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1. Regional and temporal differences in the associations between cardiovascular disease and its classic risk factors: an analysis of 49 cohorts from 11 European countries

Author

Reinikainen, J, Kuulasmaa, K, Oskarsson, V, Amouyel, P, Biasch, K, Brenner, H, De Ponti, R, Donfrancesco, C, Drygas, W, Ferrieres, J, Grassi, G, Grimsgaard, S, Iacoviello, L, Jousilahti, P, Kårhus, L, Kee, F, Linneberg, A, Luksiene, D, Mariño, J, Moitry, M, Palmieri, L, Peters, A, Piwonska, A, Quarti-Trevano, F, Salomaa, V, Sans, S, Schmidt, C, Schöttker, B, Söderberg, S, Tamosiunas, A, Thorand, B, Tunstall-Pedoe, H, Vanuzzo, D, Veronesi, G, Woodward, M, Lekadir, K, Niiranen, T, Kårhus, LL, Schmidt, CO, Reinikainen, J, Kuulasmaa, K, Oskarsson, V, Amouyel, P, Biasch, K, Brenner, H, De Ponti, R, Donfrancesco, C, Drygas, W, Ferrieres, J, Grassi, G, Grimsgaard, S, Iacoviello, L, Jousilahti, P, Kårhus, L, Kee, F, Linneberg, A, Luksiene, D, Mariño, J, Moitry, M, Palmieri, L, Peters, A, Piwonska, A, Quarti-Trevano, F, Salomaa, V, Sans, S, Schmidt, C, Schöttker, B, Söderberg, S, Tamosiunas, A, Thorand, B, Tunstall-Pedoe, H, Vanuzzo, D, Veronesi, G, Woodward, M, Lekadir, K, Niiranen, T, Kårhus, LL, and Schmidt, CO

Abstract

Aims: The regional and temporal differences in the associations between cardiovascular disease (CVD) and its classic risk factors are unknown. The current study examined these associations in different European regions over a 30-year period. Methods and results: The study sample comprised 553 818 individuals from 49 cohorts in 11 European countries (baseline: 1982-2012) who were followed up for a maximum of 10 years. Risk factors [sex, smoking, diabetes, non-HDL cholesterol, systolic blood pressure (BP), and body mass index (BMI)] and CVD events (coronary heart disease or stroke) were harmonized across cohorts. Risk factor-outcome associations were analysed using multivariable-adjusted Cox regression models, and differences in associations were assessed using meta-regression. The differences in the risk factor-CVD associations between central Europe, northern Europe, southern Europe, and the UK were generally small. Men had a slightly higher hazard ratio (HR) in southern Europe (P = 0.043 for overall difference), and those with diabetes had a slightly lower HR in central Europe (P = 0.022 for overall difference) compared with the other regions. Of the six CVD risk factors, minor HR decreases per decade were observed for non-HDL cholesterol [7% per mmol/L; 95% confidence interval (CI), 3-10%] and systolic BP (4% per 20 mmHg; 95% CI, 1-8%), while a minor HR increase per decade was observed for BMI (7% per 10 kg/m2; 95% CI, 1-13%). Conclusion: The results demonstrate that all classic CVD risk factors are still relevant in Europe, irrespective of regional area. Preventive strategies should focus on risk factors with the greatest population attributable risk.

Published
2024

3. The value of wearable cardioverter defibrillator in adult patients with recent myocardial infarction: Economic and clinical implications from a health technology assessment perspective

Author

Botto, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Biffi, M, Capucci, A, Casu, G, Notarstefano, P, Scaglione, M, Zanotto, G, Boriani, G, Botto G. L., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Biffi M., Capucci A., Casu G., Notarstefano P., Scaglione M., Zanotto G., Boriani G., Botto, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Biffi, M, Capucci, A, Casu, G, Notarstefano, P, Scaglione, M, Zanotto, G, Boriani, G, Botto G. L., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Biffi M., Capucci A., Casu G., Notarstefano P., Scaglione M., Zanotto G., and Boriani G.

Abstract

Aims: Sudden cardiac death (SCD) causes high mortality and substantial societal burdens for healthcare systems (HSs). The risk of SCD is significantly increased in patients with reduced left ventricular ejection fraction after myocardial infarction (MI). Current guidelines recommend re-evaluation of cardioverter-defibrillator implantation 40 days post-MI, earliest. Medical therapy alone does not provide sufficient protection against SCD, especially in the first month post-MI, and needs time. Consequently, there is a gap in care of high-risk patients upon hospital discharge. The wearable cardioverter defibrillator (WCD) is a proven safe, effective therapy, which temporarily protects from SCD. Little information on WCD cost-effectiveness exists. We conducted this research to demonstrate the medical need of the device in the post-MI setting defining WCD cost-effectiveness. Methods & results: Based on a randomized clinical trials (RCTs) and Italian and international data, we developed a Markov-model comparing costs, patient survival, and quality-of-life, and calculated the Incremental Cost-Effectiveness Ratio (ICER) of a WCD vs. current standard of care in post-MI patients. The rather conservative base case analysis – based on the RCT intention-to-treat results - produced an ICER of €47,709 per Quality Adjusted Life Year (QALY) gained, which is far lower than the accepted threshold of €60,000 in the Italian National HS. The ICER per Life Year (LY) gained was €38,276. Conclusion: WCD utilization in post-MI patients is clinically beneficial and cost-effective. While improving guideline directed patient care, the WCD can also contribute to a more efficient use of resources in the Italian HS, and potentially other HSs as well.

Published
2022

4. Ventricular arrhythmias and ARNI: is it time to reappraise their management in the light of new evidence?

Author

Vecchi, A, Abete, R, Marazzato, J, Iacovoni, A, Mortara, A, De Ponti, R, Senni, M, Vecchi AL, Abete R, Marazzato J, Iacovoni A, Mortara A, De Ponti R, Senni M, Vecchi, A, Abete, R, Marazzato, J, Iacovoni, A, Mortara, A, De Ponti, R, Senni, M, Vecchi AL, Abete R, Marazzato J, Iacovoni A, Mortara A, De Ponti R, and Senni M

Abstract

The remarkable scientific progress in the treatment of patients with heart failure (HF) and reduced ejection fraction (HFrEF) has more than halved the risk of sudden cardiac death (SCD) in this setting. However, SCD remains one of the major causes of death in this patient population. Beyond the acknowledged role of beta blockers and inhibitors of the renin-angiotensin-aldosterone system (RAAS), a new class of drugs, the angiotensin receptor neprilysin inhibitors (ARNI), proved to reduce the overall cardiovascular mortality and, more specifically, the risk of SCD in HFrEF patients. The mechanism by which ARNI may reduce the mortality connected with harmful ventricular arrhythmias is not utterly clear. A variety of direct and indirect mechanisms have been suggested, but a favorable left ventricular reverse remodeling seems to play a key role in this setting. Furthermore, the well-known protective effect of implantable cardioverter-defibrillator (ICD) has been debated in HFrEF patients with non-ischemic cardiomyopathy (NICM) arguing against the role of primary prevention ICD in this setting, particularly when ARNI therapy is considered. The purpose of this review was to provide insights into the SCD mechanisms involved in HFrEF patients together with the current role of electrical therapies and new drug agents in this setting. [Figure not available: see fulltext.].

Published
2022

5. Change in Eosinophil Count in Patients with Heart Failure Treated with Anakinra

Author

Golino, M, Moroni, F, Giuseppe Del Buono, M, Canada, J, Talasaz, A, Piñel, S, Mbualungu, J, Vecchiè, A, (Jane) Ho, A, Thomas, G, Carbone, S, Billingsley, H, Turlington, J, Markley, R, Trankle, C, De Ponti, R, Van Tassell, B, Abbate, A, Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. Canada, Azita H. Talasaz, Sebastian Piñel, James Mbualungu, Alessandra Vecchiè, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, Antonio Abbate, Golino, M, Moroni, F, Giuseppe Del Buono, M, Canada, J, Talasaz, A, Piñel, S, Mbualungu, J, Vecchiè, A, (Jane) Ho, A, Thomas, G, Carbone, S, Billingsley, H, Turlington, J, Markley, R, Trankle, C, De Ponti, R, Van Tassell, B, Abbate, A, Michele Golino, Francesco Moroni, Marco Giuseppe Del Buono, Justin M. Canada, Azita H. Talasaz, Sebastian Piñel, James Mbualungu, Alessandra Vecchiè, Ai-Chen (Jane) Ho, Georgia K. Thomas, Salvatore Carbone, Hayley E. Billingsley, Jeremy Turlington, Roshanak Markley, Cory Trankle, Roberto De Ponti, Benjamin Van Tassell, and Antonio Abbate

Abstract

Background: Interleukin-1 blockade with anakinra leads to a transient increase in eosinophil blood count (eosinophils) in patients with acute myocardial infarction. We aimed to investigate the effect of anakinra on changes in eosinophils in patients with heart failure (HF) and their correlation with cardiorespiratory fitness (CRF). Methods: We measured eosinophils in 64 patients with HF (50% females), 55 (51–63) years of age, before and after treatment, and, in a subset of 41 patients, also after treatment cessation. We also evaluated CRF, measuring peak oxygen consumption (VO2) with a treadmill test. Results: Treatment with anakinra significantly and transiently increased eosinophils, from 0.2 [0.1–0.3] to 0.3 [0.1–0.4] × 103 cells/µL (p < 0.001) and from 0.3 [0.2–0.5] to 0.2 [0.1–0.3] × 103 cells/µL, with suspension (p < 0.001). Changes in eosinophils correlated with the changes in peak VO2 (Spearman’s Rho = +0.228, p = 0.020). Eosinophils were higher in patients with injection site reactions (ISR) (n = 8, 13%; 0.5 [0.4–0.6] vs. 0.2 [0.1–0.4] × 103 cells/µL, p = 0.023), who also showed a greater increase in peak VO2 (3.0 [0.9–4.3] vs. 0.3 [−0.6–1.8] mLO2·kg−1·min−1, p = 0.015). Conclusion: Patients with HF treated with anakinra experience a transient increase in eosinophils, which is associated with ISR and a greater improvement in peak VO2.

Published
2023

7. Cost-minimization analysis of a wearable cardioverter defibrillator in adult patients undergoing ICD explant procedures: Clinical and economic implications

Author

Boriani, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Arena, G, Curnis, A, Forleo, G, Guerra, F, Porcu, M, Sgarito, G, Botto, G, Boriani G., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Arena G., Curnis A., Forleo G., Guerra F., Porcu M., Sgarito G., Botto G. L., Boriani, G, Mantovani, L, Cortesi, P, De Ponti, R, D'Onofrio, A, Arena, G, Curnis, A, Forleo, G, Guerra, F, Porcu, M, Sgarito, G, Botto, G, Boriani G., Mantovani L. G., Cortesi P. A., De Ponti R., D'Onofrio A., Arena G., Curnis A., Forleo G., Guerra F., Porcu M., Sgarito G., and Botto G. L.

Abstract

Aims: Patients with permanently increased risk of sudden cardiac death (SCD) can be protected by implantable cardioverter defibrillators (ICD). If an ICD must be removed due to infection, for example, immediate reimplantation might not be possible or indicated. The wearable cardioverter defibrillator (WCD) is an established, safe and effective solution to protect patients from SCD during this high-risk bridging period. Very few economic evaluations on WCD use are currently available. Methods: We conducted a systematic review to evaluate the available evidence of WCD in patients undergoing ICD explant/lead extraction. Additionally, a decision model was developed to compare use and costs of the WCD with standard therapy (in-hospital stay). For this purpose, a cost-minimization analysis was conducted, and complemented by a one-way sensitivity analysis. Results: In the base case scenario, the WCD was less expensive compared to standard therapy. The cost-minimization analysis showed a cost reduction of €1782 per patient using the WCD. If costs of standard care were changed, cost savings associated with the WCD varied from €3500 to €0, assuming costs for standard care of €6800 to €3600. Conclusion: After ICD explantation, patients can be safely and effectively protected from SCD after hospital discharge through WCD utilization. Furthermore, the use of a WCD for this patient group is cost saving when compared to standard therapy.

Published
2021

12. 2019 ESC Guidelines for themanagement of patients with supraventricular tachycardia

Author

Brugada, J, Katritsis, D, Arbelo, E, Arribas, F, Bax, J, Blomstrom-Lundqvist, C, Calkins, H, Corrado, D, Deftereos, S, Diller, G, Gomez-Doblas, J, Gorenek, B, Grace, A, Ho, S, Kaski, J, Kuck, K, Lambiase, P, Sacher, F, Sarquella-Brugada, G, Suwalski, P, Zaza, A, De Potter, T, Sticherling, C, Aboyans, V, Basso, C, Bocchiardo, M, Budts, W, Delgado, V, Dobrev, D, Fitzsimons, D, Gevaert, S, Heidbuchel, H, Hindricks, G, Hlivak, P, Kanagaratnam, P, Katus, H, Kautzner, J, Kriebel, T, Lancellotti, P, Landmesser, U, Leclercq, C, Lewis, B, Lopatin, Y, Merkely, B, Paul, T, Pavlovic, N, Petersen, S, Petronio, A, Potpara, T, Roffi, M, Scherr, D, Shlyakhto, E, Simpson, I, Zeppenfeld, K, Windecker, S, Baigent, C, Collet, J, Dean, V, Gale, C, Grobbee, D, Halvorsen, S, Iung, B, Juni, P, Lettino, M, Mueller, C, Richter, D, Sousa-Uva, M, Touyz, R, Amara, W, Grigoryan, S, Podczeck-Schweighofer, A, Chasnoits, A, Vandekerckhove, Y, Sokolovich, S, Traykov, V, Skoric, B, Papasavvas, E, Riahi, S, Kampus, P, Parikka, H, Piot, O, Etsadashvili, K, Stellbrink, C, Manolis, A, Csanadi, Z, Gudmundsson, K, Erwin, J, Barsheshet, A, De Ponti, R, Abdrakhmanov, A, Jashari, H, Lunegova, O, Jubele, K, Refaat, M, Puodziukynas, A, Groben, L, Grosu, A, Ibtissam, F, Trines, S, Poposka, L, Haugaa, K, Kowalski, O, Cavaco, D, Dobreanu, D, Mikhaylov, E, Zavatta, M, Nebojsa, M, Ferreira-Gonzalez, I, Juhlin, T, Reichlin, T, Haouala, H, Akgun, T, Gupta, D, Brugada J., Katritsis D. G., Arbelo E., Arribas F., Bax J. J., Blomstrom-Lundqvist C., Calkins H., Corrado D., Deftereos S. G., Diller G. -P., Gomez-Doblas J. J., Gorenek B., Grace A., Ho S. Y., Kaski J. -C., Kuck K. -H., Lambiase P. D., Sacher F., Sarquella-Brugada G., Suwalski P., Zaza A., De Potter T., Sticherling C., Aboyans V., Basso C., Bocchiardo M., Budts W., Delgado V., Dobrev D., Fitzsimons D., Gevaert S., Heidbuchel H., Hindricks G., Hlivak P., Kanagaratnam P., Katus H., Kautzner J., Kriebel T., Lancellotti P., Landmesser U., Leclercq C., Lewis B., Lopatin Y., Merkely B., Paul T., Pavlovic N., Petersen S., Petronio A. S., Potpara T., Roffi M., Scherr D., Shlyakhto E., Simpson I. A., Zeppenfeld K., Windecker S., Baigent C., Collet J. -P., Dean V., Gale C. P., Grobbee D. E., Halvorsen S., Iung B., Juni P., Lettino M., Mueller C., Richter D. J., Sousa-Uva M., Touyz R. M., Amara W., Grigoryan S., Podczeck-Schweighofer A., Chasnoits A., Vandekerckhove Y., Sokolovich S., Traykov V., Skoric B., Papasavvas E., Riahi S., Kampus P., Parikka H., Piot O., Etsadashvili K., Stellbrink C., Manolis A. S., Csanadi Z., Gudmundsson K., Erwin J., Barsheshet A., De Ponti R., Abdrakhmanov A., Jashari H., Lunegova O., Jubele K., Refaat M. M., Puodziukynas A., Groben L., Grosu A., Ibtissam F., Trines S. A., Poposka L., Haugaa K. H., Kowalski O., Cavaco D., Dobreanu D., Mikhaylov E. N., Zavatta M., Nebojsa M., Ferreira-Gonzalez I., Juhlin T., Reichlin T., Haouala H., Akgun T., Gupta D., Brugada, J, Katritsis, D, Arbelo, E, Arribas, F, Bax, J, Blomstrom-Lundqvist, C, Calkins, H, Corrado, D, Deftereos, S, Diller, G, Gomez-Doblas, J, Gorenek, B, Grace, A, Ho, S, Kaski, J, Kuck, K, Lambiase, P, Sacher, F, Sarquella-Brugada, G, Suwalski, P, Zaza, A, De Potter, T, Sticherling, C, Aboyans, V, Basso, C, Bocchiardo, M, Budts, W, Delgado, V, Dobrev, D, Fitzsimons, D, Gevaert, S, Heidbuchel, H, Hindricks, G, Hlivak, P, Kanagaratnam, P, Katus, H, Kautzner, J, Kriebel, T, Lancellotti, P, Landmesser, U, Leclercq, C, Lewis, B, Lopatin, Y, Merkely, B, Paul, T, Pavlovic, N, Petersen, S, Petronio, A, Potpara, T, Roffi, M, Scherr, D, Shlyakhto, E, Simpson, I, Zeppenfeld, K, Windecker, S, Baigent, C, Collet, J, Dean, V, Gale, C, Grobbee, D, Halvorsen, S, Iung, B, Juni, P, Lettino, M, Mueller, C, Richter, D, Sousa-Uva, M, Touyz, R, Amara, W, Grigoryan, S, Podczeck-Schweighofer, A, Chasnoits, A, Vandekerckhove, Y, Sokolovich, S, Traykov, V, Skoric, B, Papasavvas, E, Riahi, S, Kampus, P, Parikka, H, Piot, O, Etsadashvili, K, Stellbrink, C, Manolis, A, Csanadi, Z, Gudmundsson, K, Erwin, J, Barsheshet, A, De Ponti, R, Abdrakhmanov, A, Jashari, H, Lunegova, O, Jubele, K, Refaat, M, Puodziukynas, A, Groben, L, Grosu, A, Ibtissam, F, Trines, S, Poposka, L, Haugaa, K, Kowalski, O, Cavaco, D, Dobreanu, D, Mikhaylov, E, Zavatta, M, Nebojsa, M, Ferreira-Gonzalez, I, Juhlin, T, Reichlin, T, Haouala, H, Akgun, T, Gupta, D, Brugada J., Katritsis D. G., Arbelo E., Arribas F., Bax J. J., Blomstrom-Lundqvist C., Calkins H., Corrado D., Deftereos S. G., Diller G. -P., Gomez-Doblas J. J., Gorenek B., Grace A., Ho S. Y., Kaski J. -C., Kuck K. -H., Lambiase P. D., Sacher F., Sarquella-Brugada G., Suwalski P., Zaza A., De Potter T., Sticherling C., Aboyans V., Basso C., Bocchiardo M., Budts W., Delgado V., Dobrev D., Fitzsimons D., Gevaert S., Heidbuchel H., Hindricks G., Hlivak P., Kanagaratnam P., Katus H., Kautzner J., Kriebel T., Lancellotti P., Landmesser U., Leclercq C., Lewis B., Lopatin Y., Merkely B., Paul T., Pavlovic N., Petersen S., Petronio A. S., Potpara T., Roffi M., Scherr D., Shlyakhto E., Simpson I. A., Zeppenfeld K., Windecker S., Baigent C., Collet J. -P., Dean V., Gale C. P., Grobbee D. E., Halvorsen S., Iung B., Juni P., Lettino M., Mueller C., Richter D. J., Sousa-Uva M., Touyz R. M., Amara W., Grigoryan S., Podczeck-Schweighofer A., Chasnoits A., Vandekerckhove Y., Sokolovich S., Traykov V., Skoric B., Papasavvas E., Riahi S., Kampus P., Parikka H., Piot O., Etsadashvili K., Stellbrink C., Manolis A. S., Csanadi Z., Gudmundsson K., Erwin J., Barsheshet A., De Ponti R., Abdrakhmanov A., Jashari H., Lunegova O., Jubele K., Refaat M. M., Puodziukynas A., Groben L., Grosu A., Ibtissam F., Trines S. A., Poposka L., Haugaa K. H., Kowalski O., Cavaco D., Dobreanu D., Mikhaylov E. N., Zavatta M., Nebojsa M., Ferreira-Gonzalez I., Juhlin T., Reichlin T., Haouala H., Akgun T., and Gupta D.

Abstract

E' una "linea-guida" non esiste abstract.

Published
2020

13. Grey zones on the use of new oral anticoagulants in atrial fibrillation. Expert opinion [Grey zones sull'uso dei nuovi anticoagulanti orali nella fibrillazione atriale. Opinioni degli esperti]

Author

Di Pasquale, G, Iacovoni, A, Filardi, P, Giustozzi, M, De Ponti, R, Falanga, A, Botto, G, De Filippo, P, Gavazzi, A, Sciatti, E, Senni, M, Porcu, M, Di Pasquale G, Iacovoni A, Filardi PP, Giustozzi M, De Ponti R, Falanga A, Botto GL, De Filippo P, Gavazzi A, Sciatti E, Senni M, Porcu M, Di Pasquale, G, Iacovoni, A, Filardi, P, Giustozzi, M, De Ponti, R, Falanga, A, Botto, G, De Filippo, P, Gavazzi, A, Sciatti, E, Senni, M, Porcu, M, Di Pasquale G, Iacovoni A, Filardi PP, Giustozzi M, De Ponti R, Falanga A, Botto GL, De Filippo P, Gavazzi A, Sciatti E, Senni M, and Porcu M

Abstract

Clinical guidelines, while representing an objective reference to perform appropriate treatment choices, contain grey zones, where recommendations are not supported by solid evidence. In a conference held in Bergamo in October 2018, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies regarding new oral anticoagulants (NOACs) and atrial fibrillation (AF). The manuscript represents the organization of the meeting, with an initial review of current guidelines on this topic, followed by an expert presentation of pros (white) and cons (black) related to the identified "gaps of evidence". For every issue is then reported the response derived from the votes of the experts and the public, the discussion and, finally, the highlights, which are intended as practical "take home messages" to be used in everyday clinical practice. The first topic concerns the indication for anticoagulant therapy in patients with subclinical AF revealed by implanted devices. The second issue examines the opportunity to use NOACs in oncological patients with AF. The third gap evaluates the necessity of anticoagulating patients with AF and CHA2DS2-VASc 1 or CHA2DS2-VASc 2 if women. The last "gap in evidence" concerns the preference of triple or double therapy in patients with AF and acute coronary syndrome/coronary stenting. The work has also been implemented with evidences deriving from important randomized studies published after the date of the Conference.

Published
2020

14. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

Author

De Rosa, S, Spaccarotella, C, Basso, C, Calabro, M, Curcio, A, Filardi, P, Mancone, M, Mercuro, G, Muscoli, S, Nodari, S, Pedrinelli, R, Sinagra, G, Indolfi, C, Angelini, F, Barilla, F, Bartorelli, A, Benedetto, F, Bernabo, P, Bolognese, L, Briani, M, Cacciavillani, L, Calabrese, A, Calabro, P, Caliendo, L, Calo, L, Casella, G, Casu, G, Cavallini, C, Ciampi, Q, Ciccone, M, Comito, M, Corrada, E, Crea, F, D'Andrea, A, D'Urbano, M, De Caterina, R, De Ferrari, G, De Ponti, R, Della Mattia, A, DI Mario, C, Donnazzan, L, Esposito, G, Fedele, F, Ferraro, A, Galasso, G, Galie, N, Gnecchi, M, Golino, P, Golia, B, Guarini, P, Leonardi, S, Locuratolo, N, Luzza, F, Manganiello, V, Francesca Marchetti, M, Marenzi, G, Margonato, A, Meloni, L, Metra, M, Milo, M, Mongiardo, A, Monzo, L, Morisco, C, Novo, G, Pancaldi, S, Parollo, M, Paterno, G, Patti, G, Priori, S, Ravera, A, Giuseppe Rebuzzi, A, Rossi, M, Scherillo, M, Semprini, F, Senni, M, Sibilio, G, Siviglia, M, Tamburino, C, Tortorici, G, Versace, F, Villari, B, Volpe, M, De Rosa S., Spaccarotella C., Basso C., Calabro M. P., Curcio A., Filardi P. P., Mancone M., Mercuro G., Muscoli S., Nodari S., Pedrinelli R., Sinagra G., Indolfi C., Angelini F., Barilla F., Bartorelli A., Benedetto F., Bernabo P., Bolognese L., Briani M., Cacciavillani L., Calabrese A., Calabro P., Caliendo L., Calo L., Casella G., Casu G., Cavallini C., Ciampi Q., Ciccone M., Comito M., Corrada E., Crea F., D'Andrea A., D'Urbano M., De Caterina R., De Ferrari G., De Ponti R., Della Mattia A., DI Mario C., Donnazzan L., Esposito G., Fedele F., Ferraro A., Galasso G., Galie N., Gnecchi M., Golino P., Golia B., Guarini P., Leonardi S., Locuratolo N., Luzza F., Manganiello V., Francesca Marchetti M., Marenzi G., Margonato A., Meloni L., Metra M., Milo M., Mongiardo A., Monzo L., Morisco C., Novo G., Pancaldi S., Parollo M., Paterno G., Patti G., Priori S., Ravera A., Giuseppe Rebuzzi A., Rossi M., Scherillo M., Semprini F., Senni M., Sibilio G., Siviglia M., Tamburino C., Tortorici G., Versace F., Villari B., Volpe M., De Rosa, S, Spaccarotella, C, Basso, C, Calabro, M, Curcio, A, Filardi, P, Mancone, M, Mercuro, G, Muscoli, S, Nodari, S, Pedrinelli, R, Sinagra, G, Indolfi, C, Angelini, F, Barilla, F, Bartorelli, A, Benedetto, F, Bernabo, P, Bolognese, L, Briani, M, Cacciavillani, L, Calabrese, A, Calabro, P, Caliendo, L, Calo, L, Casella, G, Casu, G, Cavallini, C, Ciampi, Q, Ciccone, M, Comito, M, Corrada, E, Crea, F, D'Andrea, A, D'Urbano, M, De Caterina, R, De Ferrari, G, De Ponti, R, Della Mattia, A, DI Mario, C, Donnazzan, L, Esposito, G, Fedele, F, Ferraro, A, Galasso, G, Galie, N, Gnecchi, M, Golino, P, Golia, B, Guarini, P, Leonardi, S, Locuratolo, N, Luzza, F, Manganiello, V, Francesca Marchetti, M, Marenzi, G, Margonato, A, Meloni, L, Metra, M, Milo, M, Mongiardo, A, Monzo, L, Morisco, C, Novo, G, Pancaldi, S, Parollo, M, Paterno, G, Patti, G, Priori, S, Ravera, A, Giuseppe Rebuzzi, A, Rossi, M, Scherillo, M, Semprini, F, Senni, M, Sibilio, G, Siviglia, M, Tamburino, C, Tortorici, G, Versace, F, Villari, B, Volpe, M, De Rosa S., Spaccarotella C., Basso C., Calabro M. P., Curcio A., Filardi P. P., Mancone M., Mercuro G., Muscoli S., Nodari S., Pedrinelli R., Sinagra G., Indolfi C., Angelini F., Barilla F., Bartorelli A., Benedetto F., Bernabo P., Bolognese L., Briani M., Cacciavillani L., Calabrese A., Calabro P., Caliendo L., Calo L., Casella G., Casu G., Cavallini C., Ciampi Q., Ciccone M., Comito M., Corrada E., Crea F., D'Andrea A., D'Urbano M., De Caterina R., De Ferrari G., De Ponti R., Della Mattia A., DI Mario C., Donnazzan L., Esposito G., Fedele F., Ferraro A., Galasso G., Galie N., Gnecchi M., Golino P., Golia B., Guarini P., Leonardi S., Locuratolo N., Luzza F., Manganiello V., Francesca Marchetti M., Marenzi G., Margonato A., Meloni L., Metra M., Milo M., Mongiardo A., Monzo L., Morisco C., Novo G., Pancaldi S., Parollo M., Paterno G., Patti G., Priori S., Ravera A., Giuseppe Rebuzzi A., Rossi M., Scherillo M., Semprini F., Senni M., Sibilio G., Siviglia M., Tamburino C., Tortorici G., Versace F., Villari B., and Volpe M.

Abstract

Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.

Published
2020

17. Five waves of COVID-19 pandemic in Italy: results of a national survey evaluating the impact on activities related to arrhythmias, pacing, and electrophysiology promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Guerra, F., De Ponti, R., D'Onofrio, A., Accogli, M., Bertini, M., Bisignani, G., Forleo, G. B., Landolina, M., Lavalle, C., Notarstefano, P., Ricci, R. P., Zanotto, G., Palmisano, P., Luise, R., De Bonis, S., Pangallo, A., Talarico, A., Maglia, G., Aspromonte, V., Nigro, G., Bianchi, V., Rapacciuolo, A., Ammendola, E., Solimene, F., Stabile, G., Biffi, M., Ziacchi, M., Malpighi, P. S. O., Saporito, D., Casali, E., Turco, V., Malavasi, V. L., Vitolo, M., Imberti, J. F., Anna, A. S., Zardini, M., Placci, A., Quartieri, F., Bottoni, N., Carinci, V., Barbato, G., De Maria, E., Borghi, A., Ramazzini, O. B., Bronzetti, G., Tomasi, C., Boggian, G., Virzi, S., Sassone, B., Corzani, A., Sabbatani, P., Pastori, P., Ciccaglioni, A., Adamo, F., Scaccia, A., Spampinato, A., Patruno, N., Biscione, F., Cinti, C., Pignalberi, C., Calo, L., Tancredi, M., Di Belardino, N., Ricciardi, D., Cauti, F., Rossi, P., Cardinale, M., Ansalone, G., Narducci, M. L., Pelargonio, G., Silvetti, M., Drago, F., Santini, L., Pentimalli, F., Pepi, P., Caravati, F., Taravelli, E., Belotti, G., Rordorf, R., Mazzone, P., Bella, P. D., Rossi, S., Canevese, L. F., Cilloni, S., Doni, L. A., Vergara, P., Baroni, M., Perna, E., Gardini, A., Negro, R., Perego, G. B., Curnis, A., Arabia, G., Russo, A. D., Marchese, P., Dell'Era, G., Occhetta, E., Pizzetti, F., Amellone, C., Giammaria, M., Devecchi, C., Coppolino, A., Tommasi, S., Anselmino, M., Coluccia, G., Guido, A., Rillo, M., Palama, Z., Luzzi, G., Pellegrino, P. L., Grimaldi, M., Grandinetti, G., Vilei, E., Potenza, D., Scicchitano, P., Favale, S., Santobuono, V. E., Sai, R., Melissano, D., Candida, T. R., Bonfantino, V. M., Di Canda, D., Gianfrancesco, D., Carretta, D., Pisano, E. C. L., Medico, A., Giaccari, R., Aste, R., Murgia, C., Nissardi, V., Sanna, G. D., Firetto, G., Crea, P., Ciotta, E., Sgarito, G., Caramanno, G., Ciaramitaro, G., Faraci, A., Fasheri, A., Di Gregorio, L., Campsi, G., Muscio, G., Giannola, G., Padeletti, M., Del Rosso, A., Nesti, M., Miracapillo, G., Giovannini, T., Pieragnoli, P., Rauhe, W., Marini, M., Guarracini, F., Ridarelli, M., Fedeli, F., Mazza, A., Zingarini, G., Andreoli, C., Carreras, G., Zorzi, A., Rossillo, A., Ignatuk, B., Zerbo, F., Molon, G., Fantinel, M., Zanon, F., Marcantoni, L., Zadro, M., and Bevilacqua, M.

Subjects
Cardiac resynchronization therapy, Remote monitoring, Emergency Medicine, Internal Medicine, Ablation, Arrhythmia, Atrial fibrillation, COVID-19, Implantable cardioverter defibrillators, Pacemakers
Abstract

The subsequent waves of the COVID-19 pandemic in Italy had a major impact on cardiac care.A survey to evaluate the dynamic changes in arrhythmia care during the first five waves of COVID-19 in Italy (first: March-May 2020; second: October 2020-January 2021; third: February-May 2021; fourth: June-October 2021; fifth: November 2021-February 2022) was launched.A total of 127 physicians from arrhythmia centers (34% of Italian centers) took part in the survey. As compared to 2019, a reduction in 40% of elective pacemaker (PM), defibrillators (ICD), and cardiac resynchronization devices (CRT) implantations, with a 70% reduction for ablations, was reported during the first wave, with a progressive and gradual return to pre-pandemic volumes, generally during the third-fourth waves, slower for ablations. For emergency procedures (PM, ICD, CRT, and ablations), recovery from the initial 10% decline occurred in most cases during the second wave, with some variability. However, acute care for atrial fibrillation, electrical cardioversions, and evaluations for syncope showed a prolonged reduction of activity. The number of patients with devices which started remote monitoring increased by 40% during the first wave, but then the adoption of remote monitoring declined.The dramatic and profound derangement in arrhythmia management that characterized the first wave of the COVID-19 pandemic was followed by a progressive return to the volume of activities of the pre-pandemic periods, even if with different temporal dynamics and some heterogeneity. Remote monitoring was largely implemented during the first wave, but full implementation is needed.

Published
2022

19. Role of the right ventricle in heart failure with preserved ejection fraction [Ruolo del ventricolo destro nello scompenso cardiaco a frazione di eiezione preservata]

Author

Vecchi, A, Iacovoni, A, Palmieri, V, De Ponti, R, Senni, M, Vecchi AL, Iacovoni A, Palmieri V, De Ponti R, Senni M, Vecchi, A, Iacovoni, A, Palmieri, V, De Ponti, R, Senni, M, Vecchi AL, Iacovoni A, Palmieri V, De Ponti R, and Senni M

Abstract

Heart failure with preserved ejection fraction represents an emerging pandemic and one of the most relevant causes of admission in the elderly population. The hemodynamic and prognostic role of the right ventricular function in this population has been recently investigated and a position statement on behalf of the Heart Failure Association of the European Society of Cardiology has been published to guide physicians to perform a multiparametric evaluation of right ventricular morphology and function. In this brief review we summarize the role of the right ventricle and pulmonary pressure in heart failure with preserved ejection fraction, focusing on hemodynamic and clinical characteristics that identify high-risk patients with poor prognosis.

Published
2019

20. Grey zones on the use of new oral anticoagulants in atrial fibrillation. Expert opinion [Grey zones sull'uso dei nuovi anticoagulanti orali nella fibrillazione atriale. Opinioni degli esperti]

Author

Di Pasquale G, Iacovoni A, Filardi PP, Giustozzi M, De Ponti R, Falanga A, Botto GL, De Filippo P, Gavazzi A, Sciatti E, Senni M, Porcu M, Di Pasquale, G, Iacovoni, A, Filardi, P, Giustozzi, M, De Ponti, R, Falanga, A, Botto, G, De Filippo, P, Gavazzi, A, Sciatti, E, Senni, M, and Porcu, M

Subjects
New oral anticoagulant, CHA2DS2-VASc score, Atrial high-rate episode, Guideline, Triple therapy, Atrial fibrillation
Abstract

Clinical guidelines, while representing an objective reference to perform appropriate treatment choices, contain grey zones, where recommendations are not supported by solid evidence. In a conference held in Bergamo in October 2018, an attempt was made to highlight some of the main grey zones in Cardiology and, through a comparison between experts, to draw shared conclusions that can illuminate our clinical practice. This manuscript contains the statements of the symposium concerning the controversies regarding new oral anticoagulants (NOACs) and atrial fibrillation (AF). The manuscript represents the organization of the meeting, with an initial review of current guidelines on this topic, followed by an expert presentation of pros (white) and cons (black) related to the identified "gaps of evidence". For every issue is then reported the response derived from the votes of the experts and the public, the discussion and, finally, the highlights, which are intended as practical "take home messages" to be used in everyday clinical practice. The first topic concerns the indication for anticoagulant therapy in patients with subclinical AF revealed by implanted devices. The second issue examines the opportunity to use NOACs in oncological patients with AF. The third gap evaluates the necessity of anticoagulating patients with AF and CHA2DS2-VASc 1 or CHA2DS2-VASc 2 if women. The last "gap in evidence" concerns the preference of triple or double therapy in patients with AF and acute coronary syndrome/coronary stenting. The work has also been implemented with evidences deriving from important randomized studies published after the date of the Conference.

Published
2020

21. 2019 ESC Guidelines for themanagement of patients with supraventricular tachycardia

Author

Brugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomstrom-Lundqvist, C., Calkins, H., Corrado, D., Deftereos, S. G., Diller, G. -P., Gomez-Doblas, J. J., Gorenek, B., Grace, A., S. Y., Ho, Kaski, J. -C., Kuck, K. -H., Lambiase, P. D., Sacher, F., Sarquella-Brugada, G., Suwalski, P., Zaza, A., De Potter, T., Sticherling, C., Aboyans, V., Basso, C., Bocchiardo, M., Budts, W., Delgado, V., Dobrev, D., Fitzsimons, D., Gevaert, S., Heidbuchel, H., Hindricks, G., Hlivak, P., Kanagaratnam, P., Katus, H., Kautzner, J., Kriebel, T., Lancellotti, P., Landmesser, U., Leclercq, C., Lewis, B., Lopatin, Y., Merkely, B., Paul, T., Pavlovic, N., Petersen, S., Petronio, A. S., Potpara, T., Roffi, M., Scherr, D., Shlyakhto, E., Simpson, I. A., Zeppenfeld, K., Windecker, S., Baigent, C., Collet, J. -P., Dean, V., Gale, C. P., Grobbee, D. E., Halvorsen, S., Iung, B., Juni, P., Lettino, M., Mueller, C., Richter, D. J., Sousa-Uva, M., Touyz, R. M., Amara, W., Grigoryan, S., Podczeck-Schweighofer, A., Chasnoits, A., Vandekerckhove, Y., Sokolovich, S., Traykov, V., Skoric, B., Papasavvas, E., Riahi, S., Kampus, P., Parikka, H., Piot, O., Etsadashvili, K., Stellbrink, C., Manolis, A. S., Csanadi, Z., Gudmundsson, K., Erwin, J., Barsheshet, A., De Ponti, R., Abdrakhmanov, A., Jashari, H., Lunegova, O., Jubele, K., Refaat, M. M., Puodziukynas, A., Groben, L., Grosu, A., Ibtissam, F., Trines, S. A., Poposka, L., Haugaa, K. H., Kowalski, O., Cavaco, D., Dobreanu, D., Mikhaylov, E. N., Zavatta, M., Nebojsa, M., Ferreira-Gonzalez, I., Juhlin, T., Reichlin, T., Haouala, H., Akgun, T., Gupta, D., Brugada, J, Katritsis, D, Arbelo, E, Arribas, F, Bax, J, Blomstrom-Lundqvist, C, Calkins, H, Corrado, D, Deftereos, S, Diller, G, Gomez-Doblas, J, Gorenek, B, Grace, A, Ho, S, Kaski, J, Kuck, K, Lambiase, P, Sacher, F, Sarquella-Brugada, G, Suwalski, P, Zaza, A, De Potter, T, Sticherling, C, Aboyans, V, Basso, C, Bocchiardo, M, Budts, W, Delgado, V, Dobrev, D, Fitzsimons, D, Gevaert, S, Heidbuchel, H, Hindricks, G, Hlivak, P, Kanagaratnam, P, Katus, H, Kautzner, J, Kriebel, T, Lancellotti, P, Landmesser, U, Leclercq, C, Lewis, B, Lopatin, Y, Merkely, B, Paul, T, Pavlovic, N, Petersen, S, Petronio, A, Potpara, T, Roffi, M, Scherr, D, Shlyakhto, E, Simpson, I, Zeppenfeld, K, Windecker, S, Baigent, C, Collet, J, Dean, V, Gale, C, Grobbee, D, Halvorsen, S, Iung, B, Juni, P, Lettino, M, Mueller, C, Richter, D, Sousa-Uva, M, Touyz, R, Amara, W, Grigoryan, S, Podczeck-Schweighofer, A, Chasnoits, A, Vandekerckhove, Y, Sokolovich, S, Traykov, V, Skoric, B, Papasavvas, E, Riahi, S, Kampus, P, Parikka, H, Piot, O, Etsadashvili, K, Stellbrink, C, Manolis, A, Csanadi, Z, Gudmundsson, K, Erwin, J, Barsheshet, A, De Ponti, R, Abdrakhmanov, A, Jashari, H, Lunegova, O, Jubele, K, Refaat, M, Puodziukynas, A, Groben, L, Grosu, A, Ibtissam, F, Trines, S, Poposka, L, Haugaa, K, Kowalski, O, Cavaco, D, Dobreanu, D, Mikhaylov, E, Zavatta, M, Nebojsa, M, Ferreira-Gonzalez, I, Juhlin, T, Reichlin, T, Haouala, H, Akgun, T, and Gupta, D

Subjects
Focal, Supraventricular, Atrioventricular, Nodal, Guidelines, Ablation, Flutter, Guideline, Tachycardia, Re-entrant, Arrhythmia, Junctional, Macrore-entrant, Pre-excitation
Abstract

E' una "linea-guida" non esiste abstract.

Published
2020

22. [The Pacemaker and Implantable Cardioverter-Defibrillator Registry of the Italian Association of Arrhythmology and Cardiac Pacing - Annual report 2019]

Author

Proclemer, A., Zecchin, M., Zanotto, G., D'Onofrio, A., De Ponti, R., Ricci, R. P., Facchin, D., Rebellato, L., Ghidina, M., Bianco, G., Bernardelli, E., Miconi, A., Zorzin, A. F., and Gregori, D.

Subjects
Aged, 80 and over, Pacemaker, Artificial, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Pacemaker, Italy, Artificial, Atrial Fibrillation, Aged, Humans, Registries, 80 and over, Implantable, Defibrillators
Abstract

The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) Registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2019 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers.The Registry collects prospectively national PM and ICD implantation activity on the basis of European cards.PM Registry: data about 22 889 PM implantations were collected (19 621 first implants and 3268 replacements). The number of collaborating centers was 173. Median age of treated patients was 81 years (75 quartile I; 87 quartile III). ECG indications included atrioventricular conduction disorders in 33.3% of first PM implants, sick sinus syndrome in 16.4%, atrial fibrillation plus bradycardia in 11.6%, other in 38.7%. Among atrioventricular conduction defects, third-degree atrioventricular block was the most common type (18.3% of first implants). Use of single-chamber PMs was reported in 25.5% of first implants, of dual-chamber PMs in 67.1%, of PMs with cardiac resynchronization therapy (CRT) in 1.5%, and of single lead atrial-synchronized ventricular stimulation (VDD/R PMs) in 5.8%. ICD Registry: data about 17 328 ICD implantations were collected (12 129 first implants and 5199 replacements). The number of collaborating centers was 425. Median age of treated patients was 71 years (62 quartile I; 77 quartile III). Primary prevention indication was reported in 83.1% of first implants, secondary prevention in 16.9% (cardiac arrest in 5.9%). A single-chamber ICD was used in 26.1% of first implants, dual-chamber ICD in 28.0% and biventricular ICD in 45.9%.The PM and ICD Registry appears fundamental for monitoring PM and ICD utilization on a large national scale with rigorous examination of demographics and clinical indications. The PM Registry showed stable electrocardiographic and symptom indications, with an important prevalence of dual-chamber pacing. The use of CRT-PM regards a very limited number of patients. The ICD Registry documented a large use of prophylactic and biventricular ICD, reflecting a favorable adherence to trials and guidelines in clinical practice. In order to increase and optimize the cooperation of Italian implanting centers, online data entry (https://www.aiac.it/riprid) should be adopted at large scale.

Published
2021

24. Out-of-hospital cardiac arrest and ambient air pollution: A dose-effect relationship and an association with OHCA incidence

Author

Gentile, F. R., Primi, R., Baldi, E., Compagnoni, S., Mare, C., Contri, E., Reali, F., Bussi, D., Facchin, F., Currao, A., Bendotti, S., Savastano, S., Cuzzoli, A., Pagliosa, A., Matiz, G., Russo, A., Vecchi, A. L., Fantoni, C., Parogni, P., Fava, C., Franzosi, C., Vimercati, C., Franchi, D., Storti, E., Rizzi, U., Ruggeri, S., Taravelli, E., Giovenzana, F., Buetto, G., Villa, G. F., Botteri, M., Caico, S. I., Bergamini, G., Cominesi, I. R., Carnevale, L., Caresani, M., Luppi, M., Migliori, M., Centineo, P., Genoni, P., Bertona, R., De Ponti, R., Buratti, S., Danzi, G. B., Marioni, A., Palo, A., De Pirro, A., Molinari, S., Sgromo, V., Musella, V., Paglino, M., Mojoli, F., Lusona, B., Pagani, M., Curti, M., Klersy, C., Campi, S., Castiglioni, B., Piccolo, U., Cazzaniga, M., Passarelli, I., Perone, G., Panni, G., Ghiraldin, D., Bettari, L., Moschini, L., and Zanotti, L.

Subjects
Atmospheric Science, Meteorological Concepts, Epidemiology, Air pollution, Cardiovascular Medicine, Logistic regression, medicine.disease_cause, Geographical locations, chemistry.chemical_compound, Medical Conditions, Medicine and Health Sciences, Cardiac Arrest, Emergency medical services, Medicine, media_common, Air Pollutants, Multidisciplinary, Geography, Organic Compounds, Incidence, Incidence (epidemiology), Pollution, Europe, Chemistry, Italy, Cardiovascular Diseases, Physical Sciences, Research Article, media_common.quotation_subject, Science, Cardiology, Meteorology, Air Pollution, Environmental health, Humans, Nitrogen dioxide, European Union, Air quality index, Pollutant, business.industry, Ecology and Environmental Sciences, Organic Chemistry, Chemical Compounds, Humidity, Benzene, Environmental Exposure, Logistic Models, chemistry, Medical Risk Factors, Earth Sciences, Out-of-Hospital Cardiac Arrest, People and places, business
Abstract

Background Pollution has been suggested as a precipitating factor for cardiovascular diseases. However, data about the link between air pollution and the risk of out-of-hospital cardiac arrest (OHCA) are limited and controversial. Methods By collecting data both in the OHCA registry and in the database of the regional agency for environmental protection (ARPA) of the Lombardy region, all medical OHCAs and the mean daily concentration of pollutants including fine particulate matter (PM10, PM2.5), benzene (C6H6), carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2), and ozone (O3) were considered from January 1st to December 31st, 2019 in the southern part of the Lombardy region (provinces of Pavia, Lodi, Cremona and Mantua; 7863 km2; about 1550000 inhabitants). Days were divided into high or low incidence of OHCA according to the median value. A Probit dose-response analysis and both uni- and multivariable logistic regression models were provided for each pollutant. Results The concentrations of all the pollutants were significantly higher in days with high incidence of OHCA except for O3, which showed a significant countertrend. After correcting for temperature, a significant dose-response relationship was demonstrated for all the pollutants examined. All the pollutants were also strongly associated with high incidence of OHCA in multivariable analysis with correction for temperature, humidity, and day-to-day concentration changes. Conclusions Our results clarify the link between pollutants and the acute risk of cardiac arrest suggesting the need of both improving the air quality and integrating pollution data in future models for the organization of emergency medical services.

Published
2021

27. Ventricular Preexcitation: An Anomalous Wave Interfering with the Ordered Ventricular Activation

Author

Bagliani, G., De Ponti, R., Notaristefano, F., Cavallini, C., Padeletti, M., and Leonelli, F. M.

Subjects
Aged, 80 and over, Male, Pre-Excitation Syndromes, Heart Ventricles, Oesophageal pacing, Accessory Atrioventricular Bundle, ECG recording, Electrocardiography, Heart Conduction System, Ventricular preexcitation, Kent bundle, Mahaim fibers, Humans
Abstract

Ventricular preexcitation is a depolarization of the ventricles that occurs before the conventional sequence, and the electrocardiogram is the specific test for diagnosis. A Kent bundle is the paradigm of ventricular preexcitation, and it is associated with short PR, wide QRS and delta wave. This finding is not always very evident, as it can have different degrees of pre-eccitazione; therefore great diagnostic care must be taken in this field. If not properly identified, the pattern of ventricular preexcitation may lead to an incorrect diagnosis. The methodology of precision electrocardiology is able to confront all these aspects.

Published
2020

28. The Atrial Fibrillation Ablation Pilot Study: an European Survey on Methodology and results of catheter ablation for atrial fibrillation conducted by the European Heart Rhythm Association

Author

Arbelo, Elena, Brugada, Josep, Hindricks, Gerhard, Maggioni, Aldo P., Tavazzi, Luigi, Vardas, Panos, Laroche, Cécile, Anselme, Frédéric, Inama, Giuseppe, Jais, Pierre, Kalarus, Zbigniew, Kautzner, Josef, Lewalter, Thorsten, Mairesse, Georges H., Perez-Villacastin, Julian, Riahi, Sam, Taborsky, Milos, Theodorakis, George, Trines, Serge A., Brugada, Josep, Arbelo, Elena, Hindriks, Gerhard, Maggioni, Aldo P., Morgan, John, Tavazzi, Luigi, Vardas, Panos, Alonso, Angeles, Ferrari, Roberto, Komajda, Michel, Tavazzi, Luigi, Wood, David, Vardas, Panos, Brugada, Josep, Mairesse, Georges, Taborsky, Milos, Kautzner, Josef, Lewalter, Thorsten, Riahi, Sam, Jais, Pierre, Anselme, Frédéric, Theodorakis, George, Inama, Giuseppe, Trines, Serge, Kalarus, Zbigniew, Villacastin, Julian Perez, Maggioni, Aldo P., Manini, Malika, Gracia, Gérard, Laroche, Cécile, Missiamenou, Viviane, Taylor, Charles, Konte, Marème, Fiorucci, Emanuela, Lefrancq, Elin Folkesson, Glémot, Myriam, McNeill, Patti-Ann, Bois, Timothée, Heidbüchel, H., Nuyens, D., Boland, J., Dinraths, V., Herzet, J.-M., Hoffer, E., Malmendier, D., Massoz, M., Pourbaix, S., Ballant, E., Blommaert, D., Deceuninck, O., Dormal, F., Xhaet, O., De Potter, T., Geelen, P., Derycker, K., Duytschaever, M., Tavernier, R., Vandekerckhove, Y., Vankats, D., Bulava, A., Hanis, J., Sitek, D., Blahova, M., Cihak, R., Hanyasova, L., Jansova, H., Peichl, P., Tanzerova, M., Wichterle, D., Duda, J., Haman, L., Parizek, P., Coling, L., Neuzil, P., Petru, J., Sediva, L., Skoda, J., Chovancik, J., Fiala, M., Neuwirth, R., Karlsdottir, A., Pehrson, S., Gerdes, C., Jensen, H.K., Lukac, P., Nielsen, J. C., Hansen, J., Johannessen, A., Hansen, P. S., Pedersen, A.K., Heath, F.P., Hjortshoj, S., Thogersen, A.M., Da Costa, A., Martel, I., Romeyer-Bouchard, C., Sadki, N., Schmid, A., Haissaguerre, M., Hocini, M., Knecht, S., Sacher, F., Ait Said, M., Cauchemez, B., Ledoux, F., Thomas, O., Cebron, J.-P., Decarsin, N., Gras, D., Hervouet, S., Durand, C., Durand-Dubief, A., Poty, H., Babuty, D., Pierre, B., Albenque, J.-P., Boveda, S., Combes, N., Mas, R., Hermida, J-S., Kubala, M., Godin, B., Savouré, A., Soublin, Y., Defaye, P., Jacon, P., Brigadeau, F., Corbut, S., Flament-Balzola, F., Kacet, S., Klug, D., Lacroix, D., Copie, X., Gilles, L., Hocine, Z., Paziaud, O., Piot, O., Crocq, C., Kaballu, G., Le Moal, V., Lotton, P., Mabo, P., Pavin, D., Andronache, M., De Chillou, C., Magnin-Poull, I., Deharo, J.-C., Durand, C., Franceschi, F., Peyrouse, E., Prevot, S., Etchegoin, M., Extramiana, F., Leenhardt, A., Messali, A., Heine, T., Schneider, A., Winter, N., Brachmann, J., Ritscher, G., Schertel-Gruenler, B., Simon, H., Sinha, A.-M., Turschner, O., Wystrach, A., Stemberg, M., Kuck, K.-H., Metzner, A., Tilz, R., Wissner, E., Heitmann, K., Willems, S., Andresen, D., Mueller, S., Volkmer, M., Schmidt, B., Kostopoulou, A., Livanis, E., Voudris, V., Efremidis, M., Letsas, K., Tsikrikas, S., Christoforatou, E., Ioannidis, P., Katsivas, A., Kourouklis, S., Andrikopoulos, G., Rassias, I., Tzeis, S., Dakos, G., Paraskevaidis, S., Stavropoulos, G., Theofilogiannakos, E., Vassilikos, V.P., Bongiorni, M.G., Zucchelli, G., Raviele, A., Themistoclakis, S., Pratola, C., Tritto, M., Della Bella, P., Mazzone, P., Moltrasio, M., Tondo, C., Calo, L., De Luca, L., Guarracini, F., Lioy, E., Dozza, L., Frigoli, E., Giannelli, L., Pappone, C., Saviano, M., Schiavina, G., Vicedomini, G.G., De Ponti, R., Doni, L. A., Marazzi, R., Salerno-Uriarte, J.A., Tamborini, C., Anselmino, M., Ferraris, F., Gaita, F., Bertaglia, E., Brandolino, G., Zoppo, F., De Groot, N., Janse, P., Jordaens, L., Pison, L., Roos, C., Van Gelder, I., Manusama, R., Meijer, A., Van der Voort, P., Trines, S., Compier, Marieke G., Kazmierczak, J., Kornacewicz-Jach, Z., Wielusinski, M., Baran, J., Kulakowski, P., Dzidowski, M., Fuglewicz, A., Nowak, K., Pruszkowska-Skrzep, P., Wozniak, A., Nowak, S., Trusz-Gluza, M., Almendral, J., Atienza, F., Castellanos, E., De Diego, C., Ortiz, M., Moreno Planas, J., Perez Castellano, N., Benezet, J., Farre Muncharaz, J., Rubio Campal, J.M., Hernandez Madrid, A., Matia, R., Arana, E., Pedrote, A., Cozar, R., Peinado, R., Valverde, I., Arbelo, E., Berruezo, A., Calvo, N., Guiu, E., Husseini, S., and Mont Girbau, L.

Published
2014
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29. Role of the right ventricle in heart failure with preserved ejection fraction [Ruolo del ventricolo destro nello scompenso cardiaco a frazione di eiezione preservata]

Author

Vecchi AL, Iacovoni A, Palmieri V, De Ponti R, Senni M, Vecchi, A, Iacovoni, A, Palmieri, V, De Ponti, R, and Senni, M

Subjects
Right ventricle, Heart failure, Pulmonary hypertension
Abstract

Heart failure with preserved ejection fraction represents an emerging pandemic and one of the most relevant causes of admission in the elderly population. The hemodynamic and prognostic role of the right ventricular function in this population has been recently investigated and a position statement on behalf of the Heart Failure Association of the European Society of Cardiology has been published to guide physicians to perform a multiparametric evaluation of right ventricular morphology and function. In this brief review we summarize the role of the right ventricle and pulmonary pressure in heart failure with preserved ejection fraction, focusing on hemodynamic and clinical characteristics that identify high-risk patients with poor prognosis.

Published
2019

32. The unmet needs of sudden cardiac death. The role of the wearable cardioverter defibrillator when the risk is transient or uncertain

Author

Guerra, F., Palmisano, P., Bisignani, G., Forleo, G., Landolina, M., Soldati, E., Stabile, G., Zanotto, G., Berisso, M. Z., Boriani, G., De Ponti, R., and Ricci, R. P.

Subjects
Health Services Needs and Demand, Wearable Electronic Devices, Sudden cardiac death, Death, Sudden, Cardiac, Electric Countershock, Uncertainty, Humans, Implantable cardioverter-defibrillator, Ventricular fibrillation, Ventricular tachycardia, Wearable cardioverter-defibrillator, Defibrillators, Implantable
Abstract

Sudden cardiac death is defined as a natural death due to termination of cardiac activity associated with loss of consciousness, spontaneous breathing and circulation. Nowadays, the prevention of sudden cardiac death represents a major issue and many areas of uncertainty are not met by current evidences. Among those, reliable tools for risk stratification are still lacking, as well as solution for patients in which the risk of sudden cardiac death is due to a transient or correctable condition.The concept of the wearable cardioverter defibrillator is based on a potential solution for such grey areas. It merges long-term monitoring capabilities, shockable rhythm discrimination and shock delivery without the need for bystander assistance or invasive procedures. The present review aims to summarize current problems in dealing with this insidious condition, and to discuss potential options for patients in whom sudden cardiac death could be prevented more safely and cost-effectively.

Published
2020

33. Accessory Pathway–Mediated Tachycardias: Precision Electrocardiology Through Standard and Advanced Electrocardiogram Recording Techniques

Author

Bagliani, G, De Ponti, R, Sciarra, L, Zingarini, G, and Leonelli, Fm

Subjects
Wolff-Parkinson-White syndrome, Standard ECG recording, Electrophysiologic study, Esophageal pacing, Esophageal recording, Precision electrocardiology, Reciprocating tachycardia, Supraventricular tachycardia, Accessory Atrioventricular Bundle, Electrocardiography, Heart Conduction System, Tachycardia, Humans, Precision Medicine, Electrophysiologic Techniques, Cardiac
Abstract

An accessory pathway (AP) can be apparent during sinus rhythm if it depolarizes part of the ventricles ahead of the normal wave front from the conduction system. An AP can generate an anatomic circuit able to sustain a macroreentrant atrioventricular reentrant tachycardia. This arrhythmia can engage the normal conducting system in an antegrade direction or retrogradely, generating, respectively, a narrow or a wide complex tachycardia. The combined use of a standard electrocardiogram and an esophageal recording-pacing can be particularly useful in the first approach to patients with Wolff-Parkinson-White syndrome, further stratifying patients requiring electrophysiology study and transcatheter ablation.

Published
2020

34. 2019 ESC Guidelines for themanagement of patients with supraventricular tachycardia

Author

Brugada, J. Katritsis, D.G. Arbelo, E. Arribas, F. Bax, J.J. Blomstrom-Lundqvist, C. Calkins, H. Corrado, D. Deftereos, S.G. Diller, G.-P. Gomez-Doblas, J.J. Gorenek, B. Grace, A. Ho, S.Y. Kaski, J.-C. Kuck, K.-H. Lambiase, P.D. Sacher, F. Sarquella-Brugada, G. Suwalski, P. Zaza, A. De Potter, T. Sticherling, C. Aboyans, V. Basso, C. Bocchiardo, M. Budts, W. Delgado, V. Dobrev, D. Fitzsimons, D. Gevaert, S. Heidbuchel, H. Hindricks, G. Hlivak, P. Kanagaratnam, P. Katus, H. Kautzner, J. Kriebel, T. Lancellotti, P. Landmesser, U. Leclercq, C. Lewis, B. Lopatin, Y. Merkely, B. Paul, T. Pavlović, N. Petersen, S. Petronio, A.S. Potpara, T. Roffi, M. Scherr, D. Shlyakhto, E. Simpson, I.A. Zeppenfeld, K. Windecker, S. Baigent, C. Collet, J.-P. Dean, V. Gale, C.P. Grobbee, D.E. Halvorsen, S. Iung, B. Jüni, P. Lettino, M. Mueller, C. Richter, D.J. Sousa-Uva, M. Touyz, R.M. Amara, W. Grigoryan, S. Podczeck-Schweighofer, A. Chasnoits, A. Vandekerckhove, Y. Sokolovich, S. Traykov, V. Skoric, B. Papasavvas, E. Riahi, S. Kampus, P. Parikka, H. Piot, O. Etsadashvili, K. Stellbrink, C. Manolis, A.S. Csanádi, Z. Gudmundsson, K. Erwin, J. Barsheshet, A. De Ponti, R. Abdrakhmanov, A. Jashari, H. Lunegova, O. Jubele, K. Refaat, M.M. Puodziukynas, A. Groben, L. Grosu, A. Ibtissam, F. Trines, S.A. Poposka, L. Haugaa, K.H. Kowalski, O. Cavaco, D. Dobreanu, D. Mikhaylov, E.N. Zavatta, M. Nebojša, M. Ferreira-Gonzalez, I. Juhlin, T. Reichlin, T. Haouala, H. Akgun, T. Gupta, D. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC), Association for European Paediatric Congenital Cardiology (AEPC)

Published
2020

35. Impact of COVID-19 pandemic on the clinical activities related to arrhythmias and electrophysiology in Italy: results of a survey promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

Author

Boriani, G., Palmisano, P., Guerra, F., Bertini, M., Zanotto, G., Lavalle, C., Notarstefano, P., Accogli, M., Bisignani, G., Forleo, G. B., Landolina, M., D'Onofrio, A., Ricci, R., De Ponti, R., Luise, R., Grieco, P., Pangallo, A., Quirino, G., Talarico, A., De Bonis, S., Carbone, A., De Simone, A., Nappi, F., Rotondi, F., Stabile, G., Uran, C., Balla, C., Boggian, G., Carinci, V., Barbato, G., Corzani, A., Sabbatani, P., Erminio, M., Imberti, J. F., Malavasi, N., Pastori, P., Quartieri, F., Bottoni, N., Saporito, D., Virzi, S., Sassone, B., Zardini, M., Placci, A., Ziacchi, M., Massaro, G., Adamo, F., Scaccia, A., Spampinato, A., Biscione, F., Castro, A., Cauti, F., Rossi, P., Cinti, C., Gatto, M., Kol, A., Narducci, M. L., Pelargonio, G., Patruno, N., Pignalberi, C., Ricci, R. P., Ricciardi, D., Santini, L., Tancredi, M., Di Belardino, N., Pentimalli, F., Zoni-Berisso, M., Belotti, G., Chieffo, E., Cilloni, S., Doni, L. A., Gardini, A., Malaspina, D., Mazzone, P., Della Bella, P., Negro, R., Perego, G. B., Rordorf, R., Cipolletta, L., Russo, A. D., Luzi, M., Amellone, C., Ebrille, E., Favro, E., Lucciola, M. T., Devecchi, C., Rametta, F., Devecchi, F., Matta, M., Sant'Andrea, A. O., Santagostino, M., Dell'Era, G., Candida, T. R., Bonfantino, V. M., Gianfrancesco, D., Guido, A., Pellegrino, P. L., Pisano, E. C. L., Rillo, M., Palama, Z., Sai, R., Santobuono, V. E., Favale, S., Scicchitano, P., Nissardi, V., Campisi, G., Sgarito, G., Arena, G., Casorelli, E., Fumagalli, S., Giaccardi, M., Nesti, M., Padeletti, M., Rossi, A., Piacenti, M., Del Greco, M., Catanzariti, D., Manfrin, M., Werner, R., Marini, M., Andreoli, C., Fedeli, F., Mazza, A., Pagnotta, F., Ridarelli, M., Molon, G., and Rossillo, A.

Subjects
Male, Cardiac pacing, 030204 cardiovascular system & hematology, Ablation, Cardiac Resynchronization Therapy, 0302 clinical medicine, Surveys and Questionnaires, Health care, Pandemic, Registries, 030212 general & internal medicine, Acute management, Secondary prevention, Atrial fibrillation, Arrhythmia, COVID-19, Emergency, Implantable cardioverter defibrillators, Pacemakers, Remote monitoring, Middle Aged, Electrophysiology, Italy, Emergency Medicine, Female, Coronavirus Infections, Adult, medicine.medical_specialty, Atrial fbrillation, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Implantable cardioverter defbrillators, NO, 03 medical and health sciences, Physicians, medicine, Internal Medicine, Humans, Pandemics, Ablation, Arrhythmia, Atrial fbrillation, Emergency, Implantable cardioverter defbrillators, Pacemakers, Remote monitoring, COVID-19, Aged, business.industry, Outbreak, Arrhythmias, Cardiac, medicine.disease, Im - Original, Emergency medicine, business
Abstract

COVID-19 outbreak had a major impact on the organization of care in Italy, and a survey to evaluate provision of for arrhythmia during COVID-19 outbreak (March–April 2020) was launched. A total of 104 physicians from 84 Italian arrhythmia centres took part in the survey. The vast majority of participating centres (95.2%) reported a significant reduction in the number of elective pacemaker implantations during the outbreak period compared to the corresponding two months of year 2019 (50.0% of centres reported a reduction of > 50%). Similarly, 92.9% of participating centres reported a significant reduction in the number of implantable cardioverter-defibrillator (ICD) implantations for primary prevention, and 72.6% a significant reduction of ICD implantations for secondary prevention (> 50% in 65.5 and 44.0% of the centres, respectively). The majority of participating centres (77.4%) reported a significant reduction in the number of elective ablations (> 50% in 65.5% of the centres). Also the interventional procedures performed in an emergency setting, as well as acute management of atrial fibrillation had a marked reduction, thus leading to the conclusion that the impact of COVID-19 was disrupting the entire organization of health care, with a massive impact on the activities and procedures related to arrhythmia management in Italy. Electronic supplementary material The online version of this article (10.1007/s11739-020-02487-w) contains supplementary material, which is available to authorized users.

Published
2020

36. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

Author

De Rosa, Miriam Stefania, Spaccarotella, C., Basso, C., Calabro, M. P., Curcio, A., Filardi, P. P., Mancone, M., Mercuro, G., Muscoli, S., Nodari, S., Pedrinelli, R., Sinagra, G., Indolfi, C., Angelini, F., Barilla, F., Bartorelli, A., Benedetto, F., Bernabo, P., Bolognese, L., Briani, M., Cacciavillani, L., Calabrese, Anna Chiara, Calabro, P., Caliendo, L., Calo, L., Casella, Gioietta, Casu, G., Cavallini, C., Ciampi, Q., Ciccone, M., Comito, M., Corrada, E., Crea, Filippo, D'Andrea, A., D'Urbano, M., De Caterina, R., De Ferrari, G., De Ponti, R., Della Mattia, A., Di Mario, Clara, Donnazzan, L., Esposito, Gianfranco, Fedele, F., Ferraro, A., Galasso, G., Galie, N., Gnecchi, M., Golino, P., Golia, B., Guarini, P., Leonardi, S., Locuratolo, N., Luzza, F., Manganiello, V., Francesca Marchetti, M., Marenzi, Giancarlo, Margonato, A., Meloni, L., Metra, M., Milo, Anna Maria, Mongiardo, A., Monzo, L., Morisco, C., Novo, G., Pancaldi, S., Parollo, M., Paterno, G., Patti, G., Priori, S., Ravera, A., Giuseppe Rebuzzi, A., Rossi, M., Scherillo, M., Semprini, F., Senni, M., Sibilio, G., Siviglia, M., Tamburino, C., Tortorici, G., Versace, F., Villari, B., Volpe, M., De Rosa S. (ORCID:0000-0002-8869-155X), Calabrese A., Casella G., Crea F. (ORCID:0000-0001-9404-8846), DI Mario C., Esposito G., Marenzi G., Milo M., De Rosa, Miriam Stefania, Spaccarotella, C., Basso, C., Calabro, M. P., Curcio, A., Filardi, P. P., Mancone, M., Mercuro, G., Muscoli, S., Nodari, S., Pedrinelli, R., Sinagra, G., Indolfi, C., Angelini, F., Barilla, F., Bartorelli, A., Benedetto, F., Bernabo, P., Bolognese, L., Briani, M., Cacciavillani, L., Calabrese, Anna Chiara, Calabro, P., Caliendo, L., Calo, L., Casella, Gioietta, Casu, G., Cavallini, C., Ciampi, Q., Ciccone, M., Comito, M., Corrada, E., Crea, Filippo, D'Andrea, A., D'Urbano, M., De Caterina, R., De Ferrari, G., De Ponti, R., Della Mattia, A., Di Mario, Clara, Donnazzan, L., Esposito, Gianfranco, Fedele, F., Ferraro, A., Galasso, G., Galie, N., Gnecchi, M., Golino, P., Golia, B., Guarini, P., Leonardi, S., Locuratolo, N., Luzza, F., Manganiello, V., Francesca Marchetti, M., Marenzi, Giancarlo, Margonato, A., Meloni, L., Metra, M., Milo, Anna Maria, Mongiardo, A., Monzo, L., Morisco, C., Novo, G., Pancaldi, S., Parollo, M., Paterno, G., Patti, G., Priori, S., Ravera, A., Giuseppe Rebuzzi, A., Rossi, M., Scherillo, M., Semprini, F., Senni, M., Sibilio, G., Siviglia, M., Tamburino, C., Tortorici, G., Versace, F., Villari, B., Volpe, M., De Rosa S. (ORCID:0000-0002-8869-155X), Calabrese A., Casella G., Crea F. (ORCID:0000-0001-9404-8846), DI Mario C., Esposito G., Marenzi G., and Milo M.

Abstract

Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.

Published
2020

40. Surface Electrocardiogram Recording: Baseline 12-lead and Ambulatory Electrocardiogram Monitoring

Author

Padeletti, M., Bagliani, G., De Ponti, R., Leonelli, F. M., and Locati, E. T.

Subjects
Body surface mapping, Adult, Aged, 80 and over, Male, Ambulatory ECG recording, Vectorcardiography, Signal Processing, Computer-Assisted, Middle Aged, Electrocardiography, Child, Preschool, Standard ECG, Humans, Female, Child
Abstract

The 12-lead standard electrocardiogram (ECG) is a 10 second recording of human myocytes electrical activity. Filters and oversampling are necessary in order to acquire a smooth signal without distortion. ECG recordings may display ongoing arrhythmias, and some leads may be helpful in formulating the diagnosis. Advanced modalities of baseline ECG recording can be used to extract additional information with significant prognostic value. Ambulatory ECG (AECG) recording is a long-term and low-cost external recording obtained with 1 to 12 leads lasting from 24 to 30 days. For patient comfort, longer AECG recordings use fewer leads.

Published
2019

41. Precision Electrocardiology: A Rational Approach for Simple and Complex Arrhythmias

Author

Bagliani, G., De Ponti, R., and Leonelli, F. M.

Subjects
Adult, Male, ECG, Arrhythmias, Interpretative method, Precision electrocardiology, Arrhythmias, Cardiac, Middle Aged, Electrocardiography, Humans, Female, Precision Medicine, Aged
Abstract

Electrocardiography (ECG) in all its forms, from 12-lead ECG to long-term monitoring, is considered, an old and increasingly irrelevant test in this high technology era. This article reviews the clinical utility of this tool and argues that the obsolescence is due to an increasing inability to read electrocardiographic tracings. The usual interpretative pitfalls are discussed and a logical approach is proposed with illustrative examples. Finally, the concept of precision ECG is presented and its meaning reviewed.

Published
2019

42. Challenging Cases of Wide Complex Tachycardias: Use and Limits of Algorithms

Author

Tordini, A., Leonelli, F. M., De Ponti, R., Bagliani, G., Donzelli, S., Lazzari, L., Marini, C., Pirrami, M. M., and Carreras, G.

Subjects
Electrocardiography, Aberrant ventricular conduction, Arrhythmogenic right ventricular cardiomyopathy, Epsilon wave, Outflow tract ventricular tachycardia, Right branch ventricular tachycardia, Ventricular tachycardia, Wide QRS complex tachycardia, Tachycardia, Ventricular, Humans, Algorithms
Abstract

Electrocardiographic algorithms are particularly useful to differentiate, in the presence of a wide complex tachycardia, between supraventricular aberrancy and ventricular tachycardias (VT). There are numerous limitations to the sensitivity and specificity of these algorithms including the presence of accessory pathways, use of antiarrhythmic drugs, congenital heart diseases, electrolytes impairments, and artificial pacing. Once the diagnosis of VT has been reached, other algorithms can help in localizing the origin of the ventricular arrhythmia. These approaches are also limited by the anatomic structure of where the arrhythmia originates. This article illustrates the difficulties in applying common algorithms in many clinical circumstances.

Published
2019

43. Polymorphic Wide QRS Complex Tachycardia: Differential Diagnosis

Author

Jebberi, Z., Marazzato, J., De Ponti, R., Bagliani, G., Leonelli, F. M., Boveda, S., and Clinical sciences

Subjects
Ventricular Fibrillation/diagnosis, Polymorphic ventricular tachycardia, Afterdepolarizations, Bidirectional ventricular tachycardia, Phase 2 reentry, Preexcited atrial fibrillation, Torsade de pointes, Ventricular fibrillation, Diagnosis, Differential, Electrocardiography, Atrial Fibrillation, Ventricular Fibrillation, cardiovascular system, Atrial Fibrillation/diagnosis, Tachycardia, Ventricular/diagnosis, Tachycardia, Ventricular, Humans, cardiovascular diseases, Cardiology and Cardiovascular Medicine
Abstract

Polymorphic wide QRS complex tachycardia is defined as a tachyarrhythmia showing variable and frequently alternating morphologies of the QRS complex with irregular R-R intervals. It may present with a specific and reproducible pattern including torsade de pointes and bidirectional ventricular tachycardia or with a nonspecific and very irregular pattern, different from ventricular fibrillation. Polymorphic ventricular tachycardia is a challenging diagnosis and is associated with a high risk for sudden cardiac death. Although rare, preexcited atrial fibrillation over multiple accessory pathways can also generate a polymorphic wide QRS complex tachycardia mimicking polymorphic ventricular tachycardia.

Published
2019

44. Italian Ablation Register 2017. Italian Association of Arrhythmology and Cardiostimulation

Author

Stabile, G., Bertaglia, E., Guerra, F., Palmisano, P., Berisso, M. Z., Soldati, E., Bisignani, G., Forleo, G. B., Zanotto, G., Landolina, M., De Ponti, R., Boriani, G., and Ricci, R. P.

Subjects
Registry, Italy, Medical, Arrhythmias, Catheter ablation, Arrhythmias, Cardiac, Cardiology, Catheter Ablation, Electrophysiologic Techniques, Cardiac, Humans, Retrospective Studies, Societies, Medical, Registries, Electrophysiologic Techniques, Societies, Cardiac
Published
2019

50. Privacy y control del correo y de la navegaciòn por la Red en el puesto de trabajo

Author

De Ponti, R, PECORELLA, CLAUDIA, Boix Reig, J, Jareno Leal, A, De Ponti, R, and Pecorella, C

Subjects
diritto alla riservatezza sul luogo di lavoro, diritto alla segretezza della corrispondenza e delle comunicazioni, comunicazioni informatiche
Abstract

El control del empresario sobre el correo de los empleados interfiere en el derecho a la libertad y al secreto “de la corrispondencia y de cualquier otra forma de comunicación” que en el articulo 15 de la Constitución italiana se declara inviolable y en relación al cual se admiten limitaciones “solamente por acto motivado de la autoridad judicial con las garantías establecidas por la ley”. En este sentido resulta significativa también la jurisprudencia de la Corte Europea de Derechos Humanos, que no dudó en extender a los mensajes de correo electrónico las garantías de confidencialidad establecidas para la correspondencia del art. 8 CEDH. Consecuentemente, la falta de respeto a esa esfera de intimidad por parte del empresario – y/o por otra persona autorizada por él – adquiere relevancia penal en el ordenamiento italiano por violación de correspondencia en el sentido del articulo 616 c.p., o por acceso abusivo en el sentido del articulo 615-ter c.p. si la comunicación ya ha concluido y los mensajes archivados. La diversa cuestión del control de la navegación por la Red tiene que ser afrontada respecto a las normas del Estatuto de los Trabajadores, que prevé una prohibición casi absoluta de utilizar aparatos para controlar “a distancia” la actividad de los trabajadores.

Published
2010

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