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12 results on '"Barts Heart Centre [London, UK] (St Bartholomew’s Hospital)"'

1. Putting (One's) Heart into Music

Author

Elaine Chew, Pier D. Lambiase, Michele Orini, Représentations musicales (Repmus), Sciences et Technologies de la Musique et du Son (STMS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), University College of London [London] (UCL), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], and European Project: 788960 ERC-2017-AdG,COSMOS

Subjects
[SHS.MUSIQ]Humanities and Social Sciences/Musicology and performing arts, business.industry, MEDLINE, Heart, 030204 cardiovascular system & hematology, CardioPulse, 03 medical and health sciences, 0302 clinical medicine, Nursing, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Medicine, Humans, AcademicSubjects/MED00200, 030212 general & internal medicine, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], Cardiology and Cardiovascular Medicine, business, Music, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2021

2. Cardiac response to live music performance: effect of large-scale musical structure on action potential duration

Author

Chew, Elaine, Taggart, Peter, Lambiase, Pier, Représentations musicales (Repmus), Sciences et Technologies de la Musique et du Son (STMS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), UCL Institute of Cardiovascular Science London, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), and Barts Health NHS Trust [London, UK]

Subjects
[SHS.MUSIQ]Humanities and Social Sciences/Musicology and performing arts, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM]
Abstract

International audience; Abstract: Funding Acknowledgements: This work has received funding from the ERC under the EU’s Horizon 2020 R&I programme (Grant agreement No. 788960) Background: Strong emotions can trigger cardiac arrhythmias, but the heart-brain mechanism by which they do so is not well understood. Music induces strong emotions, precipitated by musical changes and intensified during live performance; it thus serves as a powerful tool through which to investigate heart-brain interaction. However, existing studies use short, artificial or pre-recorded music excerpts, out of context and classified into singular, simple emotion classes over which aggregate response are reported, ignoring the range of responses possible for the same music stimulus. None has considered electrical response to music as measured from the heart muscles. Purpose: To evaluate the impact on action potential duration due to musical changes at large-scale structural boundaries in live music performance. Methods: Patients implanted with biventricular pacemakers/ICDs are invited to a live classical piano concert. Prior to the concert, the patients’ pacemakers are programmed from CRT to dual chamber pacing at 80 bpm or ten above their intrinsic heart rate. Following a ten-minute adjustment period, they listen to three pieces lasting 15 minutes; this was subsequently expanded to five lasting 30 minutes. Continuous recordings of the intracardiac electrogram (EGM) signals are downloaded from the ICD lead connected to the left ventricle whilst the patients listen to the music. The pacemakers are returned to their original settings after the concert. The patients further provide annotations for perceived change boundaries and tension, as well as information on their music training/experience. We approximate the action potential duration (APD) using the action recovery interval (ARI) extracted from the EGM signal, and compare the ARIs before and after each structural boundary indicated in the music score. Results: We analyze the ARI data surrounding 24 music structural boundaries. The first results are for the three patients (two male; one female) from the initial study day. We perform a two-sample t-test to assess the population means in ARI values before and after each of the 24 structural boundaries. The figure attached shows the statistically significant changes across structural boundaries for α = 0.05; the bar plots show the sample means and 95% confidence intervals (CI) for the 80 ARIs before and after a boundary, and report the p-values of the t-tests. Patients 1 and 3 each reacted significantly to three out of the 24 boundaries (12.5%), sometimes in opposite directions, and Patient 2 to 15 out of the 24 boundaries (62.5%). The CIs for the significant differences spanned the range (–4.4896,4.8745). Conclusions: We show that structural boundaries, where music features change or transition, can produce significant changes in APD. A range of significant responses are observed, including contradictory ones, that span a nearly 10ms range, which could play a contributory role to clinical understanding of arrhythmias and emotion responses. Abstract Figure.

Published
2020

3. Prognosis of Type 2 Myocardial Infarction Patients Implanted With a Prophylactic Defibrillator (from the Very-High-Rate Registry)

Author

Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Saint Etienne, Christophe, Grammatico-Guillon, Leslie, Porto, Alizée, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, Fauchier, Laurent, Garcia, Rodrigue, Boveda, Serge, Defaye, Pascal, Sadoul, Nicolas, Narayanan, Kumar, Perier, Marie-Cécile, Klug, Didier, Leclercq, Christophe, Babuty, Dominique, Bordachar, Pierre, Gras, Daniel, Deharo, Jean-Claude, Piot, Olivier, Providencia, Rui, Marijon, Eloi, Algalarrondo, Vincent, Theron, Alexis, David, Charlotte, André, Clémentine, Pierre, Bertrand, Bernard, Anne, Angoulvant, Denis, Clementy, Nicolas, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Clinique Pasteur, Clinique Pasteur [Toulouse], Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pontchaillou [Rennes], IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre cardiologique du Nord (CCN), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), and EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Myocardial Infarction, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, [SHS]Humanities and Social Sciences, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Registries, Aged, Retrospective Studies, Ejection fraction, business.industry, Stroke Volume, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Prognosis, Defibrillators, Implantable, Transplantation, Primary Prevention, Survival Rate, Death, Sudden, Cardiac, Treatment Outcome, Heart failure, Cardiology, Myocardial infarction complications, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices. Methods: Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France. Results: A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10–599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P =0.005), cardiovascular death (relative risk, 0.82; corrected P =0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P

Published
2020

4. Wearable cardioverter-defibrillator to reduce the transient risk of sudden cardiac death in coronary artery disease

Author

Serge Boveda, Jean-Claude Deharo, Eloi Marijon, Kumar Narayanan, Mario Njeim, Christophe Leclercq, Julia W. Erath-Honold, François Roubille, Johanne Silvain, Pascal Defaye, Claude S. Elayi, Rui Providência, Reza Jabbari, Sérgio Barra, University of Florida [Gainesville] (UF), Frankfurt University, Frankfurt, Germany., ispebjerg Hospital, Copenhagen University, Copenhagen, Denmark., 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), Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hospital da Luz Arrabida, V. N. Gaia, Portugal, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Hôpital Hôtel Dieu de France [Beirut, Lebanon] (2HDF), Medicover Hospitals, Hyderabad, India, Aix Marseille Université (AMU), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Pasteur Clinic, Toulouse, France, Clinique Pasteur et Groupe Rythmologie Stimulation Cardiaque/SFC, Clinique Pasteur [Toulouse], Grenoble University Hospital, Grenoble, France, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Rennes University Hospital, Rennes, France, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiac Electrophysiology Section, European Georges Pompidou Hospital and Paris University, 20 Rue Leblanc, 75908 Paris Cedex 15, France., Clinical sciences, 1University of Florida, Gainesville, FL, USA, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Hotel Dieu Hospital, Beirut, Lebanon., 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), 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) (APHP)-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), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
medicine.medical_specialty, Consensus, [SDV]Life Sciences [q-bio], Electric Countershock, Coronary Artery Disease, 030204 cardiovascular system & hematology, Sudden cardiac death, acute coronary syndrome, Coronary artery disease, 03 medical and health sciences, Wearable Electronic Devices, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Humans, 030212 general & internal medicine, Death, Sudden, Cardiac/epidemiology, ComputingMilieux_MISCELLANEOUS, business.industry, Arrhythmias, Cardiac, medicine.disease, 3. Good health, Death, Sudden, Cardiac, Cardiology, Transient (oscillation), Coronary Artery Disease/diagnosis, business, Cardiology and Cardiovascular Medicine, Wearable cardioverter defibrillator, Defibrillators
Abstract

International audience

Published
2020

5. The year 2017 in the European Heart Journal—Cardiovascular Imaging: Part I

Author

Bogdan A Popescu, Steffen E Petersen, Pál Maurovich-Horvat, Kristina H Haugaa, Erwan Donal, Gerald Maurer, Thor Edvardsen, Jonchère, Laurent, Department of Cardiology [Bucharest, Romania], University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD)-Emergency Institute for Cardiovascular Diseases 'Prof. Dr. C.C. Iliescu' [Bucharest, Romania], The William Harvey Research Institute [London, UK] (NIHR Barts Biomedical Research Centre), Queen Mary University of London (QMUL), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Cardiovascular Imaging Research Group - CIRG [Budapest, Hungary] (MTA-SE ), Semmelweis University [Budapest], Department of Cardiology [Oslo, Norway] (Centre of Cardiological Innovation), Oslo University Hospital [Oslo], Institute of Clinical Medicine [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Internal Medicine II [Wien, Austria] (Division of Cardiology), Medizinische Universität Wien = Medical University of Vienna, 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), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV.IB] Life Sciences [q-bio]/Bioengineering, Myocardium, education, Myocardial Ischemia, Heart, Coronary Artery Disease, General Medicine, 030204 cardiovascular system & hematology, Cardiovascular System, humanities, 030218 nuclear medicine & medical imaging, 3. Good health, Cardiac Imaging Techniques, 03 medical and health sciences, 0302 clinical medicine, Cardiovascular Diseases, Reference Values, Humans, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, health care economics and organizations
Abstract

International audience; The European Heart Journal - Cardiovascular Imaging was launched in 2012. It has gained an impressive impact factor of 8.336 during its first 6 years and is now established as one of the top 10 cardiovascular journals in the world and the most important cardiovascular imaging journal in Europe. The most important studies published in the journal in 2017 will be highlighted in two reports. Part I will focus on studies about myocardial function, coronary artery disease and myocardial ischaemia, and emerging techniques and applications in cardiovascular imaging, whereas Part II will focus on valvular heart disease, heart failure, cardiomyopathies, and congenital heart disease.

Published
2018

6. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion - an update

Author

Boveda, Serge, Garcia, Rodrigue, Defaye, Pascal, Piot, Olivier, Narayanan, Kumar, Barra, Sergio, Gras, Daniel, Providencia, Rui, Algalarrondo, Vincent, Beganton, Frankie, Perier, Marie-Cécile, Jacob, Sophie, Bordachar, Pierre, Babuty, Dominique, Klug, Didier, Leclercq, Christophe, Fauchier, Laurent, Sadoul, Nicolas, Deharo, Jean-Claude, Marijon, Eloi, Glikson, Michael, Wolff, Rafael, Hindricks, Gerhard, Mandrola, John, Camm, a John, Lip, Gregory, Betts, Tim, Lewalter, Thorsten, Saw, Jacqueline, Tzikas, Apostolos, Sternik, Leonid, Nietlispach, Fabian, Berti, Sergio, Sievert, Horst, Bertog, Stefan, Meier, Bernhard, Lenarczyk, Radoslaw, Nielsen-Kudsk, Jens Erik, Tilz, Roland, Kalarus, Zbigniew, Deneke, Thomas, Heinzel, Frank, Landmesser, Ulf, Hildick-Smith, David, Clinique Pasteur, Clinique Pasteur [Toulouse], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Cardiac Stimulation and Rhythmology, CHU Grenoble, Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France, Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hospital da Luz Arrabida, V. N. Gaia, Portugal, Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Université de Montréal (UdeM), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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), Paris Sudden Death Expertise Center [Paris] (Paris-SDEC), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie B, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Lille, 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], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Tours], Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Marseille, Service de cardiologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), The Hebrew University of Jerusalem (HUJ), Universität Leipzig, Liverpool Heart & Chest Hospital, Fondazione Toscana Gabriele Monasterio, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), PSE-SANTE/SESANE/LEPID, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Universität Leipzig [Leipzig], and Clinical sciences

Subjects
medicine.medical_specialty, Catheters, Consensus, Statement (logic), medicine.medical_treatment, Left auricular appendage, MEDLINE, Catheter ablation, Left atrial appendage occlusion, [SHS]Humanities and Social Sciences, Physiology (medical), Internal medicine, Atrial Fibrillation, medicine, Humans, Atrial Appendage, cardiovascular diseases, Thrombus, EHRA/EAPCI, EXPERT CONSENSUS STATEMENT, ComputingMilieux_MISCELLANEOUS, business.industry, Expert consensus, Atrial fibrillation, medicine.disease, Catheter, Ischemic stroke, cardiovascular system, Catheter Ablation, Cardiology, Cardiology and Cardiovascular Medicine, business, catheter-based left atrial appendage occlusion
Abstract

The rationale for the quest to close the left atrial appendage (LAA) for stroke prevention is composed of three elements: the concept that atrial fibrillation (AF) causes strokes, the concept that strokes are associated with thrombus formation in the LAA, and that these thrombi cause strokes by embolisation to the cerebral circulation. There are strong data supporting an association between AF and stroke. The Framingham study following 5,070 patients over 34 years demonstrated an approximately fivefold higher stroke risk in individuals with AF than in those without.1 Though this does not prove a causal relationship, it is important to mention that this risk remained even after adjustment for other risk factors such as hypertension, coronary artery disease, congestive heart failure, and age. Another element to support LAA closure is that there must be proof that thrombus formation occurs predominantly in the LAA. One would imagine that there are abundant data to support the concept that, in AF, thrombus formation occurs predominantly in the LAA; however, in almost all texts discussing the pathophysiology of stroke in AF there are few publications cited to support this concept. Blackshear et al included 1,288 patients with non-valvular AF who underwent either transoesophageal echocardiography (TOE) or autopsy. 2 Thrombus formation was reported in 222 patients, 91% of which was located in the LAA. It was further supported by a more comprehensive meta-analysis by Mahajan et al who demonstrated that 89% of thrombi in the left atrium (LA) were located in the LAA.3 This was corroborated by a study in the realm of degenerative aortic stenosis by Parashar et al.4 In this study, all left atrial thrombi resided in the LAA. It is worth mentioning that the LAA is the most common site of intracardiac thrombi not only in patients with AF but also in patients in sinus rhythm.5 More direct evidence is now available proving that a large proportion of strokes in AF are the result of thrombus in the LAA. The PROTECT AF and PREVAIL studies (described later in this document) provide evidence for the protective effect of LAA closure on thromboembolic events (Chapter 5), although some have debated the evidence (Chapter 6).6 In order to justify LAA closure it is important to show that, when thrombus occurs in the LAA, it can embolise in the cerebral circulation. o demonstrate this, a thrombus embolising to the brain would have to be caught in the act. Parekh et al describe real-time imaging capture of LAA thrombus embolisation during TOE with subsequent stroke after a delay of 4 hours of the witnessed embolisation, possibly due to initial retention at a non-occlusive location with subsequent fragmentation and delayed more distal embolisation.7 The fact that LAA closure prevents thromboembolic events as detailed above is also indirect proof for embolisation from LAA as a cause of embolic events.

Published
2019

7. Long-Term Outcome and Valve Surgery for Infective Endocarditis in the Systematic Analysis of a Community Study

Author

Providência, Rui, Marijon, Eloi, Lambiase, Pier, Bouzeman, Abdeslam, Defaye, Pascal, Klug, Didier, Amet, Denis, Perier, Marie‐cécile, Gras, Daniel, Algalarrondo, Vincent, Deharo, Jean‐claude, Leclercq, Christophe, Fauchier, Laurent, Babuty, Dominique, Bordachar, Pierre, Sadoul, Nicolas, Piot, Olivier, Boveda, Serge, Beganton, Frankie, Wilkoff, Bruce, Stiles, Martin, Morillo, Carlos, Al-Khatib, Sana, Almendral, Jesús, Aguinaga, Luis, Berger, Ronald, Cuesta, Alejandro, Daubert, James, Dubner, Sergio, Ellenbogen, Kenneth, Mark Estes, N.A., Fenelon, Guilherme, Garcia, Fermin, Gasparini, Maurizio, Haines, David, Healey, Jeff, Hurtwitz, Jodie, Keegan, Roberto, Kolb, Christof, Kuck, Karl-Heinz, Marinskis, Germanas, Martinelli, Martino, Mcguire, Mark, Molina, Luis, Okumura, Ken, Proclemer, Alessandro, Russo, Andrea, Singh, Jagmeet, Swerdlow, Charles, Teo, Wee Siong, Uribe, William, Viskin, Sami, Wang, Chun-Chieh, Zhang, Shu, Pericart, Lauriane, Bourguignon, Thierry, Bernard, Louis, Angoulvant, Denis, Delahaye, François, Bernard, Anne, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), The Heart Hospital [London], University College of London [London] (UCL), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), CHU Grenoble, Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Clinique Pasteur [Toulouse], Duke University Medical Center, Virginia Commonwealth University (VCU), Centro Cardiologico Monzino [Milano], Dpt di Scienze Cliniche e di Comunità [Milano] (DISCCO), Università degli Studi di Milano = University of Milan (UNIMI)-Università degli Studi di Milano = University of Milan (UNIMI)-Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Hospital Privado Del Sur, Université Francois Rabelais [Tours], Service de Cardiologie A (TOURS - Cardiologie A), Cellules Dendritiques, Immunomodulation et Greffes, Hopital Cardio-Thoracique et Vasculaire Louis Pradel, Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), and QFAB Bioinformatics

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Prosthesis-Related Infections, Time Factors, Heart Valve Diseases, 030204 cardiovascular system & hematology, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Endocarditis, Hospital Mortality, Registries, 030212 general & internal medicine, Survival rate, Aged, Retrospective Studies, Heart Valve Prosthesis Implantation, business.industry, Mortality rate, Hazard ratio, Retrospective cohort study, Middle Aged, medicine.disease, Confidence interval, Surgery, Survival Rate, Echocardiography, Infective endocarditis, Cohort, Female, France, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

International audience; Background There are limited data describing sex specificities regarding implantable cardioverter defibrillators (ICDs) in the real‐world European setting. Methods and Results Using a large multicenter cohort of consecutive patients referred for ICD implantation for primary prevention (2002–2012), in ischemic and nonischemic cardiomyopathy, we examined the sex differences in subjects' characteristics and outcomes. Of 5539 patients, only 837 (15.1%) were women and 53.8% received cardiac resynchronization therapy. Compared to men, women presented a significantly higher proportion of nonischemic cardiomyopathy (60.2% versus 36.2%, P 120 ms: 74.6% versus 68.5%, P =0.003), higher New York Heart Association functional class (≥III in 54.2%♀ versus 47.8%♂, P =0.014), and lower prevalence of atrial fibrillation (18.7% versus 24.9%, P

Published
2016

8. Outcomes after cryoballoon or radiofrequency ablation for persistent atrial fibrillation: a multicentric propensity-score matched study

Author

Pedro Sousa, Sophie Jacob, Ziad Khoueiry, Franck Halimi, Jean-Paul Albenque, Stéphane Combes, Jean-Pierre Cebron, Serge Boveda, Rui Providência, Dominique Pavin, Nicolas Combes, Frédéric Anselme, Pascal Defaye, Clinique Pasteur [Toulouse], Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], CHU Grenoble, CHU Pontchaillou [Rennes], Nouvelles Cliniques Nantaises - NCN [Nantes], CHU Rouen, Normandie Université (NU), Hôpital privé de Parly-2, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Radiobiologie et épidémiologie (DRPH/SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), and Laboratoire d'épidémiologie des rayonnements ionisants (LEPID)

Subjects
Male, medicine.medical_specialty, Radiofrequency ablation, medicine.medical_treatment, Cryotherapy, Catheter ablation, 030204 cardiovascular system & hematology, Pulmonary vein isolation, Disease-Free Survival, Pulmonary vein, law.invention, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Risk Factors, law, Physiology (medical), Internal medicine, Atrial Fibrillation, Prevalence, medicine, Humans, 030212 general & internal medicine, Propensity Score, Survival rate, business.industry, Atrial fibrillation, Middle Aged, Ablation, medicine.disease, Survival Rate, Log-rank test, Arrhythmia relapse, Treatment Outcome, Cryoballoon ablation, Chronic Disease, Catheter Ablation, Cardiology, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; PURPOSE:Recent data show no benefit of additional ablation beyond pulmonary vein isolation (PVI) in persistent atrial fibrillation (AF). Evidence suggests that radiofrequency energy (RF) and cryoballoon (CRYO) have comparable efficacy for PVI. We aimed to assess the outcomes after a single catheter ablation procedure, comparing PVI using CRYO vs. RF ablation for PVI plus additional ablation in a cohort of patients with persistent AF.METHODS:In this prospective multicenter propensity score-matched comparison, 59 consecutive patients undergoing CRYO ablation of persistent AF were matched to 59 patients treated with RF from November 2010 to June 2012.RESULTS:During a mean follow-up of 15.6 ± 11.5 months, 43.2 % of patients presented atrial arrhythmia relapse after a blanking period of 3 months, which was comparable between the two groups (40.7 % in CRYO vs. 45.8 % in RF, Log rank P = 0.14; HR = 0.67, 95 %CI 0.38-1.16, P = 0.15), despite the fact that 52.5 % of RF patients add additional complex fractionated atrial electrogram ablation, as well as left atrial linear ablation in over two-thirds (roof line in 67.8 % and mitral isthmus in 32.2 %). On multivariate Cox regression, only AF duration in years (HR = 1.10, 95 %CI 1.01-1.10, P = 0.04) was a predictor of relapse. Patients undergoing RF ablation presented a numerically, but non-significantly, lower complication rate (6.8 vs 10.2 %, P = 0.51).CONCLUSION:In our multicenter experience, freedom from atrial arrhythmias was comparable among matched patients treated with CRYO and RF, despite non-significant trends in favor of RF in terms of complications, at the cost of longer procedure times.

Published
2016

9. Comparison of Outcome of Possible Versus Definite Infective Endocarditis Involving Native Heart Valves

Author

Boveda, Serge, Narayanan, Kumar, Jacob, Sophie, Providencia, Rui, Algalarrondo, Vincent, Bouzeman, Abdeslam, Beganton, Frankie, Defaye, Pascal, Perier, Marie-Cécile, Sadoul, Nicolas, Piot, Olivier, Klug, Didier, Gras, Daniel, Fauchier, Laurent, Bordachar, Pierre, Babuty, Dominique, Deharo, Jean-Claude, Leclercq, Christophe, Marijon, Eloi, Pericart, Lauriane, Bernard, Anne, Bourguignon, Thierry, Bernard, Louis, Angoulvant, Denis, Clementy, Nicolas, Clinique Pasteur [Toulouse], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de RadioBiologie et d'Epidémiologie (IRSN/DRPH/SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Laboratoire d épidémiologie des rayonnements ionisants (IRSN/PSE-SANTE/SESANE/LEPID), Service de recherche sur les effets biologiques et Sanitaires des rayonnements ionisants (IRSN/PSE-SANTE/SESANE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), Cardiac Stimulation and Rhythmology, CHU Grenoble, Laboratoire d'Electronique des Systèmes TEmps Réel (LESTER), Université de Bretagne Sud (UBS)-Centre National de la Recherche Scientifique (CNRS), Centre cardiologique du Nord (CCN), Service de Cardiologie A, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Nouvelles Cliniques Nantaises, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Hôpital Haut-Lévêque, Université Sciences et Technologies - Bordeaux 1 (UB)-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire des Écoulements Géophysiques et Industriels [Grenoble] (LEGI ), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Service de Médecine Interne et Maladies Infectieuses [Tours], Cellules Dendritiques, Immunomodulation et Greffes, and CHU Trousseau [Tours]

Subjects
Male, medicine.medical_specialty, Time Factors, Heart Valve Diseases, 030204 cardiovascular system & hematology, Duke criteria, [SHS]Humanities and Social Sciences, Academic institution, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Mitral valve, Cause of Death, medicine, Humans, 030212 general & internal medicine, Heart valve, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Aged, 80 and over, Endocarditis, business.industry, Middle Aged, medicine.disease, Prognosis, Heart Valves, Survival Rate, medicine.anatomical_structure, Echocardiography, Infective endocarditis, Cardiology, Female, France, Morbidity, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract

There are very few data on the prognosis of possible versus definite infective endocarditis (IE). We studied data from 365 consecutive patients with IE involving native heart valve seen in an academic institution from 1990 to 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 101, 28%) and those with definite IE (n = 264, 72%). Patients with possible IE were older than those with definite IE (66 ± 15 vs 62 ± 16, p = 0.05). A causative microorganism was identified in 66% of patients with possible IE versus all patients with definite IE (p0.0001) and only 41% had major echocardiographic criteria (vs 100%; p0.0001). Overall, 139 patients died over a mean ± SD follow-up of 3.9 ± 4.5 years (median 2.2, interquartile range 5.9 years). Patients with possible and definite IE had a similar risk of death. Independent predictors of long-term mortality were increasing age (hazard ratio [HR] 1.02, 95% confidence interval [CI] 1.01 to 1.04; p = 0.0009), vegetation length15 mm (HR 1.87, 95% CI 1.14 to 3.06; p = 0.01), and stroke (HR 4.10, 95% CI 1.84 to 9.17; p = 0.0006), whereas infection of mitral valve (HR 0.57, 95% CI 0.34 to 0.94; p = 0.03) and surgery (HR 0.43, 95% CI 0.19 to 0.99; p = 0.05) were associated with a better prognosis. Patients with definite IE and those with possible IE who did not undergo surgery had a worse prognosis than their counterparts with surgery. In conclusion, unselected patients with possible IE (Duke criteria) had a similar prognosis than those with definite IE.

Published
2016

10. Is oral anticoagulation needed in patients with atrial fibrillation and stent implantation at low–moderate risk of stroke?

Author

Providência, Rui, Boveda, Serge, Defaye, Pascal, Segal, Oliver, Algalarrondo, Vincent, Sadoul, Nicolas, Lambiase, Pier, Piot, Olivier, Klug, Didier, Perier, Marie-Cecile, Bouzeman, Abdeslam, Barra, Sergio, Bories, Marie-Cécile, Gras, Daniel, Fauchier, Laurent, Bordachar, Pierre, Babuty, Dominique, Deharo, Jean-Claude, Leclercq, Christophe, Marijon, Eloi, Ruiz-Nodar, Juan, Valdés, Mariano, Angoulvant, Denis, Lip, Gregory Y.H., Marín, Francisco, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Clinique Pasteur [Toulouse], CHU Grenoble, Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], The Heart Hospital [London], University College of London [London] (UCL), Biospectroscopie Translationnelle - EA 7506 (BIOSPECT), Université de Reims Champagne-Ardenne (URCA), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), Hospital da Luz Arrabida, V. N. Gaia, Portugal, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Aix Marseille Université (AMU), 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], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospital Clínico Universitario Virgen de la Arrixaca = University Hospital Virgen de la Arrixaca [Murcia], Service de Cardiologie A (TOURS - Cardiologie A), Cellules Dendritiques, Immunomodulation et Greffes, University of Liverpool, Aalborg University [Denmark] (AAU), and Universidad de Murcia

Subjects
Male, medicine.medical_specialty, Administration, Oral, Hemorrhage, 030204 cardiovascular system & hematology, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Atrial Fibrillation, Internal Medicine, medicine, Stent implantation, Humans, In patient, 030212 general & internal medicine, Stroke, Oral anticoagulation, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, business.industry, Coronary stenting, Anticoagulants, Atrial fibrillation, Middle Aged, medicine.disease, Cardiology, Oral anticoagulant, Female, Stents, business
Abstract

International audience

Published
2016

11. Prediction of Nonarrhythmic Mortality in Primary Prevention Implantable Cardioverter-Defibrillator Patients With Ischemic and Nonischemic Cardiomyopathy

Author

Nicolas Sadoul, Pascal Defaye, Dai-Pp Investigators, Vincent Algalarrondo, Eloi Marijon, Marie-Cécile Perier, Olivier Piot, Didier Klug, Abdeslam Bouzeman, Jean-Claude Deharo, Pierre Bordachar, Christophe Leclercq, Pier D. Lambiase, Serge Boveda, Rui Providência, Dominique Babuty, Daniel Gras, Laurent Fauchier, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), The Heart Hospital [London], University College of London [London] (UCL), Cardiac Stimulation and Rhythmology, CHU Grenoble, Hôpital Antoine Béclère, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre cardiologique du Nord (CCN), Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire de Recherche en Imagerie : Méthodes d'imagerie des Échanges transcapillaires (LRI - EA4062), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier de Versailles André Mignot (CHV), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Service de Cardiologie B, Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Dorogoichenko, Aleksandra

Subjects
medicine.medical_specialty, Framingham Risk Score, business.industry, Mortality rate, medicine.medical_treatment, Atrial fibrillation, medicine.disease, Ventricular tachycardia, Implantable cardioverter-defibrillator, Confidence interval, Sudden cardiac death, [SHS]Humanities and Social Sciences, Heart failure, Internal medicine, Cardiology, Medicine, [SHS] Humanities and Social Sciences, business, ComputingMilieux_MISCELLANEOUS
Abstract

The objective of this study was to investigate the feasibility of identifying heart failure patients who are less likely to benefit from implantable cardioverter-defibrillator (ICD) therapy among those eligible for primary prevention ICDs.The cost-effectiveness of ICDs in primary prevention may be improved dramatically.Using a cause-of-death analysis approach, we evaluated the discriminative and predictive values of a risk score with regard to overall mortality and specific causes of death by examining 2,485 patients enrolled in the French Primary Prevention ICD program (2002 to 2012). The risk score included points for New York Heart Association functional class III or greater, age70 years, QRS duration120 ms, atrial fibrillation, and glomerular filtration rate 60 ml/min. Sensitivity analyses were performed for ischemic and nonischemic cardiomyopathy, as well as for patients undergoing cardiac resynchronization therapy.After a mean follow-up of 3.0 ± 2.1 years, the overall mortality rate was 5.9 per 100 patient-years (95% confidence interval: 5.4 to 6.5), which increased with the number of risk factors (0 to 5, respectively), as follows: 2.5, 2.9, 4.8, 9.0, 12.3, and 14.8 per 100 patient-years (p 0.001). The higher mortality rate among patients with the highest scores resulted from an increase in nonarrhythmic mortality (from 2.1 to 14.8 per 100 patient-years, p 0.001), whereas the occurrence of appropriate ICD therapies did not change significantly across the categories. The C statistic testing of the score was observed to be highly similar for patients with ischemic cardiomyopathy (0.685) and nonischemic cardiomyopathy (0.658) and those receiving cardiac resynchronization therapy (0.678).Our findings suggest the feasibility of and interest in identifying patients eligible for primary prevention ICD implantation who are at significant risk of nonarrhythmic death in the real-world setting.

Published
2015

12. Cardiac Response to Live Music Performance: Computing Techniques for Feature Extraction and Analysis

Author

Elaine Chew, Peter Taggart, Pier Lambiase, Représentations musicales (Repmus), Sciences et Technologies de la Musique et du Son (STMS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Institut de Recherche et Coordination Acoustique/Musique (IRCAM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), UCL Institute of Cardiovascular Science London, Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], and Chew, Elaine

Subjects
0206 medical engineering, heart-brain interaction, [SHS.PSY]Humanities and Social Sciences/Psychology, 02 engineering and technology, musical performance, 020601 biomedical engineering, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SHS.PSY] Humanities and Social Sciences/Psychology, action potential duration, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, musical prosody, cardiac electrophysiology, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing
Abstract

International audience; Strong emotions and mental stress have been linked to potentially deadly arrhythmias. Music evokes strong emotion through the regulation of tension and release and the modulation of changes and transitions. We exploit this in a novel study involving patients with implanted cardiac defibrillators to study the impact of live music performance on cardiac electrophysiology. The patients' heart rates are artificially fixed with pacing at the higher of 80 beats per minute or 10 above the heart's intrinsic rate. We make continuous recordings directly from the heart muscle whilst the patients are listening to a short classical music concert, which is concurrently recorded in a separate stream. The participants provide annotations of perceived boundaries/transitions and felt tension. The recorded cardiac and music information is further processed to extract relevant features. Here, we describe the experiment design, and the mathematical and computing techniques used to represent and abstract the features from the recorded data. Cardiac reaction is measured by the action potential duration (APD), approximated using the action recovery interval (ARI). The expressive parameters extracted from the music include the time varying loudness, tempo, and harmonic tension. The synchronized information layers allow for detailed analysis of immediate cardiac response to dynamically varying expressive nuances in performed music.

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