. Simulation methods in cardiology include high-fidelity simulators, clinical scenarios, serious games, hybrid simulation and virtual reality. Simulation involves all fields of cardiology: transoesophageal echocardiography, cardiac catheterization, coronary angioplasty and electrophysiology. Beyond purely technical issues, simulation can also enhance communication skills, by using standardized patients, and can improve the management of situations related to the announcement of serious diseases. In this review of recent literature, we present existing simulation modalities, their applications in different fields of cardiology and their advantages and limitations. Finally, we detail the growing role for simulation in the teaching of medical students following the recent legal obligation to use simulation to evaluate medical students in France.
Published: 2021
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15. Cryoballoon ablation of atrial fibrillation in patients with atypical right pulmonary vein anatomy

Author: Camille Pichard, Raphaël P. Martins, Nathalie Behar, Mathieu Lederlin, Celine Chérel, Amélie Nicolas, Vincent Galand, Christophe Leclercq, Philippe Mabo, Jean-Claude Daubert, D. Pavin, Charlène Coquard, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 CCSD, Accord Elsevier
Subjects: Male, Cryoablation, medicine.medical_treatment, Action Potentials, Catheter ablation, 030204 cardiovascular system & hematology, Arrhythmias, Cryosurgery, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Risk Factors, medicine, Humans, In patient, Sinus rhythm, Prospective Studies, 030212 general & internal medicine, Cryoballoon ablation, Aged, Phrenic nerve, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Atrial fibrillation, General Medicine, Anatomy, Middle Aged, medicine.disease, 3. Good health, Electrophysiology, Treatment Outcome, Pulmonary Veins, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Cryoballoon ablation is widely used for pulmonary vein isolation in patients with atrial fibrillation. There are no data regarding the clinical efficacy of cryoballoon ablation in patients with atypical right pulmonary vein anatomy. Aim - We aimed to evaluate the impact of right pulmonary vein anatomy on the safety and efficacy of cryoballoon ablation. Methods - Patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. Left atrial computed tomography was performed before cryoballoon ablation to determine whether the right pulmonary vein anatomy was "normal" or "atypical". For patients with atypical anatomy, cryoballoon ablation was only performed for right superior and right inferior pulmonary veins, neglecting accessory pulmonary veins. Results - Overall, 303 patients were included: 254 (83.8%) with normal and 49 (16.2%) with atypical right pulmonary vein anatomy. First-freeze isolation for right superior and right inferior pulmonary veins occurred in 44 (89.8%) and 37 (75.5%) patients with atypical pulmonary vein anatomy, and in 218 (85.8%) and 217 (85.4%) patients with typical pulmonary vein anatomy, respectively (P not significant). Phrenic nerve palsies were only observed in patients with normal anatomy (0 vs. 26 [8.6%]; P=0.039). Mid-term survival free from atrial arrhythmia was similar, regardless of right pulmonary vein anatomy. Conclusions - A significant proportion of patients have atypical right pulmonary vein anatomy. Procedural characteristics, acute pulmonary vein isolation success and mid-term procedural efficacy were similar, regardless of right pulmonary vein anatomy. In addition to left-side pulmonary vein isolation, cryoballoon ablation of right superior and right inferior pulmonary veins only, neglecting accessory pulmonary veins, is sufficient to obtain acute right-side pulmonary vein isolation and mid-term sinus rhythm maintenance in patients with atypical anatomy.
Published: 2020
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16. Relation of Body Mass Index to Outcomes in Patients With Heart Failure Implanted With Left Ventricular Assist Devices

Author: Céline Chabanne, Romain Eschalier, Marylou Para, Marion Charton, Edeline Pelcé, Fabrice Vanhuyse, Michel Kindo, Raphaël P. Martins, Matteo Pozzi, Thierry Bourguignon, E. Varlet, Nicolas Sadoul, Bernard Lelong, David Hamon, Tam Hoang Minh, Fabien Garnier, Mathieu Pernot, Céline Goéminne, Vlad Gariboldi, Philippe Rouvière, Jean Porterie, Pierre-Yves Litzler, Constance Verdonk, Thibaud Genet, Christophe Leclercq, Magali Michel, Philippe Gaudard, Marie-Cécile Bories, Marie Bielefeld, Katrien Blanchart, Clément Delmas, Olivier Chavanon, Thomas Senage, Costin Radu, Erwan Flecher, Karine Nubret, Nicolas D'Ostrevy, Frédéric Anselme, Vincent Galand, Aude Boignard, Gerard Babatasi, André Vincentelli, Jean-François Obadia, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Bordeaux (UB), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Institut de rythmologie et modélisation cardiaque [Pessac] (IHU Liryc), Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Lapeyronie [Montpellier] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Institut d'Aménagement et d'Urbanisme de la Région d'Ile-de-France (IAU Île-de-France), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHI Créteil, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], The French Federation of Cardiology, 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 Jonchère, Laurent
Subjects: Male, medicine.medical_specialty, Population, Left ventricular assist device, 030204 cardiovascular system & hematology, Overweight, 03 medical and health sciences, 0302 clinical medicine, Thinness, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, Humans, Medicine, Obesity, education, Body mass index, Aged, Retrospective Studies, Heart Failure, 2. Zero hunger, education.field_of_study, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, mortality, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Cardiac surgery, Survival Rate, Treatment Outcome, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Heart failure, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Underweight, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies, Destination therapy
Abstract: International audience; We aimed at characterizing the impact of low and high body mass index (BMI) on outcomes after left-ventricular assist device (LVAD) surgery and define the predictors of mortality in patients with abnormal BMI (low/high). This study was conducted in 19 centers from 2006 to 2016. Patients were divided based on their baseline BMI into 3 groups of BMI: low (BMI ≤18.5 kg/m²); normal (BMI = 18.5 to 24.99 kg/m²) and high (BMI ≥25 kg/m²) (including overweight (BMI = 25 to 29.99 kg/m²), and obesity (BMI ≥30 Kg/m²)). Among 652 patients, 29 (4.4%), 279 (42.8%) and 344 (52.8%) had a low-, normal-, and high BMI, respectively. Patients with high BMI were significantly more likely men, with more co-morbidities and more history of ventricular/supra-ventricular arrhythmias before LVAD implantation. Patients with abnormal BMI had significantly lower survival than those with normal BMI. Notably, those with low BMI experienced the worst survival whereas overweight or obese patients had similar survival. Four predictors of mortality for LVAD candidates with abnormal BMI were defined: total bilirubin ≥16 µmol/L before LVAD, hypertension, destination therapy, and cardiac surgery with LVAD. Depending on the number of predictor per patients, those with abnormal BMI may be divided in 3 groups of 1-year mortality risk, i.e., low (0 to 1 predictor: 29% and 31%), intermediate (2 to 3 predictors, 51% and 52%, respectively), and high (4 predictors: 83%). In conclusion, LVAD recipients with abnormal BMI experience lower survival, especially underweight patients. Four predictors of mortality have been identified for LVAD population with abnormal BMI, differentiating those a low-, intermediate-, and high risks of death.
Published: 2020
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17. Implantable cardiac defibrillator leads dysfunction after LVAD implantation

Author: Gerard Babatasi, Nicolas D'Ostrevy, Pierre-Yves Litzler, Christophe Leclercq, Raphaël P. Martins, Matteo Pozzi, Philippe Gaudard, Edeline Pelcé, Vincent Galand, Eloi Marijon, Nicolas Lellouche, Thierry Bourguignon, Jean-Luc Pasquié, Marie Bielefeld, Aude Boignard, Bertrand Pierre, Marylou Para, André Vincentelli, Fabien Garnier, Frédéric Anselme, Stéphane Boulé, Philippe Maury, David Hamon, Pascal Defaye, Nicolas Welte, Hamed Bourenane, Emilie Varlet, Hugues Blangy, Vincent Probst, Michel Kindo, François Picard, Erwan Flecher, Thomas Cardi, Nicolas Sadoul, Katrien Blanchart, Jean-François Obadia, Vincent Algalarrondo, Jean-Baptiste Gourraud, Pierre Mondoly, Vlad Gariboldi, Romain Eschalier, 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), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université de Bordeaux (UB), CHU Strasbourg, 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), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Clermont-Ferrand, 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), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), NA, Fédération Française de Cardiologie, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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, medicine.medical_specialty, implantable cardioverter defibrillator, medicine.medical_treatment, Lead impedance, [SDV]Life Sciences [q-bio], Icd lead, lead parameters dysfunction, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, left ventricular assist device, Humans, 030212 general & internal medicine, Lead (electronics), ComputingMilieux_MISCELLANEOUS, Aged, Pacing impedance, business.industry, General Medicine, Middle Aged, equipment and supplies, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Electrodes, Implanted, Prosthesis Failure, Ventricular assist device, Cardiology, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: Background Implantable cardioverter-defibrillator (ICD) lead dysfunction has been reported after left ventricular assist device (LVAD) implantation in limited single-center studies. We aimed at describing and characterizing the incidence of ICD lead parameters dysfunction after LVAD implantation. Methods Among the 652 patients enrolled in the ASSIST-ICD study, only patients with an ICD prior to LVAD were included (n = 401). ICD lead parameters dysfunction following LVAD implantation is defined as follows: (a) >50% decrease in sensing threshold, (b) pacing lead impedance increase/decrease by >100Ω, and (c) >50% increase in pacing threshold. Results One hundred twenty-two patients with an ICD prior to LVAD had available ICD interrogation reports prior and after LVAD. A total of 67 (55%) patients exhibited at least one significant lead dysfunction: 17 (15%) exhibited >50% decrease in right ventricular (RV) sensing, 51 (42%) had >100 Ω increase/decrease in RV pacing impedance, and 24 (20%) experienced >50% increase in RV pacing threshold. A total of 52 patients experienced ventricular arrhythmia during follow-up and all were successfully detected and treated by the device. All lead dysfunction could be managed conservatively. Conclusion More than 50% of LVAD-recipients may experience >1 significant change in lead parameters but none had severe clinical consequences.
Published: 2020
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18. Outcomes of Left Ventricular Assist Device Implantation in Patients With Uncommon Etiology Cardiomyopathy

Author: Romain Eschalier, Marie Bielefeld, Nicolas D'Ostrevy, Philippe Rouvière, Aude Boignard, Vincent Galand, Olivier Chavanon, François Picard, Céline Chabanne, Fabien Garnier, Frédéric Anselme, Jérôme Jouan, Katrien Blanchart, Erwan Flecher, Camille Dambrin, Hugues Blangy, Fabrice Vanhuyse, Gerard Babatasi, Edeline Pelcé, Walid Ghodhbane, Tam Hoang Minh, Céline Goéminne, Thierry Bourguignon, Raphaël P. Martins, Matteo Pozzi, Pierre-Yvesl Litzler, Frederic Sacher, Philippe Gaudard, E. Varlet, Constance Verdonk, Nicolas Lellouche, Thomas Senage, Magali Michel, Vlad Gariboldi, Bernard Lelong, Thibaud Genet, Michel Kindo, Christophe Leclercq, David Hamon, Jean-François Obadia, Clément Delmas, André Vincentelli, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), 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], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Carnegie Mellon University [Pittsburgh] (CMU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Henri Mondor [Créteil], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Fédération Française de Cardiologie, Rennes University Hospital, 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 [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Henri Mondor, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre de recherches (CRT), Société Lafarge, Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Nouvel Hôpital Civil, Strasbourg, France., Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Hospital Bichat Paris, 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), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Caen (CHRU Caen), Anti-infectieux : supports moléculaires des résistances et innovations thérapeutiques (RESINFIT), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de cardiologie et maladies vasculaires, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and MORNET, Dominique
Subjects: Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Myocarditis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Cardiomyopathy, Myocardial Ischemia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Idiopathic dilated cardiomyopathy, medicine, Humans, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Mortality rate, valvular heart disease, Hypertrophic cardiomyopathy, Cardiomyopathy, Hypertrophic, Middle Aged, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Ventricular assist device, Etiology, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; The impact of uncommon etiology cardiomyopathies on Left-ventricular assist device (LVAD)-recipient outcomes is not very well known. This study aimed to characterize patients with uncommon cardiomyopathy etiologies and examine the outcomes between uncommon and ischemic/idiopathic dilated cardiomyopathy. This observational study was conducted in 19 centers between 2006 and 2016. Baseline characteristics and outcomes of patients with uncommon etiology were compared to patients with idiopathic dilated/ischemic cardiomyopathies. Among 652 LVAD-recipients included, a total of 590 (90.5%) patients were classified as ischemic/idiopathic and 62 (9.5%) patients were classified in the "uncommon etiologies" group. Main uncommon etiologies were: hypertrophic (n = 12(19%)); cancer therapeutics-related cardiac dysfunction (CTRCD) (n = 12(19%)); myocarditis (n = 11(18%)); valvulopathy (n = 9(15%)) and others (n = 18(29%)). Patients with uncommon etiologies were significantly younger with more female and presented less co-morbidities. Additionally, patients with uncommon cardiomyopathies were less implanted as destination therapy compared with ischemic/idiopathic group (29% vs 38.8%). During a follow-up period of 9.1 months, both groups experienced similar survival. However, subgroup of hypertrophic/valvular cardiomyopathies and CTRCD had significantly higher mortality compared to the ischemic/idiopathic or myocarditis/others cardiomyopathies. Conversely, patients with myocarditis/others etiologies experienced a better survival. Indeed, the 12-months survival in the myocarditis/others; ischemic/idiopathic and hypertrophic/CTRCD/valvulopathy group were 77%; 65%, and 46% respectively. In conclusion, LVAD-recipients with hypertrophic cardiomyopathy, valvular heart disease and CTRCD experienced the higher mortality rate.
Published: 2020
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19. Utility of Computed Tomography to Predict Ventricular Arrhythmias in Patients With Nonischemic Cardiomyopathy Receiving Cardiac Resynchronization Therapy

Author: Christophe Leclercq, Jackie Szymonifka, Raphaël P. Martins, Vincent Galand, Brian B. Ghoshhajra, Jagmeet P. Singh, Saumya Das, Quynh A. Truong, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Harvard Medical School [Boston] (HMS), CHU Pontchaillou [Rennes], New York University [New York] (NYU), NYU System (NYU), Center for neurogenetics [Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York], Weill Medical College of Cornell University [New York], K23HL098370, Foundation for the National Institutes of Health, National Heart, Lung, and Blood Institute, Abbott Pharmaceuticals, Jonchère, Laurent, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Tachycardia, Male, medicine.medical_specialty, genetic structures, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, Cardiac resynchronization therapy, Computed tomography, Pilot Projects, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Aged, medicine.diagnostic_test, business.industry, Middle Aged, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Nonischemic cardiomyopathy, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Predictive value of tests, Cardiology, Tachycardia, Ventricular, cardiovascular system, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Wall thickness, Cardiomyopathies, Tomography, X-Ray Computed
Abstract: International audience; The residual risk of ventricular arrhythmia (VA) after cardiac resynchronization therapy (CRT) implantation in patients with nonischemic cardiomyopathy (NICM) remains difficult to evaluate. The impact of left ventricular (LV) wall thickness (WT) measured using computed tomography (CT) on the occurrence of VA after CRT implantation has never been investigated. In this pilot study, we examined the association of LV WT and the occurrence of VA in NICM patients receiving CRT. Thirty three patients with NICM scheduled for CRT underwent preprocedural CT. Reduced LV WT was defined as WT
Published: 2020
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20. CRT-Pacemaker Versus CRT-Defibrillator: Who Needs Sudden Cardiac Death Protection?

Author: Raphaël P. Martins, Camille Pichard, Nathalie Behar, Christophe Leclercq, Vincent Galand, Philippe Mabo, Laboratoire Traitement du Signal et de l'Image (LTSI), 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 Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Pacemaker, Artificial, medicine.medical_specialty, medicine.medical_treatment, Cardiomyopathy, Cardiac resynchronization therapy, Heart failure, 030204 cardiovascular system & hematology, Ventricular Function, Left, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Ventricular arrhythmias, Physiology (medical), Internal medicine, Implantable cardioverter defibrillator, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Cardiac imaging, Ejection fraction, Ventricular Remodeling, business.industry, Stroke Volume, Implantable cardioverter-defibrillator, medicine.disease, Defibrillators, Implantable, 3. Good health, Cardiac surgery, Death, Sudden, Cardiac, Emergency Medicine, Cardiology, cardiovascular system, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Purpose of the review - Patients with cardiomyopathy and impaired left ventricular (LV) ejection fraction are at risk of sudden cardiac death (SCD). In selected heart failure patients, cardiac resynchronization therapy (CRT) provides LV reverse remodeling and improves the cellular and molecular function leading to a reduced risk of ventricular arrhythmia and SCD. Consequently, some CRT candidates may not need concomitant ICD therapy. This review aimed at focusing on the residual risk of SCD in patients receiving CRT and discussing the requirement of a concomitant ICD therapy in CRT candidates. Recent findings - New imaging diagnostic tools may be helpful to accurately predict patient with a residual risk of SCD and who required a CRT-D implantation. Recent data highlighted that cardiac computed tomography (CT) or myocardial scar tissue analysis using contrast-enhanced cardiac magnetic resonance (CMR) was able to predict the occurrence of VA in patients with bi-ventricular pacing. Cardiac imaging and specifically myocardial scar analysis seem promising to evaluate the risk of SCD following bi-ventricular pacing and will probably be of great help in the future to accurately identify those who needs concomitant defibrillator's protection.
Published: 2020
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21. From innovation to guideline implementation a long way

Author: Nathalie Behar, Raphaël P. Martins, Vincent Galand, Christophe Leclercq, CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], 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 (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Heart Failure, Process management, business.industry, [SDV]Life Sciences [q-bio], Stroke Volume, 030204 cardiovascular system & hematology, [SDV] Life Sciences [q-bio], Hospitalization, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Guideline implementation, Medicine, Humans, 030212 general & internal medicine, Guideline Adherence, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019
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22. The challenging right inferior pulmonary vein A systematic approach for successful cryoballoon ablation

Author: Nathalie Behar, Mathieu Lederlin, Celine Chérel, D. Pavin, Raphaël P. Martins, Christophe Leclercq, Philippe Mabo, Camille Pichard, Vincent Galand, Jean-Claude Daubert, Amélie Nicolas, 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 (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CCSD, Accord Elsevier
Subjects: Male, Reoperation, Cryoablation, medicine.medical_specialty, Isolation veineuse pulmonaire, medicine.medical_treatment, Action Potentials, Rhythm control, 030204 cardiovascular system & hematology, Cryosurgery, Pulmonary vein isolation, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Right inferior pulmonary vein, Heart Rate, Recurrence, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Cryoballoon ablation, ComputingMilieux_MISCELLANEOUS, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Veine pulmonaire inférieure droite, business.industry, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Ablation, Surgery, Fibrillation Atriale, Catheter, Treatment Outcome, Pulmonary Veins, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: Summary Background Pulmonary vein isolation (PVI) using cryoballoon ablation is widely used for rhythm control in patients with paroxysmal atrial fibrillation. This technique has a steep learning curve, and PVI can be achieved quickly in most patients. However, the right inferior pulmonary vein (RIPV) is often challenging to occlude and isolate. Aim We aimed to analyse the efficacy of RIPV ablation using a systematic approach. Methods Consecutive patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. A systematic approach was used for RIPV cryoablation. The primary endpoint was acute RIPV isolation during initial freeze. Results A total of 214 patients were included. RIPV isolation during initial freeze occurred in 179 patients (82.2%). Real-time PVI could be observed in 72 patients (33.6%), whereas cryoballoon stability required pushing the Achieve™ catheter inside the RIPVs in the remaining patients. The rate of unsuccessful or aborted first freeze as a result of insufficient minimal temperature was significantly higher in patients with real-time pulmonary vein potential recording (16.7% vs. 6.3%; P = 0.031). To overcome this issue and obtain both stability and real-time PVI, a dedicated “whip technique” was developed. Twelve patients (5.6%) required a redo ablation; only two of these had a reconnected RIPV. Conclusions A systematic approach to RIPV cryoablation can lead to a high rate of first freeze application. Operators should not struggle to visualize pulmonary vein potentials before ablation, as this may decrease cryoapplication efficacy. Thus, stability should be preferred over real-time PVI for RIPV ablation. Both stability and real-time PVI can be obtained using a “whip technique”.
Published: 2019
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23. Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality

Author: Vincent Auffret, Walid Ghodbane, Stéphane Boulé, Annette Belin, Michel Kindo, Nicolas Jacob, Romain Eschalier, Gerard Babatasi, Mathieu Pernot, Philippe Rouvière, Fabien Garnier, Frédéric Anselme, Christophe Leclercq, Anne Rollin, Philippe Gaudard, Edeline Pelcé, David Hamon, Nicolas Lellouche, Thomas Senage, Jean-François Obadia, Nicolas D'Ostrevy, Arnaud Savouré, André Vincentelli, Olivier Chavanon, Marie-Cécile Bories, Vincent Galand, Vlad Gariboldi, Raphaël P. Martins, Matteo Pozzi, Erwan Flecher, Laurent Barandon, Pascal Defaye, Jean-Philippe Verhoye, Thierry Bourguignon, Camille Pichard, Hugues Blangy, Constance Verdonk, Thomas Cardi, Bertrand Pierre, Eloi Marijon, Fabrice Vanhuyse, Marie Bielefeld, Pierre Mondoly, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Univ Rennes, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Department of Cardiology and Cardiac Surgery, CHU Lille, Institut Coeur-Poumons, Lille, France, Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France, Department of Cardiovascular Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Department of Anesthesiology and Critical Care Medicine, Centre hospitalier universitaire de Nantes (CHU Nantes), Cardiac Stimulation and Rhythmology, CHU Grenoble, Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France, Hospital Bichat Paris, Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France, Hôpital de la Timone [CHU - APHM] (TIMONE), Department of Cardiac Surgery, 'Louis Pradel' Cardiologic Hospital, Lyon, France, Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Clermont-Ferrand, 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), Cardiology Department, European Georges Pompidou Hospital, Paris, France, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, 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), Department of Cardiology, Department of Cardiac Surgery, CHU de Toulouse, Toulouse, France, 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), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], Discharged alive, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, medicine, left ventricular assist device, Humans, Post operative mortality, Clinical significance, 030212 general & internal medicine, post-operative mortality, Aged, Retrospective Studies, ventricular arrhythmia, Heart Failure, Ejection fraction, business.industry, Incidence (epidemiology), Arrhythmias, Cardiac, Middle Aged, medicine.disease, 3. Good health, Heart failure, Ventricular assist device, Ventricular fibrillation, Cardiology, Female, Heart-Assist Devices, business
Abstract: International audience; Objectives - This study aimed to evaluate incidence, clinical significance, and predictors of early ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients. Background - LVAD implantation is increasingly used in patients with end-stage heart failure. Early VAs may occur during the 30-day post-operative period, but many questions remain unanswered regarding their incidence and clinical impact. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Early VAs were defined as sustained ventricular tachycardia and/or ventricular fibrillation occurring
Published: 2019
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24. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study

Author: Caroline Kerneis, Nicolas D'Ostrevy, Fabien Garnier, Frédéric Anselme, Edeline Pelcé, Magali Michel, Pierre Mondoly, Erwan Flecher, Pierre-Yves Litzler, Christophe Leclercq, Romain Eschallier, Fabrice Vanhuyse, Vincent Galand, Raphaël P. Martins, Matteo Pozzi, Jean-Baptiste Gourraud, Pascal Defaye, Nicolas Sadoul, Frederic Sacher, Marie Bielefeld, Nicolas Lellouche, Hamed Bourenane, Vincent Auffret, Pierre Bordachar, Stéphane Boulé, Michel Kindo, Valentin Loobuyck, Jérôme Jouan, Gerard Babatasi, Philippe Rouvière, Thierry Bourguignon, Olivier Chavanon, Philippe Gaudard, Annette Belin, David Hamon, Camille Dambrin, Walid Ghodhbane, Marie-Cécile Bories, Vlad Gariboldi, Thomas Cardi, Bertrand Pierre, Daniel Grinberg, CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES), 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Université de Bordeaux (UB), Université de Strasbourg (UNISTRA), CHU Strasbourg, 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Rouen, Normandie Université (NU), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, 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), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rennes (UR), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Radiofrequency ablation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Left ventricular assist device, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular tachycardia, law.invention, Cohort Studies, Postoperative Complications, 0302 clinical medicine, law, Interquartile range, 030212 general & internal medicine, Incidence, Incidence (epidemiology), Age Factors, Middle Aged, Markov Chains, 3. Good health, Survival Rate, Cardiology, Female, ventricular tachycardia, Cardiology and Cardiovascular Medicine, electrical storm, Adult, medicine.medical_specialty, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, Physiology (medical), Internal medicine, medicine, Humans, Survival rate, Aged, Proportional Hazards Models, Retrospective Studies, ventricular arrhythmia, Heart Failure, business.industry, medicine.disease, ventricular fibrillation, mortality, Ventricular assist device, Heart failure, Ventricular fibrillation, Tachycardia, Ventricular, Heart-Assist Devices, business
Abstract: International audience; Background - Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. Objective - We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients. Methods - Patients analyzed were those included in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval. Results - Of 652 patients with an LVAD, 61 (9%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (63%). The incidence then tended to decrease during the initial years of follow-up and increased again after the third year post LVAD implantation. History of VAs before LVAD implantation and heart failure duration > 84 months were independent predictors of ES. The occurrence of ES was associated with an increased early mortality since 20 patients (33%) died within the first 2 weeks of ES. Twenty-two patients (36.1%) presented at least 1 recurrence of ES, occurring 43.0 (IQR 8.0-69.0) days after the initial ES. Patients experiencing ES had a significantly lower 1-year survival rate than did those free from ES (log-rank, P = .039). Conclusion - There is a significant incidence of ES in patients with an LVAD. The short-term mortality after ES is high, and one-third of patients will die within 15 days. Whether radiofrequency ablation of arrhythmias improves outcomes would require further studies.
Published: 2019
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25. An entirely leadless cardiac resynchronization therapy

Author: Vincent Galand, Raphaël P. Martins, Baptiste Polin, Christophe Leclercq, 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), CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, MEDLINE, Cardiac resynchronization therapy, 02 engineering and technology, 030204 cardiovascular system & hematology, 021001 nanoscience & nanotechnology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 0210 nano-technology, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019
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26. Risk factors and prognostic impact of left ventricular assist device–associated infections

Author: Marylou Para, Vincent Veniard, Louis Bernard, Vincent Auffret, Stéphane Boulé, Constance Verdonk, Laurent Barandon, Michel Kindo, Thierry Bourguignon, Pascal Defaye, Marie Bielefeld, David Hamon, Edeline Pelcé, Pierre Tattevin, Jérôme Jouan, Fabien Garnier, Philippe Gaudard, Pierre-Yves Litzler, Christophe Leclercq, Fabrice Vanhuyse, Nicolas Lellouche, Thomas Senage, Clément Delmas, Emilie Varlet, Thomas Cardi, Vlad Gariboldi, Daniel Grinberg, André Vincentelli, Arnaud Savouré, Erwan Flecher, Annette Belin, Nicolas Jacob, Gerard Babatasi, Philippe Rouvière, Romain Eschalier, Olivier Chavanon, Hugues Blangy, Camille Dambrin, Raphaël P. Martins, Matteo Pozzi, Nicolas D'Ostrevy, Vincent Galand, MORNET, Dominique, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], 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], Centre Hospitalier Universitaire de Lille (CHU de Lille), Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Equipe 'Obésité et insuffisance cardiaque: approches moléculaires et cliniques ', Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Bordeaux II, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Michallon, Hospital Bichat Paris, Hospital,Bichat- Paris, Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Chirurgie Cardiaque [Hôpital de la Timone - APHM], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, 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), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French Federation of Cardiology, 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), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN)
Subjects: Male, medicine.medical_specialty, Percutaneous, Prosthesis-Related Infections, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Device Removal, Retrospective Studies, Heartmate ii, Pseudomonas aeruginosa, business.industry, Retrospective cohort study, Middle Aged, Prognosis, equipment and supplies, Cannula, 3. Good health, Icd implantation, Defibrillators, Implantable, [SDV] Life Sciences [q-bio], Staphylococcus aureus, Ventricular assist device, Catheter-Related Infections, Multivariate Analysis, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections. Methods - Patients included in the ASSIST-ICD study (19 centers) were enrolled. The main outcome was the occurrence of LVAD-associated infection (driveline infection, pocket infection, or pump/cannula infection) during follow-up. Results - Of the 652 patients enrolled, 201 (30.1%) presented a total of 248 LVAD infections diagnosed 6.5 months after implantation, including 171 (26.2%), 51 (7.8%), and 26 (4.0%) percutaneous driveline infection, pocket infection, or pump/cannula infection, respectively. Patients with infections were aged 58.7 years, and most received HeartMate II (82.1%) or HeartWare (13.4%). Most patients (62%) had implantable cardioverter-defibrillators (ICDs) before LVAD, and 104 (16.0%) had ICD implantation, extraction, or replacement after the LVAD surgery. Main pathogens found among the 248 infections were Staphylococcus aureus (n = 113' 45.4%), Enterobacteriaceae (n = 61; 24.6%), Pseudomonas aeruginosa (n = 34; 13.7%), coagulase-negative staphylococci (n = 13; 5.2%), and Candida species (n = 13; 5.2%). In multivariable analysis, HeartMate II (subhazard ratio, 1.56; 95% CI, 1.03 to 2.36; P = .031) and ICD-related procedures post-LVAD (subhazard ratio, 1.43; 95% CI, 1.03-1.98; P = .031) were significantly associated with LVAD infections. Infections had no detrimental impact on survival. Conclusions - Left ventricular assist device-associated infections affect one-third of LVAD recipients, mostly related to skin pathogens and gram-negative bacilli, with increased risk with HeartMate II as compared with HeartWare, and in patients who required ICD-related procedures post-LVAD. This is a plea to better select patients needing ICD implantation/replacement after LVAD implantation.
Published: 2019
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27. Response of secondary mitral regurgitation to cardiac resynchronization therapy is the atrium to blame?

Author: Claude Daubert, Raphaël P. Martins, Vincent Galand, 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, Blame, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Heart Atria, 030212 general & internal medicine, Atrium (heart), ComputingMilieux_MISCELLANEOUS, media_common, Mitral regurgitation, business.industry, Mitral Valve Insufficiency, Atrial fibrillation, medicine.disease, 3. Good health, medicine.anatomical_structure, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Heart atrium
Abstract: International audience
Published: 2018
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28. Procedural safety and long-term follow-up after pacemaker implantation in nonagenarians

Author: Raphaël P. Martins, Vincent Galand, Aurélie Loirat, Duc Dang, Nathalie Behar, Vincent Auffret, Philippe Mabo, Jean-Claude Daubert, Christophe Leclercq, CHU Pontchaillou [Rennes], 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), CHU Bordeaux [Bordeaux], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Pacemaker, Artificial, Time Factors, complications, Population, Clinical Investigations, 030204 cardiovascular system & hematology, Risk Assessment, nonagenarian, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, Interquartile range, Risk Factors, Atrial Fibrillation, medicine, Clinical endpoint, Odds Ratio, Humans, education, Retrospective Studies, Aged, 80 and over, education.field_of_study, Inpatients, business.industry, Hazard ratio, Age Factors, Atrial fibrillation, General Medicine, Odds ratio, Length of Stay, medicine.disease, Confidence interval, pacemaker, 3. Good health, Surgery, Survival Rate, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, 0305 other medical science, Cardiology and Cardiovascular Medicine, business, Complication, Follow-Up Studies
Abstract: International audience; Background - The rate of pacemaker (PM) implantations is constantly growing. Since life expectancy of the population is projected to increase, a large number of nonagenarian patients will need PM implantation. We aimed at analyzing short- and long-term outcomes after PM implantation in nonagenarians. Methods - Patients aged ≥90 years referred for PM implantation from 2004 to 2017 were included. The primary clinical endpoint was total mortality. Secondary endpoints included procedure-related and in-hospital complications. Results - A total of 172 patients were included (92.6 ± 2.1 years, from 90.0 to 101.4 years). Procedure duration was 50.0 ± 19.7 minutes. Most of the patients had VVI devices implanted (143 pts, 83.1%) and mean hospital stay was 3.5 ± 1.5 days. Nine patients (5.2%) had short-term device-related complications and 29 patients (16.8%) had post-procedural complications, non-related to the implantation, including four leading to patients' death. During a follow-up of 22.5 months (interquartile range: 7.3-38.0), 94 patients (54.7%) died. Survival rates were 82.9% (95% confidence interval [CI]: 76.0-88.0), 73.7% (95% CI: 65.7-80.1) and 37.5% (95% CI: 27.5-47.5) after 1, 2, and 5 years, respectively. The Charlson comorbidity index was a predictive factor of procedural complications (odds ratio = 1.33; 95% CI: 1.05-1.69, P = 0.02) while having a complication (hazard ratio [HR] = 4.04; 95% CI: 1.79-9.11, P = 0.001) and atrial fibrillation (HR = 1.63; 95% CI: [1.02-2.63], P = 0.043) were predictors of post-implantation death. Conclusion - PM implantation in nonagenarians is safe, with a low risk of procedural complications, but many comorbidities-related complications can occur. Caution should be taken in this old and frail population since complications significantly impact patients' survival.
Published: 2018
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29. Predictors and Clinical Impact of Late Ventricular Arrhythmias in Patients With Continuous-Flow Left Ventricular Assist Devices

Author: Walid Ghodbane, Raphaël P. Martins, Matteo Pozzi, Vincent Auffret, Assist-Icd Investigators, David Hamon, Philippe Rouvière, Stéphane Boulé, Michel Kindo, Romain Eschalier, Pierre-Yves Litzler, Thierry Bourguignon, Olivier Chavanon, Christophe Leclercq, Camille Dambrin, Bertrand Pierre, Marie Bielefeld, Magali Michel, Hugues Blangy, Pierre Mondoly, Marie-Cécile Bories, Thomas Cardi, Jean-François Obadia, Pascal Defaye, Edeline Pelcé, Frederic Sacher, Costin Radu, Constance Verdonk, Annette Belin, Vlad Gariboldi, Erwan Flecher, Nicolas D'Ostrevy, Vincent Galand, Karine Nubret, Philippe Gaudard, Fabien Garnier, Frédéric Anselme, Gerard Babatasi, Fabrice Vanhuyse, Jean-Baptiste Gourraud, Eloi Marijon, André Vincentelli, Jean-Philippe Verhoye, 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), Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Cardiac Stimulation and Rhythmology, CHU Grenoble, Hôpital Michallon, 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), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carnegie Mellon University [Pittsburgh] (CMU), Service de chirurgie cardiaque, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Département Matériaux (LCPC/MAT), Laboratoire Central des Ponts et Chaussées (LCPC)-PRES Université Nantes Angers Le Mans (UNAM), Griset SA, Diehl - Griset, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service chirurgie cardio-vasculaire, Centre Hospitalier Universitaire de Clermont-Ferrand, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], 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], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Unité de recherche de l'institut du thorax (ITX-lab), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Cardiomyopathy, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, implantable cardioverter-defibrillator, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, left ventricular assist device, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Fibrillation, Ejection fraction, business.industry, ventricular arrhythmias, Arrhythmias, Cardiac, Atrial fibrillation, Middle Aged, Implantable cardioverter-defibrillator, medicine.disease, equipment and supplies, Defibrillators, Implantable, 3. Good health, Ventricular assist device, Heart failure, Etiology, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, medicine.symptom, business
Abstract: International audience; Objectives - This study aimed to evaluate the incidence, clinical impact, and predictors of late ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients aiming to clarify implantable cardioverter-defibrillator (ICD) indications. Background - The arrhythmic risk and need for ICD in patients implanted with an LVAD are not very well known. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Late VAs were defined as sustained ventricular tachycardia or fibrillation occurring >30 days post-LVAD implantation, without acute reversible cause and requiring appropriate ICD therapy, external electrical shock, or medical therapy. Results - Among 659 LVAD recipients, 494 (median 58.9 years of age; mean left ventricular ejection fraction 20.7 ± 7.4%; 73.1% HeartMate II, 18.6% HeartWare, 8.3% Jarvik 2000) were discharged alive from hospital and included in the final analysis. Late VAs occurred in 133 (26.9%) patients. Multivariable analysis identified 6 independent predictors of late VAs: VAs before LVAD implantation, atrial fibrillation before LVAD implantation, idiopathic etiology of the cardiomyopathy, heart failure duration >12 months, early VAs (
Published: 2018
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30. The second generation cryoballoon has improved durable isolation of left but not right pulmonary veins new insights from amulticentre study

Author: Raphaël P. Martins, Philippe Mabo, Antoine Milhem, Vincent Auffret, Jean-Claude Daubert, Vincent Galand, Nathalie Behar, Olivier Cesari, Dominique Pavin, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Clinique St Gatien, CH La Rochelle, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Action Potentials, 030204 cardiovascular system & hematology, Arrhythmias, Cryoballoon, Cryosurgery, Pulmonary vein isolation, Cardiac Catheters, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Recurrence, Physiology (medical), Internal medicine, medicine, Humans, In patient, 030212 general & internal medicine, Aged, Retrospective Studies, Paroxysmal AF, business.industry, Significant difference, Second-generation cryoballoon, Equipment Design, Middle Aged, Ablation, Atrial fibrillation, First generation, Treatment Outcome, Pulmonary Veins, Right superior, Cardiology, cardiovascular system, Female, lipids (amino acids, peptides, and proteins), Catheter ablation, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Left superior, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Aims Pulmonary vein isolation (PVI) using second-generation cryoballoon (CB2) is associated with improved outcomes compared with first generation (CB1). We aimed at investigating the characteristics of left and right PV reconnections after CB1 and CB2 ablations in patients with clinical recurrences requiring redo ablation. Methods and results From 2010 to 2016, 776 patients underwent 28-mm cryoballoon PVI for symptomatic paroxysmal atrial fibrillation (AF) in 3 centres, 279 with CB1 and 497 with CB2. Among them, 94 patients (12.1%) had symptomatic AF recurrences requiring a redo ablation [43 (15.4%) CB1 and 51 (10.3%) CB2]. The benefit of CB2 over CB1 was compared for each PV. Durable PVI was confirmed in 7 CB1 (16.3%) and 14 CB2 (27.4%) patients, and 2.7 +/- 2.1 and 1.4 +/- 1.4 gaps per patient were found, respectively (P = 0.002). Significantly more left superior and left inferior PVs were found to be isolated in CB2 compared with CB1 group (78.4% vs. 48.8%, P = 0.005 and 78.4% vs. 46.5%, P = 0.003, respectively) while the rate of durable right superior and right inferior PVs isolation were similar (68.6% vs. 60.5%, P = 0.542 and 66.7% vs. 55.8%, P = 0.387, respectively). Significantly fewer gaps were found in left PVs in CB2 patients, while there was no significant difference for right PVs. Gaps localization was similar in both groups. Conclusion Fewer reconnection gaps are observed during redo ablations of paroxysmal AF in patients primarily ablated with CB2. This difference is driven by less reconnection gaps observed in both left PVs, while no difference was observed for right PVs.
Published: 2018
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31. A novel method for localization and ablation of conduction gaps after wide antral circumferential ablation of pulmonary veins

Author: Frédéric Sebag, Nathalie Behar, D. Pavin, Philippe Mabo, Raphaël P. Martins, Christophe Leclercq, Baptiste Polin, Raoul Bacquelin, Jean-Claude Daubert, Vincent Galand, Jonathan Lacaze, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], 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 ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: Male, Novel technique, Time Factors, Isolation veineuse pulmonaire, medicine.medical_treatment, Action Potentials, 030204 cardiovascular system & hematology, Ablation, Pulmonary vein, 0302 clinical medicine, Heart Rate, Recurrence, Prospective Studies, 030212 general & internal medicine, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Antrum, Cardiac Pacing, Artificial, Atrial fibrillation, General Medicine, Middle Aged, Catheter, Ostium, Treatment Outcome, Pulmonary Veins, Catheter Ablation, Cardiology, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Electrophysiologic Techniques, Cardiac, Cardiology and Cardiovascular Medicine, Conduction gap, Gaps de conduction, medicine.medical_specialty, Récurrence, Pulmonary vein isolation, Lesion, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Fibrillation atriale, Humans, Aged, business.industry, medicine.disease, business
Abstract: International audience; Background - Atrial fibrillation ablation is often performed by achieving pulmonary vein isolation using the "wide antral circumferential ablation" (WACA) technique, but many pulmonary veins remain connected because of conduction gaps in the ablation line. Aim - To analyse the efficacy of a novel technique based on pacing manoeuvres to detect gaps in an initial WACA lesion. Methods - Patients referred for radiofrequency atrial fibrillation ablation were enrolled prospectively. A WACA lesion set was performed, isolating ipsilateral pulmonary veins together. If pulmonary vein isolation was not achieved, the atria were paced using an ablation catheter. For each pacing site, "activation delay" and "activation sequence" were analysed using a circular mapping catheter positioned at the pulmonary vein ostium. Results - Twenty-one patients were included. A total of 25 non-isolated WACA lesion sets were studied. Three patterns were identified: (1) the activation delays converged towards one point with the shortest delay; no modification of the activation sequence (indicating one gap); (2) the activation delays converged towards at least two close locations; no change in the activation sequence (indicating at least two close gaps); (3) the activation delays converged towards at least two remote locations; modification of the activation sequence (indicating at least two remote gaps). Pacing manoeuvres and effect of ablation allowed precise localization of gaps, ultimately leading to pulmonary vein isolation in all patients. Conclusion - This simple pacing method accurately detected the location of residual connections after WACA lesion sets performed for atrial fibrillation ablation, allowing pulmonary vein isolation to be achieved.
Published: 2018
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32. Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes

Author: Elena Galli, Raphaël P. Martins, Arnaud Hubert, Erwan Donal, François Carré, Christophe Leclercq, D. Pavin, Frédéric Schnell, Vincent Galand, 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Adult, Male, medicine.medical_specialty, Longitudinal strain, Databases, Factual, Paroxysmal atrial fibrillation, Cardiovascular risk factors, 030204 cardiovascular system & hematology, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, strain, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Reference Values, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, atrial fibrillation, 030212 general & internal medicine, Tachycardia, Paroxysmal, Retrospective Studies, Observer Variation, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Receiver operating characteristic analysis, biology, business.industry, Athletes, Training level, Atrial fibrillation, General Medicine, medicine.disease, biology.organism_classification, Atrial Function, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Increased risk, ROC Curve, Echocardiography, Case-Control Studies, atria, Cardiology, Exercise Test, Physical Endurance, [SDV.IB]Life Sciences [q-bio]/Bioengineering, athlete, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Aims - Intensive endurance sport practice is associated with an increased risk of atrial fibrillation (AF) in male veteran athletes. Paroxysmal AF (PAF) is the very beginning step of this disease. The description of atrial remodelling occurring at this early stage might enable to depict predictive factors of AF in veteran athletes in order to give them personalized recommendation according to their sport practice.Methods and results - Twenty-seven male endurance veteran athletes with documented PAF were retrospectively enrolled and compared with 30 control endurance athletes without documented AF, with similar training level, age, and cardiovascular risk factors. All subjects underwent a resting-electrocardiogram (ECG) to assess the electric remodelling of P-waves as well as an echocardiography, to evaluate the left and right atrial (LA, RA) anatomical and functional (assessed by 2D strain) remodelling. No difference was noted between groups for the ECG P-wave parameters. Atrial function was decreased in the PAF group, particularly the peak atrial longitudinal strain (L-ɛ-Max) of LA (29.3 ± 7.9% vs. 49.1 ± 7.8% respectively in the PAF group and in controls, P Conclusion - Atrial function analysed by strain in echocardiography is strongly associated with PAF and might enable to identify male endurance veteran athletes at risk to develop AF.
Published: 2018
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33. Cardiac electronic implantable devices after tricuspid valve surgery

Author: Raphaël P. Martins, Christophe Leclercq, Jean-Claude Daubert, Vincent Galand, 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 ), Service de cardiologie et maladies vasculaires, Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Jonchère, Laurent, 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), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Ventricular lead, Conduction disorders, Defibrillation, medicine.medical_treatment, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Implantable Cardioverter-Defibrillator, Physiology (medical), Tricuspid valve, medicine, Humans, 030212 general & internal medicine, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Cardiac Surgical Procedures, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Arrhythmias, Cardiac, Implantable cardioverter-defibrillator, Tricuspid Valve Insufficiency, Implantation, 3. Good health, Surgery, Defibrillators, Implantable, Pacemaker, Increased risk, medicine.anatomical_structure, Registry data, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; The demand for tricuspid valve (TV) surgery has increased continuously in the last years. Recent registry data have confirmed that TV repair or replacement carry an increased risk of conduction disorders requiring permanent pacemaker implantation, specifically for patients having multivalve surgery. The implantation of an endocardial right ventricular lead in those patients may impair TV function, and some other approaches may be discussed to avoid traversing the valve. This contemporary review describes the different options currently available for patients requiring pacemaker or defibrillation lead implantation after TV surgery.
Published: 2018
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34. Multimodal images integration for catheter ablation of ventricular tachycardia

Author: Antoine Simon, Mathieu Lederlin, S Bruge, Raphaël P. Martins, Nicolas Courtial, Mireille Garreau, 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), Département de Radiologie [CHU de Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)
Subjects: medicine.medical_specialty, Catheters, medicine.medical_treatment, Anatomical structures, Cardiology, Catheter ablation, 030204 cardiovascular system & hematology, Ablation, Ventricular tachycardia, Ablation procedures, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Left ventricular, Radiofrequency catheter ablation, business.industry, Recurrent ventricular tachycardia, Patient treatment, Patient specific, medicine.disease, Computerized tomography, 3. Good health, Patient specific model, medicine.anatomical_structure, Ventricle, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Multi-modal image
Abstract: International audience; Radiofrequency catheter ablation is an important therapeutic option for patients with recurrent ventricular tachycardia (VT). The procedure aims at cauterizing regions of the ventricle. A good knowledge of anatomical structures and tissues properties can improve procedure safety and efficacy. This work aimed at analysing the feasibility of a workflow based on multimodal image integration to assist the intervention. We focused here on a model including myocardial thickness and fibrosis extracted from late gadolinium enhanced MRI (LGE-MRI) sequence, and left ventricular anatomy segmented from multiphase computed tomography (CT). The produced model can be imported within Carto-3® system (Biosense Webster Inc, Diamond Bar, CA), the software used during the ablation procedure. Four patients cases have been included in this preliminary study. The four produced patient specific models have been validated by a clinician, and two of them have been integrated within Carto-3® system and used during the intervention. © 2017 IEEE Computer Society. All rights reserved.
Published: 2017
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35. Peritoneal migration of an epicardial pacemaker

Author: Vincent Galand, Baptiste Polin, Raphaël P. Martins, Christophe Leclercq, Jean Marc Schleich, Jean-Claude Daubert, 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), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Pacemaker, Artificial, medicine.medical_specialty, Cardiac pacing, Day of life, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Foreign-Body Migration, Device removal, Physiology (medical), Internal medicine, Humans, Medicine, Pericardium, 030212 general & internal medicine, Atrioventricular Block, Peritoneal Cavity, Device Removal, business.industry, Cardiac Pacing, Artificial, medicine.disease, 3. Good health, medicine.anatomical_structure, Ventricle, Child, Preschool, Heart failure, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: International audience; A newborn with complete congenital atrioventricular block of immune origin, in severe heart failure, was implanted with a pacemaker at 1 day of life. The pacing lead was fixed to the epicardial right ventricle and the generator conventionally implanted in a pocket created beneath rectus muscles...
Published: 2017
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36. Ventricular fibrillation triggered by a pacemaker-mediated tachycardia protection algorithm

Author: Nathalie Behar, Raphaël P. Martins, Vincent Galand, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, Pacemaker, Artificial, medicine.medical_specialty, Cardiac pacing, Electric Countershock, 030204 cardiovascular system & hematology, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Humans, Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, business.industry, Cardiac Pacing, Artificial, Equipment Design, Pacemaker mediated tachycardia, medicine.disease, Defibrillators, Implantable, Death, Sudden, Cardiac, Ventricular Fibrillation, Ventricular fibrillation, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Algorithms
Abstract: International audience
Published: 2017
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37. Twiddler's syndrome with a baroreflex stimulator device

Author: Raphaël P. Martins, Christophe Leclercq, Vincent Galand, 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), 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Baroreceptor, Electric Countershock, Ischaemic cardiomyopathy, Pressoreceptors, 030204 cardiovascular system & hematology, Baroreflex, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Secondary Prevention, Medicine, Humans, Twiddler's Syndrome, cardiovascular diseases, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Secondary prevention, Heart Failure, Ejection fraction, business.industry, Mental Disorders, Implantable Neurostimulators, Syndrome, Middle Aged, medicine.disease, 3. Good health, Defibrillators, Implantable, Heart failure, Anesthesia, cardiovascular system, Cardiology, Patient Compliance, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: A 48-year-old man with a biventricular ischaemic cardiomyopathy with severe left ventricular ejection fraction impairment (20%) and narrow QRS complexes underwent a single-chamber implantable cardioverter-defibrillator (ICD) implantation for secondary prevention. In December 2014, despite optimal medical therapy, the …
Published: 2016
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38. 0019: High-degree atrioventricular block complicating ST-segment elevation myocardial infarction in the contemporary era: data from the ORBI prospective French regional registry

Author: Marc Bedossa, Dominique Boulmier, Régis Delaunay, Philippe Castellant, Hervé Le Breton, Vincent Auffret, Raphaël P. Martins, Martine Gilard, Isabelle Coudert, Jean-Philippe Hacot, Josiane Treuil, Philippe Druelles, Aurélie Loirat, Gilles Rouault, Bertrand Avez, Marielle Le Guellec, Jean-Claude Daubert, Emmanuelle Filippi, Guillaume Leurent, Antoine Rialan, B. Boulanger, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Vannes], Centre hospitalier de Vannes, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de cardiologie [Saint Malo], CH de Saint-Malo [Broussais], Service de cardiologie [Quimper], CH de Quimper, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Pediatrics, medicine.medical_specialty, business.industry, Mortality rate, Incidence (epidemiology), Present on admission, medicine.disease, Independent predictor, 3. Good health, medicine, ST segment, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Myocardial infarction, business, Complication, Cardiology and Cardiovascular Medicine, Atrioventricular block
Abstract: Background High-degree atrioventricular block (HAVB) is a common complication of ST-segment elevation myocardial infarction (STEMI). HAVB in STEMI is historically considered as a marker of worse outcome but overall data about HAVB in the contemporary era of mechanical reperfusion and potent antiplatelet therapies are scarce. Aim We aimed at analyzing incidence, clinical correlates and impact on inhospital outcomes of HAVB in a large prospective registry (ORBI) of modern management of STEMI with a special focus on potential differences between patients with HAVB on admission and those who developed HAVB during hospitalization. Methods All patients enrolled in ORBI between June 2006 and December 2013 were included in the present analysis and were divided into 3 groups: patients without HAVB at any time, patients with HAVB on admission and those who developed HAVB during hospitalization. Results 6662 patients (age: 62.0 [52.0-74.0]; male: 76.3%) were included in the present analysis. HAVB was documented in 3.5% of patients, present on admission in 63.7% of patients and occurring during hospitalization in 36.3%. Patients with HAVB on admission or occurring during the first 24h of hospitalization had higher in-hospital mortality rates (18.1% and 28.6% respectively) than patients without (4.5%) or with HAVB occurring beyond the first 24h of hospitalization (8.0%). However by multivariable analysis, HAVB was not independently associated with in-hospital mortality. Conclusion Patients with HAVB had a higher mortality rate than patients without. However HAVB is not an independent predictor of in-hospital mortality. Download : Download high-res image (214KB) Download : Download full-size image Abstract 0019 – Figure: Multivariable analysis
Published: 2016
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39. An unusual indication of heart transplantation

Author: Erwan Flecher, Raphaël P. Martins, C. Chabanne, Vincent Galand, Marc Bedossa, Jonchère, Laurent, 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], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Heart transplantation, [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, business.industry, medicine.medical_treatment, Ischemia, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, Angina, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Cardiology, Medicine, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Refractory angina, Cardiac symptoms, ComputingMilieux_MISCELLANEOUS
Abstract: Article history: Received 8 October 2015 Accepted 18 October 2015 Available online 19 October 2015 of life. Two months later, the patient underwent an orthotopic heart transplantation,with no complications and he remains free of any cardiac symptoms at 1 year follow-up. Two criteria must be fulfilled to validate the presence of refractory angina: 1) ischemia should be authenticated by stress tests and should be responsible for symptoms of angina; 2) the patient is under maxi
Published: 2016
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40. High-degree atrioventricular block complicating ST segment elevation myocardial infarction in the contemporary era

Author: Philippe Castellant, Philippe Druelles, Bertrand Avez, Gilles Rouault, Marielle Le Guellec, Jean-Claude Daubert, Dominique Boulmier, Raphaël P. Martins, Jean Philippe Hacot, Aurélie Loirat, Régis Delaunay, Martine Gilard, Hervé Le Breton, Emmanuelle Filippi, Guillaume Leurent, Isabelle Coudert, Josiane Treuil, Vincent Auffret, Marc Bedossa, Antoine Rialan, B. Boulanger, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), Service de cardiologie [Vannes], Centre hospitalier de Vannes, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de cardiologie [Saint Malo], CH de Saint-Malo [Broussais], Service de cardiologie [Quimper], CH de Quimper, SAMU [Vannes], CHBA Vannes, SAMU [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Time Factors, Myocardial Infarction, Myocardial Reperfusion, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Reperfusion therapy, Risk Factors, Internal medicine, Odds Ratio, medicine, Humans, ST segment, Hospital Mortality, Registries, 030212 general & internal medicine, Myocardial infarction, Atrioventricular Block, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, Chi-Square Distribution, business.industry, Incidence, Cardiogenic shock, Mortality rate, Middle Aged, medicine.disease, 3. Good health, Hospitalization, Logistic Models, Treatment Outcome, Multivariate Analysis, Cardiology, Platelet aggregation inhibitor, Myocardial infarction complications, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, Myocardial infarction diagnosis, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors
Abstract: International audience; Background High-degree atrioventricular block (HAVB) is a common complication of ST segment elevation myocardial infarction (STEMI). HAVB in STEMI is historically considered as a marker of worse outcome but overall data about HAVB in the contemporary era of mechanical reperfusion and potent antiplatelet therapies are scarce. Aim Analysing incidence, clinical correlates and impact on inhospital outcomes of HAVB in a large prospective registry (Observatoire Régional Breton sur l'Infarctus, ORBI) of modern management of STEMI with a special focus on potential differences between patients with HAVB on admission and those who developed HAVB during hospitalisation. Methods All patients enrolled in ORBI between June 2006 and December 2013 were included in the present analysis and were divided into 3 groups: patients without HAVB at any time, patients with HAVB on admission and those who developed HAVB during hospitalisation. Results A total of 6662 patients (age: 62.0 (52.0–74.0) years; male: 76.3%) were included in the present analysis. HAVB was documented in 3.5% of patients, present on admission in 63.7% of patients and occurring during hospitalisation in 36.3%. Patients with HAVB on admission or occurring during the first 24 h of hospitalisation had higher inhospital mortality rates (18.1% and 28.6%, respectively) than patients without (4.5%) or with HAVB occurring beyond the first 24 h of hospitalisation (8.0%). However by multivariable analysis, HAVB was not independently associated with inhospital mortality contrarily to age, presentation as cardiac arrest, anterior STEMI location, reperfusion therapy, cardiogenic shock, mechanical ventilation and occurrence of sustained ventricular tachyarrhythmias or mechanical complication. Conclusions Patients with HAVB had a higher mortality rate than patients without. However HAVB is not an independent predictor of inhospital mortality
Published: 2016
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41. Defining nonvalvular atrial fibrillation: A quest for clarification

Author: Raphaël P. Martins, Jean-Claude Daubert, Nathalie Behar, Christophe Leclercq, Vincent Galand, Edouard Colette, Philippe Mabo, Dominique Pavin, CIC-IT Rennes, Hôpital Pontchaillou-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], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Population, Heart Valve Diseases, 030204 cardiovascular system & hematology, Antithrombins, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Atrial Fibrillation, medicine, Humans, Mitral Valve Stenosis, 030212 general & internal medicine, Heart valve, education, Bioprosthesis, [SDV.IB] Life Sciences [q-bio]/Bioengineering, education.field_of_study, Mitral valve repair, business.industry, Contraindications, Atrial fibrillation, Evidence-based medicine, medicine.disease, 3. Good health, Aortic valvuloplasty, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Stroke, Stenosis, medicine.anatomical_structure, Heart Valve Prosthesis, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Factor Xa Inhibitors
Abstract: International audience; Non-vitamin K oral anticoagulants (NOACs) are currently recommended for patients with nonvalvular atrial fibrillation since the publication of the 4 major pivotal trials evaluating the efficacy and safety of factor IIa and factor Xa inhibitors. The definition of nonvalvular atrial fibrillation is unclear, varying from one trial to another and even between North American and European guidelines, which is a source of uncertainties in clinical practice. However, many patients with atrial fibrillation present signs of valvular involvement, and clarification of this term is needed to not deny NOACs to patients based on the wrong perception that they may have valvular atrial fibrillation. The currently unique contraindications to NOACs are patients with mechanical heart valves and those with moderate-to-severe mitral stenosis, as stated by the recent 2015 position paper of the European Heart Rhythm Association. Patients with native heart valve involvement, regardless of their severity, are suitable for NOAC therapy. Patients with bioprosthetic heart valves and mitral valve repair may be suitable for NOACs except for the first 3 and the first 3-6 months postoperatively, respectively. Patients with transaortic valve implantation or percutaneous transluminal aortic valvuloplasty are also considered as being eligible for NOACs, although the bleeding risk has to be carefully considered in this population often requiring a combination with antiplatelet therapy. Future studies are warranted to increase the level of evidence of use of NOACs, particularly in patients with transaortic valve implantation and valvular surgery, and to determine whether they could be used in the future in the only 2 remaining contraindications. © 2016 Elsevier, Inc.
Published: 2016
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42. Why We Have to Use Cardiac Resynchronization Therapy–Pacemaker More

Author: Raphaël P. Martins, Christophe Leclercq, Jean-Claude Daubert, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-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), and Jonchère, Laurent
Subjects: Pacemaker, Artificial, genetic structures, medicine.medical_treatment, 030204 cardiovascular system & hematology, Ventricular tachycardia, 0302 clinical medicine, Prevalence, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Cardiac resynchronization therapy, Evidence-Based Medicine, General Medicine, Prognosis, Combined Modality Therapy, Defibrillators, Implantable, 3. Good health, Survival Rate, Pacemaker, Practice Guidelines as Topic, cardiovascular system, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, circulatory and respiratory physiology, medicine.medical_specialty, Risk Assessment, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, Humans, In patient, Cardiac Resynchronization Therapy Devices, cardiovascular diseases, Reverse remodeling, Intensive care medicine, Heart Failure, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Patient Selection, Evidence-based medicine, equipment and supplies, medicine.disease, Chronic heart failure, Death, Sudden, Cardiac, Heart failure, Ventricular fibrillation, business
Abstract: Both cardiac resynchronization therapy with a pacemaker (CRT-P) and with a biventricular implantable cardioverter-defibrillator (CRT-D) are electrical treatment modalities validated for the management of chronic heart failure. There is no strong scientific evidence that a CRT-D must be offered to all candidates. Common sense should limit the prescription of these costly and complicated devices. The choice of CRT-P is currently acceptable. A direction to explore could be to downgrade from CRT-D to CRT-P at the time of battery depletion in patients with large reverse remodeling and no ventricular tachycardia and ventricular fibrillation detected.
Published: 2015
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43. 45 Assessment of left ventricular dyssynchrony and prediction of response to cardiac resynchronization therapy: a new three-dimensionnal echocardiography integral-based indicator of longitudinal strain

Author: Raphaël P. Martins, Philipe Mabo, Erwan Donai, Alfredo Hernandez, Maxime Fournet, Christophe Leclercq, Albin Behaghel, Jean-Claude Daubert, Anne Bernard, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, medicine.medical_specialty, Longitudinal strain, business.industry, medicine.medical_treatment, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Ventricular dyssynchrony, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; no abstract
Published: 2015
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44. 0346 : Procedural safety and long-term follow-up after pacemaker implantation in nonagenarians

Author: Alain Le Helloco, Raphaël P. Martins, Aurélie Loirat, Damien Feneon, Nathalie Behar, Albin Behaghel, Philippe Mabo, Christophe Leclercq, Jean-Claude Daubert, 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), 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Long term follow up, business.industry, [SDV]Life Sciences [q-bio], Cardiomyopathy, Atrial fibrillation, 030204 cardiovascular system & hematology, medicine.disease, Hemothorax, 3. Good health, Surgery, Pacemaker implantation, Total mortality, 03 medical and health sciences, 0302 clinical medicine, Hematoma, medicine, Clinical endpoint, 030212 general & internal medicine, business, Cardiology and Cardiovascular Medicine
Abstract: Introduction The rate of pacemaker(PM) implantations is continuously growing. A large number of nonagenarian patients will be implanted in the future. We aimed at analyzing the outcome after PM implantation in the elderly. Methods Patients aged ≥90 yo referred for PM implantation from 2004 to 2014 were retrospectively included. The primary clinical endpoint was total mortality. Results 113 patients were included (92.6±2.1yo). Five patients (3.5%) had short-term device-related complications (3 pocket hematoma, 1 lead displacement, 1 hemothorax). During the follow-up, 48 patients (42.5%) died. Survival rates were 77.4% (95%CI:67.4-84.7%), 68.7% (95%CI:57.4-77.6%) and 36.4% (95%CI:23.3-49.7%) after 1, 2 and 5 years, respectively. Atrial fibrillation (OR 3.5,95%CI:1.6-7.2) and a cardiomyopathy (OR 2.3,95%CI:1.2-4.4) at the time of implantation were independent predictors of mortality. Conclusion PM implantation in nonagenarians is safe, with a low risk of procedural complications. Download : Download full-size image Figure: Survival for nonagenarians after PM implantation
Published: 2015
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45. Safety and efficacy of a second-generation cryoballoon in the ablation of paroxysmal atrial fibrillation

Author: Nathalie Behar, Albin Behaghel, Jean-Claude Daubert, Jean-Marc Sellal, Dominique Pavin, Raphaël P. Martins, Olivier Cesari, David Hamon, Philippe Mabo, Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), 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 [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Clinique Saint Gatien, SELLAL, Jean-Marc, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Cryoablation, medicine.medical_specialty, Phrenic nerve palsy, medicine.medical_treatment, Cryosurgery, Pulmonary vein isolation, Pulmonary vein, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Superior vena cava, Physiology (medical), Internal medicine, Atrial Fibrillation, Medicine, Fluoroscopy, Humans, Phrenic nerve, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Paroxysmal atrial fibrillation, business.industry, Cryoablation, Paroxysmal atrial fibrillation, Cryoballoon ablation, Pulmonary vein, Pulmonary vein isolation, Phrenic nerve palsy, Atrial fibrillation, Balloon Occlusion, Middle Aged, Ablation, medicine.disease, Phrenic Nerve, Catheter, Treatment Outcome, Echocardiography, Cryoballoon ablation, Cardiology, Female, Patient Safety, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND: Compared with the first-generation Arctic Front cryoballoon (ARC-CB), the new Arctic Front Advance cryoballoon (ARC-Adv-CB) increases the efficient CB-tissue contact surface during freezing, which may increase the incidence of phrenic nerve (PN) palsy (PNP). OBJECTIVE: To evaluate the safety and efficacy of paroxysmal atrial fibrillation (AF) ablation with the ARC-Adv-CB as well as the merits of a predictor of PNP. METHODS: AF ablation was performed by using a "single 28-mm big CB" approach. The rate of pulmonary vein (PV) isolation with a first cryoapplication was measured. The distance between the CB and a PN pacing catheter in the superior vena cava was measured to predict PNP during freezing. RESULTS: In 147 patients, PV were isolated with a single cryoapplication in 205 (81.3%) of 252 PV treated with the ARC-CB and in 280 (90.3%) of 310 PV treated with the ARC-Adv-CB (P = .003). The mean time to PV isolation was 52 ± 34 seconds and 40 ± 25 seconds (P < .001) and the temperature at the time of isolation was -36.1 ± 10.3°C and -32.3 ± 10.2°C (P = .001) in the ARC-CB and ARC-Adv-CB groups, respectively. Mean procedure and fluoroscopy durations were significantly shorter in the ARC-Adv-CB group. Transient PNP was observed in 7(10.6%) and 20(24.4%) of the patients treated with the ARC-CB and ARC-Adv-CB, respectively (P = .048). The distance between the lateral edge of the CB and a vertical line through the tip of the pacing catheter accurately predicted PNP (P < .001). CONCLUSIONS: The 28-mm ARC-Adv-CB enabled more efficient ablation of paroxysmal AF and shorter procedures than did the ARC-CB. This higher performance was associated with a higher incidence of PNP, which was predicted by the distance between the CB and the PN.
Published: 2014
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46. Resolution of left bundle branch block-induced cardiomyopathy by cardiac resynchronization therapy

Author: Nathalie Behar, Caroline Vaillant, Philippe Mabo, Christophe Leclercq, Raphaël P. Martins, Christophe Thebault, Jean-Claude Daubert, Erwan Donal, 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), and This study was supported by unrestricted research funds from the Department of Cardiology and Vascular Diseases and the 'Direction de la Recherche Clinique' of the University Hospital, Rennes, France.
Subjects: Male, MESH: Echocardiography, Doppler, medicine.medical_treatment, Cardiomyopathy, 030204 cardiovascular system & hematology, MESH: Stroke Volume, Cardiac Resynchronization Therapy, Electrocardiography, 0302 clinical medicine, 030212 general & internal medicine, MESH: Bundle-Branch Block, Ejection fraction, MESH: Middle Aged, medicine.diagnostic_test, Left bundle branch block, Stroke volume, Middle Aged, cardiac resynchronization, Echocardiography, Doppler, 3. Good health, Cardiology, cardiovascular system, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiomyopathies, Cardiology and Cardiovascular Medicine, circulatory and respiratory physiology, Adult, medicine.medical_specialty, MESH: Cardiac Resynchronization Therapy, Heart Ventricles, Bundle-Branch Block, Cardiac resynchronization therapy, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, left bundle branch block, cardiovascular diseases, Retrospective Studies, Heart Failure, MESH: Humans, business.industry, cardiac dyssynchrony, systolic dysfunction, Stroke Volume, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH: Male, MESH: Electrocardiography, MESH: Cardiomyopathies, Time course, MESH: Heart Failure, MESH: Heart Ventricles, business, cardiomyopathy, MESH: Female
Abstract: International audience; OBJECTIVES: The study sought to describe a specific syndrome characterized by isolated left bundle branch block (LBBB) and a history of progressive left ventricular (LV) dysfunction, successfully treated by cardiac resynchronization therapy (CRT). BACKGROUND: Isolated LBBB in animals causes cardiac remodeling due to mechanical dyssynchrony, reversible by biventricular stimulation. However, the existence of LBBB-induced cardiomyopathy in humans remains uncertain. METHODS: Between 2007 and 2010, 375 candidates for CRT were screened and retrospectively included in this study if they met all criteria of a pre-defined syndrome, including: 1) history of typical LBBB for >5 years; 2) LV ejection fraction (EF) >50%; 3) decrease in LVEF to 45% and decrease in NYHA functional class at 1 year. RESULTS: The syndrome was identified in 6 patients (1.6%), 50.5 years of age on average at the time of LBBB diagnosis. HF developed over a mean of 11.6 years. At the time of referral, Doppler echocardiograms showed major mechanical dyssynchrony at left atrioventricular, interventricular, and left intraventricular levels. During CRT, NYHA functional class decreased, LV dimensions normalized and mechanical dyssynchrony was nearly resolved in all patients, and mean LVEF increased from 31 ± 12% to 56 ± 8% (p = 0.027). CONCLUSIONS: These observations support the existence of a specific LBBB-induced cardiomyopathy resolved by CRT. Its prevalence, time course, and risk factors need to be prospectively studied.
Published: 2013
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47. New insights into ventricular interactions during cardiac resynchronization

Author: Albin Behaghel, Raphaël P. Martins, Claude Daubert, Department of Cardiology, Karolinska University Hospital, Karolinska Institutet [Stockholm], Service de cardiologie et maladies vasculaires, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and CHU Pontchaillou [Rennes]
Subjects: medicine.medical_specialty, genetic structures, dyssynchrony, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Left, Cardiac resynchronization therapy, Hemodynamics, 030204 cardiovascular system & hematology, electrophysiology mapping, Ventricular interaction, Cardiac Resynchronization Therapy, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Internal medicine, medicine, Ventricular Function, Humans, Animals, In patient, cardiovascular diseases, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Heart Failure, Ventricular function, medicine.diagnostic_test, business.industry, medicine.disease, myocardial work, 3. Good health, Heart failure, Cardiac resynchronization, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business, ventricular interaction
Abstract: Cardiac resynchronization therapy (CRT) improves hemodynamics in patients with drug-resistant heart failure, and its efficacy has been clearly demonstrated in large-scale studies in which our group was directly involved [(1–3)][1]. The initial rationale leading to the development of CRT was the
Published: 2013
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48. Predictive value of QRS changes after cardiac resynchronization therapy

Author: Raphaël P. Martins, Christophe Leclercq, J. Claude Daubert, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and CHU Pontchaillou [Rennes]
Subjects: Male, medicine.medical_specialty, MESH: Cardiac Resynchronization Therapy, medicine.medical_treatment, Cardiac resynchronization therapy, MESH: Ventricular Remodeling, 030204 cardiovascular system & hematology, Independent predictor, Cardiac Resynchronization Therapy, 03 medical and health sciences, QRS complex, Ventricular Dysfunction, Left, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), Internal medicine, MESH: Ventricular Dysfunction, Left, Medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Ventricular remodeling, ComputingMilieux_MISCELLANEOUS, Lv function, Ejection fraction, MESH: Humans, Ventricular Remodeling, business.industry, Arrhythmias, Cardiac, Odds ratio, medicine.disease, Predictive value, MESH: Male, MESH: Arrhythmias, Cardiac, cardiovascular system, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, MESH: Female, circulatory and respiratory physiology
Abstract: d i n a In this issue of HeartRhythm, Rickard et al provide some evidence that QRS widening after cardiac resynchronization therapy (CRT) may predict deterioration in left ventricular (LV) systolic function and thus an increased risk of echocardiographic nonresponse. They retrospectively studied a series of approximately 500 patients implanted with a CRT device for a guideline indication. Clinical, electrocardiographic, and echocardiographic data were collected preoperatively. QRS change after CRT was assessed postoperatively by measuring a QRS index equal to [(post-CRT biventricular-paced QRS duration – pre-CRT QRS duration)/(pre-CRT QRS duration)] 100. The echocardiographic response was assessed by the absolute change in the left ventricular ejection fraction. An LV function deterioration was defined by a decrease of 5% in left ventricular ejection fraction from baseline. Because of the retrospective design of the study, the time delay to follow-up echocardiogram varied greatly between patients, starting at 2 months. This is a clear limitation of the study as it is well known that reverse ventricular remodeling after CRT is a progressive process, starting rarely before 3 months and continuing to progress up to 9–12 months. However, the mean delay for follow-up echo was not statistically different between patients with (14.7 12.8 months) and without left ventricular ejection fraction deterioration (12.3 10.9 months). Within these limitations, the authors show that QRS widening indexed to the baseline QRS duration is an independent predictor of LV deterioration (odds ratio 1.14 (1.06–1.23); P .001). Is the change in QRS duration acutely after CRT predictive of midto long-term outcomes? The predictive value of QRS shortening or widening after CRT has been a matter of debate from the very first time of the therapy until now. As QRS change is based on 12-lead surface electrocardiogram analysis, it is important to know the accuracy and reproducibility of QRS duration measurement during both intrinsic conduction (before CRT) and biventricular pacing (after CRT). A core center analysis was done in the REsynchronization reVErses Remodeling in Systolic
Published: 2012
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49. Parental electrocardiographic screening identifies a high degree of inheritance for congenital and childhood nonimmune isolated atrioventricular block

Author: Hervé Le Marec, Caroline Bonnet, Jean-René Lusson, Raphaël P. Martins, Jean-Jacques Schott, Francis Rouault, Alban-Elouen Baruteau, Jean-Benoit Thambo, Christian Dina, Elisabeth Villain, François Godart, Philippe Mabo, Vincent Probst, Alain Fraisse, François Marçon, Albin Behaghel, Véronique Gournay, Sophie Guillaumont, Yves Dulac, Jean-Marc Schleich, Stéphanie Chatel, Swanny Fouchard, Alain Chantepie, Béatrice Delasalle, Jean-Claude Daubert, unité de recherche de l'institut du thorax UMR1087 UMR6291 ( ITX ), Université de Nantes ( UN ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Department de Chirurgie cardiaque des cardiopathies congénitales, Centre chirurgical Marie Lannelongue, Service de cardiologie et maladies vasculaires, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire de génie des procédés - environnement - agroalimentaire ( GEPEA ), Mines Nantes ( Mines Nantes ) -Université de Nantes ( UN ) -Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique ( ONIRIS ) -Centre National de la Recherche Scientifique ( CNRS ), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service cardiologie pédiatrique [Bordeaux], CHU Bordeaux [Bordeaux], Service de Cardiologie Infantile [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Service de cardiologie pédiatrique [Nantes], Centre hospitalier universitaire de Nantes ( CHU Nantes ), Cabinet de Cardiologie pédiatrique, Service de cardiologie pédiatrique [Tours], CHU Tours, Service de cardiologie Pédiatrique [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Service de cardiologie Pédiatrique [Lille], Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de cardiologie pédiatrique et congénitale adulte [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de cardiologie Pédiatrique [Marseille], Hôpital de la Timone [CHU - APHM] ( TIMONE ), Service de cardiologie [Clermont-Ferrand], CHU Clermont-Ferrand, Service pédiatrie-cardiologie, CHU Toulouse [Toulouse]-Hôpital des Enfants, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Hôpital Pontchaillou-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), Laboratoire de génie des procédés - environnement - agroalimentaire (GEPEA), Mines Nantes (Mines Nantes)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, CHU Toulouse [Toulouse], Unité de recherche de l'institut du thorax (ITX-lab), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre Chirurgical Marie Lannelongue (CCML), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes (UN)-Université de Nantes (UN)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS), Service Cardiologie pédiatrique [CHU Toulouse], Pôle Enfants [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Le Corre, Morgane, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Parents, MESH : Retrospective Studies, Heart malformation, MESH : NAV1.5 Voltage-Gated Sodium Channel, MESH : Prevalence, MESH : Aged, Electrocardiography, 0302 clinical medicine, MESH: Pregnancy, MESH : Child, Pregnancy, Prenatal Diagnosis, MESH: Child, Medicine, Sinus rhythm, genetics, Child, 0303 health sciences, MESH: Middle Aged, MESH: Genetic Testing, MESH : Infant, MESH: Infant, 3. Good health, MESH : Phenotype, MESH: Young Adult, MESH : Electrocardiography, Child, Preschool, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, conduction, MESH : Young Adult, Prenatal diagnosis, MESH: Phenotype, Sudden death, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), MESH : Adolescent, MESH : Genetic Testing, Humans, MESH : Middle Aged, Genetic Testing, MESH: Prenatal Diagnosis, MESH : Prenatal Diagnosis, MESH: Prevalence, Aged, Retrospective Studies, [SDV.IB] Life Sciences [q-bio]/Bioengineering, MESH: Adolescent, MESH: Parents, MESH: Humans, MESH: Child, Preschool, MESH : Humans, Infant, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Pregnancy, MESH : Genetic Predisposition to Disease, Atrioventricular block, MESH: Female, Pediatrics, ECG screening, 030204 cardiovascular system & hematology, MESH : Child, Preschool, NAV1.5 Voltage-Gated Sodium Channel, atrioventricular block, Prevalence, Mass Screening, MESH : Female, [ SDV.IB ] Life Sciences [q-bio]/Bioengineering, Family history, MESH : Parents, MESH: Aged, MESH: Infant, Newborn, MESH: Genetic Predisposition to Disease, Middle Aged, MESH : Adult, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Atrioventricular Block, Phenotype, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Adult, Adolescent, pediatrics, MESH : Male, MESH : Infant, Newborn, Asymptomatic, Young Adult, MESH: Atrioventricular Block, Genetic Predisposition to Disease, MESH: Mass Screening, PR interval, 030304 developmental biology, MESH : Mass Screening, business.industry, Infant, Newborn, MESH: NAV1.5 Voltage-Gated Sodium Channel, MESH: Male, MESH: Electrocardiography, business
Abstract: Background— The origin of congenital or childhood nonimmune isolated atrioventricular (AV) block remains unknown. We hypothesized that this conduction abnormality in the young may be a heritable disease. Methods and Results— A multicenter retrospective study (13 French referral centers, from 1980–2009) included 141 children with AV block diagnosed in utero, at birth, or before 15 years of age without structural heart abnormalities and without maternal antibodies. Parents and matched control subjects were investigated for family history and for ECG screening. In parents, a family history of sudden death or progressive cardiac conduction defect was found in 1.4% and 11.1%, respectively. Screening ECGs from 130 parents (mean age 42.0±6.8 years, 57 couples) were compared with those of 130 matched healthy control subjects. All parents were asymptomatic and in sinus rhythm, except for 1 with undetected complete AV block. Conduction abnormalities were more frequent in parents than in control subjects, found in 50.8% versus 4.6%, respectively ( P P P P SCN5A mutation screening identified 2 mutations in 2 patients among 97 children. Conclusions— ECG screening in parents of children affected by idiopathic AV block revealed a high prevalence of conduction abnormalities. These results support the hypothesis of an inheritable trait in congenital and childhood nonimmune isolated AV block.
Published: 2012
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50. Relationship between Holter findings immediately after ablation of typical atrial flutter and subsequent risk of atrial fibrillation

Author: Dominique Pavin, Raphaël P. Martins, Philippe Mabo, Claire Bouleti, Nathalie Behar, Ghassan Moubarak, Christophe Leclercq, Jean-Claude Daubert, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], 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), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_treatment, Atrial flutter, 030204 cardiovascular system & hematology, 0302 clinical medicine, Postoperative Complications, Risk Factors, MESH: Risk Factors, Typical atrial flutter, MESH: Postoperative Complications, Medicine, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, MESH: Aged, MESH: Middle Aged, P wave, Follow up studies, Atrial fibrillation, MESH: Follow-Up Studies, Middle Aged, Ablation, 3. Good health, MESH: Atrial Fibrillation, Holter recording, MESH: Atrial Flutter, Cardiology, Catheter Ablation, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, MESH: Electrocardiography, Ambulatory, medicine.medical_specialty, Catheter ablation, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Humans, Aged, MESH: Humans, MESH: Catheter Ablation, business.industry, medicine.disease, MESH: Male, Electrocardiography, Ambulatory, business, MESH: Female, Follow-Up Studies
Abstract: and subsequent risk of atrial fibrillation Ghassan Moubarak ⁎, Dominique Pavin , Nathalie Behar , Raphael Pedro Martins , Claire Bouleti , Christophe Leclercq , Jean-Claude Daubert , Philippe Mabo a,b,c a Departement de cardiologie et maladies vasculaires, Centre hospitalo-universitaire de Rennes, Rennes, France b Universite de Rennes 1, Rennes, France c Unite INSERM 642, Rennes, France d Departement de cardiologie, Centre hospitalo-universitaire Bichat, Paris, France
Published: 2012
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