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51. The Best + ICD Trial

Author

Cappato, R., Bongiorni, M.G., Brignole, M., Capucci, A., Gaita, F., Mangiameli, S., Montenero, A., Pedretti, R., Raviele, A., Salerno, J., and Sermasi, S.

Published
1999
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58. EHRA White Paper: knowledge gaps in arrhythmia management-status 2019

Author

Goette, A., Auricchio, A., Boriani, G., Braunschweig, F., Terradellas, J.B., Burri, H., Camm, A.J., Crijns, H., Dagres, N., Deharo, J.C., Dobrev, D., Hatala, R., Hindricks, G., Hohnloser, S.H., Leclercq, C., Lewalter, T., Lip, G.Y.H., Merino, J.L., Mont, L., Prinzen, F., Proclemer, A., Purerfellner, H., Savelieva, I., Schilling, R., Steffel, J., Gelder, I.C. van, Zeppenfeld, K., Zupan, I., Heidbuchel, H., Boveda, S., Defaye, P., Brignole, M., Chun, J., Ramos, J.M.G., Fauchier, L., Svendsen, J.H., Traykov, V.B., Heinzel, F.R., ESC Sci Document Grp, Otto-von-Guericke-Universität Magdeburg, Center for Computational Medicine in Cardiology [Lugano], Università della Svizzera italiana = University of Italian Switzerland (USI), Università degli Studi di Modena e Reggio Emilia, University of Geneva [Switzerland], Hôpital de la Timone [CHU - APHM] (TIMONE), Goethe-University Frankfurt am Main, 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), 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), Cardiology Department, Thorax Clinic Institute, Hospital Cliınic, Institut d'Investigacions Biomèdiques [Barcelona], Universitat de Barcelona (UB), Department of Physiology [Maastricht], Maastricht University [Maastricht], Universiteit Antwerpen [Antwerpen], RS: CARIM - R2.01 - Clinical atrial fibrillation, Cardiologie, MUMC+: MA Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Fysiologie, RS: CARIM - R2 - Cardiac function and failure, RS: Carim - H06 Electro mechanics, Clinical sciences, Otto-von-Guericke-Universität Magdeburg = Otto-von-Guericke University [Magdeburg] (OVGU), Università degli Studi di Modena e Reggio Emilia = University of Modena and Reggio Emilia (UNIMORE), Université de Genève = University of Geneva (UNIGE), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universiteit Antwerpen = University of Antwerpen [Antwerpen], Cardiovascular Centre (CVC), and ESC Sci Document Grp

Subjects
Biomedical Research, IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR, medicine.medical_treatment, Medizin, Management of atrial fibrillation, RHYTHM SOCIETY HRS, White Paper, Heart failure, 030204 cardiovascular system & hematology, Sudden death, 03 medical and health sciences, 0302 clinical medicine, White paper, Ventricular tachycardia ablation, AIAC ITALIAN ASSOCIATION, Physiology (medical), PERSISTENT ATRIAL-FIBRILLATION, Tachycardia, medicine, Humans, Organizational Objectives, 030212 general & internal medicine, PULMONARY VEIN ISOLATION, Societies, Medical, EXPERT CONSENSUS STATEMENT, European Heart Rhythm Association, CATHETER ABLATION, ddc:616, Medical education, CARDIAC-RESYNCHRONIZATION THERAPY, VENTRICULAR-TACHYCARDIA ABLATION, business.industry, Arrhythmia, Fibrillation, Cardiac arrhythmia, Arrhythmias, Cardiac, Subject (documents), Implantable cardioverter-defibrillator, ATRIOVENTRICULAR NODE ABLATION, 3. Good health, Heart Rhythm, Europe, Arrhythmias, Cardiac/therapy, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Human medicine, business, Cardiology and Cardiovascular Medicine
Abstract

Clinicians accept that there are many unknowns when we make diagnostic and therapeutic decisions. Acceptance of uncertainty is essential for the pursuit of the profession: bedside decisions must often be made on the basis of incomplete evidence. Over the years, physicians sometimes even do not realize anymore which the fundamental gaps in our knowledge are. As clinical scientists, however, we have to halt and consider what we do not know yet, and how we can move forward addressing those unknowns. The European Heart Rhythm Association (EHRA) believes that scanning the field of arrhythmia / cardiac electrophysiology to identify knowledge gaps which are not yet the subject of organized research, should be undertaken on a regular basis. Such a review (White Paper) should concentrate on research which is feasible, realistic, and clinically relevant, and should not deal with futuristic aspirations. It fits with the EHRA mission that these White Papers should be shared on a global basis in order to foster collaborative and needed research which will ultimately lead to better care for our patients. The present EHRA White Paper summarizes knowledge gaps in the management of atrial fibrillation, ventricular tachycardia/sudden death and heart failure.

Published
2019

71. The pathophysiology of the vasovagal response

Author

Jardine, D.L., Wieling, W., Brignole, M., Lenders, J.W.M., Sutton, R., Stewart, J., Jardine, D.L., Wieling, W., Brignole, M., Lenders, J.W.M., Sutton, R., and Stewart, J.

Abstract

Item does not contain fulltext, In part I of this study, we found that the classical studies on vasovagal syncope, conducted in fit young subjects, overstated vasodilatation as the dominant hypotensive mechanism. Since 1980, blood pressure and cardiac output have been measured continuously using noninvasive methods during tilt, mainly in patients with recurrent syncope, including women and the elderly. This has allowed us to analyze in more detail the complex sequence of hemodynamic changes leading up to syncope in the laboratory. All tilt-sensitive patients appear to progress through 4 phases: (1) early stabilization, (2) circulatory instability, (3) terminal hypotension, and (4) recovery. The physiology responsible for each phase is discussed. Although the order of phases is consistent, the time spent in each phase may vary. In teenagers and young adults, progressive hypotension during phases 2 and 3 can be driven by vasodilatation or falling cardiac output. The fall in cardiac output is secondary to a progressive decrease in stroke volume because blood is pooled in the splanchnic veins. In adults a fall in cardiac output is the dominant hypotensive mechanism because systemic vascular resistance always remains above baseline levels.

Published
2018

72. Guidelines for the diagnosis and management of syncope (version 2009)

Author

Moya, A., Sutton, R., Ammirati, F., Blanc, J. J., Brignole, M., Dahm, J. B., Deharo, J. C., Gajek, J., Gjesdal, K., Krahn, A., Massin, M., Pepi, M., Pezawas, T., Ruiz Granell, R., Sarasin, François, Ungar, A., van Dijk, J. G., Walma, Edmond P., and Wieling, Wouter

Subjects
Diagnostic Techniques, Neurological, Continuity of Patient Care, Risk Assessment, Age Distribution, Syncope/*diagnosis/etiology/*therapy, Cost of Illness, Recurrence, Risk Factors, Tilt-Table Test, Ambulatory Care/methods, Exercise Test, Prevalence, Quality of Life, Humans, Referral and Consultation, ddc:613
Published
2016

73. 213 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

Author

Brignole, M, Auricchio, A, Baron-Esquivias, G, Bordachar, P, Boriani, G, Breithardt, O, Cleland, J, Deharo, J, Delgado, V, Elliott, P, Gorenek, B, Israel, C, Leclercq, C, Linde, C, Mont, L, Padeletti, L, Sutton, R, Vardas, P, Zamorano, J, Achenbach, S, Baumgartner, H, Bax, J, Bueno, H, Dean, V, Deaton, C, Erol, C, Fagard, R, Ferrari, R, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Lancellotti, P, Linhart, A, Nihoyannopoulos, P, Piepoli, M, Ponikowski, P, Sirnes, P, Tamargo, J, Tendera, M, Torbicki, A, Wijns, W, Windecker, S, Blomstrom-Lundqvist, C, Badano, L, Aliyev, F, Bansch, D, Bsata, W, Buser, P, Charron, P, Daubert, J, Dobreanu, D, Faerestrand, S, Le Heuzey, J, Mavrakis, H, Mcdonagh, T, Merino, J, Nawar, M, Nielsen, J, Pieske, B, Poposka, L, Ruschitzka, F, Wilson, C, Brignole M., Auricchio A., Baron-Esquivias G., Bordachar P., Boriani G., Breithardt O. -A., Cleland J., Deharo J. -C., Delgado V., Elliott P. M., Gorenek B., Israel C. W., Leclercq C., Linde C., Mont L., Padeletti L., Sutton R., Vardas P. E., Zamorano J. L., Achenbach S., Baumgartner H., Bax J. J., Bueno H., Dean V., Deaton C., Erol C., Fagard R., Ferrari R., Hasdai D., Hoes A. W., Kirchhof P., Knuuti J., Kolh P., Lancellotti P., Linhart A., Nihoyannopoulos P., Piepoli M. F., Ponikowski P., Sirnes P. A., Tamargo J. L., Tendera M., Torbicki A., Wijns W., Windecker S., Blomstrom-Lundqvist C., Badano L. P., Aliyev F., Bansch D., Bsata W., Buser P., Charron P., Daubert J. -C., Dobreanu D., Faerestrand S., Le Heuzey J. -Y., Mavrakis H., McDonagh T., Merino J. L., Nawar M. M., Nielsen J. C., Pieske B., Poposka L., Ruschitzka F., Wilson C. M., Brignole, M, Auricchio, A, Baron-Esquivias, G, Bordachar, P, Boriani, G, Breithardt, O, Cleland, J, Deharo, J, Delgado, V, Elliott, P, Gorenek, B, Israel, C, Leclercq, C, Linde, C, Mont, L, Padeletti, L, Sutton, R, Vardas, P, Zamorano, J, Achenbach, S, Baumgartner, H, Bax, J, Bueno, H, Dean, V, Deaton, C, Erol, C, Fagard, R, Ferrari, R, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Lancellotti, P, Linhart, A, Nihoyannopoulos, P, Piepoli, M, Ponikowski, P, Sirnes, P, Tamargo, J, Tendera, M, Torbicki, A, Wijns, W, Windecker, S, Blomstrom-Lundqvist, C, Badano, L, Aliyev, F, Bansch, D, Bsata, W, Buser, P, Charron, P, Daubert, J, Dobreanu, D, Faerestrand, S, Le Heuzey, J, Mavrakis, H, Mcdonagh, T, Merino, J, Nawar, M, Nielsen, J, Pieske, B, Poposka, L, Ruschitzka, F, Wilson, C, Brignole M., Auricchio A., Baron-Esquivias G., Bordachar P., Boriani G., Breithardt O. -A., Cleland J., Deharo J. -C., Delgado V., Elliott P. M., Gorenek B., Israel C. W., Leclercq C., Linde C., Mont L., Padeletti L., Sutton R., Vardas P. E., Zamorano J. L., Achenbach S., Baumgartner H., Bax J. J., Bueno H., Dean V., Deaton C., Erol C., Fagard R., Ferrari R., Hasdai D., Hoes A. W., Kirchhof P., Knuuti J., Kolh P., Lancellotti P., Linhart A., Nihoyannopoulos P., Piepoli M. F., Ponikowski P., Sirnes P. A., Tamargo J. L., Tendera M., Torbicki A., Wijns W., Windecker S., Blomstrom-Lundqvist C., Badano L. P., Aliyev F., Bansch D., Bsata W., Buser P., Charron P., Daubert J. -C., Dobreanu D., Faerestrand S., Le Heuzey J. -Y., Mavrakis H., McDonagh T., Merino J. L., Nawar M. M., Nielsen J. C., Pieske B., Poposka L., Ruschitzka F., and Wilson C. M.

Published
2013

75. SYNCOPE: PACING VERSUS RECORDING IN THE LATER YEARS. A RANDOMIZED PRAGMATIC CLINICAL TRIAL OF STRATEGIES OF PERMANENT PACEMAKER VERSUS IMPLANTABLE CARDIAC MONITOR IN OLDER PATIENTS WITH SYNCOPE

Author

Sheldon, R., primary, Talajic, M., additional, Becker, G., additional, Essebag, V., additional, Sultan, O., additional, Ritchie, D., additional, Rose, S., additional, Morillo, C., additional, Krahn, A., additional, Brignole, M., additional, and Maxey, C., additional

Published
2017
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76. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)

Author

Brignole, M, Auricchio, A, Baron-Esquivias, G, Bordachar, P, Boriani, G, Breithardt, O A, Cleland, J, Deharo, J C, Delgado, V, Elliott, P M, Gorenek, B, Israel, C W, Leclercq, C, Linde, C, Mont, L, Padeletti, L, Sutton, R, Vardas, P E, Zamorano, J L, Achenbach, S, Baumgartner, H, Bax, J J, Bueno, H, Dean, V, Deaton, C, Erol, C, Fagard, R, Ferrari, R, Hasdai, D, Hoes, A W, Kirchhof, P, Knuuti, J, Kolh, P, Lancellotti, P, Linhart, A, Nihoyannopoulos, P, Piepoli, M F, Ponikowski, P, Sirnes, P A, Tamargo, J L, Tendera, M, University of Zurich, and Brignole, M

Subjects
10209 Clinic for Cardiology, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine
Published
2013

77. 213 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

Author

Brignole M., Auricchio A., Baron-Esquivias G., Bordachar P., Boriani G., Breithardt O. -A., Cleland J., Deharo J. -C., Delgado V., Elliott P. M., Gorenek B., Israel C. W., Leclercq C., Linde C., Mont L., Padeletti L., Sutton R., Vardas P. E., Zamorano J. L., Achenbach S., Baumgartner H., Bax J. J., Bueno H., Dean V., Deaton C., Erol C., Fagard R., Ferrari R., Hasdai D., Hoes A. W., Kirchhof P., Knuuti J., Kolh P., Lancellotti P., Linhart A., Nihoyannopoulos P., Piepoli M. F., Ponikowski P., Sirnes P. A., Tamargo J. L., Tendera M., Torbicki A., Wijns W., Windecker S., Blomstrom-Lundqvist C., Badano L. P., Aliyev F., Bansch D., Bsata W., Buser P., Charron P., Daubert J. -C., Dobreanu D., Faerestrand S., Le Heuzey J. -Y., Mavrakis H., McDonagh T., Merino J. L., Nawar M. M., Nielsen J. C., Pieske B., Poposka L., Ruschitzka F., Wilson C. M., Brignole, M, Auricchio, A, Baron-Esquivias, G, Bordachar, P, Boriani, G, Breithardt, O, Cleland, J, Deharo, J, Delgado, V, Elliott, P, Gorenek, B, Israel, C, Leclercq, C, Linde, C, Mont, L, Padeletti, L, Sutton, R, Vardas, P, Zamorano, J, Achenbach, S, Baumgartner, H, Bax, J, Bueno, H, Dean, V, Deaton, C, Erol, C, Fagard, R, Ferrari, R, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Lancellotti, P, Linhart, A, Nihoyannopoulos, P, Piepoli, M, Ponikowski, P, Sirnes, P, Tamargo, J, Tendera, M, Torbicki, A, Wijns, W, Windecker, S, Blomstrom-Lundqvist, C, Badano, L, Aliyev, F, Bansch, D, Bsata, W, Buser, P, Charron, P, Daubert, J, Dobreanu, D, Faerestrand, S, Le Heuzey, J, Mavrakis, H, Mcdonagh, T, Merino, J, Nawar, M, Nielsen, J, Pieske, B, Poposka, L, Ruschitzka, F, and Wilson, C

Subjects
Heart Defects, Congenital, Reoperation, Pregnancy Complications, Cardiovascular, Myocardial Infarction, Heart failure, Syncope, Cardiac Resynchronization Therapy, Pregnancy, Rare Disease, Secondary Prevention, Contraindication, Prosthesis-Related Infection, Child, Emergency Treatment, Heart Valve Prosthesis Implantation, Postoperative Care, Remote Consultation, Cardiac Pacing, Artificial, Arrhythmias, Cardiac, Stroke Volume, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiomyopathy, Hypertrophic, Atrial fibrillation, Magnetic Resonance Imaging, Defibrillators, Implantable, Pacemaker, Algorithm, Heart Valve Disease, Aortic Valve, Catheter Ablation, Heart Transplantation, Female, Cardiac pacing, Human
Published
2013

78. Early and late outcome of treated patients referred for syncope to emergency department: the EGSYS 2 follow-up study

Author

Ungar A., Del Rosso A., Giada F., Bartoletti A., Furlan R., Quartieri F., Lagi A., Morrione A., Mussi C., Lunati M., De Marchi G., De Santo T., Marchionni N., Brignole M., Evaluation of Guidelines in Syncope Study 2 Group, CORTELLI, PIETRO, Ungar A., Del Rosso A., Giada F., Bartoletti A., Furlan R., Quartieri F., Lagi A., Morrione A., Mussi C., Lunati M., De Marchi G., De Santo T., Marchionni N., Brignole M., Cortelli P., and Evaluation of Guidelines in Syncope Study 2 Group.

Subjects
Pediatrics, medicine.medical_specialty, Heart disease, biology, business.industry, Incidence (epidemiology), Follow up studies, Syncope (genus), Late outcome, Emergency department, Neurological disorder, medicine.disease, biology.organism_classification, Surgery, medicine, Cardiology and Cardiovascular Medicine, business, Cardiovascular mortality
Abstract

Out of the 465 patients enrolled in the EGSYS 2 study, 398 (86%) underwent a complete follow-up. We excluded 18 patients with non-syncopal attacks. Among the remaining 380 patients, death of any cause occurred in 35 (9.2%). The mean follow-up was 614+73 days. Six deaths (17% of total) occurred during the first month of follow-up. Patients who died were older, had a higher incidence of structural heart disease and/or abnormal ECG, had injuries related to syncope and higher EGSYS score. Syncope recurred in 63 (16.5%) patients. Syncopal relapses occurred in only one patient during the first month of follow-up. The incidence of syncopal recurrences was unrelated to the mechanism of syncope. No clinical differences were found between patients with or without syncopal recurrence and in patients with EGSYS score , or � 3. Conclusion A peak of cardiovascular mortality but not of syncopal recurrences was observed in patients attending to the emergency department for syncope within the first month. Late unfavourable outcomes were caused by associated cardiovascular diseases rather than by the mechanism of syncope. The causes of syncope did not determine the recurrence rate.

Published
2010

79. Guidelines for the diagnosis and management of syncope (version 2009): the Task Force for the diagnosis and management of syncope of the European Society of Cardiology (ESC)

Author

European Heart Rhythm Association, Heart Failure Association, Heart Rhythm Society, European Society of Emergency Medicine, European Federation of Internal Medicine, European Union Geriatric Medicine Society, American Geriatrics Society, European Neurological Society, European Federation of Autonomic Societies, American Autonomic Society, Moya A., Sutton R., Ammirati F., Blanc J. J., Brignole M., Dham J. B., Deharo J. C., Gajek J., Gjesdal K., Krahn A., Massin M., Pepi M., Pezawas T., Granell R. R., Sarasin F., Ungar A., van DijK J. G., Walma E. P., Wieling W., Abe H., Benditt D. G., Decker W. W., Grubb B. P., Kaufmann H., Morillo C., Olshansky B., Parry S. W., Sheldon R., Shen W. K., ESC Committee for Practice Guidelines, Vahanian A., Auricchio A., Bax J., Ceconi C., Dean V., Filippatos G., Funck Brentano C., Hobbs R., Kearney P., McDonagh T., McGregor K., Popescu B. A., Reiner Z., Sechtem U., Sirnes P. A., Tendera M., Vardas P., Widimsky P., Acarturk E., Andreotti F., Asteggiano R., Bauersfeld U., Bellou A., Benetos A., Brandt J., Chung M. K., da Costa A., Extramiana F., Ferro J., Gorenek B., Hedman A., Hirsch R., Kaliska G., Kenny R. A., Kjeldsen K. P., Lampert R., Molgard H., Paju R., Puodziukynas A., Raviele A., Roman P., Scherer M., Schondorf R., Sicari R., Vanbrabant P., Wolpert C., Zamorano J. L., CORTELLI, PIETRO, European Heart Rhythm Association (EHRA), Heart Failure Association (HFA), Heart Rhythm Society (HRS), European Society of Emergency Medicine (EuSEM), European Federation of Internal Medicine (EFIM), European Union Geriatric Medicine Society (EUGMS), American Geriatrics Society (AGS), European Neurological Society (ENS), European Federation of Autonomic Societies (EFAS), American Autonomic Society (AAS), Moya A., Sutton R., Ammirati F., Blanc J.J., Brignole M., Dham J.B., Deharo J.C., Gajek J., Gjesdal K., Krahn A., Massin M., Pepi M., Pezawas T., Granell R.R., Sarasin F., Ungar A., van DijK J.G., Walma E.P., Wieling W., Abe H., Benditt D.G., Decker W.W., Grubb B.P., Kaufmann H., Morillo C., Olshansky B., Parry S.W., Sheldon R., Shen W.K., ESC Committee for Practice Guidelines (CPG), Vahanian A., Auricchio A., Bax J., Ceconi C., Dean V., Filippatos G., Funck-Brentano C., Hobbs R., Kearney P., McDonagh T., McGregor K., Popescu B.A., Reiner Z., Sechtem U., Sirnes P.A., Tendera M., Vardas P., Widimsky P., Acarturk E., Andreotti F., Asteggiano R., Bauersfeld U., Bellou A., Benetos A., Brandt J., Chung M.K., Cortelli P., da Costa A., Extramiana F., Ferro J., Gorenek B., Hedman A., Hirsch R., Kaliska G., Kenny R.A., Kjeldsen K.P., Lampert R., Molgard H., Paju R., Puodziukynas A., Raviele A., Roman P., Scherer M., Schondorf R., Sicari R., Vanbrabant P., Wolpert C., and Zamorano J.L.

Subjects
medicine.medical_specialty, media_common.quotation_subject, MEDLINE, Diagnostic Techniques, Neurological, Risk Assessment, Syncope, Age Distribution, Quality of life (healthcare), Cost of Illness, Ambulatory care, Recurrence, Risk Factors, Tilt-Table Test, Internal medicine, Ambulatory Care, Prevalence, Humans, Medicine, Quality (business), Referral and Consultation, media_common, business.industry, Conflict of interest, Evidence-based medicine, Continuity of Patient Care, Exercise Test, Quality of Life, Cardiology, Table (database), Esc Guidelines, Cardiology and Cardiovascular Medicine, business, Risk assessment
Abstract

Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been previously discussed. A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC Web Site (http://www.escardio.org/guidelines). In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk/benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in Tables 1 and 2 . View this table: Table 1 Classes of recommendations View this table: Table 2 Levels of evidence The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House Headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified …

Published
2009

80. Sincope Neuromediate ( riflesse) : diagnosi e terapia

Author

Del Rosso, A, Brignole, M, PINTO, Antonio, Nichele Brignole, Andrea Ungar, Del Rosso, A, Brignole, M, and Pinto, A

Subjects
sincope, sincope neuromediata, Settore M-EDF/01 - Metodi E Didattiche Delle Attivita' Motorie
Published
2009

81. Orthostatic hypotension as cause of syncope in patients older than 65 years admitted to emergency departments for transient loss of consciousness

Author

Mussi C., Ungar A., Salvioli G., Menozzi C., Bartoletti A., Giada F., Lagi A., Ponassi I., Re G., Furlan R., Maggi R., Brignole M., Evaluation of guidelines in Syncope Study 2 Group, CORTELLI, PIETRO, Mussi C., Ungar A., Salvioli G., Menozzi C., Bartoletti A., Giada F., Lagi A., Ponassi I., Re G., Furlan R., Maggi R., Brignole M., Cortelli P., and Evaluation of guidelines in Syncope Study 2 Group.

Subjects
Male, Orthostatic hypotension, Older, Emergency department, Diagnosis, Adverse drug reaction, Aging, Pediatrics, medicine.medical_specialty, Digoxin, Orthostatic vital signs, Electrocardiography, Hypotension, Orthostatic, Risk Factors, Prevalence, Syncope, Vasovagal, Medicine, Humans, Prospective Studies, Risk factor, Prospective cohort study, Diuretics, Aged, Aged, 80 and over, Nitrates, biology, business.industry, Unconsciousness, Syncope (genus), Parkinson Disease, medicine.disease, biology.organism_classification, Comorbidity, Italy, Anesthesia, Practice Guidelines as Topic, Accidental Falls, Female, Geriatrics and Gerontology, medicine.symptom, business, Emergency Service, Hospital
Abstract

Syncope due to orthostatic hypotension (OH) refers to loss of consciousness caused by hypotension induced by the upright position; it is an important risk factor for fall-related physical injuries, especially in the elderly adults. We evaluated the prevalence of OH syncope and the clinical characteristics of patients older than 65 years with syncope due to OH in the Evaluation of Guidelines in Syncope Study 2 group population.Two hundred fifty nine patients older than 65 years consecutively admitted to the emergency department because of loss of consciousness in a period of a month were submitted to a standardized protocol approved by the European Task Force for the diagnosis of syncope; all the patients were studied by a trained physician who interacted with a central supervisor as the management of syncope was concerned, using a decision-making software.Prevalence of OH syncope was 12.4%. Patients with OH syncope were more likely to be affected by Parkinson's disease and by other neurological diseases. ST changes and longer values of QTc were found in OH syncope group, and they took a greater number of diuretics, nitrates, and digoxin. In multivariate analysis, Parkinson's disease (p = .001) and use of nitrates (p = .001) and diuretics (p = .020) were independently related to OH syncope.In patients older than 65 years, Parkinson's disease and neurological comorbidity are strictly related to OH syncope. Moreover, this study suggests the independent link between OH syncope and the use of vasoactive drugs, identifying the majority of cases as adverse drug reaction, a preventable risk factor for syncope and falls in the older population.

Published
2009

82. Clinical and genetic heterogeneity of right bundle branch block and ST-segment elevation syndrome: A prospective evaluation of 52 families

Author

Priori, S, Napolitano, C, Gasparini, M, Pappone, C, Della Bella, P, Brignole, M, Giordano, U, Giovannini, T, Menozzi, C, Bloise, R, Crotti, L, Terreni, L, Schwartz, P, Priori SG, Napolitano C, Gasparini M, Pappone C, Della Bella P, Brignole M, Giordano U, Giovannini T, Menozzi C, Bloise R, Crotti L, Terreni L, Schwartz PJ, Priori, S, Napolitano, C, Gasparini, M, Pappone, C, Della Bella, P, Brignole, M, Giordano, U, Giovannini, T, Menozzi, C, Bloise, R, Crotti, L, Terreni, L, Schwartz, P, Priori SG, Napolitano C, Gasparini M, Pappone C, Della Bella P, Brignole M, Giordano U, Giovannini T, Menozzi C, Bloise R, Crotti L, Terreni L, and Schwartz PJ

Abstract

Background - The ECG pattern of right bundle branch block and ST-segment elevation in leads V1 to V3 (Brugada syndrome) is associated with high risk of sudden death in patients with a normal heart. Current management and prognosis are based on a single study suggesting a high mortality risk within 3 years for symptomatic and asymptomatic patients alike. As a consequence, aggressive management (implantable cardioverter defibrillator) is recommended for both groups. Methods and Results - Sixty patients (45 males aged 40±15 years) with the typical ECG pattern were clinically evaluated. Events at follow-up were analyzed for patients with at least one episode of aborted sudden death or syncope of unknown origin before recognition of the syndrome (30 symptomatic patients) and for patients without previous history of events (30 asymptomatic patients). Prevalence of mutations of the cardiac sodium channel was 15%, demonstrating genetic heterogeneity. During a mean follow-up of 33±38 months, ventricular fibrillation occurred in 5 (16%) of 30 symptomatic patients and in none of the 30 asymptomatic patients. Programmed electrical stimulation was of limited value in identifying patients at risk (positive predictive value 50%, negative predictive value 46%). Pharmacological challenge with sodium channel blockers was unable to unmask most silent gene carriers (positive predictive value 35%). Conclusions - At variance with current views, asymptomatic patients are at lower risk for sudden death. Programmed electrical stimulation identifies only a fraction of individuals at risk, and sodium channel blockade fails to unmask most silent gene carriers. This novel evidence mandates a reappraisal of therapeutic management

Published
2000

85. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy

Author

Brignole, M., Auricchio, A., Baron Esquivias, G., Bordachar, P., Boriani, Giuseppe, Breithardt, O. A., Cleland, J., Deharo, J. C., Delgado, V., Elliott, P. M., Gorenek, B., Israel, C. W., Leclercq, C., Linde, C., Mont, L., Padeletti, L., Sutton, R., Vardas, P. E., Zamorano, J. L., Achenbach, S., Baumgartner, H., Bax, J. J., Bueno, H., Dean, V., Deaton, C., Erol, C., Fagard, R., Ferrari, R., Hasdai, D., Hoes, A. W., Kirchhof, P., Knuuti, J., Kolh, P., Lancellotti, P., Linhart, A., Nihoyannopoulos, P., Piepoli, M. F., Ponikowski, P., Sirnes, P. A., Tamargo, J. L., Tendera, M., Torbicki, A., Wijns, W., Windecker, S., Blomstrom Lundqvist, C., Badano, L. P., Aliyev, F., Bansch, D., Bsata, W., Buser, P., Charron, P., Daubert, J. C., Dobreanu, D., Faerestrand, S., Le Heuzey, J. Y., Mavrakis, H., Mcdonagh, T., Merino, J. L., Nawar, M. M., Nielsen, J. C., Pieske, B., Poposka, L., Ruschitzka, F., Van Gelder, I. C., and Wilson, C. M.

Subjects
ATRIAL FIBRILLATION, CARDIAC RESYNCHRONIZATION THERAPY, cardiac pacing
Published
2013

87. 2012 EHRA/HRS expert consensus statement on cardiac resynchronization therapy in heart failure: implant and follow-up recommendations and management

Author

Daubert, J.C., Saxon, L., Adamson, P.B., Auricchio, A., Berger, R.D., Beshai, J.F., Breithard, O., Brignole, M., Cleland, J., DeLurgio, D.B., Dickstein, K., Exner, D.V., Gold, M., Grimm, R.A., Hayes, D.L., Israel, C., Leclercq, C., Linde, C., Lindenfeld, J., Merkely, B., Mont, L., Murgatroyd, F., Prinzen, F., Saba, S.F., Shinbane, J.S., Singh, J., Tang, A.S., Vardas, P.E., Wilkoff, B.L., Zamorano, J.L., Anand, I., Blomstroem-Lundqvist, C., Boehmer, J.P., Calkins, H., Cazeau, S., Delgado, V., Estes, N.A.M., Haines, D., Kusumoto, F., Leyva, P., Ruschitzka, F., Stevenson, L.W., Torp-Pedersen, C.T., Task Force Chairs, Writing Committee Members, and Peer Reviewers

Subjects
Cardiac resynchronization therapy, Non-responder, Follow-up, CRT, Consensus recommendations
Published
2012

88. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012

Author

Mcmurray, Jj, Adamopoulos, S, Anker, Sd, Auricchio, A, Böhm, M, Dickstein, K, Falk, V, Filippatos, G, Fonseca, C, Gomez Sanchez MA, Jaarsma, T, Køber, L, Lip, Gy, Maggioni, Ap, Parkhomenko, A, Pieske, Bm, Popescu, Ba, Rønnevik, Pk, Rutten, Fh, Schwitter, J, Seferovic, P, Stepinska, J, Trindade, Pt, Voors, Aa, Zannad, F, Zeiher, A, Task Force for the Diagnosis, Treatment of Acute, Chronic Heart Failure 2012 of the European Society of Cardiology, Bax, Jj, Baumgartner, H, Ceconi, Claudio, Dean, V, Deaton, C, Fagard, R, Funck Brentano, C, Hasdai, D, Hoes, A, Kirchhof, P, Knuuti, J, Kolh, P, Mcdonagh, T, Moulin, C, Reiner, Z, Sechtem, U, Sirnes, Pa, Tendera, M, Torbicki, A, Vahanian, A, Windecker, S, Bonet, La, Avraamides, P, Ben Lamin HA, Brignole, M, Coca, A, Cowburn, P, Dargie, H, Elliott, P, Flachskampf, Fa, Guida, Gf, Hardman, S, Iung, B, Merkely, B, Mueller, C, Nanas, Jn, Nielsen, Ow, Orn, S, Parissis, Jt, Ponikowski, P, and ESC Committee for Practice Guidelines

Subjects
Beta-blockers, Ejection fraction, Transplantation, Digitalis, Heart failure, Natriuretic peptides, Reninangiotensin system, NO
Published
2012

94. Cardiac arrhythmias and arrhythmogenic conditions

Author

Delise, P, Giada, F, Inama, G, Alboni, P, Ammirati, F, Biffi, A, Brignole, M, Corrado, Domenico, D'Este, D, Furlanello, F, Gaita, F, Lunati, M, Gulizia, M, Priori, S, Raviele, A, Salerno, Jm, Santini, M, Schwartz, Pj, Vergara, G, and Zeppilli, P.

Subjects
Settore M-EDF/01 - METODI E DIDATTICHE DELLE ATTIVITÀ MOTORIE, WOLFF-PARKINSON-WHITE, LONG-QT SYNDROME
Published
2010

95. Orientações para pacing cardíaco e terapia de ressincronização cardíaca [Guidelines for cardiac pacing and cardiac resynchronization therapy]

Author

Vardas, P.E., Auricchio, A., Blanc, J.J., Daubert, J.C., Drexler, H., Ector, H., Gasparini, M., Linde, C., Morgado, F.B., Oto, A., Sutton, R., Trusz-Gluza, M., Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Funck-Brentano, C., Filippatos, G., Hellemans, I., Kristensen, S.D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J.L., Priori, S.G., Blomström-Lundqvist, C., Brignole, M., Terradellas, J.B., Castellano, P., Cleland, J., Farre, J., Fromer, M., Le Heuzey, J.Y., Lip, G.Y., Merino, J.L., Montenero, A.S., Ritter, P., Schalij, M.J., and Stellbrink, C.

Published
2008

96. Reproducibility of electrocardiographic findings in patients with suspected reflex neurally-mediated syncope

Author

Brignole, M, Sutton, R, Menozzi, C, Moya, A, Garcia-Civera, R, G Benditt, D, Vardas, P, Wieling, W, Andresen, D, Migliorini, R, Hollinworth, D, Grovale, N, Zanna, F, P Lopez, M, Mohammad, S, Guthmann, A, Manders, M, D Van Aggel, Erckens, D, Andersen, V, Sousani, E, Eppacher, C, J St Ores, T De Santo, Bottoni, N, Ammirati, F, Santini, M, Donateo, P, Reviele, A, Giada, F, Orazi, S, Alboni, P, Dinelli, M, Perego, G, Brambilla, R, A Del Rosso, Vincenti, A, S De Ceglia, Sassone, B, T Baratto, M, Ungar, A, Currò, S, Gulizia, M, Francese, M, Pandolfo, L, Burattini, M, Cornacchia, D, Casali, E, Giani, P, Santangelo, L, Panico, S, G De Marchi, Marchetti, A, Buja, G, Folino, F, Spampinato, A, Bruni, G, Lunati, M, Buttera, G, García-Civera, R, Morell, S, Ruiz, R, Sanjuan, R, F Garcia-Sacristan, J, Beiras, X, Campos, G, Alonso, C, Garcia-Alberola, A, Lacuna, J, P Villacastín, J, Castellanos, P, Roda, J, Palanca, V, Martí, J, Delclós, J, Alvarez, M, Tercedor, L, Castellanos, E, Mauri, T, F Lozano, I, Tomás, J, Bènèzet, J, Fidalgo, M, G Martinez, J, Herreros, B, Muñoz, F, A J, J Aerts, L V, A Boersma, M Schroeder-Tanka, J, R Van Mechelen, H Ruiter, J, Ehlers, C, Meinerts, T, Schuchert, A, Vieth, T, Reithmann, C, P Von Lowis, Cripps, T, Sulke, N, A Kenny, R, D Skehan, J, Paul, V, Wrigley, M, E Louridas, G, Vasilikos, V, N Jakobsen, T, H Simonsen, E, B Johansen, J, W Grander Affiliation, ACS - Amsterdam Cardiovascular Sciences, and General Internal Medicine

Subjects
Male, medicine.medical_specialty, Socio-culturale, Neurological disorder, Ventricular tachycardia, Electrocardiography, Internal medicine, medicine, Syncope, Vasovagal, Humans, Sinus rhythm, Prospective Studies, cardiovascular diseases, Asystole, Prospective cohort study, medicine.diagnostic_test, biology, business.industry, Syncope (genus), Reproducibility of Results, Middle Aged, medicine.disease, biology.organism_classification, Electrocardiographic Finding, Anesthesia, Cardiology, cardiovascular system, Female, Cardiology and Cardiovascular Medicine, business
Abstract

The reproducibility of electrocardiographic (ECG) recordings in syncopal recurrences and the diagnostic role of nonsyncopal arrhythmias are not well known. The objective of this study was to analyse the reproducibility of the ECG findings recorded with implantable loop recorders in 41 patients with suspected neurally-mediated syncope who were included in the International Study on Syncope of Uncertain Origin-2 study and that had > or =2 events recorded by implantable loop recorders. In these patients, the electrocardiogram obtained with the first documented syncope (index syncope) was compared with other recorded events. Twenty-two patients had > or =2 syncopes, and their electrocardiograms were reproducible in 21 (95%): 15 with sinus rhythm, 5 with asystole, and 1 with ventricular tachycardia; 1 had asystole at first syncope and sinus rhythm at recurrent syncope. In 32 patients with nonsyncopal episodes, an arrhythmia was documented in 9, and all of them had the same arrhythmia during the index syncope (100% reproducibility); conversely, when sinus rhythm was documented (23 patients) during nonsyncopal episodes, an arrhythmia was still documented in 6 during the index syncope (70% reproducibility; p = 0.0004). In conclusion, the ECG findings during the first syncope are highly reproducible in subsequent syncopes. The presence of an arrhythmia during nonsyncopal episodes is also highly predictive of the mechanism of syncope, but the presence of sinus rhythm does not rule out the possibility of arrhythmia during syncope. Therefore the finding of an arrhythmia during a nonsyncopal episode allows the etiologic diagnosis of syncope, and eventually to anticipate treatment, without waiting for syncope

Published
2008

97. Guidelines for cardiac pacing and cardiac resynchronization therapy: The Task Force for Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology. Developed in Collaboration with the European Heart Rhythm Association

Author

Vardas, P. E., Auricchio, A., Blanc, J. J., Daubert, J. C., Drexler, H., Ector, H., Gasparini, M., Linde, C., Morgado, F. B., Oto, A., Sutton, R., Trusz-Gluza, M., Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Funck-Brentano, C., Filippatos, G., Hellemans, I., Kristensen, Steen Dalby, McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., Priori, S. G., Blomstrom-Lundqvist, C., Brignole, M., Terradellas, J. B., Castellano, P., Cleland, J., Farre, J., Fromer, M., Le Heuzey, J. Y., Lip, G. Y., Merino, J. L., Montenero, A. S., Ritter, P., Schalij, M. J., and Stellbrink, C.

Published
2007

98. International study on syncope of uncertain aetiology 3 (ISSUE 3): pacemaker therapy for patients with asystolic neurally-mediated syncope: rationale and study design

Author

Brignole, M., Andresen, Dietrich, Benditt, David, Blanc, Jean Jacques, Garcia-Civera, Roberto, Khran, Andrew, Menozzi, Carlo, Moya, Angel, Sutton, Richard, Vardas, Panos, Wieling, Wouter, ACS - Amsterdam Cardiovascular Sciences, and General Internal Medicine

Subjects
Adult, Canada, Pacemaker, Artificial, medicine.medical_specialty, Heart disease, Syncope, law.invention, Orthostatic vital signs, Epilepsy, Double-Blind Method, Randomized controlled trial, law, Physiology (medical), Internal medicine, Secondary Prevention, medicine, Implantable loop recorder, Humans, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, biology, business.industry, Syncope (genus), Middle Aged, biology.organism_classification, medicine.disease, United States, Europe, Research Design, Cardiology, Cardiology and Cardiovascular Medicine, business, Subclavian steal syndrome
Abstract

Aim To assess the effectiveness of pacing therapy for preventing syncope recurrence in patients with a high probability of cardio-inhibitory neurally-mediated syncope (NMS). Study design Multi-centre, prospective, double-blind, randomized placebo-controlled study. Inclusion criteria Eligible patients are at least 40 years of age and have suffered, in the prior 2 years, > or = 3 syncope episodes of suspected NMS (with the exception of carotid sinus syndrome), which is considered by the attending physician to have a severe clinical presentation requiring treatment initiation. Patients with positive and negative tilt testing are included. Exclusion criteria Patients with one or more of the following are excluded: carotid sinus syndrome; suspected or definite heart disease and high likelihood of cardiac syncope; symptomatic orthostatic hypotension diagnosed by standing blood pressure measurement; loss of consciousness different from syncope (e.g. epilepsy, psychiatric, metabolic, drop-attack, TIA, intoxication, cataplexy); subclavian steal syndrome. Study protocol Eligible patients receive an Implantable Loop Recorder and are followed till the first documented syncopal recurrence or a significant asystolic event. Those patients who have an asystolic pause (sinus arrest or AV block) > 6 s or a syncopal asystolic pause > or = 3 s receive a dual-chamber pacemaker implantation and are randomized to active therapy (Pm ON) or to placebo therapy (Pm OFF). End-points: Primary end-point is the first syncope recurrence after pacemaker implant. Sample size and duration: A maximum of 710 patients are to be enrolled during an anticipated period of 2 years to allow randomization of 60 patients in the Pm ON arm and 60 in the Pm OFF arm (total 120).

Published
2007

99. Long QT syndrome revealed by exercise

Author

Wilde, A. A. M., Simmers, T. A., García-Civera, R., Barón-Esquivias, G., Blanc, J. J., Brignole, M., Moya i Mitjans, A., Ruiz-Granell, R., Wieling, W., Amsterdam Cardiovascular Sciences, and Cardiology

Published
2006

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