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51. P3804Left ventricular wall thickness measured with computed tomography predicts mitral regurgitation improvement in patients implanted with cardiac resynchronization therapy

Author: Christophe Leclercq, Jagmeet P. Singh, Brian B. Ghoshhajra, Jackie Szymonifka, Quynh A. Truong, Saumya Das, Vincent Galand, and Mary Orencole
Subjects: medicine.medical_specialty, Mitral regurgitation, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Ventricular wall, Cardiac resynchronization therapy, Computed tomography, Internal medicine, Cardiology, medicine, In patient, Cardiology and Cardiovascular Medicine, business
Abstract: Background Secondary mitral regurgitation (MR) is common in heart failure (HF) patients and results in progressive left ventricular (LV) dilatation, papillary muscle (PM) displacement and mitral valve leaflet tethering. In selected HF patients, cardiac resynchronization therapy (CRT) has been proved to reduce MR by LV reverse remodeling, resynchronization of PM insertion site contraction and reduction in MV tenting area and inter PM distance. However, data regarding the impact of LV wall thickness (WT) on MR improvement are scarce. Methods In this prospective study, a total 54 patients scheduled for CRT, underwent pre procedural CT. Reduced LV WT was defined as WT Results Among the 54 patients, 38 (70.4%) had mild to severe MR at baseline and a total of 16 (42.1%) experienced MR improvement by ≥1 class at 6 months. there was no difference regarding the co-morbidities, electrocardiogram and echocardiographic parameters between patients with or without MR improvement. However, patients without MR improvement had significant higher NT-pro BNP level at baseline. Interestingly, patients without MR improvement had larger LVWT Left ventriculat segmentation Conclusion LV WT evaluated using CT is a strong predictor of no MR improvement in HF patients with mild to severe MR and who scheduled for CRT implantation.
Published: 2019

52. P5684Left ventricular wall thickness measured with computed tomography stratifies the response to cardiac resynchronization therapy in patients with non-ischemic cardiomyopathy

Author: Quynh A. Truong, Saumya Das, Christophe Leclercq, B G Ghoshhajra, Jackie Szymonifka, Jagmeet P. Singh, Mary Orencole, and Vincent Galand
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Ventricular wall, Cardiac resynchronization therapy, Non ischemic cardiomyopathy, Computed tomography, Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business
Abstract: Background Cardiac resynchronization therapy (CRT) has provided benefit in selected heart failure (HF) patients. Unfortunately, up to 30% of device recipients do not benefit clinically from CRT. Left ventricular (LV) wall geometry analyzed using computed tomography (CT) has not been evaluated in the response to CRT. The objective of this study was to examine the association of LV wall thickness (WT) and the ability for reverse LV remodeling after CRT in non ischemic cardiomyopathy (NICM) patients. Methods In this prospective study, a total 54 patients (33 NICM) scheduled for CRT, underwent pre procedural CT. Reduced LV WT was defined as WT≤6mm and was quantified as a percentage of total LV area. End points were 6-month clinical and echocardiographic response to CRT (NYHA functional class, LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVEDV)) and 2-year major adverse cardiac events (MACE). Of note, positive reduction was defined as in reduction LVESV and LVEDV by ≥15% and ≥10% respectively and ≥5% absolute increase in LVEF. Results The 33 NICM enrolled patients were divided in 3 groups according to the percentage of LV WT Left ventriculat segmentation Conclusion LV WT evaluated using CT could help to stratify the response to CRT in NICM patients.
Published: 2019

53. Reply: Epicardial Connection : A Major Pitfall to Find Gaps After Wide Antral Pulmonary Veins Ablation

Author: Raphaël P, Martins, Dominique, Pavin, and Vincent, Galand
Subjects: Heart Rate, Pulmonary Veins, Atrial Fibrillation, Catheter Ablation, Humans
Published: 2019

54. Reply: Let's Keep Chasing Signals!

Author: Raphaël P, Martins, Dominique, Pavin, and Vincent, Galand
Subjects: Heart Rate, Pulmonary Veins
Published: 2019

55. From innovation to guideline implementation a long way

Author: Nathalie Behar, Raphaël P. Martins, Vincent Galand, Christophe Leclercq, CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Heart Failure, Process management, business.industry, [SDV]Life Sciences [q-bio], Stroke Volume, 030204 cardiovascular system & hematology, [SDV] Life Sciences [q-bio], Hospitalization, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Guideline implementation, Medicine, Humans, 030212 general & internal medicine, Guideline Adherence, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

56. The challenging right inferior pulmonary vein A systematic approach for successful cryoballoon ablation

Author: Nathalie Behar, Mathieu Lederlin, Celine Chérel, D. Pavin, Raphaël P. Martins, Christophe Leclercq, Philippe Mabo, Camille Pichard, Vincent Galand, Jean-Claude Daubert, Amélie Nicolas, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and CCSD, Accord Elsevier
Subjects: Male, Reoperation, Cryoablation, medicine.medical_specialty, Isolation veineuse pulmonaire, medicine.medical_treatment, Action Potentials, Rhythm control, 030204 cardiovascular system & hematology, Cryosurgery, Pulmonary vein isolation, Pulmonary vein, 03 medical and health sciences, 0302 clinical medicine, Right inferior pulmonary vein, Heart Rate, Recurrence, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Cryoballoon ablation, ComputingMilieux_MISCELLANEOUS, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Veine pulmonaire inférieure droite, business.industry, Atrial fibrillation, General Medicine, Middle Aged, medicine.disease, Ablation, Surgery, Fibrillation Atriale, Catheter, Treatment Outcome, Pulmonary Veins, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: Summary Background Pulmonary vein isolation (PVI) using cryoballoon ablation is widely used for rhythm control in patients with paroxysmal atrial fibrillation. This technique has a steep learning curve, and PVI can be achieved quickly in most patients. However, the right inferior pulmonary vein (RIPV) is often challenging to occlude and isolate. Aim We aimed to analyse the efficacy of RIPV ablation using a systematic approach. Methods Consecutive patients referred for cryoballoon ablation of paroxysmal atrial fibrillation were enrolled prospectively. A systematic approach was used for RIPV cryoablation. The primary endpoint was acute RIPV isolation during initial freeze. Results A total of 214 patients were included. RIPV isolation during initial freeze occurred in 179 patients (82.2%). Real-time PVI could be observed in 72 patients (33.6%), whereas cryoballoon stability required pushing the Achieve™ catheter inside the RIPVs in the remaining patients. The rate of unsuccessful or aborted first freeze as a result of insufficient minimal temperature was significantly higher in patients with real-time pulmonary vein potential recording (16.7% vs. 6.3%; P = 0.031). To overcome this issue and obtain both stability and real-time PVI, a dedicated “whip technique” was developed. Twelve patients (5.6%) required a redo ablation; only two of these had a reconnected RIPV. Conclusions A systematic approach to RIPV cryoablation can lead to a high rate of first freeze application. Operators should not struggle to visualize pulmonary vein potentials before ablation, as this may decrease cryoapplication efficacy. Thus, stability should be preferred over real-time PVI for RIPV ablation. Both stability and real-time PVI can be obtained using a “whip technique”.
Published: 2019

57. 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

58. Incidence, predictors and clinical impact of electrical storm in patients with left ventricular assist devices: new insights from the ASSIST-ICD study

Author: Caroline Kerneis, Nicolas D'Ostrevy, Fabien Garnier, Frédéric Anselme, Edeline Pelcé, Magali Michel, Pierre Mondoly, Erwan Flecher, Pierre-Yves Litzler, Christophe Leclercq, Romain Eschallier, Fabrice Vanhuyse, Vincent Galand, Raphaël P. Martins, Matteo Pozzi, Jean-Baptiste Gourraud, Pascal Defaye, Nicolas Sadoul, Frederic Sacher, Marie Bielefeld, Nicolas Lellouche, Hamed Bourenane, Vincent Auffret, Pierre Bordachar, Stéphane Boulé, Michel Kindo, Valentin Loobuyck, Jérôme Jouan, Gerard Babatasi, Philippe Rouvière, Thierry Bourguignon, Olivier Chavanon, Philippe Gaudard, Annette Belin, David Hamon, Camille Dambrin, Walid Ghodhbane, Marie-Cécile Bories, Vlad Gariboldi, Thomas Cardi, Bertrand Pierre, Daniel Grinberg, CHU Pontchaillou [Rennes], Université de Rennes (UNIV-RENNES), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Toulouse [Toulouse], Université de Bordeaux (UB), Université de Strasbourg (UNISTRA), CHU Strasbourg, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Grenoble, Hôpital Michallon, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Rouen, Normandie Université (NU), Service de cardiologie [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Cardiologie [CHRU Nancy], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Fédération Française de Cardiologie, Université de Rennes (UR), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, Radiofrequency ablation, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Left ventricular assist device, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Ventricular tachycardia, law.invention, Cohort Studies, Postoperative Complications, 0302 clinical medicine, law, Interquartile range, 030212 general & internal medicine, Incidence, Incidence (epidemiology), Age Factors, Middle Aged, Markov Chains, 3. Good health, Survival Rate, Cardiology, Female, ventricular tachycardia, Cardiology and Cardiovascular Medicine, electrical storm, Adult, medicine.medical_specialty, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, Physiology (medical), Internal medicine, medicine, Humans, Survival rate, Aged, Proportional Hazards Models, Retrospective Studies, ventricular arrhythmia, Heart Failure, business.industry, medicine.disease, ventricular fibrillation, mortality, Ventricular assist device, Heart failure, Ventricular fibrillation, Tachycardia, Ventricular, Heart-Assist Devices, business
Abstract: International audience; Background - Ventricular arrhythmias (VAs) can occur after continuous flow left ventricular assist device (LVAD) implantation as a single arrhythmic event or as electrical storm (ES) with multiple repetitive VA episodes. Objective - We aimed at analyzing the incidence, predictors, and clinical impact of ES in LVAD recipients. Methods - Patients analyzed were those included in the multicenter ASSIST-ICD observational study. ES was consensually defined as occurrence of ≥3 separate episodes of sustained VAs within a 24-hour interval. Results - Of 652 patients with an LVAD, 61 (9%) presented ES during a median follow-up period of 9.1 (interquartile range [IQR] 2.5-22.1) months. The first ES occurred after 17 (IQR 4.0-56.2) days post LVAD implantation, most of them during the first month after the device implantation (63%). The incidence then tended to decrease during the initial years of follow-up and increased again after the third year post LVAD implantation. History of VAs before LVAD implantation and heart failure duration > 84 months were independent predictors of ES. The occurrence of ES was associated with an increased early mortality since 20 patients (33%) died within the first 2 weeks of ES. Twenty-two patients (36.1%) presented at least 1 recurrence of ES, occurring 43.0 (IQR 8.0-69.0) days after the initial ES. Patients experiencing ES had a significantly lower 1-year survival rate than did those free from ES (log-rank, P = .039). Conclusion - There is a significant incidence of ES in patients with an LVAD. The short-term mortality after ES is high, and one-third of patients will die within 15 days. Whether radiofrequency ablation of arrhythmias improves outcomes would require further studies.
Published: 2019

59. Computed Tomography-Guided Assessment of Response to Cardiac Resynchronization Therapy

Author: Vincent Galand, Jagmeet P. Singh, Brian B. Ghoshhajra, Jackie Szymonifka, Christophe Leclercq, and Quynh A. Truong
Subjects: Male, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Heart Ventricles, Cardiac resynchronization therapy, Computed tomography, Cardiac Resynchronization Therapy, medicine, Humans, cardiovascular diseases, Cardiac Resynchronization Therapy Devices, Prospective Studies, Reverse remodeling, Aged, Ideal (set theory), medicine.diagnostic_test, Ventricular Remodeling, business.industry, Middle Aged, Treatment Outcome, cardiovascular system, Female, Radiology, Wall thickness, business, Tomography, X-Ray Computed
Abstract: It has been well established that responders to cardiac resynchronization therapy (CRT) experience left ventricular (LV) reverse remodeling. However, data are scarce regarding the impact of CRT on LV wall thickness (WT). Computed tomography (CT) is an ideal modality that provides pertinent
Published: 2019

60. Can cardiac resynchronization therapy be used as a tool to reduce sudden cardiac arrest risk?

Author: Vincent Galand, E. Kevin Heist, Jagmeet P. Singh, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), French Federation of CardiologyFrench Federation of Cardiology, Rennes University Hospital, Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, medicine.medical_treatment, Cardiomyopathy, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, 03 medical and health sciences, Ventricular Dysfunction, Left, 0302 clinical medicine, Ventricular arrhythmias, Sudden cardiac arrest, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Heart Failure, Ejection fraction, business.industry, Stroke Volume, medicine.disease, Implantable cardioverter-defibrillator, 3. Good health, Defibrillators, Implantable, Death, Sudden, Cardiac, Heart failure, Concomitant, cardiovascular system, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Cardiology and Cardiovascular Medicine, Post implantation, business
Abstract: Patients with cardiomyopathy and reduced left ventricular (LV) ejection fraction are at risk of heart failure (HF) symptoms and sudden cardiac arrest (SCA). In selected HF patients, cardiac resynchronization therapy (CRT) provides LV reverse remodeling and improves the cellular and molecular function. However controversial results have been published regarding the effect of CRT on the residual ventricular arrhythmia risk. Indeed, the decrease in SCA risk is inconsistent and some factors strongly influence the residual post implantation arrhythmic risk. Conversely, proarrhythmic effect of CRT has been previously described. In this review we aim to describe the relationship between CRT implantation and the SCA risk decrease and discuss the patients who only require cardiac resynchronization therapy-pacemaker and those who need a concomitant implantable cardioverter defibrillator.
Published: 2019

61. An entirely leadless cardiac resynchronization therapy

Author: Vincent Galand, Raphaël P. Martins, Baptiste Polin, Christophe Leclercq, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, MEDLINE, Cardiac resynchronization therapy, 02 engineering and technology, 030204 cardiovascular system & hematology, 021001 nanoscience & nanotechnology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, 0210 nano-technology, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

62. Alternative left ventricular pacing approaches for an optimal cardiac resynchronization therapy

Author: Vincent Galand, Jagmeet P. Singh, Christophe Leclercq, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Heart Ventricles, medicine.medical_treatment, Implantation Site, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, endocardial stimulation, Ventricular Function, Left, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, Coronary sinus, ComputingMilieux_MISCELLANEOUS, Heart Failure, Ejection fraction, business.industry, leadless stimulation, Stroke Volume, optimal left ventricular lead location, Ventricular pacing, medicine.disease, 3. Good health, non-responder, Heart failure, cardiovascular system, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: Cardiac resynchronization therapy (CRT) improves mortality, morbidity, and quality of life in selected heart failure patients with severe left ventricular (LV) ejection fraction impairment. However, between 20% and 40% of device recipients do not benefit clinically from CRT. Indeed, some anatomic and technical difficulties are related to the coronary venous implantation site via the coronary sinus (CS). Additionally, electrical constraints have been described, and CS does not always correspond to the optimal LV lead position. In the last decade, engineers and physicians have worked together to overcome the challenging LV lead implantation, and various biventricular pacing alternatives have been developed to improve CRT response. In this review, we discuss the evolution from CS pacing to wireless LV stimulation and His-bundle pacing.
Published: 2019

63. Risk factors and prognostic impact of left ventricular assist device–associated infections

Author: Marylou Para, Vincent Veniard, Louis Bernard, Vincent Auffret, Stéphane Boulé, Constance Verdonk, Laurent Barandon, Michel Kindo, Thierry Bourguignon, Pascal Defaye, Marie Bielefeld, David Hamon, Edeline Pelcé, Pierre Tattevin, Jérôme Jouan, Fabien Garnier, Philippe Gaudard, Pierre-Yves Litzler, Christophe Leclercq, Fabrice Vanhuyse, Nicolas Lellouche, Thomas Senage, Clément Delmas, Emilie Varlet, Thomas Cardi, Vlad Gariboldi, Daniel Grinberg, André Vincentelli, Arnaud Savouré, Erwan Flecher, Annette Belin, Nicolas Jacob, Gerard Babatasi, Philippe Rouvière, Romain Eschalier, Olivier Chavanon, Hugues Blangy, Camille Dambrin, Raphaël P. Martins, Matteo Pozzi, Nicolas D'Ostrevy, Vincent Galand, MORNET, Dominique, Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Centre Hospitalier Universitaire de Lille (CHU de Lille), Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Equipe 'Obésité et insuffisance cardiaque: approches moléculaires et cliniques ', Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Adaptation cardiovasculaire à l'ischemie, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Bordeaux II, Centre Hospitalier Régional Universitaire de Strasbourg (CHRU de Strasbourg), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Michallon, Hospital Bichat Paris, Hospital,Bichat- Paris, Hôpital de la Timone [CHU - APHM] (TIMONE), Département de Chirurgie Cardiaque [Hôpital de la Timone - APHM], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie cadiovasculaire et thoracique [Rouen], Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Henri Mondor, Service de cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Clermont-Ferrand, chirurgie cardio-vasculaire, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French Federation of Cardiology, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rouen Normandie (UNIROUEN), and Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-Université de Rouen Normandie (UNIROUEN)
Subjects: Male, medicine.medical_specialty, Percutaneous, Prosthesis-Related Infections, medicine.medical_treatment, Heart Ventricles, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, 030212 general & internal medicine, Device Removal, Retrospective Studies, Heartmate ii, Pseudomonas aeruginosa, business.industry, Retrospective cohort study, Middle Aged, Prognosis, equipment and supplies, Cannula, 3. Good health, Icd implantation, Defibrillators, Implantable, [SDV] Life Sciences [q-bio], Staphylococcus aureus, Ventricular assist device, Catheter-Related Infections, Multivariate Analysis, Female, France, Heart-Assist Devices, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Background - Left ventricular assist device (LVAD)-associated infections may be life-threatening and impact patients' outcome. We aimed to identify the characteristics, risk factors, and prognosis of LVAD-associated infections. Methods - Patients included in the ASSIST-ICD study (19 centers) were enrolled. The main outcome was the occurrence of LVAD-associated infection (driveline infection, pocket infection, or pump/cannula infection) during follow-up. Results - Of the 652 patients enrolled, 201 (30.1%) presented a total of 248 LVAD infections diagnosed 6.5 months after implantation, including 171 (26.2%), 51 (7.8%), and 26 (4.0%) percutaneous driveline infection, pocket infection, or pump/cannula infection, respectively. Patients with infections were aged 58.7 years, and most received HeartMate II (82.1%) or HeartWare (13.4%). Most patients (62%) had implantable cardioverter-defibrillators (ICDs) before LVAD, and 104 (16.0%) had ICD implantation, extraction, or replacement after the LVAD surgery. Main pathogens found among the 248 infections were Staphylococcus aureus (n = 113' 45.4%), Enterobacteriaceae (n = 61; 24.6%), Pseudomonas aeruginosa (n = 34; 13.7%), coagulase-negative staphylococci (n = 13; 5.2%), and Candida species (n = 13; 5.2%). In multivariable analysis, HeartMate II (subhazard ratio, 1.56; 95% CI, 1.03 to 2.36; P = .031) and ICD-related procedures post-LVAD (subhazard ratio, 1.43; 95% CI, 1.03-1.98; P = .031) were significantly associated with LVAD infections. Infections had no detrimental impact on survival. Conclusions - Left ventricular assist device-associated infections affect one-third of LVAD recipients, mostly related to skin pathogens and gram-negative bacilli, with increased risk with HeartMate II as compared with HeartWare, and in patients who required ICD-related procedures post-LVAD. This is a plea to better select patients needing ICD implantation/replacement after LVAD implantation.
Published: 2019

64. Response of secondary mitral regurgitation to cardiac resynchronization therapy is the atrium to blame?

Author: Claude Daubert, Raphaël P. Martins, Vincent Galand, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, Blame, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Heart Atria, 030212 general & internal medicine, Atrium (heart), ComputingMilieux_MISCELLANEOUS, media_common, Mitral regurgitation, business.industry, Mitral Valve Insufficiency, Atrial fibrillation, medicine.disease, 3. Good health, medicine.anatomical_structure, Cardiology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Heart atrium
Abstract: International audience
Published: 2018

65. Left ventricular wall thickness measured with computed tomography predicts clinical outcomes in patients receiving cardiac resynchronization therapy

Author: Vincent Galand, Brian B. Ghoshhajra, Raphaël P. Martins, Judy Hung, Subhrata Das, Quynh A. Truong, Jackie Szymonifka, Jagmeet P. Singh, Christophe Leclercq, and V. Barré
Subjects: Mitral regurgitation, medicine.medical_specialty, genetic structures, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Cardiac resynchronization therapy, Computed tomography, medicine.disease, Internal medicine, Heart failure, cardiovascular system, Cardiology, Medicine, In patient, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business, Wall thickness, Left ventricular wall
Abstract: Background Up to 30% of selected heart failure patients do not benefit clinically from cardiac resynchronization therapy (CRT). Left ventricular (LV) wall thickness (WT) analyzed using computed tomography (CT) has rarely been evaluated in response to CRT and mitral regurgitation (MR) improvement. Purpose We examined the association of LVWT and the ability for reverse LV remodeling and MR improvement after CRT. Methods Fifty-four patients scheduled for CRT underwent pre-procedural CT. Reduced LVWT was defined as WT Results Patients were divided in 3 groups according to the percentage of LVWT Conclusion WT evaluated using CT could help to stratify the response to CRT and predict MR improvement and outcomes.
Published: 2020

66. Procedural safety and long-term follow-up after pacemaker implantation in nonagenarians

Author: Raphaël P. Martins, Vincent Galand, Aurélie Loirat, Duc Dang, Nathalie Behar, Vincent Auffret, Philippe Mabo, Jean-Claude Daubert, Christophe Leclercq, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Pacemaker, Artificial, Time Factors, complications, Population, Clinical Investigations, 030204 cardiovascular system & hematology, Risk Assessment, nonagenarian, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, Interquartile range, Risk Factors, Atrial Fibrillation, medicine, Clinical endpoint, Odds Ratio, Humans, education, Retrospective Studies, Aged, 80 and over, education.field_of_study, Inpatients, business.industry, Hazard ratio, Age Factors, Atrial fibrillation, General Medicine, Odds ratio, Length of Stay, medicine.disease, Confidence interval, pacemaker, 3. Good health, Surgery, Survival Rate, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, France, 0305 other medical science, Cardiology and Cardiovascular Medicine, business, Complication, Follow-Up Studies
Abstract: International audience; Background - The rate of pacemaker (PM) implantations is constantly growing. Since life expectancy of the population is projected to increase, a large number of nonagenarian patients will need PM implantation. We aimed at analyzing short- and long-term outcomes after PM implantation in nonagenarians. Methods - Patients aged ≥90 years referred for PM implantation from 2004 to 2017 were included. The primary clinical endpoint was total mortality. Secondary endpoints included procedure-related and in-hospital complications. Results - A total of 172 patients were included (92.6 ± 2.1 years, from 90.0 to 101.4 years). Procedure duration was 50.0 ± 19.7 minutes. Most of the patients had VVI devices implanted (143 pts, 83.1%) and mean hospital stay was 3.5 ± 1.5 days. Nine patients (5.2%) had short-term device-related complications and 29 patients (16.8%) had post-procedural complications, non-related to the implantation, including four leading to patients' death. During a follow-up of 22.5 months (interquartile range: 7.3-38.0), 94 patients (54.7%) died. Survival rates were 82.9% (95% confidence interval [CI]: 76.0-88.0), 73.7% (95% CI: 65.7-80.1) and 37.5% (95% CI: 27.5-47.5) after 1, 2, and 5 years, respectively. The Charlson comorbidity index was a predictive factor of procedural complications (odds ratio = 1.33; 95% CI: 1.05-1.69, P = 0.02) while having a complication (hazard ratio [HR] = 4.04; 95% CI: 1.79-9.11, P = 0.001) and atrial fibrillation (HR = 1.63; 95% CI: [1.02-2.63], P = 0.043) were predictors of post-implantation death. Conclusion - PM implantation in nonagenarians is safe, with a low risk of procedural complications, but many comorbidities-related complications can occur. Caution should be taken in this old and frail population since complications significantly impact patients' survival.
Published: 2018

67. Predictors and Clinical Impact of Late Ventricular Arrhythmias in Patients With Continuous-Flow Left Ventricular Assist Devices

Author: Walid Ghodbane, Raphaël P. Martins, Matteo Pozzi, Vincent Auffret, Assist-Icd Investigators, David Hamon, Philippe Rouvière, Stéphane Boulé, Michel Kindo, Romain Eschalier, Pierre-Yves Litzler, Thierry Bourguignon, Olivier Chavanon, Christophe Leclercq, Camille Dambrin, Bertrand Pierre, Marie Bielefeld, Magali Michel, Hugues Blangy, Pierre Mondoly, Marie-Cécile Bories, Thomas Cardi, Jean-François Obadia, Pascal Defaye, Edeline Pelcé, Frederic Sacher, Costin Radu, Constance Verdonk, Annette Belin, Vlad Gariboldi, Erwan Flecher, Nicolas D'Ostrevy, Vincent Galand, Karine Nubret, Philippe Gaudard, Fabien Garnier, Frédéric Anselme, Gerard Babatasi, Fabrice Vanhuyse, Jean-Baptiste Gourraud, Eloi Marijon, André Vincentelli, Jean-Philippe Verhoye, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [CHU de Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Chirurgie Cardio-Vasculaire, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de chirurgie thoracique et cardio-vasculaire, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Cardiac Stimulation and Rhythmology, CHU Grenoble, Hôpital Michallon, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carnegie Mellon University [Pittsburgh] (CMU), Service de chirurgie cardiaque, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Bactériologie, Virologie, Hygiène [CHU Limoges], CHU Limoges, Département Matériaux (LCPC/MAT), Laboratoire Central des Ponts et Chaussées (LCPC)-PRES Université Nantes Angers Le Mans (UNAM), Griset SA, Diehl - Griset, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service chirurgie cardio-vasculaire, Centre Hospitalier Universitaire de Clermont-Ferrand, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service Chirurgie Cardio-Vasculaire [CHU Toulouse] (CCV), Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve-Université de Montpellier (UM), Unité de recherche de l'institut du thorax (ITX-lab), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Clermont-Ferrand, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Cardiomyopathy, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, implantable cardioverter-defibrillator, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, Internal medicine, left ventricular assist device, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Fibrillation, Ejection fraction, business.industry, ventricular arrhythmias, Arrhythmias, Cardiac, Atrial fibrillation, Middle Aged, Implantable cardioverter-defibrillator, medicine.disease, equipment and supplies, Defibrillators, Implantable, 3. Good health, Ventricular assist device, Heart failure, Etiology, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Heart-Assist Devices, medicine.symptom, business
Abstract: International audience; Objectives - This study aimed to evaluate the incidence, clinical impact, and predictors of late ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients aiming to clarify implantable cardioverter-defibrillator (ICD) indications. Background - The arrhythmic risk and need for ICD in patients implanted with an LVAD are not very well known. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Late VAs were defined as sustained ventricular tachycardia or fibrillation occurring >30 days post-LVAD implantation, without acute reversible cause and requiring appropriate ICD therapy, external electrical shock, or medical therapy. Results - Among 659 LVAD recipients, 494 (median 58.9 years of age; mean left ventricular ejection fraction 20.7 ± 7.4%; 73.1% HeartMate II, 18.6% HeartWare, 8.3% Jarvik 2000) were discharged alive from hospital and included in the final analysis. Late VAs occurred in 133 (26.9%) patients. Multivariable analysis identified 6 independent predictors of late VAs: VAs before LVAD implantation, atrial fibrillation before LVAD implantation, idiopathic etiology of the cardiomyopathy, heart failure duration >12 months, early VAs (
Published: 2018

68. Antiarrhythmic Drugs Are not the Only Option in Electrical Storm: Extracorporeal Membrane Oxygenation as a Life-saving Alternative

Author: Raphaël P. Martins, Solène Le Pennec-Prigent, Erwan Flecher, and Vincent Galand
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Storm, General Medicine, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Extracorporeal Membrane Oxygenation, Extracorporeal membrane oxygenation, medicine, Humans, 030212 general & internal medicine, Life saving, business, Intensive care medicine, Anti-Arrhythmia Agents
Published: 2018

69. The second generation cryoballoon has improved durable isolation of left but not right pulmonary veins new insights from amulticentre study

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

70. A novel method for localization and ablation of conduction gaps after wide antral circumferential ablation of pulmonary veins

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

71. Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes

Author: Elena Galli, Raphaël P. Martins, Arnaud Hubert, Erwan Donal, François Carré, Christophe Leclercq, D. Pavin, Frédéric Schnell, Vincent Galand, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Adult, Male, medicine.medical_specialty, Longitudinal strain, Databases, Factual, Paroxysmal atrial fibrillation, Cardiovascular risk factors, 030204 cardiovascular system & hematology, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, strain, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Reference Values, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, atrial fibrillation, 030212 general & internal medicine, Tachycardia, Paroxysmal, Retrospective Studies, Observer Variation, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Receiver operating characteristic analysis, biology, business.industry, Athletes, Training level, Atrial fibrillation, General Medicine, medicine.disease, biology.organism_classification, Atrial Function, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Increased risk, ROC Curve, Echocardiography, Case-Control Studies, atria, Cardiology, Exercise Test, Physical Endurance, [SDV.IB]Life Sciences [q-bio]/Bioengineering, athlete, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Aims - Intensive endurance sport practice is associated with an increased risk of atrial fibrillation (AF) in male veteran athletes. Paroxysmal AF (PAF) is the very beginning step of this disease. The description of atrial remodelling occurring at this early stage might enable to depict predictive factors of AF in veteran athletes in order to give them personalized recommendation according to their sport practice.Methods and results - Twenty-seven male endurance veteran athletes with documented PAF were retrospectively enrolled and compared with 30 control endurance athletes without documented AF, with similar training level, age, and cardiovascular risk factors. All subjects underwent a resting-electrocardiogram (ECG) to assess the electric remodelling of P-waves as well as an echocardiography, to evaluate the left and right atrial (LA, RA) anatomical and functional (assessed by 2D strain) remodelling. No difference was noted between groups for the ECG P-wave parameters. Atrial function was decreased in the PAF group, particularly the peak atrial longitudinal strain (L-ɛ-Max) of LA (29.3 ± 7.9% vs. 49.1 ± 7.8% respectively in the PAF group and in controls, P Conclusion - Atrial function analysed by strain in echocardiography is strongly associated with PAF and might enable to identify male endurance veteran athletes at risk to develop AF.
Published: 2018

72. Cardiac electronic implantable devices after tricuspid valve surgery

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

73. Atrial Fibrillation in a Dual-Chamber ICD Recipient with Activation of the Ventricular Intrinsic Preference Algorithm: What Is the Mechanism?

Author: Christophe Leclercq, Nathalie Behar, Vincent Galand, Jean-Claude Daubert, Raphaël P. Martins, and Philippe Mabo
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Mechanism (biology), business.industry, Treatment outcome, Atrial fibrillation, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Heart failure, Cardiology, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Electrocardiography
Published: 2016

74. P811Right versus left durable pulmonary vein isolation using the first and second generation cryoballoons: comparative results from a French multicenter study

Author: A. Milhem, Vincent Galand, Raphaël P. Martins, Olivier Cesari, Jean-Claude Daubert, Vincent Auffret, D. Pavin, Philippe Mabo, and Nathalie Behar
Subjects: medicine.medical_specialty, Multicenter study, Isolation (health care), business.industry, Medicine, Cardiology and Cardiovascular Medicine, business, Pulmonary vein, Surgery
Published: 2017

75. Radiofrequency ablation of right ventricular tachycardia in patients with no femoral access: safety and efficacy of a superior approach

Author: Philippe Mabo, Nathalie Behar, Adeline Basquin, Christophe Leclercq, Dominique Pavin, Vincent Galand, Raphaël P. Martins, Jean-Claude Daubert, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Tachycardia, Adult, Heart Defects, Congenital, Male, medicine.medical_specialty, Heart disease, Radiofrequency ablation, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Ablation, 030204 cardiovascular system & hematology, Ventricular tachycardia, Subclavian Vein, Inferior vena cava, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Physiology (medical), Internal medicine, Catheterization, Peripheral, medicine, Secondary Prevention, Humans, cardiovascular diseases, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Congenital heart disease, Retrospective Studies, business.industry, Body Surface Potential Mapping, medicine.disease, Thrombosis, 3. Good health, medicine.anatomical_structure, Treatment Outcome, medicine.vein, Ventricle, cardiovascular system, Cardiology, Catheter Ablation, Tachycardia, Ventricular, Female, medicine.symptom, Jugular Veins, Cardiology and Cardiovascular Medicine, business
Abstract: Aims Ventricular tachycardia (VT) ablation has been proven to be effective and safe to avoid arrhythmia recurrences in patients with repaired congenital heart disease (CHD). However, some of these patients may present right ventricular (RV) access issues [agenesia or thrombosis of inferior vena cava (IVC)], making impossible to access the right ventricle through an inferior approach. In such patients, only a superior approach would theoretically be feasible. Methods and results All VT ablations performed through a jugular or subclavian approach in CHD patients between 2012 and 2017 were included. Among 247 patients scheduled for VT ablation, two patients underwent three VT ablation procedures via a superior approach for due to the inability to access the right ventricle through a conventional IVC access (IVC interruption with azygos continuation in one patient and IVC thrombosis in the other). Ablation was performed using a three-dimensional system through a superior approach, using a subclavian access in both cases. A redo ablation had to be performed in the first patient using a jugular approach. Large curve catheters were used to facilitate RV outflow tract access. Supposed critical isthmuses could be localized and ablated. Patients remained free from arrhythmias during follow-up. Conclusion In patients with repaired CHD and 'no femoral access', ablation of RV tachycardia can be performed using a subclavian or a jugular approach. Mapping may be challenging, requiring large curve catheters. Conventional isthmuses can be mapped and ablated successfully, and such patients should not be denied radiofrequency ablation.
Published: 2017

76. State-of-the-Art of Left Ventricular Assist Device use in France: the ASSIST-ICD registry

Author: Stéphane Boulé, Michel Kindo, Hugues Blangy, André Vincentelli, M. Pozzi, C V Verdonk, Rosana de Carvalho Cristo Martins, Laurent Fauchier, Jean-François Obadia, M. Michel, A. Belin, Olivier Bouchot, F. Sacher, P.Y. Litlzer, Vincent Galand, Erwan Flecher, Jean-Claude Deharo, Philippe Rouvière, G. Babatasi, Jean-Christian Roussel, Laurent Barandon, Romain Eschalier, E. Marijon, Christophe Leclercq, Pascal Defaye, Pierre Mondoly, Gabriel Laurent, Vlad Gariboldi, Thierry Bourguignon, Nicolas Lellouche, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Charles Sadron (ICS), Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Cardiac Stimulation and Rhythmology, CHU Grenoble, Univers, Transport, Interfaces, Nanostructures, Atmosphère et environnement, Molécules (UMR 6213) (UTINAM), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), LyRe, Lyonnaise des Eaux, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et nanosciences d'Alsace, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), CHU Bordeaux [Bordeaux]-Université Bordeaux Segalen - Bordeaux 2, Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, 030204 cardiovascular system & hematology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Ventricular assist device, Internal medicine, medicine, Cardiology, 030212 general & internal medicine, State (computer science), Medical emergency, Cardiology and Cardiovascular Medicine, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience
Published: 2017

77. Peritoneal migration of an epicardial pacemaker

Author: Vincent Galand, Baptiste Polin, Raphaël P. Martins, Christophe Leclercq, Jean Marc Schleich, Jean-Claude Daubert, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Pacemaker, Artificial, medicine.medical_specialty, Cardiac pacing, Day of life, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Foreign-Body Migration, Device removal, Physiology (medical), Internal medicine, Humans, Medicine, Pericardium, 030212 general & internal medicine, Atrioventricular Block, Peritoneal Cavity, Device Removal, business.industry, Cardiac Pacing, Artificial, medicine.disease, 3. Good health, medicine.anatomical_structure, Ventricle, Child, Preschool, Heart failure, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract: International audience; A newborn with complete congenital atrioventricular block of immune origin, in severe heart failure, was implanted with a pacemaker at 1 day of life. The pacing lead was fixed to the epicardial right ventricle and the generator conventionally implanted in a pocket created beneath rectus muscles...
Published: 2017

78. Ventricular fibrillation triggered by a pacemaker-mediated tachycardia protection algorithm

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

79. Reply

Author: Vincent Galand, Raphaël P. Martins, and Dominique Pavin
Subjects: 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, medicine, Medical physics, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiac magnetic resonance, business
Abstract: We thank Drs. Bisbal and Adelino for their interest in our review [(1)][1] and for raising, once again, important questions about cardiac magnetic resonance (CMR). To write this article about CMR, we carefully read the seminal papers in the field, and tried to summarize them as fairly as possible.
Published: 2019

80. Los fármacos antiarrítmicos no son la única opción en la tormenta eléctrica: el oxigenador extracorpóreo de membrana es una alternativa

Author: Vincent Galand, Raphaël P. Martins, Solène Le Pennec-Prigent, and Erwan Flecher
Subjects: business.industry, Medicine, Cardiology and Cardiovascular Medicine, business, Humanities
Published: 2019

81. Atrial Fibrillation in a Dual-Chamber ICD Recipient with Activation of the Ventricular Intrinsic Preference Algorithm: What Is the Mechanism?

Author: Raphael P, Martins, Vincent, Galand, Nathalie, Behar, Philippe, Mabo, Jean-Claude, Daubert, Christophe, Leclercq, CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent
Subjects: Heart Failure, Male, [SDV.IB] Life Sciences [q-bio]/Bioengineering, TheoryofComputation_MISCELLANEOUS, TheoryofComputation_GENERAL, defibrillation - ICD, Defibrillators, Implantable, Diagnosis, Differential, Electrocardiography, Treatment Outcome, Therapy, Computer-Assisted, Humans, atrial fibrillation, [SDV.IB]Life Sciences [q-bio]/Bioengineering, ComputingMilieux_MISCELLANEOUS, Aged
Abstract: International audience; DEVICE ROUNDS
Published: 2016

82. Twiddler's syndrome with a baroreflex stimulator device

Author: Raphaël P. Martins, Christophe Leclercq, Vincent Galand, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, Baroreceptor, Electric Countershock, Ischaemic cardiomyopathy, Pressoreceptors, 030204 cardiovascular system & hematology, Baroreflex, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, Secondary Prevention, Medicine, Humans, Twiddler's Syndrome, cardiovascular diseases, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Secondary prevention, Heart Failure, Ejection fraction, business.industry, Mental Disorders, Implantable Neurostimulators, Syndrome, Middle Aged, medicine.disease, 3. Good health, Defibrillators, Implantable, Heart failure, Anesthesia, cardiovascular system, Cardiology, Patient Compliance, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, business
Abstract: A 48-year-old man with a biventricular ischaemic cardiomyopathy with severe left ventricular ejection fraction impairment (20%) and narrow QRS complexes underwent a single-chamber implantable cardioverter-defibrillator (ICD) implantation for secondary prevention. In December 2014, despite optimal medical therapy, the …
Published: 2016

83. An unusual indication of heart transplantation

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

84. Defining nonvalvular atrial fibrillation: A quest for clarification

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

85. P1444The second generation cryoballoon has improved durable left but not right pulmonary veins isolation: new insights from a multicenter study

Author: Rp. Martins, Nathalie Behar, D. Pavin, A. Milhem, P. Mabo, Vincent Auffret, Vincent Galand, Jc. Daubert, and Olivier Cesari
Subjects: medicine.medical_specialty, Multicenter study, Isolation (health care), business.industry, Physiology (medical), medicine, Cardiology and Cardiovascular Medicine, business, Surgery
Published: 2017

86. 1074Predictors and clinical impact of late ventricular arrhythmias in patients with continuous-flow left ventricular assist devices

Author: Vincent Galand, R E Eschallier, Jean-Baptiste Gourraud, M K Kindo, Stéphane Boulé, R Martins, Frédéric Anselme, E. Marijon, Pierre Mondoly, Christophe Leclercq, Bertrand Pierre, Philippe Rouvière, Pascal Defaye, and F. Sacher
Subjects: medicine.medical_specialty, Continuous flow, business.industry, Physiology (medical), Ventricular assist device, medicine.medical_treatment, Internal medicine, medicine, Cardiology, In patient, Cardiology and Cardiovascular Medicine, business
Published: 2018

87. 223Early post-operative ventricular arrhythmias increase mortality in patient with continuous-flow left ventricular assist device

Author: Vincent Galand, Stéphane Boulé, Pierre Mondoly, M K Kindo, Christophe Leclercq, R E Eschallier, C V Verdonk, F. Sacher, Frédéric Anselme, Jean-Baptiste Gourraud, Pascal Defaye, Philippe Rouvière, Bertrand Pierre, R Martins, and E. Marijon
Subjects: medicine.medical_specialty, business.industry, Continuous flow, Physiology (medical), Internal medicine, Ventricular assist device, medicine.medical_treatment, medicine, Cardiology, In patient, Post operative, Cardiology and Cardiovascular Medicine, business
Published: 2018

88. Localization of gaps during redo ablations of paroxysmal atrial fibrillation: Preferential patterns depending on the choice of cryoballoon ablation or radiofrequency ablation for the initial procedure

Author: Philippe Mabo, Raphaël P. Martins, Vincent Auffret, Vincent Galand, Damien Feneon, D. Pavin, Nathalie Behar, Albin Behaghel, and Jean-Claude Daubert
Subjects: Male, medicine.medical_specialty, Paroxysmal atrial fibrillation, Radiofrequency ablation, medicine.medical_treatment, 030204 cardiovascular system & hematology, Cryosurgery, Pulmonary vein, law.invention, 03 medical and health sciences, Electrocardiography, 0302 clinical medicine, law, Heart Conduction System, Atrial Fibrillation, Medicine, Fluoroscopy, Humans, In patient, 030212 general & internal medicine, Tachycardia, Paroxysmal, Cryoballoon ablation, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Ablation, Surgery, Treatment Outcome, Pulmonary Veins, Catheter Ablation, Female, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Echocardiography, Transesophageal, Follow-Up Studies
Abstract: Summary Background Pulmonary vein (PV) isolation, using cryoballoon or radiofrequency ablation, is the cornerstone therapy for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drugs. One-third of the patients have recurrences, mainly due to PV reconnections. Aims To describe the different locations of reconnection sites in patients who had previously undergone radiofrequency or cryoballoon ablation, and to compare the characteristics of the redo procedures in both instances. Methods Demographic data and characteristics of the initial ablation (cryoballoon or radiofrequency) were collected. Number and localization of reconduction gaps, and redo characteristics were reviewed. Results Seventy-four patients scheduled for a redo ablation of paroxysmal AF were included; 38 had been treated by radiofrequency ablation and 36 by cryoballoon ablation during the first procedure. For the initial ablation, procedural and fluoroscopy times were significantly shorter for cryoballoon ablation (147.8 ± 52.6 min vs. 226.6 ± 64.3 min [ P P = 0.005], respectively). Overall, an identical number of gaps was found during redo procedures of cryoballoon and radiofrequency ablations. However, a significantly higher number of gaps were located in the right superior PV for patients first ablated with radiofrequency (0.9 ± 1.0 vs. 0.5 ± 0.9; P = 0.009). Gap localization displayed different patterns. Although not significant, redo procedures of cryoballoon ablation were slightly shorter and needed shorter durations of radiofrequency to achieve PV isolation. Conclusions During redo procedures, gap localization pattern is different for patients first ablated with cryoballoon or radiofrequency ablation, and right superior PV reconnections occur more frequently after radiofrequency ablation. Redo ablation of a previous cryoballoon ablation appears to be easier.
Published: 2015

89. Atrioventricular nodal reentrant tachycardia ablation and inferior vena cava agenesis

Author: Vincent Galand, Nathalie Behar, Philippe Mabo, Raphaël P. Martins, and Dominique Pavin
Subjects: Tachycardia, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, medicine.medical_treatment, Vena Cava, Inferior, 030204 cardiovascular system & hematology, Asymptomatic, Inferior vena cava, 030218 nuclear medicine & medical imaging, Catheter manipulation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Tachycardia, Atrioventricular Nodal Reentry, cardiovascular diseases, General Environmental Science, business.industry, Arrhythmias, Cardiac, Middle Aged, medicine.disease, Ablation, 3. Good health, medicine.vein, lcsh:RC666-701, Agenesis, cardiovascular system, Cardiology, Catheter Ablation, General Earth and Planetary Sciences, Female, Supraventricular tachycardia, medicine.symptom, Cardiology and Cardiovascular Medicine, business, NODAL, Tomography, X-Ray Computed
Abstract: Congenital anomalies of the inferior vena cava (IVC) are rare and very often diagnosed in asymptomatic patients during computed tomography performed for other purposes. These anomalies can have significant clinical implications, for example if electrophysiology procedures are needed. Diagnostic and ablation procedures are difficult since catheter manipulation and positioning are more complex. We present here a case of successful atrioventricular nodal reentrant tachycardia ablation in a patient with unexpected IVC agenesis, using an azygos route. Resumo: As anomalias congénitas da veia cava inferior são raras e são, muitas vezes, diagnosticadas em pacientes assintomáticos como achados de tomografia computorizada realizada com outros objetivos. Estas anomalias podem ter implicações clínicas importantes, nomeadamente quando estão programados estudos eletrofisiológicos. Os procedimentos de diagnóstico e de ablação são difíceis, uma vez que o manuseamento e posicionamento do cateter é mais complexo. Apresentamos o caso bem-sucedido de uma ablação de taquicardia por reentrada nodal auriculoventricular num doente com agenesia da veia cava inferior, utilizando uma via trans-ázigos. Keywords: Supraventricular tachycardia, Ablation, Inferior vena cava agenesis, Palavras-chave: Taquicardia supraventricular, Ablação, Agenesia de veia cava inferior
Published: 2015

90. 16-51: Evolution of ICD lead parameters after continuous-flow LVAD implantation

Author: Magali Michel, Vincent Galand, Stéphane Boulé, Erwan Flecher, Raphaël P. Martins, Eloi Marijon, Hugues Blangy, Marie Cecile Bories, Fabrice Vanhuyse, Christophe Leclercq, Jean Christian Roussel, and André Vincentelli
Subjects: medicine.medical_specialty, Continuous flow, business.industry, Physiology (medical), Internal medicine, Icd lead, medicine, Cardiology, End stage heart failure, Ohm, Cardiology and Cardiovascular Medicine, business
Published: 2016

91. 219-05: ICD-related complications in patients with end-stage heart failure and left ventricular assist devices

Author: Jean Christian Roussel, Magali Michel, Fabrice Vanhuyse, Christophe Leclercq, Stéphane Boulé, Raphaël P. Martins, Erwan Flecher, Marie Cecile Bories, André Vincentelli, Eloi Marijon, Hugues Blangy, and Vincent Galand
Subjects: medicine.medical_specialty, business.industry, Physiology (medical), Internal medicine, Cardiology, medicine, In patient, End stage heart failure, Cardiology and Cardiovascular Medicine, business
Published: 2016

92. Impacts of a high-fat diet on the metabolic profile and the phenotype of atrial myocardium in mice

Author: Nadine Suffee, Elodie Baptista, Jérôme Piquereau, Maharajah Ponnaiah, Nicolas Doisne, Farid Ichou, Marie Lhomme, Camille Pichard, Vincent Galand, Nathalie Mougenot, Gilles Dilanian, Laurence Lucats, Elise Balse, Mathias Mericskay, Wilfried Le Goff, and Stéphane N Hatem
Subjects: Physiology, Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract: Obesity, diabetes and metabolic syndromes are risk factors of atrial fibrillation (AF). We tested the hypothesis that metabolic disorders have a direct impact on the atria favoring the formation of the substrate of AF.Untargeted metabolomic and lipidomic analysis was used to investigate the consequences of a prolonged high fat diet (HFD) on mouse atria. Atrial properties were characterized by measuring mitochondria respiration in saponin-permeabilized trabeculae, by recording action potential with glass microelectrodes in trabeculae and ionic currents in myocytes using the perforated configuration of patch clamp technique and by several immuno-histological and biochemical approaches. After 16 weeks of HFD, obesogenic mice showed a vulnerability to AF. The atrial myocardium acquired an adipogenic and inflammatory phenotypes. Metabolomic and lipidomic analysis revealed a profound transformation of atrial energy metabolism with a predominance of long-chain lipid accumulation and beta-oxidation activation in the obese mice. Mitochondria respiration showed an increased use of palmitoyl-CoA as energy substrate. Action potentials were short duration and sensitive to the K-ATP-dependent channel inhibitor, whereas K-ATP current was enhanced in isolated atrial myocytes of obese mouse.HFD transforms energy metabolism, causes fat accumulation, and induces electrical remodeling of the atrial myocardium of mice that become vulnerable to AF.Understanding the link between metabolic diseases and atrial fibrillation is of major importance. One hypothesis claims that, in addition to shared co-morbidities, metabolic disorders favor the substrate of atrial fibrillation. Here we show that after prolonged high fat diet, the atrial myocardium becomes adipogenic, inflamed and vulnerable to atrial fibrillation. This tissue remodeling appears to result from an unbalance between uptake and oxidation of fatty acid resulting in long-chain lipid storage, activation of metabolic-sensitive potassium channels and action potential shortening. Therefore, diet appears to be an important link between metabolic disorders and atrial fibrillation.
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93. 0029: Redo-ablations of atrial fibrillation: procedural characteristics depending on the choice of cryoenergy or radiofrequency ablation as the first line therapy

Author: Raphaël P. Martins, Philippe Mabo, Dominique Pavin, Vincent Galand, Jean-Claude Daubert, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: redo, medicine.medical_specialty, medicine.diagnostic_test, Radiofrequency ablation, business.industry, medicine.medical_treatment, Cryoablation, Atrial fibrillation, Ablation, medicine.disease, ablation, Pulmonary vein, law.invention, Surgery, First line therapy, radiofrequency, Location pattern, law, cryoablation, medicine, Fluoroscopy, [SDV.IB]Life Sciences [q-bio]/Bioengineering, atrial fibrillation, business, Cardiology and Cardiovascular Medicine
Abstract: International audience; Introduction Pulmonary vein (PV) isolation has become a cornerstone therapy for symptomatic paroxysmal AF refractory to anti-arrhythmic drugs. Nowadays, the most common energies used to achieve PV isolation are cryoenergy and radiofrequency (RF). However, approximately one third of the patients have recurrences, mainly due to PV reconnections. Little is known about the characteristics of the redo procedure, depending on the choice of the initial energy. Methods Patients referred to our center for a RF redo ablation procedure of symptomatic paroxysmal AF (PxAF) between 2010 and 2014 were retrospectively enrolled. Demographic data and characteristics of the initial ablation, i.e. cryoenergy or RF ablations, were collected. Number and location of PV gaps, and redo characteristics were reviewed. Results 74 patients scheduled for a redo ablation of AF were included, 38 and 36 using RF or cryoablation for the first procedure, respectively. For the initial ablation, procedural and fluoroscopy times were significantly shorter when using cryoenergy (147.8±52.6 vs. 226.6±64.3 min, p
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