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222 results on '"A, Eschalier"'

1. Left-axis deviation in patients with nonischemic heart failure and left bundle branch block is a purely electrical phenomenon

Author: Michel Haïssaguerre, F. Daniel Ramirez, Romain Eschalier, Hubert Cochet, Peter Huntjens, Saer Abu-Alrub, Samuel Buliard, Hugo Marchand, Pierre Bordachar, Mark Potse, Marc Strik, Sylvain Ploux, CHU Bordeaux [Bordeaux], IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Washington University in Saint Louis (WUSTL), Modélisation et calculs pour l'électrophysiologie cardiaque (CARMEN), Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-CHU Bordeaux [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, This work received financial support from the French Government as part of the 'Investments of the Future' program managed by the National Research Agency (ANR), Grant reference ANR-10-IAHU-04. FDR is supported by a Canadian Institutes of Health Research Banting Postdoctoral Fellowship., ANR-10-IAHU-0004,LIRYC,L'Institut de Rythmologie et modélisation Cardiaque(2010), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Inria Bordeaux - Sud-Ouest, and Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, medicine.medical_specialty, Heart Ventricles, Bundle-Branch Block, Block, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, Electrocardiography, 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, medicine, Electrical mapping, Humans, Cardiac structure, In patient, cardiovascular diseases, 030212 general & internal medicine, Left bundle branch, ComputingMilieux_MISCELLANEOUS, Aged, Heart Failure, medicine.diagnostic_test, Left bundle branch block, Cardiac electrophysiology, business.industry, Computer modeling, Magnetic resonance imaging, Middle Aged, medicine.disease, Heart failure, cardiovascular system, Cardiology, Left axis deviation, Female, QRS axis, Cardiology and Cardiovascular Medicine, Qrs axis, business, Left-axis deviation, Electromagnetic Phenomena
Abstract: Possible mechanisms of left-axis deviation (LAD) in the setting of left bundle branch block (LBBB) include differences in cardiac electrophysiology, structure, or anatomic axis.The purpose of this study was to clarify the mechanism(s) responsible for LAD in patients with LBBB.Twenty-nine patients with nonischemic cardiomyopathies and LBBB underwent noninvasive electrocardiographic imaging (ECGi), cardiac computed tomography, and magnetic resonance imaging in order to define ventricular electrical activation, characterize cardiac structure, and determine the cardiac anatomic axis.Sixteen patients had a normal QRS axis (NA) (mean axis 8° ± 23°), whereas 13 patients had LAD (mean axis -48° ± 13°; P.001). Total activation times were longer in the LAD group (112 ± 25 ms vs 91 ± 14 ms; P = .01) due to delayed activation of the basal anterolateral region (107 ± 10 ms vs 81 ± 17 ms; P .001). Left ventricular (LV) activation in patients with LAD was from apex to base, in contrast to a circumferential pattern of activation in patients with NA. Apex-to-base delay was longer in the LA group (95 ± 13 ms vs 64 ± 21 ms; P.001) and correlated with QRS frontal axis (RLAD in LBBB appears to be due to electrophysiological abnormalities rather than structural factors or cardiac anatomic axis.
Published: 2021
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2. Sarcopenia in patients after an episode of acute decompensated heart failure: An underdiagnosed problem with serious impact

Author: Stefan D. Anker, Ruddy Richard, Guillaume Clerfond, Yves Boirie, Pierre-Louis Tartière, Clément Riocreux, Patrick Rossignol, Bruno Pereira, Géraud Souteyrand, Nicolas Combaret, Marie Blanquet, Marie-Claire D'Agrosa Boiteux, Pascal Motreff, Aurélien Mulliez, Pelle Stolt, Frédéric Jean, Romain Eschalier, Grégoire Massoullié, CHU Clermont-Ferrand, SIGMA Clermont (SIGMA Clermont), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Centre de Recherche en Nutrition Humaine Auvergne [CHU Clermont-Ferrand] (CRNH A), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, CH Mauriac, Biostatistics Unit (Department of Clinical Research and Innovation), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Clinique Médicale Cardio-Pneumologie de Durtol, Maglia Rotta, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), 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)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), ROSSI, Sabine, Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, 0301 basic medicine, Sarcopenia, Longitudinal study, medicine.medical_specialty, Acute decompensated heart failure, Decompensated chronic heart failure, 030209 endocrinology & metabolism, Decompensation, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Activities of Daily Living, Prevalence, Humans, Medicine, In patient, Longitudinal Studies, Prospective Studies, Aged, Aged, 80 and over, Heart Failure, 030109 nutrition & dietetics, Nutrition and Dietetics, Hand Strength, business.industry, musculoskeletal system, medicine.disease, Chronic heart failure, 3. Good health, Hospitalization, body regions, Clinical trial, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Cross-Sectional Studies, Dysmobility, Cohort, Female, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, human activities
Abstract: International audience; Background & aims: Sarcopenia is a multifactorial syndrome resulting in a decrease in both muscle mass and function. Little is known about the prevalence and prognostic impact of sarcopenia in patients with acutely decompensated chronic heart failure (ADHF). We aimed to evaluate the prevalence (main endpoint) and impact of sarcopenia on ADHF patients.Methods: 140 ADHF patients were enrolled between November 2014 and September 2018 in a multi-center prospective longitudinal study. A similar, independent multi-departmental cross-sectional study in 165 ADHF patients was used for external validation of prevalence data. All subjects were assessed on the European Working Group on Sarcopenia criteria.Results: Ninety-one patients (65%) had sarcopenia (vs. 53.6% in the external replication regional cohort). Patients with sarcopenia were older and more likely to have eGFR
Published: 2021
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3. Septuagenarian population has similar survival and outcomes to younger patients after left ventricular assist device implantation

Author: Jean-François Obadia, Constance Verdonk, Olivier Chavanon, Camille Dambrin, Thomas Senage, Marie-Cécile Bories, Frédéric Anselme, Jean Marc Frapier, Edeline Pelcé, David Hamon, Fabrice Vanhuyse, Gerard Babatasi, Costin Radu, Magali Michel, Eloi Marijon, Erwan Flecher, Marylou Para, Thierry Bourguignon, Vlad Gariboldi, Céline Goéminne, Karine Nubret, Mathieu Pernot, Clément Delmas, Pierre Yves Litlzer, Philippe Gaudard, Aude Boignard, Marie Bielefeld, Anne Flore Plane, André Vincentelli, Romain Eschalier, Christophe Leclercq, Michel Kindo, Bernard Lelong, Céline Chabanne, Thibaud Genet, Raphaël P. Martins, Matteo Pozzi, Fabien Garnier, Nicolas D'Ostrevy, Vincent Galand, Tam Hoang Minh, and Hugues Blangy
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, Ventricular Function, Left, Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Interquartile range, Intensive care, medicine, Humans, 030212 general & internal medicine, education, Stroke, Aged, Heart Failure, Heart transplantation, education.field_of_study, business.industry, Age Factors, Recovery of Function, General Medicine, Middle Aged, equipment and supplies, medicine.disease, 3. Good health, Surgery, Treatment Outcome, Heart failure, Ventricular assist device, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business, Destination therapy
Abstract: Left ventricular assist device (LVAD) implantation may be an attractive alternative therapeutic option for elderly patients with heart failure who are ineligible for heart transplantation.We aimed to describe the characteristics and outcomes of elderly patients (i.e. aged≥70 years) receiving an LVAD.This observational study was conducted in 19 centres between 2006 and 2016. Patients were divided into two groups-younger (aged70 years) and elderly (aged≥70 years), based on age at time of LVAD implantation.A total of 652 patients were included in the final analysis, and 74 patients (11.3%) were aged≥70 years at the time of LVAD implantation (maximal age 77.6 years). The proportion of elderly patients receiving an LVAD each year was constant, with a median of 10.6% (interquartile range 8.0-15.4%) per year, and all were implanted as destination therapy. Elderly and younger patients had similar durations of hospitalization in intensive care units and total lengths of hospital stays. Both age groups experienced similar rates of LVAD-related complications (i.e. stroke, bleeding, driveline infection and LVAD exchange), and the occurrence of LVAD complications did not impact survival in the elderly group compared with the younger group. Lastly, when compared with younger patients implanted as destination therapy, the elderly group also exhibited similar mid-term survival.This work strongly suggests that selected elderly adults can be scheduled for LVAD implantation.
Published: 2020
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4. Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator

Author: Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessiere, Fabien Labombarda, Christelle Marquié, Jean Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Frédéric Anselme, Anouk Asselin, Caroline Audinet, Yvette Bernard, Serge Boveda, Paul Bru, Sok Sithikun Bun, Gael Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphael Martins, Jean Luc Pasquié, Jean Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Fabien Squara, Guillaume Theodore, Didier Scarlatti, Jérome Hourdain, Jean-Claude Deharo, Pierre Ollitrault, Paul Milliez, Laure Champ-Rigot, Hugues Bader, Cécile Duplantier, Antoine Milhem, Audrey Sagnard, Géraldine Bertaux, Gabriel Laurent, Marc Badoz, Agustin Bortone, Guillaume Laborie, Anne Rollin, Quentin Voglimacci Stephanopoli, Franck Mandel, Alexandre Duparc, Guillaume Domain, Jean-Paul Albenque, Christèle Cardin, Stéphane Combes, Nikita Tanese, Karim Hasni, Christophe Leclercq, Vincent Galand, Dominique Pavin, Philippe Mabo, Nathalie Behar, Nicolas Clementy, Christophe Loose, Akli Otmani, Sandrine Venier, Adrien Carabelli, Peggy Jacon, Mouna Ben Kilani, Jean Bapstist Guichard, Cécile Romeyer-Bouchard, Laurianne Le Gloan, Vincent Probst, Luc Freysz, Hugues Blangy, Christian De Chillou, Nicolas Sadoul, Pierre Khattar, Charlotte Potelle, Frederic Jean, Paul Puie, Ziad Khoueiry, Philippe Chevallier, Arnaud Dulac, Sylvie Di Filippo, Kevin Gardey, Pierre Frey, Chrystelle Akret, Antoine Dompnier, Carole Maupain, Xavier Waintraub, Françoise Hidden-Lucet, Thomas Chastre, Estelle Gandjbakhch, Nicolas Badenco, Fabrice Extramiana, Antoine Leenhardt, Amir Zouaghi, Vincent Algalarrondo, Denis Amet, Emilie Varlet, Tej Chalbia, Séverine Philibert, Jacky Ollitrault, Thomas Lavergne, Pierre Baudinaud, Adrian Mirolo, Arnaud Savouré, Bénédicte Godin, Cathy Bertrand, Pierre Fiorello, Nicolas Johnson, Pierre-Marc Lallemand, Alexis Herminda, Jean-Sylvain Hermida, Bruno Degand, Rim El Bouazzaou, Stéphane Mourot, Samuel Goussot, Gaël Jauvert, Arnaud Lazarus, Caroline Grimard, Christine Alonso, Alexandre Zhao, Olivier Thomas, Bruno Cauchemez, Ghassan Moubarak, Nicolas Lellouche, David Hamon, Bogdan Enache, Gabriel Lactu, Françoise Wiart, Olivier Geoffroy, Damien Poindron, Alice Maltret, Cristine Raimondo, Damien Bonnet, Sébastien Hascoët, Nicolas Derval, Michel Haïssaguerre, Mélèze Hocini, and Clinical sciences
Subjects: Adult, Male, medicine.medical_specialty, Long term follow up, Cyanotic congenital heart disease, medicine.medical_treatment, 030204 cardiovascular system & hematology, Sudden death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Humans, Defibrillators, Implantable/trends, Registries, 030212 general & internal medicine, Tetralogy of Fallot, business.industry, medicine.disease, Implantable cardioverter-defibrillator, Tetralogy of Fallot/epidemiology, Defibrillators, Implantable, 3. Good health, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, and sudden cardiac death represents an important mode of death in these patients. Data evaluating the implantable cardioverter defibrillator (ICD) in this patient population remain scarce. Methods: A Nationwide French Registry including all patients with tetralogy of Fallot with an ICD was initiated in 2010 by the French Institute of Health and Medical Research. The primary time to event end point was the time from ICD implantation to first appropriate ICD therapy. Secondary outcomes included ICD-related complications, heart transplantation, and death. Clinical events were centrally adjudicated by a blinded committee. Results: A total of 165 patients (mean age, 42.2±13.3 years, 70.1% males) were included from 40 centers, including 104 (63.0%) in secondary prevention. During a median (interquartile range) follow-up of 6.8 (2.5–11.4) years, 78 (47.3%) patients received at least 1 appropriate ICD therapy. The annual incidence of the primary outcome was 10.5% (7.1% and 12.5% in primary and secondary prevention, respectively; P =0.03). Overall, 71 (43.0%) patients presented with at least 1 ICD complication, including inappropriate shocks in 42 (25.5%) patients and lead dysfunction in 36 (21.8%) patients. Among 61 (37.0%) patients in primary prevention, the annual rate of appropriate ICD therapies was 4.1%, 5.3%, 9.5%, and 13.3% in patients with, respectively, 0, 1, 2, or ≥3 guidelines-recommended risk factors. QRS fragmentation was the only independent predictor of appropriate ICD therapies (hazard ratio, 3.47 [95% CI, 1.19–10.11]), and its integration in a model with current criteria increased the 5-year time-dependent area under the curve from 0.68 to 0.81 ( P =0.006). Patients with congestive heart failure or reduced left ventricular ejection fraction had a higher risk of nonarrhythmic death or heart transplantation (hazard ratio, 11.01 [95% CI, 2.96–40.95]). Conclusions: Patients with tetralogy of Fallot and an ICD experience high rates of appropriate therapies, including those implanted in primary prevention. The considerable long-term burden of ICD-related complications, however, underlines the need for careful candidate selection. A combination of easy-to-use criteria including QRS fragmentation might improve risk stratification. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03837574.
Published: 2020
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5. Prevalence of chronic pain in opioid-maintained patients using the capture–recapture method: a nationwide population-based study

Author: Alain Eschalier, Denis Ardid, Chouki Chenaf, Noémie Delage, Célian Bertin, Nicolas Authier, and Jessica Delorme
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Databases, Factual, Population, chemical and pharmacologic phenomena, Context (language use), complex mixtures, Mark and recapture, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Interquartile range, Internal medicine, Prevalence, medicine, Humans, education, education.field_of_study, business.industry, Chronic pain, Middle Aged, bacterial infections and mycoses, medicine.disease, Confidence interval, Analgesics, Opioid, Anesthesiology and Pain Medicine, Neurology, Opioid, Sample size determination, Linear Models, bacteria, Female, Neurology (clinical), Chronic Pain, business, 030217 neurology & neurosurgery, medicine.drug
Abstract: Few studies all based on classical surveys have provided prevalence estimates of chronic pain (CP) in opioid-maintained patients (OMPs) but often had a limited patient sample size and a great variability in the prevalence estimates. This study sought to assess the prevalence of CP in the exhaustive population of OMPs using the capture-recapture method applied to the French nationwide health care database. Capture-recapture methods are increasingly used to estimate the prevalence of chronic conditions but have never been used in the specific context of CP in OMPs. Three large medical-administrative sources were used: the prescription drug database (A-list), the national hospital discharge database (M-list), and the pain center database (C-list). Between 2015 and 2016, 160,429 OMPs aged 15 years and older were identified and age- and sex-matched with 160,429 non-OMPs. All patients treated with analgesic drugs for ≥6 months (A-list) or diagnosed with CP (M- and C-list) were included. Capture-recapture analyses were performed to yield CP estimates with their 95% confidence intervals using log-linear models. In 2015 to 2016, 12,765 OMPs and 2938 non-OMPs with CP were captured. Most patients were male (67%) in OMPs and non-OMPs; median ages for OMPs and non-OMPs were 46 (interquartile range: 38-51) and 48 (41-53) years, respectively. The CP prevalence estimated in OMPs and non-OMPs ranged from 23.6% (14.9-46.2) to 32.1% (28.6-36.3) and from 7.28% (3.98-18.4) to 9.32% (7.42-12.1), respectively. This first study on CP in the exhaustive population of OMPs using the capture-recapture method demonstrated a high prevalence of CP in OMPs, 3- to 4-fold than in the general population.
Published: 2020
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6. Causes of impaired biventricular pacing in cardiac resynchronization devices with left ventricular sensing

Author: Romain Eschalier, Pierre Bordachar, Remi Chauvel, Philippe Ritter, Andreas Haeberlin, Michel Haïssaguerre, Sylvain Ploux, Hugo Marchand, Nicolas Welte, and Antoine Noel
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Monitoring, Ambulatory, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, Electrocardiography, Ventricular Dysfunction, Left, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Cardiac Resynchronization Therapy Devices, 030212 general & internal medicine, 610 Medicine & health, Lead (electronics), Aged, Biventricular stimulation, business.industry, General Medicine, Middle Aged, Premature Beats, medicine.disease, Cardiac resynchronization, Cardiology, Equipment Failure, Female, Supraventricular tachycardia, Cardiology and Cardiovascular Medicine, business, Algorithms
Abstract: Background Loss of biventricular stimulation can result in nonresponse to cardiac resynchronization therapy (CRT). Problems associated with the left ventricular (LV) lead and LV sensing can be challenging to detect and their incidence is unclear. The purpose of this study was to investigate mechanisms of loss of biventricular pacing due to LV lead- and LV sensing-associated problems. Methods In this bicentric study, CRT patients were surveilled using a novel remote monitoring algorithm from Biotronik (Germany) that registers LV electrograms (EGMs) during intermittent loss of resynchronization. The episodes were analyzed to assess the mechanisms of resynchronization interruptions. Results We analyzed 582 EGMs from 61 patients. During a median follow-up of 6 months, 59% of the patients had such episodes. The majority of the episodes (61%) were related to inappropriate inhibition of LV pacing, mostly due to upper rate lock-in caused by LV sensing (58%). In contrast, 8% of episodes showed intermittent loss of LV capture, which was identified thanks to LV sensing. The remaining 31% of episodes were due to physiological reasons for resynchronization interruptions (eg, supraventricular tachycardia [18%], premature beats [8%], and others [5%]). Patients with CRT interruption episodes had lower resynchronization rates (median: 98.5% vs 100%, P = .044). Conclusions Inadequate programming (active LV sensing with T-wave protection) is the main cause of impaired resynchronization in devices with LV sensing. In general, we recommend the deactivation of the LV T-wave protection function.
Published: 2020
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7. Early and short-term intensive management after discharge for patients hospitalized with acute heart failure: a randomized study (ECAD-HF)

Author: Jean-Michel Tartière, Damien Logeart, Romain Eschalier, Nathan Mewton, Jean-Philippe Kevorkian, Emmannuelle Berthelot, Florence Beauvais, Erwan Donal, Nicolas Bihry, Jean-Christophe Eicher, Marie-France Seronde, Pascal DeGroote, Philippe Garcon, Muriel Salvat, Yann Rosamel, Ariel Cohen, Eric Vicaut, Nicolas Mansencal, Richard Isnard, Christophe Chavelas, Alireza Samadi, Nachwan Ghanem, Pierre Raphael, Abdourahmane Diallo, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Investigation Clinique [CHU Clermont-Ferrand] (CIC 1405), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Hôpital Michallon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, Hôpital Pontchaillou, 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), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Ambroise Paré [AP-HP], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), French Ministry of Health [PHRC 2011 098], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Aftercare, Transitional care services, 030204 cardiovascular system & hematology, Ventricular Function, Left, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Medicine, Humans, Transitional care, 030212 general & internal medicine, Aged, Heart Failure, business.industry, Follow-up, Stroke Volume, After discharge, medicine.disease, Patient Discharge, 3. Good health, Hospitalization, Increased risk, Heart failure, Emergency medicine, Cardiology and Cardiovascular Medicine, business, Intensive management, Readmission risk, After treatment, Readmission
Abstract: International audience; Aims Hospitalization for acute heart failure (HF) is followed by a vulnerable time with increased risk of readmission or death, thus requiring particular attention after discharge. In this study, we examined the impact of intensive, early follow-up among patients at high readmission risk at discharge after treatment for acute HF. Methods and results Hospitalized acute HF patients were included with at least one of the following: previous acute HF < 6 months, systolic blood pressure = 180 mu mol/L, or B-type natriuretic peptide >= 350 pg/mL or N-terminal pro B-type natriuretic peptide >= 2200 pg/mL. Patients were randomized to either optimized care and education with serial consultations with HF specialist and dietician during the first 2-3 weeks, or to standard post-discharge care according to guidelines. The primary endpoint was all-cause death or first unplanned hospitalization during 6-month follow-up. Among 482 randomized patients (median age 77 and median left ventricular ejection fraction 35%), 224 were hospitalized or died. In the intensive group, loop diuretics (46%), beta-blockers (49%), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (39%) and mineralocorticoid receptor antagonists (47%) were titrated. No difference was observed between groups for the primary endpoint (hazard ratio 0.97; 95% confidence interval 0.74-1.26), nor for mortality at 6 or 12 months or unplanned HF rehospitalization. Additionally, no difference between groups according to age, previous HF and left ventricular ejection fraction was found. Conclusions In high-risk HF, intensive follow-up early post-discharge did not improve outcomes. This vulnerable post-discharge time requires further studies to clarify useful transitional care services.
Published: 2021
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8. MRAs in Elderly HF Patients

Author: Faiez Zannad, Romain Eschalier, Stuart J. Pocock, Bertram Pitt, João Pedro Ferreira, Nicolas Girerd, John J.V. McMurray, Patrick Rossignol, and Xavier Rossello
Subjects: medicine.medical_specialty, education.field_of_study, Ejection fraction, business.industry, Proportional hazards model, Population, Hazard ratio, 030204 cardiovascular system & hematology, Placebo, medicine.disease, Confidence interval, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Heart failure, Meta-analysis, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, education
Abstract: Objectives This study sought to assess the effect of MRA treatment (vs. placebo) in older patients (≥75 years of age) compared with younger patients ( Background Mineralocorticoid receptor antagonists (MRAs) have been shown to reduce morbidity and mortality in patients with HF with reduced ejection fraction (HFrEF) and in a subset of patients with HF with preserved EF (HFpEF). Notwithstanding, MRAs are underused, especially in the elderly. Pooling the individual patient data (IPD) provided more statistical power with which to assess the efficacy and safety of MRA treatment in this subpopulation. Methods An IPD meta-analysis was performed using Cox proportional hazards models stratified by trial. A total of 1,756 patients (853 randomized to placebo and 903 to MRA) ≥75 years of age, along with 4,411 patients (2,242 randomized to placebo and 2,169 to MRA) Results The treatment groups were well balanced. Patients ≥75 years of age or older and those 80 years of age, 61% were male, 30% had diabetes, and the mean estimated glomerular filtration rate 59 ml/min. The primary outcome occurred in 331 patients (38.8%) in the placebo group versus 281 (31.1%) in the MRA group (hazard ratio: 0.74; 95% confidence interval: 0.63 to 0.86; p Conclusions MRAs reduced morbidity and mortality in elderly patients with HF, a beneficial effect that is more marked in patients with HFrEF but homogenous across HFrEF and HFpEF. Implementation of measures that increase MRA treatment in this population are warranted.
Published: 2019
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9. Risk assessment of using off‐label morphine sulfate in a population‐based retrospective cohort of opioid‐dependent patients

Author: Nicolas Authier, Denis Ardid, Jessica Delorme, Hélène Peyrière, Georges Brousse, Célian Bertin, Chouki Chenaf, Marie Riquelme, Alain Eschalier, Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Faculté de Médecine - Clermont-Ferrand, Université d'Auvergne - Clermont-Ferrand I (UdA), Pharmacologie fondamentale et clinique de la douleur, Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle de biologie médicale et d'anatomie pathologique, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Neuro-Dol - Clermont Auvergne (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Unité Mixte de Recherches sur les Herbivores - UMR 1213 (UMRH), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Recherche Agronomique (INRA), Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire Gabriel Montpied, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), and Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Risk Assessment, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Opiate Substitution Treatment, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Pharmacology, Morphine, business.industry, Incidence (epidemiology), Retrospective cohort study, Opioid use disorder, Off-Label Use, Original Articles, Opioid-Related Disorders, medicine.disease, Confidence interval, Buprenorphine, 3. Good health, Analgesics, Opioid, Opioid, Cohort, business, Delivery of Health Care, Methadone, medicine.drug
Abstract: AIMS: Several addictovigilance studies have described the off‐label use of morphine sulfate (MS) for nonchronic pain in opioid use disorder (OUD) patients as an alternative to conventional opioid substitution treatments (OSTs). This study primarily sought to compare the incidence of unintentional opioid‐related overdose in the year following the prescription initiation in off‐label MS users, compared to OST‐maintained patients. METHODS: Sequential cohorts of OUD patients who were regularly dispensed MS, buprenorphine, or methadone, between 1 April 2012 and 31 December 2014, were retrospectively identified using the French nationwide healthcare data system. The incidence of overdoses, deaths, doctor shopping, and complications of a viral, bacterial or thrombotic nature, was compared using the Cox regression method. RESULTS: Overall, 1075, 20 834 and 9778 OUD patients without chronic‐pain were included in the MS, buprenorphine, and methadone cohorts, respectively. Overdose incidence was 3.8 (P
Published: 2019
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10. Development and Validation of a New Risk Prediction Score for Life-Threatening Ventricular Tachyarrhythmias in Laminopathies

Author: Mélanie Fradin, Nicolas Sadoul, Xavier Waintraub, Didier Klug, Albert Hagège, Pascal Sabouraud, Arnaud Isapof, Julien Durigneux, Olivier Lascols, Pascal Laforêt, Armelle Magot, Ivana Dabaj, Eloi Marijon, Camille Vatier, Pascal Cintas, Emmanuelle Salort, Bénédicte Gaborit, Antoine Muchir, Xavier Ferrer, Pascale Richard, Corinne Metay, Stéphane Boulé, Sarah Leonard-Louis, Philippe Mabo, V. Tiffreau, Caroline Stalens, Jitendra K. Vohra, Stéphane Schaeffer, Khadija Chikhaoui, Eric Bieth, Sandra Mercier, Pierre Ambrosi, Aleksandra Nadaj-Pakleza, Michèle Mayer, Katja Zeppenfeld, Gisèle Bonne, Véronique Manel, Jean-Marc Davy, Guilhem Sole, Ghassan Moubarak, Nicolas Lamblin, Klaus Dieterich, Christophe Meune, Abdallah Fayssoil, Arnaud Lazarus, Philippe Maury, Karim Wahbi, Philippe Petiot, Isabelle Jéru, Annick Toutain, Corinne Vigouroux, Ana Ferreiro, Maud Michaud, H.M. Bécane, Bruno Eymard, Thomas D. Gossios, Marie-Christine Vantyghem, Saurabh Kumar, Estelle Gandjbakhch, Yann Péréon, T. Thompson, Marie-Christine Minot-Myhié, Anthony Behin, Frédéric Sacher, Philippe Charron, Nicolas Combes, Julien Praline, Dominique Babuty, Emmanuelle Lagrue, Usha B. Tedrow, Jean-Marc Sellal, Florence Petit, Perry M. Elliott, Frédéric Anselme, Philippe Chevalier, Frederic Taithe, Christine Barnerias, Vincent Laugel, Andoni Echaniz-Laguna, Raphaël P. Martins, Alexander F.A. Androulakis, Rabah Ben Yaou, Franck Boccara, Ulrike Walther-Louvier, Tanya Stojkovic, Françoise Bouhour, Annachiara De Sandre-Giovannoli, Susana Quijano-Roy, Françoise Chapon, Jean-Noël Trochu, Céline Tard, Anne Rollin, Jean-Marie Cuisset, Denis Duboc, Raphaël Porcher, Catherine Sarret, Jonathan M. Kalman, Florence Demurger, Damien Bonnet, Christine Francannet, Neal K. Lakdawala, Romain Eschalier, Fabien Labombarda, Kostantinos Savvatis, Raul Juntas Morales, Isabelle Desguerre, Nicolas Lévy, Anne-Claire Brehin, Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche en Myologie – U974 SU-INSERM, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Rouen, Normandie Université (NU), St Bartholomew's Hospital (London), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), 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 Paris Cité (UPCité), Association française contre les myopathies (AFM-Téléthon), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), 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), Hôpital Ambroise Paré [AP-HP], William Harvey Research Institute, Barts and the London Medical School, Biostatistique et épidemiologie clinique, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Filière Neuromusculaire (FILNEMUS), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université de Caen Normandie (UNICAEN), Laboratoire d'Informatique Scientifique et Industrielle (LISI), Université de Poitiers-Ecole Nationale Supérieure de Mécanique et d'Aérotechnique [Poitiers] (ISAE-ENSMA), Hôpital Raymond Poincaré [AP-HP], CHU Lille, Institut Européen de Génomique du Diabète - European Genomic Institute for Diabetes - FR 3508 (EGID), 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 National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Aix Marseille Université (AMU), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de génétique médicale [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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 Pasteur [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), The Royal Melbourne Hospital, Leiden University Medical Center (LUMC), Universiteit Leiden, Service de neurologie pédiatrique [CHU Necker], Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Saint-Antoine [AP-HP], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Hôpital Privé Le Bois Ramsay Santé [Lille], Service de génétique [Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Mobilités : Vieillissement, Pathologie, Santé (COMETE), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Roger Salengro [Lille], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de ressources biologiques Tissus ADN Cellules [Hôpital de la Timone - APHM] (CRB TAC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cytogénétique et de Biologie Cellulaire, Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire [Grenoble] (CHU), [GIN] Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Clermont-Ferrand, Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Bordeaux], Service de Génétique Médicale [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Trousseau [APHP], Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), 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), CHU Strasbourg, Clinique Ambroise Paré [Centres Médico-Chirurgicaux Ambroise Pré, Pierre Cherest, Hartmann], Hôpital Cochin [AP-HP], Hospices Civils de Lyon (HCL), Service de génétique médicale - Unité de génétique clinique [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Lorraine (UL), Service de neurologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Centre Hospitalier Universitaire de Reims (CHU Reims), Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de Neurologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Neurologie [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], Institut Cochin (IC UM3 (UMR 8104 / U1016)), Laboratoire d'étude de la motricité humaine - EA 3608 (LEMH), Université de Lille, Droit et Santé, Service de génétique [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Physiopathologie et thérapie du muscle strié, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR14-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Montréal (UdeM), Laboratoire Génie des procédés papetiers (LGP2 ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), The Heart Hospital [London], University College of London [London] (UCL), This study was funded by grants from the AFM-Téléthon (French Alliance against Myopathies), which was not involved in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication. Some of this work was undertaken at University College London (United Kingdom) and St. Bartholomew’s Hospital (London, United Kingdom), which received a portion of funding from the United Kingdom Department of Health’s National Institute for Health Research Biomedical Research Centres funding scheme., Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Centre de recherche en myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], 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, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Unit of Neuromuscular Morphology [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [APHP]-Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre de référence des maladies rares neuromusculaires Aquitaine-Grand Sud Ouest, CHU Bordeaux [Bordeaux], Laboratoire d'Informatique Scientifique et Industrielle (LISI / ENSMA), LISI-ENSMA, Service de Biochimie-Génétique [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Thérapie des maladies du muscle strié, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Endocrinologie et Métabolisme, Unité de Cardiologie et Soins Intensifs, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), Service de Génétique [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Référence M3C Malformations Cardiaques Congénitales Complexes, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-CHU Necker - Enfants Malades [AP-HP], Hôpital neurologique, Centre Hospitalier Universitaire de Lille (CHU de Lille), Service Neurologie Pédiatrique, Service de Neuropédiatrie, INSERM U836, équipe 4, Muscles et pathologies, Grenoble Institut des Neurosciences (GIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Département de Neurologie, Hôpital Civil de Strasbourg, Groupe Myologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de génétique médicale, CHU - HÔTEL-DIEU Clermont-Ferrand, CLAD Ouest, Centre Hospitalier Universitaire [Rennes], Centre recherche en CardioVasculaire et Nutrition (C2VN), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Neuropédiatrie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie et cerveau, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement (Inserm U1167 - RID-AGE - Institut Pasteur), Clinique Ambroise Paré, CHU Cochin [AP-HP], Epilepsie, sommeil et explorations fonctionnelles neuropédiatriques, Hospices Civils de Lyon (HCL)-Hopital Neurologique-Hôpital Femme Mère Enfant, Department of Medicine, Columbia University [New York]-College of Physicians and Surgeons, Service de neurologie, Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse [CHU - HCL], Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc - U837 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université Lille 2 - Faculté de Médecine, Hôpital de Rangueil, Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), laboratoire d'étude de la motricité humaine (LEMH EA3608), Université de Montréal - UdeM (CANADA), Laboratoire Génie des procédés papetiers (LGP2), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche en Myologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-PRES Sorbonne Paris Cité-CHU Necker - Enfants Malades [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut de Myologie, Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Association française contre les myopathies (AFM-Téléthon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), European Genomic Institute for Diabetes - FR 3508 (EGID), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, 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), Hôpital Purpan [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Association française contre les myopathies (AFM-Téléthon)-Université Pierre et Marie Curie - Paris 6 (UPMC), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut de Myologie, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Tachycardia, medicine.medical_specialty, implantable, Accurate estimation, Ventricular Tachyarrhythmias, Validation Studies as Topic, 030204 cardiovascular system & hematology, tachycardia, Sudden death, LMNA, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, death, Physiology (medical), Internal medicine, defibrillators, medicine, Humans, In patient, 030212 general & internal medicine, sudden, [SDV.GEN]Life Sciences [q-bio]/Genetics, Prediction score, business.industry, Defibrillators, Implantable, ventricular, Tachycardia, Ventricular, Cardiology, Female, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business
Abstract: Background: An accurate estimation of the risk of life-threatening (LT) ventricular tachyarrhythmia (VTA) in patients with LMNA mutations is crucial to select candidates for implantable cardioverter-defibrillator implantation. Methods: We included 839 adult patients with LMNA mutations, including 660 from a French nationwide registry in the development sample, and 179 from other countries, referred to 5 tertiary centers for cardiomyopathies, in the validation sample. LTVTA was defined as (1) sudden cardiac death or (2) implantable cardioverter defibrillator–treated or hemodynamically unstable VTA. The prognostic model was derived using the Fine-Gray regression model. The net reclassification was compared with current clinical practice guidelines. The results are presented as means (SD) or medians [interquartile range]. Results: We included 444 patients, 40.6 (14.1) years of age, in the derivation sample and 145 patients, 38.2 (15.0) years, in the validation sample, of whom 86 (19.3%) and 34 (23.4%) experienced LTVTA over 3.6 [1.0–7.2] and 5.1 [2.0–9.3] years of follow-up, respectively. Predictors of LTVTA in the derivation sample were: male sex, nonmissense LMNA mutation, first degree and higher atrioventricular block, nonsustained ventricular tachycardia, and left ventricular ejection fraction (https://lmna-risk-vta.fr). In the derivation sample, C-index (95% CI) of the model was 0.776 (0.711–0.842), and the calibration slope 0.827. In the external validation sample, the C-index was 0.800 (0.642–0.959), and the calibration slope was 1.082 (95% CI, 0.643–1.522). A 5-year estimated risk threshold ≥7% predicted 96.2% of LTVTA and net reclassified 28.8% of patients with LTVTA in comparison with the guidelines-based approach. Conclusions: In comparison with the current standard of care, this risk prediction model for LTVTA in laminopathies significantly facilitated the choice of candidates for implantable cardioverter defibrillators. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03058185.
Published: 2019
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11. Arythmie ventriculaire et activité sportive : tachycardie ventriculaire d’effort de Gallavardin sur cœur sain, à propos d’un cas et revue de la littérature

Author: Bernard Citron, T.A.A. Seghda, D. Fremy, C. Riocreux, R. Eschalier, Pascal Motreff, D. Aguettaz, G.R.C. Millogo, Y. Saludas, P.A. Catalan, and L. Flork
Subjects: Tachycardia, medicine.medical_specialty, business.industry, 030204 cardiovascular system & hematology, Ventricular tachycardia, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Ventricle, Internal medicine, medicine, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Therapeutic strategy
Abstract: Regular physical exercice has undeniable cardiovascular benefits and improves life expectancy. This benefice seems limited to moderate intensity exercises. Intense and chronic physical exercice would lead to heart structural changes. For a long time, knowledge of these cardiac effects seemed limited to the left ventricle. Since more authors have shown that right ventricle is vulnerability to the effects of intense chronic training. We report a Gallavardin-type ventricular stress tachycardia in a young with healthy hearted; in whom a right infundibular arrhythmogenic focus has been found in the absence of structural alteration of the right ventricle. Intense athletic activity may reveal a latent arrhythmogenic focus through sympathetic activation. Ablation was the preferred therapeutic strategy, preferred to drug therapy and derived from an analysis of risk-benefit ratios.
Published: 2019
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12. eDOL mHealth App and Web Platform for Self-monitoring and Medical Follow-up of Patients With Chronic Pain: Observational Feasibility Study

Author: Caroline Maindet-Dominici, Abdoul Jalil Djiberou Mahamadou, Nicolas Kerckhove, Bruno Pereira, Emmanuel Combe, Noémie Delage, Gaelle Martiné, Patrick Mertens, Serge Perrot, Sébastien Cambier, Eric Viel, Ludovic Douay, Cécile Lestrade, Stéphane Foulon, Alain Eschalier, Christian Gov, Lauriane Fourel, Bénédicte Dufraisse, Nadine Attal, Pascale Vergne-Salle, Valentine De Brisson, Eric Serra, Pascale Picard, Rodrigue Deleens, Nathalie Cantagrel, Violaine Antoine, Christian Dualé, François Jedryka, Dominique Pérocheau, Alice Corteval, Anne-Priscille Trouvin, Gaelle Espagne-Dubreuilh, Sophie Pouplin, Fabienne Marcaillou, and Nicolas Authier
Subjects: medicine.medical_specialty, business.industry, Physical therapy, medicine, Chronic pain, Medicine (miscellaneous), Health Informatics, medicine.disease, business, mHealth, Computer Science Applications
Abstract: Background Chronic pain affects approximately 30% of the general population, severely degrades quality of life (especially in older adults) and professional life (inability or reduction in the ability to work and loss of employment), and leads to billions in additional health care costs. Moreover, available painkillers are old, with limited efficacy and can cause significant adverse effects. Thus, there is a need for innovation in the management of chronic pain. Better characterization of patients could help to identify the predictors of successful treatments, and thus, guide physicians in the initial choice of treatment and in the follow-up of their patients. Nevertheless, current assessments of patients with chronic pain provide only fragmentary data on painful daily experiences. Real-life monitoring of subjective and objective markers of chronic pain using mobile health (mHealth) programs can address this issue. Objective We hypothesized that regular patient self-monitoring using an mHealth app would lead physicians to obtain deeper understanding and new insight into patients with chronic pain and that, for patients, regular self-monitoring using an mHealth app would play a positive therapeutic role and improve adherence to treatment. We aimed to evaluate the feasibility and acceptability of a new mHealth app called eDOL. Methods We conducted an observational study to assess the feasibility and acceptability of the eDOL tool. Patients completed several questionnaires using the tool over a period of 2 weeks and repeated assessments weekly over a period of 3 months. Physicians saw their patients at a follow-up visit that took place at least 3 months after the inclusion visit. A composite criterion of the acceptability and feasibility of the eDOL tool was calculated after the completion of study using satisfaction surveys from both patients and physicians. Results Data from 105 patients (of 133 who were included) were analyzed. The rate of adherence was 61.9% (65/105) after 3 months. The median acceptability score was 7 (out of 10) for both patients and physicians. There was a high rate of completion of the baseline questionnaires and assessments (mean 89.3%), and a low rate of completion of the follow-up questionnaires and assessments (63.8% (67/105) and 61.9% (65/105) respectively). We were also able to characterize subgroups of patients and determine a profile of those who adhered to eDOL. We obtained 4 clusters that differ from each other in their biopsychosocial characteristics. Cluster 4 corresponds to patients with more disabling chronic pain (daily impact and comorbidities) and vice versa for cluster 1. Conclusions This work demonstrates that eDOL is highly feasible and acceptable for both patients with chronic pain and their physicians. It also shows that such a tool can integrate many parameters to ensure the detailed characterization of patients for future research works and pain management. Trial Registration ClinicalTrial.gov NCT03931694; http://clinicaltrials.gov/ct2/show/NCT03931694
Published: 2021

13. A leadless pacemaker in the real-world setting: Patient profile and performance over time

Author: Pascal Defaye, P Mondoloy, S Winter, Werner Jung, P R Roberts, Nicolas Clementy, Romain Eschalier, D Sharman, Christophe Garweg, C Anderson, C Theis, A Pol, and Pierre Bordachar
Subjects: Bradycardia, medicine.medical_specialty, business.industry, medicine.medical_treatment, Atrial fibrillation, medicine.disease, Pericardial effusion, law.invention, law, Physiology (medical), Internal medicine, Patient profile, medicine, Cardiology, Artificial cardiac pacemaker, Hemodialysis, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Medtronic, Inc. OnBehalf Micra Acute Performance EMEA Investigators Background The first in-man implant of the Micra leadless pacemaker occurred in December 2013. While prior trials demonstrated a high implant success rate and favorable safety and efficacy results; whether the patient population and outcomes have changed over time is not well studied. Purpose To characterize the evolution of patient profile and outcomes for patients receiving a leadless pacemaker through the pre-market and post-market environment. Methods Patients undergoing a Micra leadless pacemaker implant attempt from the initial Micra Investigational Device Exemption [IDE] and current Micra studies (Micra post-approval registry [PAR], Micra acute performance [MAP] study) were analyzed. Patient characteristics and pericardial effusions regardless of severity were summarized. Results The 3466 patients included in the analysis underwent a Micra implant attempt and were enrolled during consecutive timeframes: patients from the Micra IDE study (n = 726) underwent a Micra implant attempt from 2013-2015, patients from the PAR (n = 1814) from 2015-2018, and patients from Micra MAP cohort (n = 926) from 2018 – 2020. Implant success was >99.0% in all 3 studies. Median age ranged from 78 – 79 years among the 3 studies without significant difference. There were more patients requiring dialysis in the MAP cohort compared to the PAR or IDE cohorts (10.3%, 7.9%, and 3.9%, respectively; P Conclusion Despite patient differences over time, the Micra leadless pacemaker was implanted with a high success rate and a low perforation rate, in-line with prior reports. Abstract Figure. Pericardial effusion rate by study
Published: 2021
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14. Evolution of high‐grade atrioventricular conduction disorders after transcatheter aortic valve implantation in patients who underwent implantation of a pacemaker with specific mode—that minimizes ventricular pacing—activated

Author: Carole Maupain, Laurence Guedon, Eloi Marijon, Jacques Mansourati, Romain Eschalier, Jean-Marc Dupuis, Romain Cassagneau, Didier Irles, Pierre Frey, Fiorella Salerno, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: Pacemaker, Artificial, medicine.medical_specialty, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, PR interval, Atrioventricular Block, ComputingMilieux_MISCELLANEOUS, Dual Chamber Pacemaker, business.industry, Left bundle branch block, Aortic Valve Stenosis, Odds ratio, Right bundle branch block, medicine.disease, Confidence interval, Prothesis, Treatment Outcome, Aortic Valve, Heart Valve Prosthesis, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: INTRODUCTION The evolution of atrioventricular conduction disorders after transcatheter aortic valve implantation (TAVI) remains poorly understood. We sought to identify factors associated with late (occurring ≥7 days after the procedure) high-grade atrioventricular blocks after TAVI, based on specific pacemaker memory data. METHODS AND RESULTS STIM-TAVI (NCT03338582) was a prospective, multicentre, observational study that enrolled all patients (from November 2015 to January 2017) implanted with a specific dual chamber pacemaker after TAVI, with the SafeR algorithm activated, allowing continuous monitoring of atrioventricular conduction. The primary endpoint was the occurrence of centrally adjudicated late high-grade atrioventricular blocks during the year after TAVI. Among 197 patients, 138 (70.1%) had ≥1 late high-grade atrioventricular block. Whereas oversizing (p = .005), high-grade atrioventricular block during TAVI (p
Published: 2021
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15. Achieving acute mitral isthmus block with catheter ablation with vein of marshall ethanol infusion

Author: A Pastorcici, G Massoulie, A Boudias, PA Motreff, A Costea, Mihai Puiu, PA Catalan, Gabriel Cismaru, G Souteyrand, Marius Andronache, D Blendea, Frédéric Jean, Romain Eschalier, Radu Rosu, and C Dauphin
Subjects: medicine.medical_specialty, Radiofrequency ablation, business.industry, medicine.medical_treatment, Catheter ablation, Cardiac Ablation, Ablation, Surgery, law.invention, medicine.anatomical_structure, law, Physiology (medical), Infusion Procedure, medicine, Sinus rhythm, Cardiology and Cardiovascular Medicine, Vein, business, Coronary sinus
Abstract: Funding Acknowledgements Type of funding sources: None. Background Achieving bidirectional mitral isthmus block during radiofrequency (RF) ablation for persistent atrial fibrillation (AF) is still challenging. The conventional ablation method involves RF applications on the endocardial aspect of the Mitral Isthmus (MI), and for a majority of patients, in the distal coronary sinus (CS). Purpose We have evaluated the acute success of obtaining mitral isthmus block by adding another epicardial component using ethanol infusion in the vein of Marshall (EIVOM) in addition to endocardial MI and epicardial CS ablation. Methods We studied 121 patients (pts.) with a mean age of 65 years (range 40-83) 73% men; 119 with longstanding persistent AF (98%) and 2 with perimitral flutter (2%). The mean duration of AF was 53 months (12-244 months). In the majority of patients, additional endocardial (on the ventricular aspect of the MI) and/or epicardial (distal CS) (RF) ablation was performed in order to achieve MIB. The ablation procedure was performed under general anesthesia (GA) for 81 pts (67%). EIVOM was perform with a mean 6 ml ethanol (range 2-10ml) Results Bidirectional MIB was obtained in 114 pts. (94,2%). The 7 patients without MIB were scheduled for another ablation procedure (4 pts under GA during the first procedure). The average RF delivery time to block was 160 seconds (range 42-480 seconds) for the endocardial MI RF ablation (point-by-point application with a power of 50W and an Ablation Index of 450-500, contact force 10-20g) and 156 seconds (range 55-438) for the epicardial MI RF ablation (applications with a power of 20W). Bidirectional endocardial and epicardial MIB was confirmed by conventional pacing maneuvers performed in sinus rhythm. No major complications were observed. The parameters associated with failure for MIB were AF duration, Left Atrial dilatation >200 ml, MI thickness (epicardial endocardial distance on the CARTO maps >15mm). Conclusion Ethanol infusion in the vein of Marshall is a safe approach and is associated with a higher success rate of obtaining acute bidirectional endocardial and epicardial mitral isthmus block when compared with the conventional method. Abstract Figure. Bloc Mitral Endo; Bloc Mitral Epi
Published: 2021
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16. 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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17. Sudden cardiac death risk in contact sports increased by myocarditis: a case series

Author: Michel Peoc'h, Frédéric Jean, Romain Eschalier, Marius Andronache, Baptiste Boyer, Guillaume Clerfond, Vincent Sapin, Grégoire Massoullié, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: medicine.medical_specialty, Viral Myocarditis, Myocarditis, medicine.medical_treatment, 030204 cardiovascular system & hematology, Arrhythmias/Electrophysiology, Sudden death, Sudden cardiac death, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Palpitations, medicine, Case Series, AcademicSubjects/MED00200, Cardiopulmonary resuscitation, business.industry, 030229 sport sciences, medicine.disease, Pulseless electrical activity, Ventricular fibrillation, cardiovascular system, Ventricular arrhythmia, Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Myocarditis is a known cause of sudden cardiac death of the athlete. The impact of direct chest trauma in at-risk sports or activities in patients with a history of myocarditis has never been demonstrated or studied. We report herein two cases of life-threatening ventricular arrhythmia secondary to non-penetrating blunt chest trauma while playing contact sports. Case summary The first patient, a 26-year-old man described a brief loss of consciousness after having received blunt impact to the chest (typical intensity) while playing a rugby match. The loss of consciousness was total and proceeded by rapid and regular palpitations. He had a history of viral myocarditis 10 years prior with a fibrotic sequalae in the inferolateral wall on cardiac magnetic resonance imaging (left ventricular ejection fraction 71%). Right apical ventricular pacing induced a sustained monomorphic ventricular tachycardia reproducing the patient’s symptoms. A subcutaneous implantable cardioverter-defibrillator was implanted. The second patient is a 22-year-old professional rugby player with no known notable history. During a match, a direct blow to the chest wall was followed by a cardiac arrest. A ventricular fibrillation was cardioverted to pulseless electrical activity. Patient died despite cardiopulmonary resuscitation. An autopsy identified a myocardial sequela of fibrosis with no acute inflammatory remodelling compatible with a previous myocarditis. Discussion Myocarditis may increase the risk of life-threatening ventricular arrhythmias caused by blunt impact to the chest, particularly in contact sports. Screening and prevention measures should be considered to reduce this risk.
Published: 2021
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18. Relation of outcomes to ABC (Atrial Fibrillation Better Care) pathway adherent care in European patients with atrial fibrillation:an analysis from the ESC-EHRA EORP Atrial Fibrillation General Long-Term (AFGen LT) Registry

Author: Cuisset, Thomas, Fauchier, Laurent, Deharo, Pierre, Cohen, Ariel, Waldmann, Victor, Bouzeman, Abdeslam, Duthoit, Guillaume, Koutbi, Linda, Bessiere, Francis, Labombarda, Fabien, Marquié, Christelle, Gourraud, Jean Baptiste, Mondoly, Pierre, Sellal, Jean Marc, Bordachar, Pierre, Hermida, Alexis, Anselme, Frédéric, Asselin, Anouk, Audinet, Caroline, Bernard, Yvette, Boveda, Serge, Bru, Paul, Bun, Sok Sithikun, Clerici, Gael, da Costa, Antoine, de Guillebon, Maxime, Defaye, Pascal, Elbaz, Nathalie, Eschalier, Romain, Garcia, Rodrigue, Guenancia, Charles, Guy-Moyat, Benoit, Halimi, Franck, Irles, Didier, Iserin, Laurence, Jourda, François, Ladouceur, Magalie, Lagrange, Philippe, Laredo, Mikael, Mansourati, Jacques, Massoulié, Grégoire, Mathiron, Amel, Maury, Philippe, Messali, Anne, Narayanan, Kumar, Nguyen, Cédric, Ninni, Sandro, Perier, Marie-Cécile, Pierre, Bertrand, Pujadas, Penelope, Sacher, Frédéric, Sagnol, Pascal, Sharifzadehgan, Ardalan, Walton, Camille, Winum, Pierre, Zakine, Cyril, Martins, Raphael, Pasquié, Jean Luc, Thambo, Jean Benoit, Jouven, Xavier, Combes, Nicolas, Marijon, Eloi, Squara, Fabien, Theodore, Guillaume, Scarlatti, Didier, Hourdain, Jérome, Deharo, Jean-Claude, Ollitrault, Pierre, Milliez, Paul, Champ-Rigot, Laure, Bader, Hugues, Duplantier, Cécile, Milhem, Antoine, Sagnard, Audrey, Bertaux, Géraldine, Laurent, Gabriel, Badoz, Marc, Bortone, Agustin, Laborie, Guillaume, Rollin, Anne, Stephanopoli, Quentin Voglimacci, Mandel, Franck, Duparc, Alexandre, Domain, Guillaume, Albenque, Jean-Paul, Cardin, Christèle, Combes, Stéphane, Tanese, Nikita, Hasni, Karim, Leclercq, Christophe, Galand, Vincent, Pavin, Dominique, Mabo, Philippe, Behar, Nathalie, Clementy, Nicolas, Loose, Christophe, Otmani, Akli, Venier, Sandrine, Carabelli, Adrien, Jacon, Peggy, Kilani, Mouna Ben, Guichard, Jean Bapstist, Romeyer-Bouchard, Cécile, Le Gloan, Laurianne, Probst, Vincent, Freysz, Luc, Blangy, Hugues, Chillou, Christian De, Sadoul, Nicolas, Khattar, Pierre, Potelle, Charlotte, Jean, Frederic, Puie, Paul, Khoueiry, Ziad, Chevallier, Philippe, Dulac, Arnaud, Filippo, Sylvie Di, Gardey, Kevin, Frey, Pierre, Akret, Chrystelle, Dompnier, Antoine, Maupain, Carole, Waintraub, Xavier, Hidden-Lucet, Françoise, Chastre, Thomas, Gandjbakhch, Estelle, Badenco, Nicolas, Extramiana, Fabrice, Leenhardt, Antoine, Zouaghi, Amir, Algalarrondo, Vincent, Amet, Denis, Varlet, Emilie, Chalbia, Tej, Philibert, Séverine, Ollitrault, Jacky, Lavergne, Thomas, Baudinaud, Pierre, Mirolo, Adrian, Savouré, Arnaud, Godin, Bénédicte, Bertrand, Cathy, Fiorello, Pierre, Johnson, Nicolas, Lallemand, Pierre-Marc, Herminda, Alexis, Hermida, Jean-Sylvain, Degand, Bruno, Bouazzaou, Rim El, Mourot, Stéphane, Goussot, Samuel, Jauvert, Gaël, Lazarus, Arnaud, Grimard, Caroline, Alonso, Christine, Zhao, Alexandre, Thomas, Olivier, Cauchemez, Bruno, Moubarak, Ghassan, Lellouche, Nicolas, Hamon, David, Enache, Bogdan, Lactu, Gabriel, Wiart, Françoise, Geoffroy, Olivier, Poindron, Damien, Maltret, Alice, Raimondo, Cristine, Bonnet, Damien, Hascoët, Sébastien, Derval, Nicolas, Haïssaguerre, Michel, Hocini, Mélèze, Proietti, Marco, Lip, Gregory, Laroche, Cécile, Marin, Francisco, Nabauer, Michael, Potpara, Tatjana, Dan, Gheorghe-Andrei, Kalarus, Zbigniew, Tavazzi, Luigi, Maggioni, Aldo Pietro, Boriani, Giuseppe, Hôpital de la Timone [CHU - APHM] (TIMONE), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), 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), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Paris Cité (UPCité), 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 Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier de Versailles André Mignot (CHV), CHU Pitié-Salpêtrière [AP-HP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique (SEILIRM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), 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), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), 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 Amiens-Picardie, Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Groupe Hospitalier Bretagne Sud (GHBS), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Clinique Pasteur, Clinique Pasteur [Toulouse], Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Pasteur [Nice] (CHU), CHU Saint-Pierre, Università degli Studi di Milano = University of Milan (UNIMI), Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Liverpool, Aalborg University [Denmark] (AAU), EURObservational Research Programme, European Society of Cardiology, Universidad de Murcia, University of Belgrade [Belgrade], Colentina University Hospital, University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Silesian Medical University, Katowice, Poland, University Hospital of Ferrara and Maria Cecilia Hospital, Associazione Nazionale Medici Cardiologi Ospedalieri [Firenze] (ANMCO), Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Service de cardiologie
Subjects: medicine.medical_specialty, Acute coronary syndrome, 030204 cardiovascular system & hematology, Lower risk, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Physiology (medical), Internal medicine, Thromboembolism, Atrial Fibrillation, Care pathway, Medicine, Humans, 030212 general & internal medicine, Registries, Outcomes • Registry, business.industry, Hazard ratio, Anticoagulants, Integrated care, Atrial fibrillation, medicine.disease, Confidence interval, 3. Good health, Stroke, Cohort, Cardiology and Cardiovascular Medicine, business
Abstract: Aims There has been an increasing focus on integrated, multidisciplinary, and holistic care in the treatment of atrial fibrillation (AF). The ‘Atrial Fibrillation Better Care’ (ABC) pathway has been proposed to streamline integrated care in AF. We evaluated the impact on outcomes of an ABC adherent management in a contemporary real-life European-wide AF cohort. Methods and results Patients enrolled in the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry with baseline data to evaluate ABC criteria and available follow-up data were considered for this analysis. Among the original 11 096 AF patients enrolled, 6646 (59.9%) were included in this analysis, of which 1996 (30.0%) managed as ABC adherent. Patients adherent to ABC care had lower CHA2DS2-VASc and HAS-BLED scores (mean ± SD, 2.68 ± 1.57 vs. 3.07 ± 1.90 and 1.26 ± 0.93 vs. 1.58 ± 1.12, respectively; P Conclusion In a large contemporary cohort of European AF patients, a clinical management adherent to ABC pathway for integrated care is associated with a significant lower risk for cardiovascular events, CV death, and all-cause death.
Published: 2021
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19. 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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20. Long-term follow-up of patients with tetralogy of fallot and implantable cardioverter defibrillator–The DAI-T4F nationwide registry

Author: Guillaume Duthoit, Mikael Laredo, Antoine Da Costa, Romain Eschalier, Fabien Labombarda, Laurent Fauchier, Benoit Guy-Moyat, Laurence Iserin, Pierre Winum, Marie-Cécile Perier, Philippe Maury, Nicolas Combes, Victor Waldmann, Didier Irles, Philippe Lagrange, Magalie Ladouceur, Jean-Benoit Thambo, Bertrand Pierre, Eloi Marijon, Jean-Marc Sellal, Grégoire Massoulié, Maxime De Guillebon, Ardalan Sharifzadehgan, Jacques Mansourati, Sandro Ninni, Penelope Pujadas, Linda Koutbi, Anouk Asselin, Pascal Sagnol, Nathalie Elbaz, Rodrigue Garcia, Dai-T F investigators, Caroline Audinet, G Clerici, Kumar Narayanan, Amel Mathiron, Xavier Jouven, Frédéric Anselme, Camille Walton, Anne Messali, Jean-Baptiste Gourraud, Yvette Bernard, Charles Guenancia, Alexis Hermida, Raphaël P. Martins, Pierre Bordachar, Cyril Zakine, Francis Bessière, Pierre Mondoly, Franck Halimi, Paul Bru, C. Marquie, François Jourda, Pascal Defaye, Frederic Sacher, Sok Sithikun Bun, Jean-Luc Pasquié, Cédric Nguyen, and Abdeslam Bouzeman
Subjects: medicine.medical_specialty, Long term follow up, business.industry, medicine.medical_treatment, Area under the curve, Qrs fragmentation, Implantable cardioverter-defibrillator, medicine.disease, Sudden cardiac death, Internal medicine, medicine, In patient, Cardiology and Cardiovascular Medicine, Complication, business, Tetralogy of Fallot
Abstract: Introduction Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, and sudden cardiac death represents an important mode of death in these patients. Data evaluating the implantable cardioverter defibrillator (ICD) in this patient population remain scarce. Objective We aimed to describe long-term follow-up of TOF patients implanted with ICD through a nationwide French registry. Methods Nationwide French Registry including all TOF patients with an ICD initiated in 2010 by the French Institute of Health and Medical Research. The primary time to event endpoint was the time from ICD implantation to first appropriate ICD therapy. Clinical events were centrally adjudicated by a blinded committee. Results A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% males) were included from 40 centers, including 104 (63.0%) in secondary prevention. During a median (IQR) follow-up of 6.8 (2.5–11.4) years, 78 (47.3%) patients received at least one appropriate ICD therapy. The annual incidence of the primary outcome was 10.5% (7.1% and 12.5% in primary and secondary prevention, respectively, P = 0.03). Overall, 71 (43.0%) patients presented with at least one ICD complication, including inappropriate shocks in 42 (25.5%) patients and lead dysfunction in 36 (21.8%) patients. Among 61 (37.0%) primary prevention patients, the annual rate of appropriate ICD therapies was 4.1%, 5.3%, 9.5%, and 13.3% in patients with respectively no, one, two, or ≥ three guideline-recommended risk factors. QRS fragmentation was the only independent predictor of appropriate ICD therapies (HR 3.47, 95% CI 1.19–10.11), and its integration in a model with current criteria increased the 5-year time-dependent area under the curve from 0.68 to 0.81 (P = 0.006) ( Fig. 1 ). Conclusions Patients with TOF and an ICD experience high rates of appropriate therapies, including those implanted in primary prevention. The considerable long-term burden of ICD-related complications, however, underlines the need for careful candidate selection. A combination of easy-to-use criteria including QRS fragmentation might improve risk stratification.
Published: 2021
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21. Left atrial appendage closure for thrombus trapping: the international, multicentre TRAPEUR registry

Author: Frederic A. Sebag, Roberto Galea, Adel Aminian, Antoine Sauguet, David Hildick-Smith, Ghassan Moubarak, Antoine Lepillier, Philippe Garot, Nicolas Amabile, Nicolas Lellouche, Sébastien Armero, Antoine De Meesteer, Romain Eschalier, Gregory Ducrocq, Ole De Backer, Khalil Mahmoudi, Lorenz Räber, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Aftercare, Pericardial effusion, Clinical Research, Left atrial, Atrial Fibrillation, Antithrombotic, Clinical endpoint, Humans, Medicine, Atrial Appendage, Registries, Thrombus, 610 Medicine & health, Stroke, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Embolic protection, business.industry, Thrombosis, medicine.disease, Patient Discharge, Surgery, Treatment Outcome, Tamponade, Cardiology and Cardiovascular Medicine, business
Abstract: BACKGROUND Although the presence of a thrombus contraindicates left atrial appendage closure procedure (LAAC), a previous study reported the feasibility of the thrombus trapping procedure (TTP) technique to overcome this limitation. AIMS This study aimed to analyse the short-term outcomes in a series of patients who underwent LAAC using the TTP (TTP-LAAC). METHODS This retrospective series included patients who underwent TTP-LAAC between January 2018 and May 2020 in 13 European centres. Device choice, pre-interventional work-up and post-discharge antithrombotic therapy regimens were left to the discretion of the operators. The primary endpoint was the 30-day occurrence of stroke, systemic embolism or cardiovascular death. RESULTS During the study period, a total of 1,918 patients underwent LAAC. A thrombus was identified in 71 cases but completely disappeared in 24 patients before procedure. TTP-LAAC was finally performed in 53 cases (3%). Thrombi were identified ahead of the actual day of implantation in 47 patients (87 %) and were mostly limited in size (50 cases with extension
Published: 2021
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22. Paroxysmal atrial fibrillation associated with a moderate form of COVID-19 in a middle-aged man with low cardiovascular risk factor: more still needs to be done in this topic

Author: Gislain Beyina, Kane Karamoko, Lise Camus, Sylvain Chanseaume, Joel Noutakdie Tochie, Alexandra Chanseaume, Romain Eschalier, Khaled Benfreha, Mazou Ngou Temgoua, Mischie Alexandru, Enver Hilic, Nouhoun Diallo, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: Medicine (General), medicine.medical_specialty, Adult male, Coronavirus disease 2019 (COVID-19), Paroxysmal atrial fibrillation, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Cardiovascular risk factors, Case Report, 030204 cardiovascular system & hematology, low cardiovascular risk factor, 03 medical and health sciences, 0302 clinical medicine, R5-920, COVID‐19, Internal medicine, medicine, atrial fibrillation, In patient, Major complication, Risk factor, ComputingMilieux_MISCELLANEOUS, Unusual case, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Heart Rhythm, 030220 oncology & carcinogenesis, middle‐aged patient, Cardiology, Medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Strict monitoring of the heart rhythm in patients with COVID‐19 even nonsevere case and patient with low cardiovascular risk factors is very important to prevent fatal outcomes.
Published: 2020
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23. A new clinically-relevant rat model of letrozole-induced chronic nociceptive disorders

Author: Damien Richard, Alain Eschalier, Raalib Amode, Julie Vein, Bruno Pereira, Yohann Wittrant, Aurore Collin, Christelle Guillet, David Balayssac, Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand, University of East Anglia [Norwich] (UEA), Centre de Recherche en Nutrition Humaine Auvergne [CHU Clermont-Ferrand] (CRNH A), and CHU Clermont-Ferrand-CHU Clermont-Ferrand
Subjects: 0301 basic medicine, myalgia, Nociception, medicine.medical_specialty, medicine.drug_class, Ovariectomy, Motor Activity, Toxicology, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Ganglia, Spinal, medicine, Animals, Aromatase, Pharmacology, biology, business.industry, Aromatase Inhibitors, Letrozole, Body Weight, Myalgia, Arthralgia, Pathophysiology, 3. Good health, Rats, Disease Models, Animal, 030104 developmental biology, Endocrinology, Gene Expression Regulation, Estrogen, 030220 oncology & carcinogenesis, TRPA1 Rat, Chronic Disease, biology.protein, Ovariectomized rat, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Female, Animal studies, medicine.symptom, business, medicine.drug
Abstract: International audience; Among postmenopausal women with estrogen receptor-positive breast cancer, more than 80% receive hormone therapy including aromatase inhibitors (AIs). Half of them develop chronic arthralgia - characterized by symmetric articular pain, carpal tunnel syndrome, morning stiffness, myalgia and a decrease in grip strength - which is associated with treatment discontinuation. Only a few animal studies have linked AI treatment to nociception, and none to arthralgia. Thus, we developed a new chronic AI-induced nociceptive disorder model mimicking clinical symptoms induced by AIs, using subcutaneous letrozole pellets in ovariectomized (OVX) rats. Following plasma letrozole dosage at the end of the experiment (day 73), only rats with at least 90 ng/ml of letrozole were considered significantly exposed to letrozole (OVX + high LTZ group), whereas treated animals with less than 90 ng/ml were pooled in the OVX + low LTZ group. Chronic nociceptive disorder set in rapidly and was maintained for more than 70 days in the OVX + high LTZ group. Furthermore, OVX + high LTZ rats saw no alteration in locomotion, myalgia or experimental anxiety during this period. Bone parameters of the femora were significantly altered in all OVX rats compared to Sham+vehicle pellet. A mechanistic analysis focused on TRPA1, receptor suspected to mediate AI-evoked pain, and showed no modification in its expression in the DRG. This new long-lasting chronic rat model, efficiently reproduces the symptoms of AI-induced nociceptive disorder affecting patients' daily activities and quality-of-life. It should help to study the pathophysiology of this disorder and to promote the development of new therapeutic strategies.
Published: 2020
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24. 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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25. Cross-Sectional Study of Prevalence, Characterization and Impact of Chronic Pain Disorders in Workers

Author: Bruno Pereira, Nicolas Kerckhove, Christian Dualé, Alain Eschalier, Céline Lambert, and Alice Corteval
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Cross-sectional study, Overweight, Severity of Illness Index, Occupational safety and health, 03 medical and health sciences, Young Adult, 0302 clinical medicine, 030202 anesthesiology, medicine, Prevalence, Humans, business.industry, Chronic pain, Middle Aged, medicine.disease, Obesity, Occupational Diseases, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Neurology, Mixed pain, Physical therapy, Observational study, Female, Neurology (clinical), France, medicine.symptom, Chronic Pain, business, Psychosocial, 030217 neurology & neurosurgery
Abstract: Chronic pain prevention and treatment constitute a challenge for occupational health The aim of this study was to provide data on workers in a variety of jobs and multiple contexts to determine the prevalence and characteristics of different chronic pain disorders, in view to highlighting possible new targets for preventive actions. 1,008 participants working in 14 French IKEA stores were analyzed in this observational study on the basis of their responses to surveys on their sociodemographic characteristics, psychosocial factors, lifestyle, and pain disorders. The prevalence of chronic pain, moderate-to-severe chronic pain and high-impact chronic pain were 49%, 30%, and 11%, respectively. Chronic pain was predominantly located in the neck and back, and identified mostly as nociceptive, with, for some participants, a neuropathic component (mixed pain). The majority of chronic pain was reported as being due to professional activity, and causing at least one work stoppage during the past year in half of the participants. Jobs that were the most common sources of chronic pain were those with a higher proportion of repetitive gestures, no consecutive days of rest, stress at work, such as cash-register/catering jobs. Overall, this study highlighted profiles at risk of developing or suffering from chronic pain, and several associated factors: ≥40 years old, female sex, overweight/obesity, repetitive gestures, no consecutive days of rest, stress, catastrophism, workplace environment, poor quality of life, and mental state. In conclusion, these data give interesting information on the characteristics of workers with chronic pain and highlight profiles of participants. Perspective: This study provides important information about the features of chronic pain in a model of a working population of Western countries. This information can be used to propose preventive actions.
Published: 2020

26. 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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27. Electrogram morphology discriminators in implantable cardioverter defibrillators: A comparative evaluation

Author: Sylvain Reuter, Mauro Biffi, Kevin Vernooy, Michel Haïssaguerre, Marc Strik, Bruno Pereira, Sylvain Ploux, Romain Eschalier, Julien Laborderie, Jean-Paul Bernis, Rémi Dubois, Nicolas Clementy, Philippe Ritter, Xavier Pillois, Stéphane Garrigue, Nicolas Welte, Antoine Deplagne, Antonio Frontera, Pierre Bordachar, Pierre Mondoly, Remi Chauvel, RS: Carim - H08 Experimental atrial fibrillation, MUMC+: MA Med Staf Artsass Cardiologie (9), Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H06 Electro mechanics, and RS: Carim - H01 Clinical atrial fibrillation
Subjects: RHYTHM DISCRIMINATION, medicine.medical_specialty, Discriminator, implantable cardioverter defibrillator, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Template match, Electric Countershock, Action Potentials, 030204 cardiovascular system & hematology, Ventricular tachycardia, arrhythmia, Comparative evaluation, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Heart Rate, Predictive Value of Tests, Physiology (medical), Internal medicine, VENTRICULAR-TACHYCARDIA, morphology, medicine, Tachycardia, Supraventricular, Humans, Telemetry, 030212 general & internal medicine, Retrospective Studies, algorithm, business.industry, DUAL-CHAMBER, Curve analysis, Area under the curve, Reproducibility of Results, Signal Processing, Computer-Assisted, Equipment Design, Implantable cardioverter-defibrillator, medicine.disease, Defibrillators, Implantable, Europe, SUPRAVENTRICULAR TACHYCARDIA, Cardiology, Tachycardia, Ventricular, Supraventricular tachycardia, Cardiology and Cardiovascular Medicine, business, Electrophysiologic Techniques, Cardiac, Algorithms, discrimination
Abstract: Contains fulltext : 220908.pdf (Publisher’s version ) (Closed access) BACKGROUND: Morphology algorithms are currently recommended as a standalone discriminator in single-chamber implantable cardioverter defibrillators (ICDs). However, these proprietary algorithms differ in both design and nominal programming. OBJECTIVE: To compare three different algorithms with nominal versus advanced programming in their ability to discriminate between ventricular (VT) and supraventricular tachycardia (SVT). METHODS: In nine European centers, VT and SVTs were collected from Abbott, Boston Scientific, and Medtronic dual- and triple-chamber ICDs via their respective remote monitoring portals. Percentage morphology matches were recorded for selected episodes which were classified as VT or SVT by means of atrioventricular comparison. The sensitivity and related specificity of each manufacturer discriminator was determined at various values of template match percentage from receiving operating characteristics (ROC) curve analysis. RESULTS: A total of 534 episodes were retained for the analysis. In ROC analyses, Abbott Far Field MD (area under the curve [AUC]: 0.91; P < .001) and Boston Scientific RhythmID (AUC: 0.95; P < .001) show higher AUC than Medtronic Wavelet (AUC: 0.81; P < .001) when tested for their ability to discriminate VT from SVT. At nominal % match threshold all devices provided high sensitivity in VT identification, (91%, 100%, and 90%, respectively, for Abbott, Boston Scientific, and Medtronic) but contrasted specificities in SVT discrimination (85%, 41%, and 62%, respectively). Abbott and Medtronic's nominal thresholds were similar to the optimal thresholds. Optimization of the % match threshold improved the Boston Scientific specificity to 79% without compromising the sensitivity. CONCLUSION: Proprietary morphology discriminators show important differences in their ability to discriminate SVT. How much this impact the overall discrimination process remains to be investigated.
Published: 2020

28. P957Characteristics of atrial tachycardia after mitral surgey via biatrial trans-septal approach using high density mapping system

Author: M Farhat, Marius Andronache, Grégoire Massoullié, R Bosle, C Cataldi, Romain Eschalier, and Frédéric Jean
Subjects: medicine.medical_specialty, business.industry, medicine.disease, medicine.anatomical_structure, Physiology (medical), Mitral valve, Internal medicine, Mapping system, medicine, Cardiology, Sinus rhythm, medicine.symptom, Atrium (heart), Cardiology and Cardiovascular Medicine, business, Atrioventricular block, Coronary sinus, Atrial tachycardia, Atrial flutter
Abstract: Background The biatrial trans-septal approach (BTSa) ameliorates mitral valve (MV) exposure in difficult cases when routine left atriotomy doesnt"t allow it. Main steps are an oblique incision on the right atrium (RA), reaching medially the right pulmonary veins (PV), a septal incision from the fossa ovalis, extended up to reach the first incision, then on the left atrium (LA). Purpose We aim to study the arrhythmic burden in this post-surgical context, focusing on atrial tachycardia (AT), to investigate the complexity of several possible circuits. Methods All patients (>18yo) with previous MV surgery via BTSa for MV repair or replacement, who underwent ablation of AT from January 2017 to September 2019, were enrolled. Patients ablated for persistent or paroxysmal AF, or with AF during the index procedure were excluded. Patients with associated surgery on other valves or congenital defects, coronary, surgical or percutaneous rhythm interventions weren’t excluded. Electroanatomical mapping was created using 2 different high-density mapping system. Substrate and activation map and radio-frequency (RF) ablation (25-50W, Ablation Index target 400) were realized. Cartographies were analysed to evaluate AT re-entry circuit, critical isthmus (CI) location and characterization, atrial vulnerability. Procedural outcomes (AT termination, sinus rhythm (SR) restoration, anti-arrhythmic drugs (AAD) withdrawal), and peri-procedural complications were also evaluated. Results We enrolled 49 patients (median age 57 ± 15), finding a maximum of 5 AT per procedure (2 ± 1). A total of 112 AT were mapped: the majority (72%) were persistent AT, 8,2% common atrial flutter. Cycle length was 314 ± 74 msec, with proximal-distal activation of coronary sinus (78%). A multiple re-entry circuit was observed in 70% of index AT. We identified 152 critical isthmus (maximum 5 per procedure). Only 27,9% of our patients had a single CI; CTI was the most frequent one (n = 37), envolved in 33% of all AT, while BTS scars altogether were envolved in 65% AT. A complete AT circuit was mapped in the RA, the LA and both atria in respectively 49%, 11,5% and 39%AT. The distribution of CIs is shown in figure 1. Biatrial and left AT leads to superior procedure, RF and fluoroscopy duration (p Conclusions AT occurring after a BTSa have a high prevalence of multiple re-entry circuits with multiple critical isthmus. Ablation in this context is feasible and safe but often requires a left atrial access. Mapping of both atria should be considered to identify critical isthmus and tailored ablation strategy. Abstract Figure 1. Critical Isthmus Distribution
Published: 2020
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29. Progressive implantable cardioverter-defibrillator therapies for ventricular tachycardia: The efficacy and safety of multiple bursts, ramps, and low-energy shocks

Author: Marc Strik, Romain Eschalier, Thomas Bonnin, Michel Haïssaguerre, Saer Abu-Alrub, F. Daniel Ramirez, Sylvain Ploux, Pierre Bordachar, Philippe Ritter, and Nicolas Welte
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Electric Countershock, 030204 cardiovascular system & hematology, Ventricular tachycardia, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, Asia pacific, Low energy, Heart Rate, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Aged, High rate, business.industry, Equipment Design, medicine.disease, Implantable cardioverter-defibrillator, 3. Good health, Defibrillators, Implantable, Heart Rhythm, Shock (circulatory), Cardiology, Antitachycardia Pacing, Tachycardia, Ventricular, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: The Heart Rhythm Society, the European Heart Rhythm Association, the Asia Pacific Heart Rhythm Society, the Latin American Heart Rhythm Society expert consensus statement on optimal implantable cardioverter-defibrillator programming recommends burst antitachycardia pacing (ATP) for the treatment of ventricular tachycardia (VT) up to high rates. The number of bursts is not specified, and treatment by ramps or low-energy shocks is not recommended.We investigated the efficacy and safety of progressive therapies for VTs between 150 and 200 beats/min. After 3 failed bursts, we compared 3 ramps vs 3 bursts followed by a low-energy shock vs high-energy shock.Using remote monitoring, we included monomorphic VT episodes treated with ≥1 burst.A total of 1126 VT episodes were included. A single burst was as likely to terminate VT between 150 and 200 beats/min as VT between 200 and 230 beats/min (63% vs 64%; P=.41), but was more likely to accelerate the latter (3.2% vs 0.25%; P.01). For VT200 beats/min, the likelihood of ATP success increased progressively (73% with 2 bursts, 78% with 3 bursts). Three additional bursts further increased VT termination to 89%, similar to the success rate with 3 additional ramps (88%; P=.17). Programming 6 bursts is associated with the probability of acceleration requiring shock of 6.6%. A low-energy first shock was less successful than a high-energy shock (66% vs 86%; P.01) and more likely to accelerate VT (17% vs 0%; P.01).Programming up to 6 burst ATP therapies for VTs 150-200 beats/min can avoid implantable cardioverter-defibrillator shocks in most patients. Ramp ATP after failed bursts were similarly effective. Low-energy shocks are less effective and more arrhythmogenic than high-energy shocks.
Published: 2020

30. Reduced Diuretic Dose in Patients Treated With Eplerenone

Author: Stephane Tala, Faiez Zannad, Patrick Rossignol, Bertram Pitt, Kevin Damman, Renaud Fay, Nicolas Girerd, Romain Eschalier, Morten Schou, João Pedro Ferreira, Finn Gustafsson, Kevin Duarte, Cardiovascular Centre (CVC), Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), 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)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Department of Cardiology, University Medical Center Groningen, University of Groningen, Department of Cardiology, Rigshospitalet, Copenhagen, Department of Clinical Medicine, University of Copenhagen, Denmark, Faculty of Health and Medical Sciences, University of Copenhagen, and Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte Hospital, University of Michigan [Ann Arbor], University of Michigan System, JPF, NG, PR and FZ are supported by a public grant overseen by the French National Research Agency (ANR) as part of the second 'Investissements d’Avenir' program FIGHT-HF (reference: ANR-15-RHU-0004) and by the French PIA project 'Lorraine Université d’Excellence', reference ANR-15-IDEX-04-LUE and by Contrat de Plan Etat-Région Lorraine and FEDER Lorraine., ANR-15-RHUS-0004,FIGHT-HF,Combattre l'insuffisance cardiaque(2015), ANR-15-IDEX-0004,LUE,Isite LUE(2015), BOZEC, Erwan, Combattre l'insuffisance cardiaque - - FIGHT-HF2015 - ANR-15-RHUS-0004 - RHUS - VALID, ISITE - Isite LUE - - LUE2015 - ANR-15-IDEX-0004 - IDEX - VALID, and University of Copenhagen = Københavns Universitet (UCPH)
Subjects: Male, cardiomyopathies, medicine.medical_specialty, Time Factors, treatment effect, Systole, medicine.medical_treatment, heart failure, 030204 cardiovascular system & hematology, Sodium Potassium Chloride Symporter Inhibitors, Ventricular Function, Left, Ventricular Dysfunction, Left, 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, medicine, Humans, Treatment effect, In patient, 030212 general & internal medicine, Myocardial infarction, eplerenone, Aged, Mineralocorticoid Receptor Antagonists, business.industry, sodium potassium chloride symporter inhibitors, congestion, Clinical judgement, loop diuretics, systolic dysfunction, Recovery of Function, Middle Aged, medicine.disease, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, Eplerenone, Treatment Outcome, myocardial infarction, Heart failure, Cardiology, Female, Diuretic, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: Background: Loop diuretics are used for congestion relief, and dose adaptations are usually a consequence of the clinicians’ clinical judgement about the congestive status of the patient. In EPHESUS (Eplerenone in Patients With Systolic Dysfunction After Myocardial Infarction), many patients required diuretics for congestion relief. We thus hypothesized that blinded allocation to eplerenone would lead clinicians to reduce loop diuretics, as a consequence of the improvement in patients’ status. Methods: Cox and mixed-effects models were used over a median follow-up of 1.3 years in 6632 patients. Results: A total of 6632 patients were included; at baseline, 3352 (50.5%) did not have diuretics, 2195 (33.1%) had diuretic doses between 1 and 40 mg/day, and 1085 (16.4%) had diuretic doses >40 mg/day. Patients with higher furosemide equivalent doses had a worse clinical status. Both baseline and follow-up incremental loop diuretic doses were associated with worse prognosis. Eplerenone treatment was associated with lower prescribed loop diuretic doses throughout the follow-up; lower doses were observed at 90 days and decreased further at 180 days and beyond. Eplerenone treatment led to a mean furosemide equivalent dose reduction of −2.2 mg/day (−2.9 to −1.6) throughout the follow-up. Eplerenone was effective in reducing morbidity and mortality regardless of the baseline loop diuretic dose used: hazard ratio for the outcome of cardiovascular death or heart failure hospitalization was 0.83 ([95% CI, 0.75–0.92]; P for interaction, 0.54). Conclusions: Eplerenone treatment led to a loop diuretic dose reduction during follow-up without evidence of treatment effect modification by loop diuretics. These findings suggest that eplerenone reduces congestive signs and symptoms, which enables clinicians to reduce loop diuretic doses.
Published: 2020
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31. 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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32. Initial multicenter experience with a new high-density coloring module: impact for complex atrial arrhythmias interpretation

Author: Alexis Mechulan, Ghassan Moubarak, Antoine Da Costa, Julio Justo, Marius Andronache, Vincent Roger, John Silberbauer, Grégoire Massoullié, Romain Eschalier, Olivier Thomas, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: Tachycardia, medicine.medical_specialty, medicine.medical_treatment, High density, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Tachycardia, Supraventricular, Humans, 030212 general & internal medicine, Atrial tachycardia, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, business.industry, Atrial arrhythmias, Ablation, Confidence interval, Cardiology, Catheter Ablation, Standard algorithms, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Electrophysiologic Techniques, Cardiac, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Time to diagnosis
Abstract: High-density automated mapping of complex atrial tachycardias (ATs) requires accurate assessment of activation maps. A new local activation display module (HD coloring, Biosense Webster®) provides higher map resolution, a better delineation of potential block reducing color interpolation, and a new propagation display. We evaluated the accuracy of a dedicated local activation display compared with standard algorithm. High-density maps from 10 AT were collected with a multipolar catheter and were displayed with standard activation or HD coloring. Six expert operators retrospectively analyzed activation maps and were asked to define (1) the tachycardia mechanism, (2) ablation target, and (3) level of difficulty to interpret those maps. Using HD coloring, operators were able to reach a correct diagnosis in 93% vs. 63%, p
Published: 2020
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33. Echocardiographic diastolic function evolution in patients with an anterior Q-wave myocardial infarction: insights from the REVE-2 study

Author: Olivier Huttin, João Pedro Ferreira, Renaud Fay, Zohra Lamiral, Patrick Rossignol, Romain Eschalier, Christophe Bauters, Florence Pinet, Nicolas Girerd, and Faiez Zannad
Subjects: medicine.medical_specialty, business.industry, Diastole, Odds ratio, 030204 cardiovascular system & hematology, medicine.disease, QT interval, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Heart failure, medicine, Cardiology, Myocardial fibrosis, Diastolic function, 030212 general & internal medicine, Myocardial infarction, Cardiology and Cardiovascular Medicine, Ventricular remodeling, business
Abstract: Background: Myocardial fibrosis plays a key role in the development of adverse left ventricular remodeling after myocardial infarction (MI). This study aimed to determine whether the circulating levels of BNP, collagen peptides, and galectin-3 are associated with diastolic function evolution (both deterioration and improvement) at 1-year after an anterior MI. Methods: The REVE-2 is a prospective multicenter study including 246 patients with a first anterior Q-wave MI. Echocardiographic assessment was performed at hospital discharge and ±1-year after MI. BNP, Galectin-3 and collagen peptides were measured ±1-month after MI. Left ventricular diastolic dysfunction (DD) was defined according to the presence of at least 2 criteria of echocardiographic parameters: septal e’6 mg/l (Odds Ratio, OR=5.29; 95%CI=1.05-26.66; p=0.044), Galectin-3>13 μg/l (OR=5.99; 95%CI=1.18-30.45; p=0.031), and BNP>82 ng/l (OR=10.25; 95%CI=2.36-44.50; p=0.002) quantified at 1-month post-MI were independently associated with 1-year DD. Follow-up of the 137 patients with DD at baseline among the 159 patients showed that 36 patients (26%) had a normalized diastolic function at 1-year post-MI. Patients with a BNP>82 ng/l were less likely to improve diastolic function (OR=0.06; 95%CI=0.01-0.28; p=0.0003). Conclusions. The present study suggests that circulating levels of PIIINP, Galectin-3 and BNP may be independently associated with new-onset DD in post-MI patients.
Published: 2018
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34. Response to cardiac resynchronization therapy is determined by intrinsic electrical substrate rather than by its modification

Author: Marc Strik, Philippe Ritter, Harry J.G.M. Crijns, Uyên Châu Nguyên, Antionio Frontera, Sylvain Ploux, Peter Huntjens, Nicholas Klotz, Pierre Bordachar, Romain Eschalier, Rémi Dubois, Frits W. Prinzen, Michel Haïssaguerre, Kevin Vernooy, RS: CARIM - R2.08 - Electro mechanics, MUMC+: MA Med Staf Artsass Cardiologie (9), Biomedische Technologie, Promovendi CD, RS: CARIM - R2.09 - Cardiovascular system dynamics, Fysiologie, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.01 - Clinical atrial fibrillation, and MUMC+: MA Cardiologie (9)
Subjects: Male, viruses, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, DYSSYNCHRONOUS CANINE HEART, 030212 general & internal medicine, Aged, 80 and over, Cardiac resynchronization therapy, NONRESPONDERS, Left bundle branch block, Body Surface Potential Mapping, virus diseases, Middle Aged, Treatment Outcome, FAILURE PATIENTS, cardiovascular system, Cardiology, Female, TRIAL, Cardiology and Cardiovascular Medicine, endocrine system, medicine.medical_specialty, Bundle-Branch Block, Heart failure, IMPROVEMENT, PATIENT SELECTION, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Cardiac resynchronization, Internal medicine, medicine, Humans, VENTRICULAR PACING SITES, In patient, cardiovascular diseases, Aged, Cardiac mapping, business.industry, Substrate (chemistry), Arrhythmias, Cardiac, medicine.disease, CONDUCTION, business
Abstract: Background: Electrocardiographic mapping (ECM) expresses electrical substrate through magnitude and direction of the activation delay vector (ADV). We investigated to what extent the response to cardiac resynchronization therapy (CRT) is determined by baseline ADV and by ADV modification through CRT and optimization of left ventricular (LV) pacing site. Methods: ECM was performed in 79 heart failure patients (4 RBBB, 12 QRS = 120 ms) underwent CRT implantation and in 26 patients multiple LV pacing site optimization was performed. ADV was calculated from locations/depolarization times of 2000 virtual epicardial electrodes derived from ECM. Acute response was defined as >= 10% LVdP/dt(max) increase, chronic response by composite clinical score at 6 months. Results: During intrinsic conduction, ADV direction was similar in patients with QRS < 120 ms, NICD and LBBB, pointing towards the LV free wall, while ADV magnitude was larger in LBBB (117 +/- 25 ms) than in NICD (70 +/- 29 ms, P < 0.05) and QRS < 120 ms (52 +/- 14 ms, P < 0.05). Intrinsic ADV accurately predicted the acute (AUC = 0.93) and chronic (AUC = 0.90) response to CRT. ADV change by CRT only moderately predicted response (highest AUC = 0.76). LV pacing site optimization had limited effects: +3 +/- 4% LVdP/dt(max) when compared to conventional basolateral LV pacing. Conclusion: The baseline electrical substrate, adequately measured by ADV amplitude, strongly determines acute and chronic CRT response, while the extent of its modification by conventional CRT or by varying LV pacing sites has limited effects. (c) 2018 Elsevier B.V. All rights reserved.
Published: 2018
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35. Mixed qualitative and quantitative approach for validating an information booklet before total hip arthroplasty

Author: Sylvie Aubreton, Anne Plan-Paquet, Stéphane Descamps, Aurore Chabaud, Bénédicte Eschalier, Emmanuel Coudeyre, Myriam Zullian, Dominique Saragaglia, Service de Médecine Physique et de Réadaptation [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Louise Michel [Clermont-Ferrand], CHU Clermont-Ferrand, Département de Médecine Générale, Faculté de Médecine, Université Clermont Auvergne, Service de médecine physique et de réadaptation, hôpital rhumatologique, Clinique universitaire de chirurgie orthopédique et de traumatologie du sport, Hôpital Sud, CHU de Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Chirurgie Orthopédique et Traumatologique [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Institut de Chimie de Clermont-Ferrand (ICCF), SIGMA Clermont (SIGMA Clermont)-Institut de Chimie du CNRS (INC)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), and Universite Clermont Auvergne
Subjects: Male, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Arthroplasty, Replacement, Hip, Health Personnel, [SDV]Life Sciences [q-bio], education, Sample (statistics), Osteoarthritis, Hip, 03 medical and health sciences, 0302 clinical medicine, Patient Education as Topic, Surveys and Questionnaires, Hip osteoarthritis, Humans, Medicine, Orthopedics and Sports Medicine, Postoperative Period, Aged, Aged, 80 and over, 030222 orthopedics, Health professionals, business.industry, Rehabilitation, Focus Groups, Middle Aged, Standard methods, Booklet, Focus group, 3. Good health, Hip arthroplasty, Physical therapy, Female, Pamphlets, Total hip arthroplasty, Self-care, business, 030217 neurology & neurosurgery
Abstract: International audience; ObjectiveProviding patients with validated information before total hip arthroplasty may help lessen discrepancies between patients’ expectations and the surgical result. This study sought to validate an information booklet for candidates for hip arthroplasty by using a mixed qualitative and quantitative approach based on a panel of patients and a sample of healthcare professionals.MethodsWe developed a booklet in accordance with the standard methods and then conducted focus groups to collect the opinions of a sample of multidisciplinary experts involved in the care of patients with hip osteoarthritis. The number of focus groups and experts was determined according to the data saturation principle. A panel of patients awaiting hip arthroplasty or those in the immediate post-operative period assessed the booklet with self-reporting questionnaires (knowledge, beliefs, and expectations) and semi-structured interviews.ResultsAll experts and both patient groups validated the booklet in terms of content and presentation. Semi-structured interviews were uninformative, especially for post-operative patients. Reading the booklet significantly (P < 0.001) improved the knowledge scores in both groups, with no intergroup differences, but did not affect beliefs in either patient group. Only pre-operative patients significantly changed their expectations.ConclusionOur mixed qualitative and quantitative approach allowed us to validate a booklet for patients awaiting hip arthroplasty, taking into account the opinions of both patients and healthcare professionals.
Published: 2018
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36. Defibrillation testing is mandatory in patients with subcutaneous implantable cardioverter-defibrillator to confirm appropriate ventricular fibrillation detection

Author: Karim Mahfouz, Marc Strik, Michel Haïssaguerre, Samuel Buliard, Nicolas Klotz, Romain Eschalier, Pierre Bordachar, Sylvain Ploux, Pierre Mondoly, Jean-Benoît le Polain de Waroux, Laura Houard, Bertrand Pierre, Philippe Ritter, UCL - (SLuc) Service de pathologie cardiovasculaire, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Cardiology, RS: CARIM - R2.08 - Electro mechanics, and MUMC+: MA Med Staf Artsass Cardiologie (9)
Subjects: Male, medicine.medical_treatment, Defibrillation testing, 030204 cardiovascular system & hematology, THERAPY, law.invention, Electrocardiography, 0302 clinical medicine, Randomized controlled trial, law, Sinus rhythm, 030212 general & internal medicine, Subcutaneous implantable cardioverter–defibrillator, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Undersensing, Subcutaneous implantable cardioverter-defibrillator, Shock (circulatory), SAFETY, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Defibrillation, Electric Countershock, Heart Conduction System/physiopathology, 03 medical and health sciences, Heart Conduction System, Physiology (medical), Internal medicine, medicine, Electric Countershock/instrumentation, Humans, In patient, business.industry, Reproducibility of Results, Arrhythmias, Cardiac, Arrhythmias, Cardiac/physiopathology, medicine.disease, EFFICACY, REGISTRY, Ventricular fibrillation, RANDOMIZED-CONTROLLED-TRIAL, EXPERIENCE, business, Complication, Noise
Abstract: BACKGROUND The subcutaneous implantable cardioverter-defibrillator (S-ICD) remains a new technology requiring accurate assessment of the various aspects of its functioning. Isolated cases of delayed sensing of ventricular arrhythmia have been described. OBJECTIVE The purpose of this multicenter study was to assess the quality of sensing during induced ventricular fibrillation (VF). METHODS One hundred thirty-seven patients underwent induction of VF at the end of the S-ICD implantation. RESULTS VF induction was successful in 133 patients (97%). Mean time to first therapy was 16.2 +/- 3.1 seconds, with a substantial range from 12.5 to 27.0 seconds. Four different detection profiles were arbitrarily defined: (1) optimal detection (n = 39 [29%]); (2) undersensing with moderate prolongation of time to therapy (18 seconds; n = 19 [14%]); and (4) absence of therapy or prolonged time to therapy related to noise oversensing (n = 7 [6%]). In some of the patients in the last group, despite induction of VF the initial counter was never filled, the device did not charge the capacitors, and the shock was not delivered because of a sustained diagnosis of noise (n = 5). A manual shock by the device or an external shock had to be delivered to restore the sinus rhythm. CONCLUSION Our study demonstrated a marked sensing delay leading to prolonged time to therapy in a large number of S-ICD patients. A few worrisome cases of noise oversensing inhibiting the therapies were detected. These results support the need for systematic intraoperative defibrillation testing.
Published: 2018
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37. Disruption of 5-HT 2A -PDZ protein interaction differently affects the analgesic efficacy of SSRI, SNRI and TCA in the treatment of traumatic neuropathic pain in rats

Author: Christine Courteix, Anne-Sophie Wattiez, Maryse Chalus, Amandine Dupuis, Alain Eschalier, Youssef Aissouni, Eric Chapuy, Anne-Marie Privat, Pharmacologie fondamentale et clinique de la douleur, Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de génétique moléculaire (CGM), and Centre National de la Recherche Scientifique (CNRS)
Subjects: 0301 basic medicine, Clomipramine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Analgesic, Pharmacology, 03 medical and health sciences, Cellular and Molecular Neuroscience, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Randall–Selitto test, medicine, Duloxetine, ComputingMilieux_MISCELLANEOUS, 5-HT receptor, Fluoxetine, 3. Good health, 030104 developmental biology, Endocrinology, chemistry, Neuropathic pain, Serotonin, 030217 neurology & neurosurgery, medicine.drug
Abstract: Antidepressants remain one of the first line treatments prescribed to neuropathic pain patients despite their limited efficacy and/or their numerous side effects. More and more, pharmacotherapy for neuropathic pain has evolved towards the use of therapeutic combinations. The goal of the present study was to assess the efficacy of the combination of antidepressants - selective serotonin reuptake inhibitors and serotonin-noradrenaline reuptake inhibitors-with a peptide (TAT-2ASCV) able to disrupt the interaction between serotonin type 2A (5-HT 2A ) receptors and associated PDZ proteins. Mechanical hypersensitivity was assessed in sciatic nerve ligation-induced neuropathic pain in rats using paw pressure test after acute treatment with TAT-2ASCV alone or in combination with repeated treatment with fluoxetine or duloxetine or clomipramine. First, we validated the anti-hyperalgesic effect of TAT-2ASCV on mechanical hypersensitivity at the dose of 100 ng/rat (single i.t. injection). Second, using selective receptor antagonists, we found that the effect of TAT-2ASCV on mechanical hypersensitivity involves 5-HT 2A as well as GABA A receptors. Finally, we showed that the association of TAT-2ASCV (100 ng, single i.t. injection) with fluoxetine (10 mg/kg, five i.p. injections) reveals its anti-hyperalgesic effect, while the association with duloxetine (1 mg/kg, five i.p. injections) or clomipramine (2.5 mg/kg, five i.p. injections) is only additive. Those results further accentuate the interest to develop small molecules acting like TAT-2ASCV in order to treat neuropathic pain as a monotherapy or in combination with antidepressants.
Published: 2017
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38. l-Arginine supplementation prevents allodynia and hyperalgesia in painful diabetic neuropathic rats by normalizing plasma nitric oxide concentration and increasing plasma agmatine concentration

Author: A.-M. Privat, Benoit Sion, Marie-Paule Vasson, N. Davin, Christine Courteix, Alain Eschalier, Lusliany J. Rondon, Marie-Chantal Farges, Laboratorio de Fisiología Molecular, Centro de Bioquímica y Biofísic, Instituto Venezolano de Investigaciones Cientificas (IVIC), Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Clermont Auvergne (UCA), Unité de Nutrition Humaine - Clermont Auvergne (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne (UCA), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Unité de Nutrition Humaine (UNH), and Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
Subjects: 0301 basic medicine, medicine.medical_specialty, Diabetic neuropathy, Arginine, Administration, Oral, Medicine (miscellaneous), Streptozocin, Diabetes Mellitus, Experimental, Rats, Sprague-Dawley, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Diabetic Neuropathies, nitric oxide, Internal medicine, Diabetes mellitus, L -Arginine, medicine, Animals, pain, agmatine, allodynia, hyperalgesia, neuropathic pain, Type 1 diabetes, Nutrition and Dietetics, STZ-D rats, medicine.disease, Rats, 3. Good health, neuropathie, 030104 developmental biology, Allodynia, Endocrinology, chemistry, Anesthesia, Neuropathic pain, Hyperalgesia, Neuralgia, neuropathy, douleur, medicine.symptom, Agmatine, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, 030217 neurology & neurosurgery, diabète
Abstract: Neuropathic pain is a common diabetic complication. It is characterized by symptoms of spontaneous and stimulus-evoked pain including hyperalgesia and allodynia. L-Arginine is a common precursor of many metabolites of biological interest, in particular, nitric oxide (NO), ornithine, and hence polyamines. In central nervous system, NO, glutamate, and polyamines share an N-methyl-D-aspartate (NMDA) receptor-mediated effect. We hypothesized that a variation in arginine metabolism caused by diabetes may contribute to development and maintenance of neuropathic pain and to the worsening of clinical and biological signs of diabetes. We examined whether oral L-arginine supplementation (2.58 ± 0.13 g/l in drinking water for 3 weeks) could improve the development of neuropathic pain and the clinical, biological, and metabolic complications of diabetes in streptozocin (STZ)-induced diabetic (D) rats. STZ administration induced classical symptoms of type 1 diabetes. Diabetic rats also displayed mechanical hypersensitivity, tactile, and thermal allodynia. Plasma citrulline and NO levels were increased in diabetic hyperalgesic/allodynic rats. L-Arginine supplementation failed to reduce hyperglycaemia, polyphagia, and weight loss. Moreover, it abolished hyperalgesia and allodynia by normalizing NO plasma concentration and increasing plasma agmatine concentration. L-Arginine supplementation prevented the development of mechanical hyperalgesia, tactile, and thermal allodynia in painful diabetic neuropathy with concomitant reduction of NO and increased agmatine production, offering new therapeutic opportunities for the management of diabetic neuropathic pain.
Published: 2017
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39. Low T/R ratio in inferolateral leads: A new ECG marker of sudden cardiac arrest in patients with a spontaneous type 1 Brugada pattern

Author: Pascal Defaye, Francis Bessière, Antoine Leenhardt, Horia Rosianu, Fabrice Extramiana, Eloi Marijon, Jérôme Bouet, Claude Kouakam, Pierre Winum, Adrian Baranchuk, Jérôme Taieb, Antoine Delinière, Etienne Delacrétaz, Haran Burri, Alina Scridon, O. Le Vavasseur, A. Da Costa, Dan Dobreanu, Philippe Chevalier, and Romain Eschalier
Subjects: medicine.medical_specialty, Receiver operating characteristic, business.industry, Sudden cardiac arrest, medicine.disease, Individual risk, Multicenter study, Brugada pattern, Internal medicine, Ventricular fibrillation, medicine, Cardiology, In patient, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Brugada syndrome
Abstract: Background Prediction of the individual risk of sudden cardiac arrest (SCA) remains the main challenge in Brugada syndrome. Several studies have shown that the surface electrocardiogram (ECG) can provide useful information that allows to estimate the risk of SCA. The T-wave amplitude is inversely correlated with the risk of ventricular fibrillation (VF) & SCA in several heart diseases. Objectives The purpose of this study was to evaluate the prognostic value of a low T/R ratio in patients with a spontaneous type-1 Brugada pattern (SBT1). Methods In a multicenter study, we retrospectively reviewed 115 pts (105 males, 91.3%) with a SBT1. 45 had VF and/or SCA (38.7 ± 11.5 years old, all males), while 70 (49.3 ± 12.0 years, 10 women) remained free of ventricular arrhythmia. 6 ECG markers plus the lowest T/R ratio among leads V5 & II were studied. Results The lowest T/R ratio among leads II & V5 was significantly smaller in the VF/SCA group (0.26 ± 0.15 vs. 0.35 ± 0.16; P = 0.006). The optimized cut-off value was ≤ 0.17 by the receiver operating characteristic curve method. 44.4% of pts in the VF/SCA group had a lowest T/R ratio among leads II & V5 ≤ 0.17 compared to 11.4% in the non-VF/SCA group (P Fig. 1 ). Conclusion A low T/R ratio among leads II & V5 is independently and strongly related to the risk of VF/SCA in patients with a spontaneous type-1 Brugada pattern.
Published: 2020
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40. Inherited Metabolic Diseases and Cardiac Pathology in Adults: Diagnosis and Prevalence in a CardioMetabo Study

Author: Damien Bouvier, Marina Brailova, Guillaume Clerfond, Bruno Pereira, Romain Eschalier, Julie Durif, Romain Trésorier, Vincent Sapin, Grégoire Massoullié, Régine Minet-Quinard, Assuncao de Carvalho, Manuela, CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
Subjects: medicine.medical_specialty, Ataxia, SCAD, Cardiac pathology, prevalence, lcsh:Medicine, 030204 cardiovascular system & hematology, Article, cardiac implantable electronic device, 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, medicine, conduction disorders, Hurler syndrome, inherited metabolic disease, Fabry disease, business.industry, lcsh:R, Hypertrophic cardiomyopathy, General Medicine, medicine.disease, hypertrophic cardiomyopathy, 3. Good health, Metabolism disorder, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Lactic acidosis, cardiovascular system, Etiology, medicine.symptom, business, arrhythmias, 030217 neurology & neurosurgery
Abstract: Many inherited metabolic diseases (IMD) have cardiac manifestations. The aim of this study was to estimate the prevalence of IMD in adult patients with hypertrophic cardiomyopathy (HCM) and cardiac rhythm abnormalities that require cardiac implantable electronic devices (CIEDs). The study included a review of the medical files of patients aged 18 to 65 years who were followed in our cardiology department during the period 2010&ndash, 2017. Metabolic explorations for Fabry disease (FD), mitochondrial cytopathies, and fatty-acid metabolism disorders were carried out in patients with unexplained etiology. The prevalence of IMD in patients with HCM was 5.6% (confidence interval (CI): 2.6&ndash, 11.6). Six cases of IMD were identified: 1 mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome, 1 Hurler syndrome, 2 Friedreich&rsquo, s ataxia, 1 FD, and 1 short-chain acyl-CoA dehydrogenase deficiency. Three cases of IMD were identified in patients requiring CIEDs: 1 patient with Leber hereditary optic neuropathy, 1 FD, and 1 short chain acyl-CoA dehydrogenase (SCAD) deficiency. IMD prevalence in patients with CIEDs was 3.1% (CI: 1.1&ndash, 8.8). IMD evaluation should be performed in unexplained HCM and cardiac rhythm abnormalities adult patients, since the prevalence of IMD is relatively important and they could benefit from specific treatment and family diagnosis.
Published: 2020
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41. Prognostic significance of a low T/R ratio in Brugada syndrome

Author: Eloi Marijon, Claude Kouakam, Fabrice Extramiana, Pierre-François Winum, Haran Burri, Jérôme Taieb, Dan Dobreanu, Antoine Da Costa, Antoine Delinière, Francis Bessière, Olivier Le Vavasseur, Adrian Baranchuk, Jérôme Bouet, Etienne Delacrétaz, Horia Rosianu, Philippe Chevalier, Antoine Leenhardt, Alina Scridon, Pascal Defaye, and Romain Eschalier
Subjects: Adult, Male, medicine.medical_specialty, 030204 cardiovascular system & hematology, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, T wave, Internal medicine, medicine, Humans, 030212 general & internal medicine, Brugada syndrome, Brugada Syndrome, Retrospective Studies, EARLY REPOLARIZATION SYNDROME, Myocardial repolarization, business.industry, Hypertrophic cardiomyopathy, Sudden cardiac arrest, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Ventricular fibrillation, Ventricular Fibrillation, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: To determine the prognostic value of a low T/R ratio, defined as the amplitude ratio between the T waves and the R waves, in patients (pts) with a spontaneous type-1 Brugada pattern (SBT1).Abnormalities of myocardial repolarization may play a key role in the initiation of ventricular fibrillation (VF) in Brugada syndrome (BrS). Recent studies have shown that the height of the T waves and the T/R ratio are inversely proportional to sudden cardiac arrest (SCA) risk in early repolarization syndrome and hypertrophic cardiomyopathy.In an international retrospective study, we reviewed 115 pts. (105 males, 91.3%). 45 had VF and/or SCA (38.7 ± 11.5 years old, all males), while 70 (49.3 ± 12.0 years, 10 women) remained free of ventricular arrhythmia. 6 ECG markers plus the T/R ratio in leads V5II were studied.The T/R ratio among leads IIV5 was significantly lower in the VF/SCA group (0.24 [0.14; 0.38]vs. 0.34 [0.24; 0.45]; p = 0.006). 44.4% of pts. in the VF/SCA group had a lowest T/R ratio among leads IIV5 ≤ 0.17 compared to 11.4% in the non-VF/SCA group (p 0.001). In multivariate analysis, a lowest T/R ratio among leads IIV5 ≤ 0.17 was independently associated with VF/SCA (OR 6.10, 95% CI 1.92-19.40; p = 0.002). Type 1 Brugada pattern in the peripheral leads (OR 10.78) and early repolarization (OR 3.60) were other independent markers of VF/SCA.A low T/R ratio among leads IIV5 is an independent marker for VF/SCA risk in patients with type-1 Brugada pattern.
Published: 2019

42. Transcultural adaptation and French validation of the Pain Sensitivity Questionnaire

Author: Sylvie Eschalier, Ruth Ruscheweyh, Vedat Eljezi, Claude Dubray, Christian Dualé, Candy Guiguet-Auclair, Ulrich Bauer, Brigitte Storme, CHU Gabriel Montpied (CHU), CHU Clermont-Ferrand, CIC Clermont Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Pharmacologie Clinique-CHU Gabriel-Montpied, Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pôle Cardiologie médicale et chirurgicale, Centre Hospitalier Universitaire Gabriel Montpied, Centre d’Investigation Clinique (CIC), PEPRADE, Centre Hospitalier Universitaire de Clermont-Ferrand, and Institute of Science and Technology [Austria] (IST Austria)
Subjects: medicine.medical_specialty, Psychometrics, Intraclass correlation, [SDV]Life Sciences [q-bio], Pain medicine, Concurrent validity, 03 medical and health sciences, 0302 clinical medicine, Cronbach's alpha, [SDV.SP.MED]Life Sciences [q-bio]/Pharmaceutical sciences/Medication, 030202 anesthesiology, medicine, ComputingMilieux_MISCELLANEOUS, business.industry, Cold pressor test, General Medicine, Anesthesiology and Pain Medicine, Convergent validity, Anesthesia, Physical therapy, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Anxiety, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: To validate a French translation of the Pain Sensitivity Questionnaire (PSQ), which is a valuable tool to predict an individual’s natural disposition to feel pain that could be used after surgery. We studied content validity, internal consistency, convergent validity (anxiety, depression and catastrophism) and test-retest reliability of the French version of the PSQ (PSQ-F) in 146 patients either before scheduled surgery or during pregnancy; then, convergent and concurrent validity in 85 healthy volunteers submitted to nociceptive tests. Internal consistency of the PSQ-F was found to be excellent, with Cronbach’s α at 0.866, 0.886, and 0.927, respectively for its “minor”, “moderate” and “total” scores. Test-retest reliability was significant, with intraclass correlation coefficients at 0.629, 0.629, and 0.635, respectively for the above- mentioned scores. These three scores correlated with anxiety, depression and catastrophizing scores in patients, but not in healthy volunteers, possibly because of low and few variant psychometric scores in this group. They were inversely correlated to the temperature needed to evoke heat pain rated 6 out of 10, but not to the mechanical pain threshold (electronic von Frey), nor to the heat pain threshold. Finally, they directly correlated to the pain induced by the cold pressor test (minor and total scores only). This validated version can now be used by French-speaking researchers and physicians. www.ClinicalTrials.gov (NCT03113903); 14 April, 2017.
Published: 2019
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43. 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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44. Saline nasal irrigation for acute upper respiratory tract infections in infants and children: A systematic review and meta-analysis

Author: Aurélie Cabaillot, Bruno Pereirad, Mathieu Roca, Bénédicte Eschalier, Rémy Boussageon, Philippe Vorilhon, Neuro-Dol (Neuro-Dol), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, AutomédiCation aCcompagnement Pluriprofessionnel PatienT (ACCePPT), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA), Faculté de Médecine - Clermont-Auvergne (FM - UCA), Université Clermont Auvergne (UCA), Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, and CCSD, Accord Elsevier
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Review, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Saline nasal irrigation, law, Internal medicine, medicine, Humans, 030212 general & internal medicine, Medical prescription, Sinusitis, Child, Respiratory Tract Infections, Rhinitis, Respiratory tract infections, business.industry, Incidence (epidemiology), Upper respiratory tract infection, Infant, Pharyngitis, medicine.disease, Confidence interval, 3. Good health, [SDV] Life Sciences [q-bio], Meta-analysis, 030228 respiratory system, Child, Preschool, Pediatrics, Perinatology and Child Health, Nasal Lavage, Saline Solution, business
Abstract: International audience; Purpose: Acute upper respiratory tract infections are the most common infections in infants and children. Saline nasal irrigation (SNI) is widely prescribed and recommended. We conducted a systematic review to assess the efficacy and safety of SNI in infants and children with acute rhinopharyngitis.Methods: We searched CENTRAL, Medline, Embase and clinicalTrials.gov. Two authors selected randomized control trials (RCTs), including infants ≥3 months and children ≤12 years, comparing the use of isotonic saline solutions, whatever their mode of administration, with one therapeutic abstention, or a therapy deemed less important for nasal lavage. Trial quality was assessed independently by two authors, who, with a third author, extracted and analysed data. Statistical analysis was conducted using Comprehensive Meta-Analysis software. The standard difference in means (SMD) between groups and its 95% confidence interval were estimated.Results: Four RCTs (569 participants) were included. The analysis showed a benefit of SNI for certain clinical rhinological symptoms (SMD = -0.29 [-0.45; -0.13]) but no significant improvement of respiratory symptoms (SMD = -0.19 [-0.70; 1.08]) or health status (SMD = -0.30 [-0.68; 0.07]). Its use appeared to limit the prescription of other treatments, whether local or systemic, and particularly antibiotics. Long-term use led to a decrease in the incidence of acute rhinosinusitis and its complications. SNI appeared to be a safe treatment.Conclusions: SNI is beneficial for rhinological symptoms but not respiratory symptoms. Further research is needed to address the full benefits/risks of this treatment.
Published: 2019
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45. Low fibrosis biomarker levels predict cardiac resynchronization therapy response

Author: Bernard Citron, Patrick Rossignol, S. Ploux, Charles Merlin, Marius Andronache, Pierre-Yves Marie, Xavier Chabin, Pascal Motreff, Guillaume Clerfond, Grégoire Massoullié, Romain Eschalier, Faiez Zannad, Jean René Lusson, Charles Vorilhon, Frédéric Jean, Aurélien Mulliez, Pierre Bordachar, Vincent Sapin, Bruno Pereira, and Jean Marc Sellal
Subjects: Male, 0301 basic medicine, medicine.medical_specialty, Cardiac fibrosis, medicine.medical_treatment, Cardiomyopathy, Cardiac resynchronization therapy, lcsh:Medicine, Physical examination, Article, Cardiac Resynchronization Therapy, 03 medical and health sciences, QRS complex, 0302 clinical medicine, Fibrosis, Internal medicine, medicine, Humans, Prospective Studies, lcsh:Science, Ventricular remodeling, Aged, Heart Failure, Multidisciplinary, Ventricular Remodeling, medicine.diagnostic_test, business.industry, lcsh:R, Middle Aged, medicine.disease, Peptide Fragments, Treatment Outcome, 030104 developmental biology, Heart failure, cardiovascular system, Cardiology, Biomarker (medicine), Female, lcsh:Q, Cardiology and Cardiovascular Medicine, business, Biomarkers, Procollagen, 030217 neurology & neurosurgery
Abstract: Cardiac fibrosis is associated with heart failure and poor prognosis. Fibrosis biomarkers have been poorly evaluated as a tool to predict cardiac resynchronization therapy (CRT) response generating conflicting results. The present study assessed the predictive value of cardiac fibrosis biomarkers on CRT response. Patients underwent clinical examination, echocardiography and blood fibrosis biomarker evaluation prior to CRT implantation. At six months, a positive response to CRT was defined by a composite endpoint of no death or hospitalization for heart failure, and presence of left ventricular (LV) reverse remodeling (decrease in LV end-systolic volume ≥15%). Sixty patients were included in a multicenter study. At 6 months, 38 were positive responders to CRT and reached the response criteria (63%). Compared to non-responders, CRT responders displayed lower concentration levels of the fibrosis biomarkers procollagen type I C-terminal propeptide [PICP 135[99–166] ng/ml vs. 179[142–226]ng/ml, p = 0.001)] and procollagen type III N-terminal propeptide [PIIINP 5.50[3.66–8.96] ng/ml vs. 8.01[5.01–11.86]ng/ml, p = 0.014)] at baseline. In multivariate analysis, a PICP ≤ 163 ng/ml was associated with a positive CRT response [OR = 7.8(1.3–46.7), p = 0.023] independently of the presence of LBBB, QRS duration, LV lead position or non-ischemic cardiomyopathy. Altogether, the present findings show that a lower degree of cardiac fibrosis is associated with a positive response after CRT implantation. PICP evaluation before CRT implantation could help improve patient selection.
Published: 2019
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46. Evolution of chronic kidney disease after surgical aortic valve replacement or transcatheter aortic valve implantation

Author: Bruno Pereira, Cyril Garrouste, Géraud Souteyrand, Nicolas Combaret, Guillaume Clerfond, Romain Eschalier, Adrien Reuillard, Pascal Motreff, Anne Elisabeth Heng, Julien Aniort, Kasra Azarnoush, Andrea Innorta, Service de Cardiologie Maladies Vasculaires [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Service de Chrirurgie Cardio Vasculaire [CHU Clermont-Ferrand], Institut Pascal (IP), and SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Aortic valve, medicine.medical_specialty, Time Factors, [SDV]Life Sciences [q-bio], Renal function, 030204 cardiovascular system & hematology, Kidney, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Risk Factors, medicine, Humans, Registries, 030212 general & internal medicine, Renal Insufficiency, Chronic, Stage (cooking), Aged, Retrospective Studies, Aged, 80 and over, Heart Valve Prosthesis Implantation, business.industry, Acute kidney injury, Aortic Valve Stenosis, Recovery of Function, General Medicine, Odds ratio, Acute Kidney Injury, medicine.disease, 3. Good health, Surgery, Stenosis, Treatment Outcome, medicine.anatomical_structure, Aortic Valve, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business, Glomerular Filtration Rate, Kidney disease
Abstract: Summary Background Immediate improvement in kidney function has been reported after surgical aortic valve replacement or transcatheter aortic valve implantation. Long-term data, however, are not available. Aim To assess the evolution of kidney function in chronic kidney disease stage 3b–5, 1 year after surgical aortic valve replacement or transcatheter aortic valve implantation. Methods All patients with chronic kidney disease stage 3b–5 undergoing surgical aortic valve replacement or transcatheter aortic valve implantation for aortic stenosis in a single centre were included. Kidney function was assessed 1 year postprocedure. Improvement or deterioration in estimated glomerular filtration rate was defined by an increase or decrease of 5 mL/min/1.73 m2, respectively. Results Overall, 127 procedures were analysed (54 surgical aortic valve replacements and 73 transcatheter aortic valve implantations). Kidney function improved in 51% of patients at 1 year (45% of the surgical aortic valve replacement group versus 57% of the transcatheter aortic valve implantation group; P = 0.21), and deteriorated in only 14% of patients at 1 year (18% of the surgical aortic valve replacement group versus 10% of the transcatheter aortic valve implantation group; P = 0.22). Almost a quarter of patients (23%) had an improvement in estimated glomerular filtration rate of > 15 mL/min/1.73 m2, and this was consistent at later follow-up. Few patients went onto chronic dialysis at 1 year (three after surgical aortic valve replacement and one after transcatheter aortic valve implantation). Acute kidney injury was an independent prognostic factor for long-term deterioration in kidney function (odds ratio 2.1, 95% confidence interval 1.4–3.6; P = 0.006). Conclusion Aortic valve replacement, whether by surgical aortic valve replacement or transcatheter aortic valve implantation, improved estimated glomerular filtration rate at 1 year in more than half of patients with chronic kidney disease stage 3b–5.
Published: 2019
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47. Accuracy of the pacemaker-mediated tachycardia algorithm in Boston Scientific devices

Author: Sylvain Ploux, Romain Eschalier, Pascal Defaye, Antonio Frontera, Pierre Bordachar, Marc Strik, Pierre Mondoly, M. Haissaguerre, Philippe Ritter, Cardiologie, Promovendi CD, and RS: CARIM - R2.08 - Electro mechanics
Subjects: Tachycardia, Male, Pacemaker, Artificial, medicine.medical_treatment, 030204 cardiovascular system & hematology, Ventricular tachycardia, Electrocardiography, 0302 clinical medicine, Clinical: implantable devices – physiologic pacing, Risk Factors, 030212 general & internal medicine, Diagnosis, Computer-Assisted, Young adult, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, Incidence, Equipment Design, Middle Aged, Clinical: implantable devices - physiologic pacing, Cardiology, Female, France, medicine.symptom, Cardiology and Cardiovascular Medicine, Algorithm, Algorithms, Adult, medicine.medical_specialty, Sinus tachycardia, Population, Cardiac resynchronization therapy, Clinical: implantable devices – ventricular tachycardia/fibrillation, 03 medical and health sciences, Young Adult, Internal medicine, Clinical: implantable devices - biventricular pacing/defibrillation, medicine, Humans, education, Clinical: implantable devices – biventricular pacing/defibrillation, Aged, Retrospective Studies, business.industry, Clinical: implantable devices - ventricular tachycardia/fibrillation, Retrospective cohort study, medicine.disease, Clinical: cardiac mapping - electrogram analysis, Equipment Failure Analysis, Clinical: implantable devices - pacemaker-bradyarrhythmias, Therapy, Computer-Assisted, Clinical: cardiac mapping – electrogram analysis, Tachycardia, Ventricular, business, Clinical: implantable devices – pacemaker-bradyarrhythmias
Abstract: Introduction The incidence of pacemaker-mediated tachycardia (PMT) varies as a function of patient characteristics, device programming and algorithm specificities. We investigated the efficacy of the Boston Scientific algorithm by reviewing PMT episodes in a large device population. Methods In this multicenter study, we included 328 patients implanted with a Boston Scientific device: 157 non-dependent patients with RYTHMIQ™ activated (RYTHMIQ group), 76 patients with permanent AV-conduction disorder (AV-block group) and 95 Cardiac Resynchronization Therapy patients (CRT group). For each patient, we reviewed the last 10 remote monitoring-transmitted EGMs diagnosed as PMT. Results We analyzed 784 PMT episodes across 118 patients. In the RYTHMIQ group, the diagnosis of PMT was correct in most episodes (80%) of which 69% was directly related to the prolongation of the AV-delay associated with the RYTHMIQ algorithm. The usual triggers for PMT were also observed (PVC 16%, PAC 9%). The remainder of the episodes (20%) in RYTHMIQ patients and most episodes of AV-block (66%) and CRT patients (74%) were incorrectly diagnosed as PMT during sinus tachycardia at the maximal tracking rate. The inappropriate intervention of the algorithm during exercise causes non-conducted P-waves, loss of CRT (sustained in six patients) and may have been pro-arrhythmogenic in one patient (induction of ventricular tachycardia). Conclusion Algorithms to minimize ventricular pacing can occasionally have unintended consequences such as PMT. The PMT algorithm in Boston Scientific devices is associated with a high rate of incorrect PMT diagnosis during exercise resulting in inappropriate therapy with non-conducted P-waves, loss of CRT and limited risk of pro-arrhythmic events.
Published: 2016
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48. Incidence of tramadol shopping behavior in a retrospective cohort of chronic non-cancer pain patients in France

Author: Noémie Delage, Chouki Chenaf, Bruno Pereira, Alain Eschalier, Lucie Roche, Jessica Delorme, Jean-Luc Kabore, Aurélien Mulliez, and Nicolas Authier
Subjects: medicine.medical_specialty, Epidemiology, business.industry, Incidence (epidemiology), Hazard ratio, Chronic pain, Poison control, Retrospective cohort study, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Anesthesia, Internal medicine, Medicine, Pharmacology (medical), 030212 general & internal medicine, Tramadol, Medical prescription, business, 030217 neurology & neurosurgery, medicine.drug, Cohort study
Abstract: PURPOSE: Opioid analgesic use in chronic non-cancer pain (CNCP) is increasingly prevalent, but the benefits and risks are inadequately understood. In France, tramadol is one of the most used prescription opioids, but studies on its misuse liability in CNCP are still lacking. The aim was to assess the incidence of tramadol shopping behavior in CNCP patients and to identify the associated risk factors. METHODS: A retrospective cohort of CNCP patients aged 18 years and older treated by tramadol for at least six consecutive months between 2005 and 2013 from a sample of the French Health Insurance database was established. Doctor shopping was defined as at least 1 day of overlapping prescriptions written by two or more different prescribers and filled in at least three different pharmacies. RESULTS: A total of 3505 CNCP patients were included with a majority of women (66.4%) and a mean age of 66.4 ± 14.7 years. The median tramadol treatment duration was 260 [interquartile range: 211-356] days. The 1-year incidence rate of tramadol shopping behavior was 1.0% [95%CI: 0.7-1.5]. On multivariate analysis, risk factors associated with tramadol shopping behavior were age (hazard ratio [HR] = 7.4 [95%CI: 2.8-19.7] for age CONCLUSION: Tramadol shopping behavior incidence appears low in CNCP patients but may represent a public health concern given the widespread use of tramadol. Education and best monitoring of high-risk patients are needed to reduce doctor shopping. Copyright © 2016 John Wiley & Sons, Ltd.Copyright © 2016 John Wiley & Sons, Ltd. Language: en
Published: 2016
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49. Performance of a specific algorithm to minimize right ventricular pacing: A multicenter study

Author: Michel Haïssaguerre, Pierre Mondoly, Antonio Frontera, Pierre Bordachar, Marc Strik, Kenneth A. Ellenbogen, Pascal Defaye, Philippe Ritter, Sylvain Ploux, Romain Eschalier, MUMC+: MA Med Staf Artsass Cardiologie (9), Cardiologie, and RS: Carim - H06 Electro mechanics
Subjects: Male, Tachycardia, RYTHMIQ, Refractory period, medicine.medical_treatment, Ventricular pacing, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, Electrocardiography, 0302 clinical medicine, Materials Testing, Dual, Medicine, Diagnosis, Computer-Assisted, 030212 general & internal medicine, medicine.diagnostic_test, Equipment Design, Middle Aged, Quality Improvement, Atrioventricular node, Defibrillators, Implantable, Pacemaker, medicine.anatomical_structure, Boston Scientific, Atrioventricular Node, Cardiology, Right ventricle, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, AV conduction, Algorithm, Algorithms, medicine.medical_specialty, AV block, Premature atrial contraction, Heart block, Heart Ventricles, Cardiac resynchronization therapy, 03 medical and health sciences, Physiology (medical), Internal medicine, Dyssynchronopathy, Humans, Aged, business.industry, chamber, medicine.disease, Heart Block, business, Pacemaker algorithm
Abstract: Background In Boston Scientific dual-chamber devices, the RYTHMIQ algorithm aims to minimize right ventricular pacing. Objective We evaluated the performance of this algorithm determining (1) the appropriateness of the switch from the AAI(R) mode with backup VVI pacing to the DDD(R) mode in case of suspected loss of atrioventricular (AV) conduction and (2) the rate of recorded pacemaker-mediated tachycardia (PMT) when AV hysteresis searches for restored AV conduction. Methods In this multicenter study, we included 157 patients with a Boston Scientific dual-chamber device (40 pacemakers and 117 implantable cardioverter-defibrillators) without permanent AV conduction disorder and with the RYTHMIQ algorithm activated. We reviewed the last 10 remote monitoring–transmitted RYTHMIQ and PMT episodes. Results We analyzed 1266 episodes of switch in 142 patients (90%): 207 (16%) were appropriate and corresponded to loss of AV conduction, and 1059 (84%) were inappropriate, of which 701 (66%) were related to compensatory pause (premature atrial contraction, 7%; premature ventricular contraction, 597 (56%); or both, 27 (3%)) or to a premature ventricular contraction falling in the post-atrial pacing ventricular refractory period interval (219, 21%) and 94 (10%) were related to pacemaker dysfunction. One hundred fifty-four PMT episodes were diagnosed in 27 patients (17%). In 85 (69%) of correctly diagnosed episodes, the onset of PMT was directly related to the algorithm-related prolongation of the AV delay, promoting AV dissociation and retrograde conduction. Conclusion This study highlights some of the limitations of the RYTHMIQ algorithm: high rate of inappropriate switch and high rate of induction of PMT. This may have clinical implications in terms of selection of patients and may suggest required changes in the algorithm architecture.
Published: 2016
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50. Cardiac Contractility Modulation in a Model of Repaired Tetralogy of Fallot: A Sheep Model

Author: Louis Labrousse, François Roubertie, Michel Haïssaguerre, Sylvain Ploux, Pierre Dos Santos, Caroline Rooryck, Romain Eschalier, Jean-Benoit Thambo, Pierre Bordachar, Adlane Zemmoura, and Philippe Ritter
Subjects: medicine.medical_specialty, Heart disease, Heart Ventricles, Ventricular Dysfunction, Right, Hemodynamics, 030204 cardiovascular system & hematology, Cardiac contractility modulation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Animals, In patient, 030212 general & internal medicine, Tetralogy of Fallot, Sheep, business.industry, Vascular surgery, medicine.disease, Myocardial Contraction, Cardiac surgery, Heart failure, Pediatrics, Perinatology and Child Health, Ventricular Function, Right, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: The onset of right ventricular dysfunction in patients presenting with congenital heart disease is associated with a dismal long-term outcome and often represents a therapeutic dead end. Our study had several objectives: (1) to analyse the anatomical, functional, histological and cellular characteristics of an animal model of repaired tetralogy of Fallot with right ventricular dysfunction (2) to test the new electrical treatment known as cardiac contractility modulation in this animal model. Seven sheep underwent a first surgery at the age of three weeks aiming to mimic the characteristics of a repaired tetralogy of Fallot. Five controls were sham-operated. Experimental studies were performed 12 months after the initial operation. The hemodynamic, echocardiographic, and mitochondrial function studies were carried out before and after cardiac contractility modulation in closed- and open-chest conditions. In this animal model of right ventricular dysfunction, short-term cardiac contractility modulation was associated with a significant improvement in (a) right ventricular function, as evidenced by a significant increase in right ventricular dP/dt (p
Published: 2016
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