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1. Noninvasive continuous arterial pressure monitoring shortens atrial fibrillation ablation procedural duration

Author

M Parollo, A Di Cori, F Fiorentini, R De Lucia, V Barletta, S Viani, L Paperini, A Canu, L Mazzocchetti, S Sbragi, L Segreti, G Grifoni, E Soldati, and G Zucchelli

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction Transcatheter atrial fibrillation (AF) ablation is in most centres commonly carried out with continuous invasive radial arterial blood pressure (BP) monitoring. Novel devices enable continuous non-invasive BP monitoring, with acceptable agreement and optimal safety profile when compared to standard of care invasive BP monitoring, leading to improved patient comfort in the electrophysiology lab. Purpose Aim of the study was to assess in terms of procedural efficiency continuous non-invasive BP monitoring during transcatheter atrial fibrillation ablation. Methods We prospectively enrolled 42 consecutive patients (age 61±9 years, 80% male) undergoing transcatheter AF ablation (60% paroxysmal, 40% persistent) at our centre undergoing AF ablation with continuous BP measurement using a non-invasive finger volume clamp device. We then compared them with an historical cohort of 42 consecutive patients undergoing AF ablation (62% paroxysmal, 38% persistent) with standard of care invasive BP monitoring with a radial cannula. We compared the two groups in terms of total procedural duration (in and out from the EP lab). Results Mean total procedural duration was 165,29±54,95 minutes in the non-invasive group and 196,55±46,67 minutes in the invasive group (P=0,006). Conclusion In patients undergoing AF ablation, non-invasive finger volume-clamp continuous BP monitoring allowed for a significant reduction of total procedural duration when compared to standard of care invasive BP monitoring. Larger studies are needed to confirm these results.

Published
2023
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2. Ventricular tachycardia site of origin prediction by a QRS axis-based algorithm confirmed by heterogenous tissue channel localization obtained from artificial-intelligence-powered CMR analysis

Author

L Mazzocchetti, M Parollo, S Sbragi, V Barletta, L Segreti, A Di Cori, R De Lucia, G Grifoni, E Soldati, S Viani, G Branchitta, M Carluccio, A Canu, L Paperini, and G Zucchelli

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction A previously validated algorithm allows to accurately identify ventricular tachycardia (VT) exit site in a 17-segments American Heart Association left ventricle model in patients with structural heart disease (SHD). ADAS3D is a novel artificial-intelligence cardiac magnetic resonance (CMR) post-processing software which enables heterogeneous tissue channel (HTC) identification. Purpose The aim of this study is to compare inferred VT exit site between QRS-axis based model and HTC identification from CMR post-processing. Methods All subjects allocated to a CMR-guided or aided approach from a multicenter randomized clinical trial were analyzed. Patients with available 12-lead ECG of clinical VT obtained before ablation were analyzed in terms of concordance between VT site of origin inferred from a QRS-axis and location of HTCs in a 17-segments model. Results 10 out of 15 patients had 12-lead ECG of clinical VT (80% male, 60% with ischemic cardiomyopathy, mean age 63,5±16,95 years, mean tachycardia cycle length 373,7±99,55 ms). 7 out of 10 patients (70,00%) had at least one HTC located at VT exit site as predicted by a QRS axis-based algorithm. In all remaining cases (3 out of 10) HTC location was found in a segment adjacent to ECG-derived exit site. All patients underwent CMR-guided or CMR-aided VT ablation with acute clinical success (noninducibility of the clinical VT). Conclusion VT site of origin prediction via a QRS axis-based algorithm allows for reasonable prediction of HTC presence at inferred site of origin. Larger studies are needed in order to confirm such findings and their potential clinical implications.

Published
2023
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3. P255 A GOOD PERSPECTIVE NEEDS TWO POINT OF VIEW: TRANSVENOUS CRT–D LEAD EXTRACTION COMPLICATED BY INTRAOSSEUS COURSE OF THE CORONARY SINUS LEAD

Author

S Sbragi, M Parollo, L Segreti, A Del Corso, M Carluccio, A Di Cori, V Barletta, L Mazzocchetti, L Paperini, R De Lucia, S Viani, A Canu, G Grifoni, T Cellamaro, G Branchitta, E Soldati, and G Zucchelli

Subjects
Cardiology and Cardiovascular Medicine
Abstract

A 66 year old woman with dilated cardiomyopathy, carrier of CRT–D device in secondary prevention since 2013 and a mitralic mechanical prosthesis, suffered of CIED infection, confirmed by PET imaging exam. She was scheduled in our Hospital Unit for transvenous lead extraction. The procedure was performed by the subclavian approach, and the transvenous lead extraction was staged using mechanical telescopic sheats. After the extraction of the atrial and ventricular leads, the advance of the sheats was hampered by tenacious adherences along the site of vascular subclavian access of the coronary sinus lead. Firstly the portion of the lead running inside the coronary sinus was retracted with a pigtail by femoral vein approach. The inability to pass over the tenacious adherences at the point of the subclavian vein access were overcome expanding the surgical field with the help of the Vascular Surgeon, finding out that the adherence was determined by the presence of an osteophyte embracing the lead to the clavicle. The osteophyte was then surgically removed and the lead was finally extracted by jugular vein access. In this case the CIED leads were implanted using a intrathoracic subclavian venous access, where the vein lies behind the medial region of the clavicle. This approach could rarely lead to a periosteal penetration during needle advance that can generate osteophytes between the lead and the bone. In those circumstances the transvenous lead extraction could become extremely complicated, whatever technique is used.

Published
2023
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4. Transvenous lead extraction: safety and efficacy of local anesthesia

Author

F Fiorentini, L Segreti, M Giannotti Santoro, S Viani, G Zucchelli, A Di Cori, R De Lucia, G Grifoni, L Paperini, E Soldati, V Barletta, A Canu, S Della Volpe, L Mazzocchetti, and MG Bongiorni

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction Patients undergoing transvenous lead extraction (TLE) usually receive general anesthesia, although in our experience local anesthesia is a frequent alternative. Purpose We sought to verify safety and effectiveness of local anesthesia in patients undergoing tranvenous lead extraction (TLE). Methods A retrospective analysis of patients who underwent to TLE in our center was performed. 1293 patients were divided in three groups depending on EROS class and comparisons were made in each group depending on type of anesthesia. Lead extraction was performed by manual traction or mechanical dilatation and use of transjugular approach was evaluated on case-by-case. Results In the EROS 1 group (726 pts.) 559 (77%) receive local anesthesia, in the EROS 2 (367 pts.) 252 (69%) and in the EROS 3 (200 pts.) 73 (36%). There was no differences in total complications (EROS 1 3.76% vs 2.99%, p=0.814, EROS 2 4.76% vs 5.21%, p=0.851, EROS 3 5.48% vs 11.81%, p=0.210) and clinical success (EROS 1 98.75% vs 99.40%, p=0.689, EROS 2 98.41% vs 94.78%, p=0.077, EROS 3 80.82% vs 85.04%, p=0.439) between local and general anesthesia throughout the groups; use of internal jugular approach was significantly higher in EROS 2 patients undergoing general anesthesia (4.76% vs 11.30%, p=0.021), while in EROS 1 and 3 patients this difference was not statistically significant (EROS 1 5.01% vs 8.38%, p= 0.101, EROS 3 8,22% vs 18,11%, p=0.056). Conclusion These results suggest that local anesthesia in patients undergoing transvenous lead extraction does not affect procedural outcomes and safety. Complex procedures with the need for internal jugular approach may drive this choice with preference for general anesthesia.

Published
2022
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5. ELECTRa Registry Outcome Score (EROS): validation in a single center population

Author

L Segreti, F Fiorentini, M Giannotti Santoro, V Barletta, G Zucchelli, A Di Cori, R De Lucia, A Canu, S Viani, L Paperini, T Cellamaro, E Soldati, M Carluccio, G Branchitta, and MG Bongiorni

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Funding Acknowledgements Type of funding sources: None. Introduction The ELECTRa Registry Outcome Score (EROS) was developed to identify patients at increased transvenous lead extraction (TLE) risk Purpose Aim of the study is to explore the efficiency of EROS for stratifying patients undergoing TLE. Methods We performed a retrospective analysis of 1293 patients who underwent to TLE in our center. We performed extraction procedures with manual traction or mechanical dilatation. We calculated EROS, and we divided patients into 3 groups depending on the EROS class. For this purpose, we made statistical analysis and comparison between EROS 1+2 vs. EROS 3 groups. We used an X2 for among-group comparisons or Fisher’s exact test if the expected cell count was less than five. Results Our analysis included 1293 patients. EROS-1 counted 726 patients (56,1%), EROS-2 367 (28,4%) patients and EROS-3 200 (15,5%) patients. There was no statistical difference in peri-procedural death between EROS-1+2 and EROS-3 (0.18% vs 1.50%, p=0.134). Major complications (0.82% vs. 3.00%, p=0.014), minor complications (3.11% vs. 6.50%, p=0.019) and use of internal jugular approach (6.13% vs. 14.50%, p Conclusion EROS effectively separates patients at higher risk of complications. Use of internal jugular approach was significantly higher in EROS 3 patients.

Published
2022
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6. Safety of Omitting Defibrillation Efficacy Testing With Subcutaneous Defibrillators: A Propensity-Matched Case-Control Study

Author

Valter Bianchi, Giovanni Bisignani, Federico Migliore, Mauro Biffi, Gerardo Nigro, Stefano Viani, Fabrizio Caravati, Luca Checchi, Pietro Francia, Paolo De Filippo, Domenico Pecora, Carlo Lavalle, Antonio Scalone, Pietro Rossi, Pietro Palmisano, Giovanni Licciardello, Roberto Ospizio, Mariolina Lovecchio, Sergio Valsecchi, Antonio D’Onofrio, A. D’Onofrio, V. Tavoletta, S. De Vivo, P. Pieragnoli, G. Ricciardi, L. Perrotta, L. Ottaviano, I. Diemberger, M. Ziacchi, C. Martignani, V. Russo, A. Rago, E. Ammendola, M.G. Bongiorni, R. De Lucia, A. Di Cori, L. Paperini, L. Segreti, E. Soldati, G. Zucchelli, F. Palano, C. Adduci, P. Ferrari, C. Leidi, A. Dello Russo, M. Casella, F. Guerra, L. Cipolletta, S. Molini, S. Pedretti, M. Giammaria, M.T. Lucciola, C. Amellone, M. Accogli, B. Schintu, G. Tola, A. Setzu, E. Pisanò, G. Milanese, S. De Bonis, C. La Greca, B. Sarubbi, D. Colonna, E. Romeo, S. Sala, P. Mazzone, P. Della Bella, M. Viscusi, D. Di Maggio, M. Brignoli, F. Drago, M.S. Silvetti, R. Brambilla, A. Pani, A Lupi, G. Carreras, S. Donzelli, C. Marini, A. Tordini, E. Racca, A. Gonella, G. Musumeci, G. Rossetti, E Menardi, G. P. Ballari, F. Ammirati, L. Santini, K. Mahfouz, C. Colaiaco, GB. Perego, V. Rella, G. Bertero, P. Sartori, A. Rapacciuolo, V. Liguori, A. Viggiano, G. Busacca, G. Savarese, C. Andreoli, L. Pimpinicchio, D. Pellegrini, G. Stifano, F. Romeo, D. Sergi, S. Badolati, P. Pepi, D. Nicolis, R. Rordorf, A. Vicentini, S. Savastano, B. Petracci, A. Sanzo, E. Baldi, M. Casula, F. Solimene, G. Shopova, V. Schillaci, A. Arestia, A. Agresta, A. Piro, GB. Forleo, A. Pangallo, M. Manzo, C. Esposito, F. Esposito, A. Curcio, D. Ricciardi, V. Calabrese, D. Giorgi, null Bovenzi, F. Busoni, A. Torriglia, M. Laffi, G. Gaggioli, G. Arena, V. Molendi, V. Borrello, M. Ratti, C. Bartoli, P. Capogrosso, M. Volpicelli, G. Covino, M. Mariani, M. Pagani, P. Notarstefano, M. Nesti, E. Dovellini, L. Giurlani, M. Landolina, E. Tavarelli, S. Bianchi, C. Uran, Massimo Vincenzo Bonfantino, E. Daleffe, D. Facchin, L Rebellato, V. Caccavo, M. Grimaldi, G. Katsouras, A. Coppolino, F. Lamberti, G. Lumia, C. Bellini, C. Bianchi, A Santoro, C Baiocchi, R Gentilini, S Lunghetti, and V Zacà

Subjects
medicine.medical_specialty, implantable, Defibrillation, business.industry, cardiac, medicine.medical_treatment, Case-control study, ventricular fibrillation, cause of death, defibrillator, Informed consent, Physiology (medical), Emergency medicine, Propensity score matching, medicine, arrhythmias, cardiac, defibrillator, implantable, propensity score, Cardiology and Cardiovascular Medicine, business, Body mass index, arrhythmias, Cause of death
Published
2021

7. Poster session Friday 7 December - PM: Effect of systemic illnesses on the heart

Author

G. Forleo, T. Henriques-Coelho, A. Kalogerakis, A. Nestoruc, R. Conti, G. Guzman Martinez, M. Ostojic, S. Aytekin, P. Margetis, D. Kremastinos, A. Hagege, M. Sunbul, L. Hazarapetyan, M. Fernandes, A. Pfuetzner, M. Akkaya, I. Paraskevaides, C. Zito, F. Castillo, D. G. Dorado, A Di Cori, O. Azevedo, M. Pizzarelli, TM Li Causi, A. Jaccard, A. Chilingaryan, A. Lourenco, B. Mutlu, E. Ermis, M. Martinek, D. Duval, L. Tumasyan, J. Thambo, P. Virot, P. De Araujo Goncalves, I. Sari, F. Colazzo, A. Stepura, M. S. Carvalho, B. Beleslin, P. Nihoyannopoulos, A. Corciu, E. Langesaeter, F. Kyndt, J. Schott, A. Diogo, G. Andersen, D. De Palma, H. Skulstad, P. Crea, S. Wirdeier, M. Olszowska, S. Castelvecchio, M. Muiesan, M. Kalantzi, G. Ertas, K. Branidou, I. Alvarez Pichel, E. Shkolnik, T. Schuster, M. J. Monaghan, A. Parkhomenko, V. Schiano Lomoriello, A. Ahmed, C. Jimenez Rubio, M. M. Urdaniz, A. M. Lesniak-Sobelga, G. Rubagotti, S. Gustavsson, Verena Stangl, F. Bertacchini, J. Otterstad, S. Matsushita, G. Macri, W. Streb, C. David, Y. Nogami, L. Faber, J. Kim, M. Chigira, M. Cusma-Piccione, S.-H. Shin, Cristina Maria Stanescu, M. Hlawaty, C. Napolitano, T. Kaier, S. Yurdakul, A. E. Masip, A. Zacharaki, S. Adawi, L. Menicanti, L. Tomkiewicz-Pajak, A. Patrianakos, S. Ercan, J. Stepanovic, F. Matei, U. Richter, E. Erdogan, R. Shaikh, A. Kepez, E. Soldati, K. Jarosz, M. Miceli, J. Grapsa, M. Cardoso, L. Boubrit, J. Singelton, M. Morenate, Henryk Dreger, I. Comanescu, L. Fontana, S. Morner, C. Agabiti Rosei, L. Brodin, J. Vaskelyte, E. Hamodraka, K. Uno, Fabian Knebel, R. Petraco, M. Komeda, L. Weinert, I. Daha, A. Shiran, V. Stinziani, I. Asmer, F. Antonini-Canterin, L. Iliuta, M. Rosca, P. Lindqvist, N. Cortez-Dias, E. Mueller, Z. Katidis, Y. Vasyuk, P. Rubis, R. Jonkaitiene, J. G. Acosta Velez, S. Lafitte, K. Fox, T. Rakowski, C. Manisty, D. Stassaldi, R. Piazza, L. Spinelli, S. Han, R. Lang, L. Oreto, T. Le Tourneau, L. Li, J. Areias, R. Isnard, D. Silva, Karl Stangl, T. Kukulski, M. Gaspari, A. Tsatsopoulou, Miguel Mota Carmo, P. Pugliatti, A. Atsumi, J. Hammel, J. B. Rius, F. D'auria, O. Ozer, A. Comaglio, Giulio Zucchelli, R. Sicari, P. Claus, D. Horstkotte, A. Di Molfetta, J. De La Hera Galarza, P. Wathen, M. Ganaeem, E. Nyktari, G. Alongi, N. Hayashi, L. Castiglioni, C. El Hamel, A. Melidonis, Y. Seo, M. Cogne, C. Corros, F. Procaccio, L. Fresiello, T. Graven, D. De Guillebon, I. Machado, V. Mor-Avi, R. Rubinshtein, E. Durmus, A. Venkatesh, A. Paini, E. Truemper, A. Aleixo, A. Sahlen, C. Wunderlich, H. Uyarel, R. Ippolito, J. Huhta, D. Morgan, M. Petrovic, G. Cole, C. Piper, N. Zhuravskaya, J. Dubiel, R. Bloise, A. Iniesta Manjavacas, J. Kleinau, J. Lambert Rodriguez, E. Pasanisi, V. Petitalot, D. Beldekos, H. Lim, P. Kleczynski, N. Echahidi, K. Linask, A. Tasal, U. Guerrini, B. Haugen, V. Pereira, M. Banovic, A. Moreo, J. Miralles Ibarra, J F Rodriguez Palomares, C. Park, O. Mjolstad, R. Levine, M. T. G. Alujas, A. Zagatina, M. Martin Fernandez, J. Voigt, E. Psathakis, Y.-Y. Yang, B. Smith, A. Marciniak, T. Yoshikawa, M. Mohammed, C. Aggiusti, H. Tountas, M. Montoro Lopez, M. Guazzi, T. Przewlocki, D. Kim, A. Vannozzi, P. Kogoj, A. Kablak-Ziembicka, S. Goncalves, P. Heilmeyer, S. Censi, J. Kwan, S. Crispo, I. Nogueira, G. Isasti Aizpurua, F. Parthenakis, K. Sveric, O. Uku, F. Anglano, R. Jozwa, A. Karamanou, B. Ozben, M. Delgado, A. Santoro, A. Scafa Udriste, B. Vujisic-Tesic, Y. Kameda, L. Mathias, M. Bongiorni, S. Gianstefani, K.-S. Hsieh, J. Cousins, M. Prull, M. Isailovic-Kekovic, M. Turfan, J. Reiken, R. Muscariello, O. Fernandez Cimadevilla, E. Tremoli, S. Gherardi, F. Musca, S. Kutty, B. Popovic, D. Dudek, L. Gullestad, Michael Laule, A. Almeida, S. Vrakas, C. Santoro, M. Moreno Yanguela, V. Nesvetov, I. Lekakis, V. Mizariene, H. Yamagata, I. Karch, C. Davos, E. Stepien, E. A. Di Panzillo, C. Morisco, S. Kim, M. Takeuchi, R. Del Bene, A. Gaspar, C. Choi, M. Duprey, C. Cefalu, P. Regnier, Q. Ciampi, D. Francis, Gerd Baldenhofer, J. Trochu, A. Dziewierz, T. Bombardini, I. Nedeljkovic, O. Tautu, O. Suhr, M. Enomoto, K.-P. Weng, E. Enache, J. Johnson, J. Legutko, S. Grigoryan, R. Winter, J. Sousa, K. Aonuma, G. Wulf, S. Priori, J. Attebery, A. Squeri, S. Bosi, D. Lavergne, F. Bandera, P. T. Mas, X. Iriart, P. Vardas, A. Brzozowska-Czarnek, B. Trimarco, J. Kasprzak, K. Stuuer, R. Arena, J. O. Na, E. Picano, A. Horovitz, M. Sucu, M. Vatankulu, Vasile Manoliu, Z. Siudak, T. Damy, H. Dores, G. Tsaoussis, Gert Baumann, J. Jakala, Z. Kalarus, R. Jasaityte, G. Dan, K. Takenaka, M. Gurzun, M. Mavroidis, R. Florez Gomez, S. Winter, A. Ebihara, E. Fousteris, N. Catibog, B. Kilickiran Avci, A. Deligiorgis, R. Sharma, A. Alonso Ladreda, M. Dorobantu, Y. Lutay, P. Barbier, O. Jobard, J. Jedrzychowska-Baraniak, M. Perez-Lopez, Y. Yatomi, C. Itziar Soto, P. Polisca, K. Adamyan, B. Putnikovic, M. Lourenco, N. Taha, C. Ebner, K. Obase, P. Podolec, F. Romeo, M. Yamamoto, K. Shahgaldi, T. Edvardsen, C. Leon, A. Varela, A. Anastasakis, D. Oh, I. Di Matteo, A. Manouras, A. Theodosis-Georgilas, J. Bernstein, D. Cini, P. Reant, L. Santini, I. Quelhas, A. Bacaksiz, E. Agabiti Rosei, S. Bartosh-Zelenaya, R. Enache, C. Baicus, G. T. Tura, K. Kimura, R. Esposito, P. Kekovic, A. Whittaker, K. Park, N. Monteforte, S. Foussas, M. Kostkiewicz, S. Damjanovic, T. Ishizu, I. Ene, L. Chiariello, M. van Bracht, L. Segreti, T. Gaspar, A. Neves, M. Estensen, S. Carerj, H. Nesser, K. Yoshida, E. Prappa, S. Connolly, A. Djordjevic-Dikic, A. Calin, P. Carrilho-Ferreira, V. Di Bello, C. Beladan, S. Im, Sebastian Spethmann, S. Hakky, U. Trecroci, S. Tamai, L. Wrotniak, J. Necas, H. Marques, A. Neskovic, K. Skjetne, M. Galderisi, V. Ruddox, C. Adam, J. Leshko, H. Le Marec, A. Mateescu, L. Tunyan, F. Baeza, R. De Lucia, S. Aakhus, W. Serra, D. Simion, I. Stankovic, L. G. Garcia-Moreno, S. Sahin, P. Seferovic, M. Casartelli, E. Nobili, J. Marques, V. Davutoglu, O. Goktekin, C. Ginghina, D. Gemma, C. Yodwut, T. Sakakura, M. Nedeljkovic, S. Viani, H. Von Bibra, N. Protonotarios, R. Onut, H. Dalen, E. Romo, S. Woo, M. Franzosi, D. Zamfir, P. Ierano, J. S. De Lezo, E. Yeager, H.-J. Trappe, F. Pereira Machado, S. Grego, C. Gronlund, J. O'driscoll, C. Tsilafakis, L. Carpinteiro, L. Sironi, B. Diaz Molina, V. Probst, P. Sousa, N. Hammoudi, S. Kovalova, L. Paperini, M. Lunati, H. Seo, G. Ferrari, J. Roquette, F. Toledano, R. Jurkevicius, G. Nicolosi, D. Mohty, V. Giga, R. Sachner, T. Butz, F. Pousset, O. Sonmez, N. Reckefuss, O. Vriz, G. Dobson, J. Zdzienicka, V. Labate, F. Pinto, C. Jorge, F. Purcarea, T. Wutthachusin, R. Strasser, I. Kostavassili, M. Szulik, D. Danford, J. Vignalou, D. Popovic, M. Ruiz Ortiz, B. Popescu, O. Guseva, J. Rios Blanco, S. Purkayastha, D. Zaliaduonyte-Peksiene, J. Lopez Sendon, A. Magalhaes, G. Plehn, A. Tanrikulu, D. Mesa, G. Di Bella, D. Muraru, M. Salvetti, A. Arandjelovic, and M. Costantino

Subjects
medicine.medical_specialty, business.industry, Alternative medicine, Physical therapy, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Session (computer science), Cardiology and Cardiovascular Medicine, business
Published
2012
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8. Saturday, 25 August 2012

Author

A. Welz, B. V. Antwerp, A Di Cori, A. Hager, P. Hatzigiannis, R. De Lucia, C. Yu, A. Apor, M. Niemann, R. Sampognaro, M. Fiuza, M. G. Charlot, N. Cortez Dias, A. Nagae, A. Maciag, T. Sato, M. Valgimigli, D. Levorato, S. Herrmann, T. Kimura, M. Luedde, V. Tzamou, M. Iwabuchi, C. Rickers, J. Sobierajski, J. Vecera, C. Vlachopoulos, K. Goscinska-Bis, S. Goldsmith, H. Ueno, J. Sosna, G. Malerba, W. Li, H. W. Lee, K. Bogaard, K. Yamada, A. Mateo-Martinez, J. Navarova, M. Zeman, K. Dimopoulos, M. P. Lopez Lereu, E. Pelissero, B. Gersak, J. M. Tolosana, S Manzano Fernandez, P. Mertens, J. J. M. Takkenberg, J. W. Kim, R.T. van Domburg, G. P. Diller, H. M. Yang, F. Gustafsson, P. G. Golzio, G. S. Hwang, J. Brugada, S. Stoerk, J. Hess, Y. Cavusoglu, L. Segreti, M. E. Trucco, C. Jacoby, I. Bafakis, T. Isshiuki, L. Pulpon, S. Pires, L. Paperini, A. Cremonesi, H. Baumgartner, C. Tsioufis, M. Valdes-Chavarri, S. Schaefer, M. Totzeck, A. Bochenek, F. Saia, P. Carrilho-Ferreira, M. Khatib, E. M. W. J. Utens, G. Zucchelli, R. Jenni, E. Gencer, N. Carter, A. Kovacs, C. Linde, V. Monivas, A. Marzocchi, L. Baerfacker, L. Mont, R. Weber, F. J. Enguita, T. L. Bergemann, M. Chudzik, A. Chernyavskiy, D. Dragulescu, S. Orwat, B. J. Choi, P. Opic, C. Torp-Pedersen, F. Gaita, V. A. W. M. Umans, A. Lopez-Cuenca, S. B. Christensen, E. C. Bertolino, D. Tousoulis, F. Weidemann, H. H. Kramer, J. Greenslade, J Cosin Sales, M. Gonzalez Estecha, W. Grosso Marra, T. Katsimichas, J. Hoerer, S. Mingo, M. Hochadel, M. A. Castel, M. S. Lattarulo, E. Y. Yun, K. Fattouch, H. S. Lim, A. Uebing, T. Ulus, J. Radosinska, A. Castro Beiras, J. Peteiro, M. Koren, C. Prados, A. Nunes, C. Rammos, C. Thomopoulos, T. Kameyama, F. Borgia, I. Voges, J. L. Looi, L. Cullen, C. Campo, J. Bis, S. Shiva, H. Kato, N. Frey, E. Andrikou, G. H. Gislason, J. Ruvira, A. Kasiakogias, S. Robalo Martins, A. M. Zimmer, M. H. Yacoub, M. Nobuyoshi, U. Zeymer, K. Hanazawa, F. J. Broullon, B. Petracci, K. Hu, A. Petrescu, A. M. Maceira Gonzalez, K. Harada, L. Swan, C. Felix, H. Inoue, T. Haraguchi, N. Cortez-Dias, S. Bisetti, P. Mitkowski, C. Daubert, H. J. Heuvelman, M. R. Gold, G. P. Kimman, O. Gaemperli, H. C. Lee, Y. Takasawa, V. Monivas Palomero, A. C. Andrade, S. Maddock, W. Budts, M. Penicka, F. J. Ten Cate, M. Czajkowski, C. D. Nguyen, K. Kaitani, K. Kintis, S. Castrovinci, D. Liu, T. Benova, K. W. Seo, B. A. Herzog, A. Ionac, C. Jorge, M. Iacoviello, S. Kuramitsu, Y. Nakagawa, K. U. Mert, A. Manari, S. Brili, R. Alonso-Gonzalez, A. J. Six, J. S. Mcghie, A. Goedecke, M. Kelm, F. C. Tanner, F. Marin, C. I. Santos De Sousa, L. Kober, M. Frigerio, D. Adam, B. E. Backus, U. Hendgen-Cotta, A. Belo, D. Couto Mallon, M. Dewor, M. Madsen, J. H. Shin, M. H. Yoon, L. Maiz, P. Lancellotti, A. Nunes Diogo, G. Ertl, R. Pietura, A. Mornos, M. Than, C. Andersson, C. Izumi, E. Liodakis, N. van Boven, Y. Y. Lam, T. Hansen, W. Roell, T. J. Hong, P. Luedicke, M. Sanchez-Martinez, L. Ruiz Bautista, E. N. Oechslin, T. Klaas, M. T. Martinez, W. A. Helbing, J. L. Januzzi, S. Parra-Pallares, A. Romanov, B. Sax, D. Prokhorova, P. Guastaroba, D. Silva, A. Karaskov, P. Kolkhof, B. Bouzas Zubeldia, T. Rassaf, M. Costa, C. Viczenczova, V. Antoncecchi, A. Kempny, J. Bartunek, I. Kardys, J. H. Ahn, C. Hart, A. Berruezo, C. Vittori, W. Vletter, M. Shigekiyo, S. Knob, V. Marangelli, R. Borras, A E Van Den Bosch, S. Y. Choi, E. Arbelo, G. Lazaros, T. Arita, G. Suchan, T. Nakadate, D. Van Der Linde, E. Pokushalov, K. Ando, J. Neutel, P. Biaggi, C. Mornos, R. Corti, M. Landolina, B. Merkely, B. Malecka, H. J. Hippe, S. J. Tahk, J. Aguilar, G. Piovaccari, M. Lutz, D. Rizopoulos, N. Alvarez Garcia, M. Cipriani, T. Kumamoto, S. Kubota, M. Sitges, B. K. Fleischmann, G. Caccamo, D. Tsiachris, M. A. Russ, F. Mutlu, A. Menozzi, J. C. Choi, J. V. Monmeneu, J. C. Yanez Wonenburger, N. Tribulova, C. Forleo, M. Vinci, J. W. Roos-Hesselink, O. Bodea, T. Domei, P. W. Lee, A. Puzzovivo, M. Heikenwaelder, F. Ferraris, C. Stefanadis, M. Kempa, M. Vanderheyden, A. Birdane, J. A. A. E. Cuypers, I. Andrikou, G. Casella, P. Stock, S. Favale, B. Bijnens, A. Kretschmer, J. Bernhagen, M. A. Cavero Gibanel, S. Datta, M. E. Menting, S. Viani, T. Heuft, M. Cikes, A. J. J. C. Bogers, J. Estornell, M. Pham, A. Nadir, F. J. Pinto, M. Hyodo, D. Flessas, C. Chrysohoou, O. Dewald, B. Ren, K. Wustmann, J. C. Burnett, T. Noto, G. Ruvolo, M. Witsenburg, E. Soldati, G. D. Duerr, L. Alonso Pulpon, J. H. Oh, A. Zabek, B. Albrecht-Kuepper, V. Antonakis, M. B. Nielsen, T. Huttl, B. Bacova, A. Piorkowski, I. Z. Cabrita, A. Fanelli, M. A. Weber, J. Segovia, A. I. Romero-Aniorte, J. H. Choi, V. Dosenko, C. Wackerl, J. H. Ruiter, H. Yokoi, S. Ghio, V. Knezl, F. Monitillo, M. Morello, M. Jerosch-Herold, M. L. Geleijnse, A. Bouzas Mosquera, R. Fabregas Casal, H. Mudra, J. Gruenenfelder, U. Floegel, L. Petrescu, M. A. Gatzoulis, S. Shizuta, J. Brachmann, M. G. Bongiorni, M. Pringsheim, J. Mueller, A. Nagy, R. Giron, W. T. Abraham, Y. Takabatake, F. Toyota, D. Martinez Ruiz, M. Lunati, S. Vargiu, L E De Groot De Laat, V. Shabanov, L. Lioni, R. Kast, D. Bettex, K. S. Cha, J. L. Diago, D. Cozma, H. Lieu, M. Giakoumis, E. Orenes-Pinero, G. Murana, A. Kutarski, A.P.J. van Dijk, G. Speziale, A. Boem, L. M. Belotti, B. Igual, A. M. S. Olsen, and H. Lue

Subjects
business.industry, Medicine, Ancient history, Cardiology and Cardiovascular Medicine, business
Published
2012
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9. A Method to Calculate Tissue Impedance Through a Standard Bipolar Pacing Lead

Author

E. Manfredini, G.C. Bini, E. Pardini, G. Corbucci, M. Pauletti, and L. Paperini

Subjects
Pacemaker, Artificial, Transplantation, medicine.medical_specialty, Materials science, Defibrillation, medicine.medical_treatment, General Medicine, Models, Theoretical, Impulse (physics), Electrodes, Implanted, High impedance, Electromagnetic coil, Internal medicine, Electrode, Electric Impedance, medicine, Cardiology, Equivalent circuit, Surgery, Cardiology and Cardiovascular Medicine, Electrical impedance, Tissue impedance, Biomedical engineering
Abstract

The transthoracic impedance (T) and its variations may be estimated through the measurement of the electrical impedance between the can and the right ventricular coil of a defibrillation lead. This method may allow the monitoring of fluid overload before a heart failure attack. Aim of this study was to validate in vitro a method to calculate T in case of a standard bipolar pacing lead, by performing 3 measurements: standard unipolar impedance from the tip (Zuni-tip); unipolar impedance from the ring (Zuni-ring); standard bipolar impedance (Zbip). The formula we used is derived from the standard equivalent circuit of a pacing system: $$\hbox{T} = (\hbox{Zuni-tip}-\hbox{Zbip}+\hbox{Zuni-ring})/2$$ T represents the tissue impedance between the can and the electrodes of the lead. To validate the method we used a saline solution and 3 different pacing leads manufactured by Vitatron (Vitatron BV, Arnhem, The Netherlands): Impulse II (high impedance lead), Crystalline ActFix (screw-in lead), Brilliant S+ (VDD single-lead). The measured values of the saline solution impedance were compared to the values calculated through the formula. The calculated impedance of the solution, evaluated through the proposed formula, is reliable independently of the electrode used and highly correlated to the corresponding measured values (R > 0.9). Tissue impedance may be calculated from standard unipolar and bipolar impedance measurements with a standard bipolar pacing lead.

Published
2006
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10. Histologic evidence of myocardial damage in apparently healthy subjects with ventricular arrhythmias and myocardial dysfunction

Author

S. Berti, Carlo Contini, Marcello Piacenti, Baratto Mt, A. Pozzolini, Levorato D, C. Arlotta, L. Paperini, Andrea Biagini, M. G. Bongiorni, and G. Kraft

Subjects
Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Adolescent, Heart disease, Biopsy, Heart Ventricles, Cardiomyopathy, Hemodynamics, Ventricular tachycardia, Tachycardia, Internal medicine, medicine, Humans, cardiovascular diseases, Ejection fraction, medicine.diagnostic_test, business.industry, Myocardium, Gated Blood-Pool Imaging, Dilated cardiomyopathy, General Medicine, Middle Aged, medicine.disease, Echocardiography, Doppler, medicine.anatomical_structure, Ventricle, Angiography, Electrocardiography, Ambulatory, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

The association of ventricular arrhythmias and myocardial dysfunction could be considered an early step toward cardiomyopathy; therefore, we studied 28 patients in NYHA class I and II, characterized by complex ventricular arrhythmias (VA) on 24-h Holter monitoring and volumetric and/or contractile abnormalities on a standard two-dimensional echocardiogram (2-D echo). All patients underwent radioisotopic angiography, 20 patients complete hemodynamic study, and 15 patients endomyocardial biopsy. Ambulatory ECG monitoring showed the presence of frequent premature ventricular contractions in 14 patients (50%) and episodes of ventricular tachycardia in 16 patients (57%). 2-D echo showed mono- or biventricular enlargement and dyssynergies in 25 patients (89%) (left ventricle in 6, right ventricle in 11, both in 8). Two patients showed only left ventricle enlargement and one patient isolated left ventricular dyssynergies. Radioisotopic angiography showed mono- or biventricular ejection fraction reduction in 24 patients (85%) and regional dyssynergies in 24 patients (85%) in accordance with 2-D echo. Hemodynamic study showed in all patients normal coronary arteries, and right and left angiography confirmed enlargement and/or regional dyssynergies. Endomyocardial biopsy was abnormal in 11 of 15 patients: various degrees of hypertrophy, parcellar fibrosis, and adipogenic infiltration were found. Our preliminary data suggest that the simultaneous occurrence of ventricular arrhythmias and ventricular dyssynergies and/or enlargement in patients without apparent clinical heart disease may represent an early stage of dilated cardiomyopathy.

Published
1992
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11. Is CRT Useful in Patients with Atrial Fibrillation?

Author

M. Carluccio, l. Paperini, and E. Pardini

Subjects
Cardiovascular event, education.field_of_study, medicine.medical_specialty, business.industry, medicine.medical_treatment, Population, Atrial fibrillation, medicine.disease, Ablation, Internal medicine, Heart failure, cardiovascular system, Cardiology, Medicine, Sinus rhythm, In patient, cardiovascular diseases, business, education, Left Ventricular Failure
Abstract

It may be said that CRT has a role in improving functional capacity over conventional right ventricular pacing in patients with left ventricular failure who require permanent ventricular stimulation and/or in those with an indication for AV nodal ablation. As for the great majority of patients with advanced heart failure and AF without conventional indications for permanent cardiac pacing — a wide and progressively expanding population in the “border zone” of current indications for CRT — no definite data are available. Some promising results from ablated patients show a favourable trend in major cardiac event reduction after CRT. More controlled clinical data are required to achieve definite conclusions about the indications for CRT in heart failure patients with AF.

Published
2006
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12. [Holter-detected myocardial ischemia. Impact for prognosis and decision making after acute myocardial infarction]

Author

A, Genovesi Ebert, L, Paperini, U, Baldini, M, Raugi, A, Digiorgio, and G, Magini

Subjects
Aged, 80 and over, Male, Decision Making, Myocardial Infarction, Myocardial Ischemia, Middle Aged, Prognosis, Predictive Value of Tests, Recurrence, Electrocardiography, Ambulatory, Myocardial Revascularization, Humans, Female, Aged
Abstract

Aim of the study was to evaluate the prognostic and decision making value of Holter detected myocardial ischemia after acute myocardial infarction in comparison with clinically detected postinfarction angina and exercise test.To this aim the patients consecutively admitted to our coronary care unit with acute myocardial infarction during one year were retrospectively evaluated. One hundred and eighty-nine patients (age 70+/-11 years, 137 male and 51 female) had a 24 hour Holter monitoring. One-year follow up of these patients was obtained.Myocardial ischemia was detected by Holter monitoring in 21 patients (11%), 4 with and 17 without angina. Symptom limited exercise test was obtained before discharge in 116 patients (62%): 45% were positive, 42% non-diagnostic and 13 negative for myocardial ischemia. Post infarction angina was present in 15 patients (9%). Patients with Holter detected myocardial ischemia were older (73+/-10 vs 66+/-11 years, p0.05) and had higher prevalence of both angina and positive exercise test (p0.01). One-year follow up was obtained in 186 patients. Holter detected myocardial ischemia positive predictive value for death or reinfarction was 15%, negative predictive value was 90%, similar to the absence of angina (90%) and the absence of positive exercise test (93%). Angina and exercise test identified 62% of patients with Holter detected myocardial ischemia. Residual myocardial ischemia was exclusively observed by Holter monitoring in 4% of the population, particularly in 1 patients with and 7 without exercise test.The additive contribution of Holter detected myocardial ischemia in the prognosis and decision making of post infarction patients is rather scanty.

Published
2002

13. Hyperkinetic ventricular arrhythmias in very elderly people with and without cardiac disease. Correlation with left ventricular echocardiographic parameters

Author

F, Lattanzi, L, Paperini, B, Reisenhofer, A R, Lucarini, E, Orsini, S, Giaconi, D, Levantesi, A, Topi, A M, Paci, and G, Squarcini

Subjects
Aged, 80 and over, Cardiomyopathy, Dilated, Heart Failure, Male, Cardiovascular Diseases, Electrocardiography, Ambulatory, Tachycardia, Ventricular, Humans, Female, Blood Pressure Monitoring, Ambulatory, Echocardiography, Doppler, Aged
Abstract

Morphological and functional changes induced by aging can hamper a clear distinction between pathological or paraphysiological phenomena in very old people. The incidence of hyperkinetic ventricular arrhythmias, for example, progressively increases in the elderly, even in the absence of overt cardiac disease.One-hundred fifty-two clinically stable patients older than 80 years, submitted within 15 days to clinical evaluation, 24-hour continuous ambulatory ECG monitoring and echo Doppler examination, in the absence of antiarrhythmic treatment, were retrospectively selected in order to evaluate the incidence of ventricular arrhythmias, in patients with and without significant heart disease. The further aim of the study was to correlate the number of arrhythmias with left ventricular morphological and functional parameters, echocardiographically assessed. From the initial population, 80 patients (41 males, age 83 +/- 3 years) had significant heart disease (ischemic, hypertensive or valvular): Group I. Seventy-two patients (30 males, age 83 +/- 3 years) had no clinical or instrumental signs of heart disease: Group II.Considering echocardiographic data, Group I patients had a significantly higher left ventricular end-diastolic diameter (52 +/- 6 mm vs 47 +/- 4 mm, p0.01), lower ejection fraction (57 +/- 10% vs 64 +/- 6%, p0.01) and higher mass (275 +/- 84 g vs 208 +/- 46 g, p0.01), when compared with Group II. From ECG monitoring data, significant differences between the two groups were recorded in the incidence of premature ventricular beats per hour (79 +/- 163 vs 15 +/- 34, Group I vs Group II, p0.01) and presence of complex phenomena (couplets, triplets and runs: 51% vs 22%, p0.01). In old patients with documented cardiac disease a significant correlation was present between premature ventricular beats incidence and left ventricular end diastolic diameter (r = 0.39, p0.05) and left ventricular ejection fraction (r = 0.40, p0.05), while in patients without heart disease, no significant correlation was found between incidence of premature ventricular beats and echocardiographic morpho-functional parameters.In conclusion, hyperkinetic ventricular arrhythmias are globally frequent in old persons of very advanced age (more than 80 years), but, also in this subset, a significant distinction in terms of incidence and severity of arrhythmias is present between subjects with and without cardiac disease. A significant correlation between incidence of premature beats and non-invasive morpho-functional left ventricular parameters is present only for patients with overt heart disease.

Published
1999

14. [Propafenone and flecainide in the therapy of ventricular arrhythmias]

Author

L, Paperini, A, Davini, F, Lattanzi, A, Topi, B, Reisenhofer, G, Squarcini, A, Paci, and P L, Topi

Subjects
Adult, Male, Flecainide, Arrhythmias, Cardiac, Middle Aged, Electrocardiography, Propafenone, Cardiovascular Diseases, Echocardiography, Electrocardiography, Ambulatory, Ventricular Dysfunction, Drug Evaluation, Humans, Female, Anti-Arrhythmia Agents, Aged, Follow-Up Studies
Abstract

Flecainide and propafenone are antiarrhythmic drugs of the class 1C (Vaughan and Williams) commonly used for ventricular arrhythmias. The purpose of the present study was to evaluate the efficacy of these drugs in 170 consecutive patients with ventricular arrhythmias who referred to our cardiological ambulatory. The study population was divided into two groups according to the absence (group A,82 patients) or presence of organic heart disease (group 1B: 51 patients with left ventricular ejection fraction (LVEF)35%; group 2B: 37 patients with LVEF35%). Ventricular arrhythmias were evaluated with a 48 hours Holter monitoring at baseline, and with a control 24 hours Holter monitoring at 15 days (for optimizing the dosage), at 5 months and at 10 months from the beginning of antiarrhythmic therapy. Patients of group A were randomly assigned to antiarrhythmic treatment (flecainide 150-300 mg/die or propafenone 450-900 mg/die). For patients of group B, such choice was leaded by the clinical and strumental data (32 patients were treated with flecainide, 56 patients with propafenone). In the 160 patients who ended the 10 months follow-up, we observed the following results: patients of group A showed a mean percentage reduction in incidence of premature ventricular complexes (PVC) after therapy in comparison to basal conditions of 93% and 89% with flecainide and propafenone, respectively, after a treatment of 5 months (p0.001); after 10 months mean percentage reduction of PVC was 91% with each drug (p = n.s.); complex ventricular events (CVE) were reduced of 90% and of 100% after 5 and 10 months, respectively, of treatment with flecainide and of 100% both after 5 and 10 months of treatment with propafenone (p = n.s.) -- patients of group 1B showed a mean percentage reduction of PVC of 87% and 84% after 5 and 10 months, respectiively, of treatment with propafenone (p = n.s.); after 5 months of therapy mean percentage CVE reduction was 66% with flecainide and 86% with propafenone (p0.001); after 10 months this mean reduction was 53% with flecainide and 73% with propafenone (p0.001). -- patients of group 2B showed a mean reduction of PVC of 59% and 58% after 5 and 10 months of therapy with flecainide, and of 65% and 67% after 5 and 10 months of therapy with propafenone (p = n.s.); CVE were reduced of 28% with flecainide and of 47% with propafenone after 5 months of treatment (p0.001) and of 36% with flecainide against 52% with propafenone after 10 months (p0.01). In the present study there was no significant difference between the two drugs in terms of tollerance and collateral effects (8% with flecainide vs 7%, with propafenone). Our results confirm the efficacy of the 1C class drugs in the treatment of "essential" ventricular arrhytmias. This efficacy appears reduced in non selected patients with organic heart disease. In these latter patients propafenone has shown more efficacy than flecainide in reducing CVE.

Published
1995

15. Poster Session 1

Author

A. Deshmukh, S. S. Sharma, F. G. Gobal, S. S. Singla, P. H. Hebbar, H. P. Paydak, M. Igarashi, H. Tada, Y. Sekiguchi, H. Yamasaki, K. Kuroki, T. Machino, K. Yoshida, K. Aonuma, J. Shavadia, H. Otieno, G. Yonga, A. Jinah, J. F. Qvist, P. H. Soerensen, U. Dixen, M. A. Ramirez-Marrero, B. Perez-Villardon, D. Gaitan-Roman, M. Jimenez-Navarro, J. L. Delgado-Prieto, E. De Teresa-Galvan, M. De Mora-Martin, P. B. Hebbar, W. X. Wei, S. Bardari, M. Zecchin, R. Salame', L. Vitali Serdoz, A. Di Lenarda, N. Guerrini, G. Barbati, G. Sinagra, K. Hanazawa, K. Kaitani, Y. Nakagawa, I. Lenaerts, R. Driesen, N. Hermida, H. Heidbuchel, S. Janssens, J. L. Balligand, K. R. Sipido, R. Willems, R. Sehra, D. Krummen, C. Briggs, S. Narayan, Y. Tanaka, K. Hirao, T. Nakamura, O. Inaba, A. Yagishita, K. Higuchi, H. Hachiya, M. Isobe, E. Kallergis, E. M. Kanoupakis, H. E. Mavrakis, C. A. Goudis, N. E. Maliaraki, P. E. Vardas, K. Kiuchi, C. Piorkowski, S. Kircher, T. Gaspar, N. Watanabe, A. Bollmann, G. Hindricks, K. Wauters, A. Grosse, S. Raffa, M. Brunelli, J. C. Geller, A. P. Maggioni, L. Gonzini, G. Gussoni, G. Vescovo, M. Gulizia, S. Pirelli, G. Mathieu, G. Di Pasquale, R. Salame, S. Magnani, T. Sakamoto, K. Kumagai, E. Fuke, S. Nishiuchi, T. Hayashi, Y. Miki, S. Naito, S. Oshima, I. E. Hof, E. Vonken, B. K. Velthuis, M. Meine, R. N. W. Hauer, K. P. Loh, J. O. Na, C. U. Choi, E. J. Kim, S. W. Rha, C. G. Park, H. S. Seo, D. J. Oh, H. E. Lim, D. Wichterle, V. Bulkova, M. Fiala, J. Chovancik, J. Simek, P. Peichl, R. Cihak, J. Kautzner, A. Glick, S. Viskin, B. Belhassen, A. Navarrete, F. Conte, A. Ishti, D. Sai, M. Moran, Z. Chitovova, H. Ahmed, K. Mares, J. Skoda, L. Sediva, J. Petru, V. Y. Reddy, P. Neuzil, M. Schmidt, U. Dorwarth, A. Leber, M. Wankerl, J. Krieg, F. Straube, S. Reif, E. Hoffmann, E. Mikhaylov, V. Tikhonenko, D. Lebedev, S. Y. Shin, H. S. Yong, J. I. Choi, S. H. Kim, S. Matsuo, T. Yamane, M. Hioki, K. Ito, R. Narui, T. Date, K. Sugimoto, M. Yoshimura, S. Rolf, P. Sommer, R. Batalov, S. Popov, I. Antonchenko, T. Suslova, S. Fichtner, U. Czudnochowsky, H. L. Estner, S. Ammar, T. Reents, C. Jilek, G. Hessling, I. Deisenhofer, E. Pokushalov, A. Romanov, G. Corbucci, S. Artemenko, D. Losik, V. Shabanov, A. Turov, D. Elesin, M. Abramov, P. Sanders, P. Jais, K. Roberts-Thomson, K. Fukumoto, S. Takatsuki, T. Kimura, N. Nishiyama, Y. Aizawa, T. Sato, S. Miyoshi, K. Fukuda, Y. Roux, J. Tenkorang, P. Carroz, J. Schlaepfer, P. Pascale, A. Forclaz, M. Fromer, E. Pruvot, L. Sknouril, R. Nevralova, M. Dorda, J. Januska, R. Santi, C. Geller, K. Nakamura, K. Kasseno, K. Taniguchi, A. Wutzler, M. Huemer, A. Parwani, L. H. Boldt, D. Blaschke, R. Dietz, W. Haverkamp, B. Coutu, R. Malanuk, M. Ait Said, A. Vicentini, S. Schade, K. Ando, A. Rousseauplasse, T. Deering, B. C. Picarra, A. R. Santos, P. Dionisio, P. Semedo, R. Matos, M. Leitao, A. Jacinto, M. Trinca, C. Wan, J. Glad, S. Szymkiewicz, M. Habibovic, H. Versteeg, A. J. M. Pelle, D. A. M. J. Theuns, L. Jordaens, S. S. Pedersen, S. Pakarinen, L. Toivonen, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, S. K. G. Maier, N. Lobitz, S. Paule, J. Becher, G. Mustafa, A. Ibrahim, G. King, B. Foley, B. Wilkoff, R. Freedman, D. Hayes, S. Kalbfleisch, S. Kutalek, R. Schaerf, I. A. Fazal, M. Tynan, C. J. Plummer, J. M. Mccomb, A. Oto, K. Aytemir, H. Yorgun, U. Canpolat, E. B. Kaya, L. Tokgozoglu, G. Kabakci, H. Ozkutlu, S. Greenberg, F. Hamati, R. Styperek, J. Alonso, D. Peress, O. Bolanos, R. Augostini, M. Pelini, S. Zhang, S. Stoycos, S. Witsaman, K. Mowrey, J. Bremer, A. Oza, G. Ciconte, P. Mazzone, G. Paglino, A. Marzi, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, M. Nagashima, M. Goya, Y. Soga, K. Hiroshima, K. Andou, K. Hayashi, Y. An, M. Nobuyoshi, A. Kutarski, B. Malecka, R. Pietura, P. Osmancik, D. Herman, P. Stros, V. Kocka, P. Tousek, H. Linkova, M. Bortnik, E. Occhetta, G. Dell'era, A. Degiovanni, L. Plebani, P. N. Marino, M. V. Gorev, D. G. Alimov, P. Raju, S. Kully, S. 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Morichelli, A. D'onofrio, D. Vaccari, L. Calo', G. Buja, N. Rovai, A. Gargaro, J. Sperzel, G. Speca, L. Santini, J. Haarbo, K. Dubin, M. Carlson, A. Garcia Quintana, H. Mendoza-Lemes, L. Garcia Perez, S. Led Ramos, E. Caballero Dorta, M. Matinez De Espronceda, V. Piro Mastracchio, L. Serrano Arriezu, L. Sciarra, M. Marziali, E. Marras, M. Rebecchi, G. Allocca, E. Lioy, P. Delise, V. E. Santobuono, M. Iacoviello, F. Nacci, G. Luzzi, A. Puzzovivo, M. Memeo, F. Quadrini, S. Favale, M. E. Trucco, M. Arce, J. Palazzolo, W. Uribe, R. Maggi, T. Furukawa, F. Croci, A. Solano, M. Brignole, A. Lebreiro, A. Sousa, A. S. Correia, P. Lourenco, S. Oliveira, M. Paiva, J. Freitas, M. J. Maciel, N. Linker, G. Rieger, C. Garutti, N. Edvardsson, R. Salguero Bodes, M. De Riva Silva, A. Fontenla Cerezuela, M. Lopez Gil, E. Mejia Martinez, A. Jurado Roman, S. Garcia Alvarez, F. Arribas Ynsaurriaga, N. R. Petix, A. Del Rosso, V. Guarnaccia, A. Zipoli, F. Rabajoli, G. Foglia Manzillo, C. Tolardo, C. Checchinato, S. Chiaravallotti, M. Santarone, M. T. Spinnler, C. Podoleanu, A. Frigy, D. Dobreanu, C. Ginghina, and E. Carasca

Subjects
Lv function, medicine.medical_specialty, business.industry, Physiology (medical), Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business, Predictive value, Value (mathematics), Surgery
Abstract

was higher in the NRG (p 0.70 was the more accurate RT-MCE value to predict LV regional recovery with positive predictive value of 70% and negative predictive value of 56% (p

Published
2011
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16. Poster Session 2

Author

T. Andersson, A. Magnusson, I.- L. Bryngelsson, O. Frobert, K. M. Henriksson, N. Edvardsson, D. Poci, M. Polovina, T. Potpara, M. Licina, N. Mujovic, A. Kocijancic, D. Simic, M. C. Ostojic, R. A. Providencia, A. Botelho, J. Trigo, J. Nascimento, N. Quintal, P. Mota, A. M. Leitao-Marques, R. F. Bosch, W. Kirch, L. Rosin, S. N. Willich, D. Pittrow, H. Bonnemeier, M. C. Valenza, L. Martin, T. Munoz Casaubon, G. Valenza, M. Botella, M. Serrano, B. Valenza, I. Cabrera, K. Anderson, B. S. Benzaquen, N. Koziolova, J. Nikonova, Y. Shilova, D. Scherr, S. Narayan, M. Wright, D. Krummen, A. Jadidi, P. Jais, M. Haissaguerre, M. Hocini, R. Hunter, Y. Liu, Y. Lu, W. Wang, R. J. Schilling, S. Bernstein, B. Wong, R. Rooke, C. Vasquez, R. Shah, S. Rosenberg, L. Chinitz, G. Morley, M. Bashir Choudhary, F. Holmqvist, J. Carlson, H.- J. Nilsson, P. G. Platonov, A. S. Jadidi, H. Cochet, S. Miyazaki, A. J. Shah, N. Marrouche, N. Calvo, M. Nadal, D. Andreu, D. Tamborero, F. E. Diaz, A. Berruezo, J. Brugada, L. Mont, S. Fichtner, G. Hessling, H. L. Estner, C. Jilek, T. Reents, S. Ammar, J. Wu, I. Deisenhofer, H. Nakanishi, K. Kashiwase, A. Hirata, M. Wada, Y. Ueda, J. Skoda, P. Neuzil, J. Popelova, J. Petru, L. Sediva, V. Y. Reddy, L. Uldry, A. Forclaz, N. Virag, J.- M. Vesin, L. Kappenberger, R. Sehra, C. Briggs, W.- J. Rappel, M. Janotka, M. Chovanec, K. Yamashiro, K. Takami, Y. Sakamoto, K. Satoh, T. Suzuki, H. Nakagawa, A. Romanov, E. Pokushalov, S. Artemenko, V. Shabanov, I. Stenin, D. Elesin, A. Turov, A. Yakubov, M. Hioki, S. Matsuo, K. Ito, R. Narui, S. Yamashita, K. Sugimoto, M. Yoshimura, T. Yamane, L. Di Biase, J. D. Gallinghouse, K. Rajappan, J. Kautzner, A. Dello Russo, C. Tondo, F. Lorgat, A. Natale, O. Balta, K. Buenz, M. Paessler, H. Anders, M. Horlitz, T. Deneke, L. Lickfett, I. Liberman, M. Linhart, R. Andrie, E. Mittmann-Braun, F. Stockigt, G. Nickenig, J. Schrickel, R. Tilz, A. Rillig, B. Feige, A. Metzner, A. Fuernkranz, A. Burchard, E. Wissner, F. Ouyang, T. R. Betts, M. A. Jones, K. C. K. Wong, N. Qureshi, Y. Bashir, G. Corbucci, D. Losik, V. Selina, M. A. Crandall, C. Daniels, E. Daoud, S. Kalbfleisch, H. Yamaji, T. Murakami, H. Kawamura, M. Murakami, K. Hina, S. Kusachi, G. Dakos, V. Vassilikos, S. Paraskevaidis, A. Mantziari, S. Theophylogiannakos, I. Chouvarda, I. Chatzizisis, I. Styliadis, T. Kimura, K. Fukumoto, N. Nishiyama, Y. Aizawa, Y. Fukuda, T. Sato, S. Miyoshi, S. Takatsuki, A. J. Navarrete Casas, I. Ali, F. C. Conte, M. Moran, B. G. Graham, O. Kalejs, R. Lacis, P. Stradins, A. Koris, I. Putnins, M. Vikmane, A. Lejnieks, A. Erglis, A. Estrada, A. Perez Silva, S. Castrejon, D. Doiny, J. L. Merino, A. Baranchuk, I. Greiss, C. S. Simpson, H. Abdollah, D. P. Redfearn, M. Buys-Topart, R. Nitzsche, B. Thibault, S. Kathan, C. Kolb, S. Reif, S. Schade, J. Taggeselle, A. Frey, A. Birkenhagen, S. Kohler, M. Schmidt, O. Cano Perez, F. Buendia, B. Igual, J. M. Osca, J. M. Sanchez, M. J. Sancho-Tello, J. M. Olague, A. Salvador, J. M. Tolosana, J. Fernandez-Armenta, M. Matas, M. C. Barbarin, M. Habibovic, K. C. Van Den Broek, D. A. M. J. Theuns, L. Jordaens, M. Alings, P. H. Van Der Voort, S. S. Pedersen, G. Pupita, S. Molini, M. Brambatti, A. Capucci, S. Molodykh, E. M. Idov, O. V. Belyaev, L. Segreti, E. Soldati, G. Zucchelli, A. Di Cori, S. Viani, L. Paperini, R. De Lucia, M. G. Bongiorni, L. Binner, M. Taborsky, D. Bello, H. Heuer, B. Ramza, I. Jenniskens, W. B. Johnson, M. S. Silvetti, L. Rava', M. S. Russo, C. Di Mambro, A. Ammirati, G. Gimigliano, M. Prosperi, F. Drago, A. R. Santos, B. Picarra, P. Semedo, P. Dionisio, R. Matos, M. Leitao, A. Jacinto, M. Trinca, P. Mazzone, G. Ciconte, A. Marzi, G. Paglino, P. Vergara, N. Sora, S. Gulletta, P. Della Bella, P. Koppitz, A. Fach, S. Hobbiesiefken, E. Fiehn, R. Hambrecht, J. Sperzel, M. Jung, J. Schmitt, D. Pajitnev, H. Burger, G. Goebel, W. Ehrlich, T. Walther, T. Ziegelhoeffer, V. Vancura, D. Wichterle, V. Melenovsky, M. Glikson, G. Goldenberg, A. Segev, D. Dvir, J. Kuzniec, A. Finkelstein, I. Hay, V. Guetta, W. K. Choo, S. Gupta, R. Kirkfeldt, J. Johansen, E. Nohr, M. Moller, P. Arnsbo, J. Nielsen, M. Banha, P. Stojanov, S. Raspopovic, D. Vasic, D. Savic, G. Nikcevic, V. Jovanovic, P. Defaye, B. Mondesert, A. Mbaye, R. Cassagneau, V. Gagniere, J. Jacon, V. Sanfins, H. R. Reis, J. N. Nobre, V. M. Martins, L. D. Duarte, C. M. Morais, J. C. Conceicao, M. Hero, J. L. Rey, A. Ducharme, C. Simpson, C. Stuglin, L. Blier, M. Senaratne, Y. Khaykin, A. Pinter, A. Mlynarska, R. Mlynarski, M. Sosnowski, J. Wilczek, C. Iorgulescu, S. Bogdan, D. Constantinescu, C. Caldararu, M. Dorobantu, A. Radu, R.- G. Vatasescu, S. Yusu, T. Ikeda, H. Mera, Y. Miwa, A. Abe, M. Miyakoshi, T. Tsukada, H. Yoshino, V. Nayar, P. Cantelon, A. Rawling, M. R. D. Belham, P. J. Pugh, J. Osca Asensi, O. Cano, D. Tejada, B. Munoz, M. Rodriguez, J. Olague, L. Wecke, A. Van Hunnik, T. Thompson, L. Di Carlo, M. Zdeblick, A. Auricchio, F. Prinzen, A. Doltra Magarolas, B. Bijnens, E. Silva, D. Penela, M. Sitges, P. Ofman, L. Navaravong, J. Leng, A. Peralta, P. Hoffmeister, R. Levine, J. Cook, M. Stoenescu, M. E. Tettamanti, A. Revilla Orodea, J. Lopez Diaz, L. De La Fuente Galan, R. Arnold, E. Garcia Moran, J. A. San Roman Calvar, I. Gomez Salvador, K. Nakamura, M. Takami, T. Keida, A. Mesato, S. Higa, M. Shimabukuro, H. Masuzaki, R. Proietti, A. Sagone, G. Domenichini, H. Burri, C. Valzania, M. Biffi, H. Sunthorn, G. Gavaruzzi, H. Foulkes, G. Boriani, S. Koh, W. Hou, J. Snell, J. Poore, N. Dalal, G. Bornzin, A. Kloppe, D. Mijic, H. Bogossian, I. Ninios, M. Zarse, B. Lemke, L. Guedon-Moreau, C. Kouakam, D. Klug, C. Marquie, F. Ziglio, S. Kacet, H. Mohamed Fereig Hamed, A. M. A. L. Hamdy, A. H. M. E. D. Abd El Aziz, M. R. V. A. T. Nabih, R. E. H. A. B. Hamdy, A. Yaminisaharif, G. H. Davoudi, A. Kasemisaeid, S. Sadeghian, A. Vasheghani Farahani, P. Yazdanifard, A. Shafiee, C. Alonso, C. Grimard, G. Jauvert, A. Lazarus, L. L. Mont, J. Ortiz-Perez, T. Caralt, J. Escudero, F. Perez, K. M. Griffith, R. Ferreyra, P. Urena, M. Demas, C. Muratore, H. Mazzetti, J. Guardado, M. Fernandes, V. H. Pereira, F. Canario-Almeida, F. Ferreira, B. Rodrigues, J. Almeida, A. Sokal, E. Jedrzejczyk, R. Lenarczyk, S. Pluta, O. Kowalski, P. Pruszkowska, A. Swiatkowski, Z. Kalarus, M. Heinke, B. Ismer, H. Kuehnert, T. Heinke, R. Surber, N. Osypka, D. Prochnau, H. R. Figulla, S. Iacopino, M. Landolina, A. Proclemer, L. Padeletti, V. Calvi, A. Pierantozzi, P. Di Stefano, A. Bauer, F. Bode, F. Le Gal, J. C. Deharo, M. Delay, J. Clementy, M. Kawamura, Y. Munetsugu, K. Tanno, Y. Kobayashi, D. Cannom, J. Hosoda, T. Ishikawa, K. Andoh, M. Nobuyoshi, S. Fujii, S. Shizuta, T. Isshiki, M. A. Castel, F. Perez-Villa, B. Vidal, P. Pruszkowska-Skrzep, M. Szulik, T. Kukulski, L. Gianfranchi, K. Bettiol, F. Pacchioni, P. Alboni, R. Abu Sham'a, J. Buber, E. Nof, R. Kuperstein, M. Feinberg, D. Luria, M. Eldar, K. Parks, J. R. Stone, J. P. Singh, E. Hatzinikolaou-Kotsakou, M. Kotsakou, T. H. Beleveslis, G. Moschos, E. Reppas, P. Latsios, K. Tsakiridis, A. Kazemisaeid, G. Davoodi, A. Yamini Sharif, M. Sheikhvatan, M. Toniolo, G. Zanotto, A. Rossi, L. Tomasi, C. Vassanelli, H. Versteeg, P. M. C. Mommersteeg, G. Vergara, J. Blauer, R. Ranjan, S. Vijayakumar, E. Kholmovski, N. Volland, R. Macleod, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, J. Dantur, R. Quintana, P. P. Adragao, D. Cavaco, L. Parreira, K. Reis Santos, P. Carmo, R. Miranda, S. Marcelino, D. Cabrita, P. Sommer, T. Gaspar, S. Rolf, A. Arya, C. Piorkowski, G. Hindricks, E. Valles Gras, V. Bazan, L. Portillo, F. Suarez, J. Bruguera, J. Marti, Y. Huo, S. Richter, R. Schoenbauer, N. Rivas, J. Casaldaliga, I. Roca, L. Dos, J. Perez-Rodon, A. Pijuan, D. Garcia-Dorado, A. Moya, H. B. Carter, A. Garg, J. Hegrenes, H. J. Sih, L. R. Teplitsky, K. Kuroki, H. Tada, Y. Seo, T. Ishizu, M. Igawa, Y. Sekiguchi, K. Kuga, K. Aonuma, C. Rodriguez A, J. Mejias, P. Hidalgo, J. A. Hidalgo L, M. Orczykowski, P. Derejko, F. Walczak, E. Szufladowicz, P. Urbanek, R. Bodalski, K. Bieganowska, L. Szumowski, P. Peichl, R. Cihak, I. Skalsky, P. Kubus, P. Vit, L. Zaoral, R. A. Gebauer, M. Fiala, J. Janousek, K. Hiroshima, M. Goya, M. Ohe, K. Hayashi, Y. Makihara, M. Nagashima, Y. An, M. Schloesser, T. Lawrenz, D. Meyer Zu Vilsendorf, C. Strunk-Mueller, C. Stellbrink, J. Papagiannis, D. Avramidis, C. Kokkinakis, G. Kirvassilis, G. Eidelman, A. Arenal, T. Datino, F. Atienza, E. Gonzalez Torrecilla, A. Miracle, J. Hernandez, F. Fernandez Aviles, E. Ene, P. Insulander, H. Bastani, F. Braunschweig, N. Drca, G. Kenneback, J. Schwieler, J. Tapanainen, M. Jensen-Urstad, B. Andrea, E. M. A. Andrea, W. M. Maciel, L. S. Siqueira, R. C. Cosenza, F. M. Mittidieri, S. F. Farah, J. A. Atie, E. Kanoupakis, E. Kallergis, H. Mavrakis, C. Goudis, I. Saloustros, N. Malliaraki, G. Chlouverakis, P. Vardas, J. L. Bonnes, J. Jaspers Focks, S. W. Westra, M. A. Brouwer, J. L. R. M. Smeets, G. Inama, C. Pedrinazzi, F. Oliva, M. Senni, M. Zoni Berisso, S. Mostov, M. Haim, R. Nevzorov, D. Hasadi, B. Starsberg, A. Porter, J. Kuschyk, A. Schoene, F. Streitner, C. G. Veltmann, R. Schimpf, M. Borggrefe, U. Luesebrink, A. Gardiwal, H. Oswald, T. Koenig, D. Duncker, G. Klein, R. Bastiaenen, V. Batchvarov, O. Atty, J. H. Cheng, E. R. Behr, M. M. Gallagher, A. H. Starrenburg, K. Kraaier, M. F. Scholten, J. Van Der Palen, S. Adhya, L. A. Smith, T. Zhao, C. Bannister, R. H. Kamdar, M. Martinelli, S. Siqueira, R. Greco, S. A. D. Nishioka, A. A. A. Pedrosa, R. Alkmim-Teixeira, G. L. Peixoto, R. Costa, J. C. Nielsen, P. T. Mortensen, J. B. Johansen, W. Kwasniewski, A. Filipecki, D. Urbanczyk-Swic, W. Orszulak, M. Trusz - Gluza, J. Jimenez-Candil, J. Morinigo, C. Ledesma, C. Martin-Luengo, T. Vogtmann, M. Gomer, S. Stiller, V. Kuehlkamp, G. Zach, S. Loescher, S. Kespohl, G. Baumann, J. D. Snell, N. Korsun, J. R. Snell, B. Morley, R. Bharmi, Y. Nabutovsky, M. Mollerus, L. Naslund, A. Meyer, M. Lipinski, B. Libey, K. Dornfeld, A. Martin, M. Gallego, M. K. De Bie, J. B. Van Rees, C. J. Borleffs, J. Thijssen, J. W. Jukema, M. J. Schalij, L. Van Erven, E. T. Van Der Velde, T. A. Witteman, H. Foeken, T. Szili-Torok, F. Akca, K. Caliskan, F. Ten Cate, M. Michels, D. C. Cozma, L. Petrescu, C. Mornos, S. I. Dragulescu, J. A. Groeneweg, B. K. Velthuis, M. G. P. J. Cox, P. Loh, D. Dooijes, M. J. Cramer, J. M. T. De Bakker, R. N. W. Hauer, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, D. H. Kim, A. Iorio, L. Vitali Serdoz, F. Brun, E. Daleffe, M. Zecchin, M. Dal Ferro, S. Santangelo, G. F. Sinagra, S. Ouali, R. Hammemi, S. Hammas, S. Kacem, R. Gribaa, E. Neffeti, F. Remedi, E. Boughzela, P. Korantzopoulos, K. Letsas, Z. Christogiannis, K. Kalantzi, A. Ntorkos, J. Goudevenos, P. W. X. Foley, L. Yung, E. Barnes, M. Kikuchi, H. Ito, F. Miyoshi, R. Pecini, J. M. Marott, G. B. Jensen, J. Theilade, T. Mine, T. Kodani, T. Masuyama, I. M. Mozos, C. Serban, C. Costea, L. Susan, P. Barthel, A. Mueller, M. Malik, G. Schmidt, O. Karakurt, H. Kilic, D. R. Munevver Sari, D. Mroczek-Czernecka, A. Z. Pietrucha, A. Borowiec, M. Wnuk, I. Bzukala, O. Kruszelnicka, E. Konduracka, J. Nessler, Y. Kikuchi, A. Meireles, C. Gomes, D. Anjo, C. Roque, A. Pinheiro Vieira, V. Lagarto, A. Hipolito Reis, S. Torres, L. Miller, G. Vedrenne, E. Bruguiere, A. Redheuil, T. Lavergne, J. Y. Le Heuzey, E. Mousseaux, A. Hersi, K. Alhabib, H. Alfaleh, K. Sulaiman, W. Almahmeed, J. Alsuwidi, H. Amin, A. Almotarreb, H. W. K. Pang, K. Michael, E. J. Pereira, P. W. Munt, M. F. Fitzpatrick, A. S. Revishvili, G. Simonyan, T. Dzhordzhikiya, O. Sopov, V. Kalinin, E. T. Locati, A. M. Vecchi, G. Cattafi, A. Sachero, M. Lunati, S. Sayah, A. Alizadeh, N. Nazari, M. Hekmat, M. Moradi, M. Zeighami, H. Ghanji, K. Suzuki, M. Takagi, K. Maeda, H. Tatsumi, P. Vieira, H. Reis, A. Toth, H. Vago, P. Takacs, E. Edes, A. Marki, G. Y. Balazs, K. Huttl, B. Merkely, F. Lainis, M. M. Buckley, E. J. Johns, C. M. Seifer, L. Daba, K. Liebrecht, W. Piwowarska, J. Toquero Ramos, E. Perez Pereira, C. Mitroi, V. Castro Urda, J. M. Fernandez Villanueva, A. Corona Figueroa, L. Hernandez Reina, I. Fernandez Lozano, A. Bartoletti, P. Bocconcelli, S. Giuli, R. Massa, C. Svetlich, G. Tarsi, F. Tronconi, E. Vitale, P. Stryjewski, M. Wegrzynowska, A. Lousinha, J. Labandeiro, E. Antunes, S. Silva, S. Alves, A. Timoteo, M. Oliveira, R. Cruz Ferreira, and J. Jedrzejczyk-Spaho

Subjects
medicine.medical_specialty, Voltage-dependent calcium channel, business.industry, medicine.drug_class, Umbilical artery, 030204 cardiovascular system & hematology, Cyclase, 3. Good health, Low testosterone levels, 03 medical and health sciences, 0302 clinical medicine, Bkca channel, Endocrinology, Physiology (medical), Internal medicine, medicine.artery, Natriuretic peptide, Medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Ionic Channels
Abstract

Inthelastdecadesseveralinvestigatorshavesuggestedtheassociationofandrogenswithhypertension. Recently, some studies have shown that the incidence of cardiovascular diseases is increased in men with low testosterone levels, suggesting a protective role of androgens. Hypertension is one of the mostcommonproblemsinpregnancythatcomplicates5-10 %ofpregnancies.Anincreaseofmorbidity wasobservedinbabiesfrompregnantwomenwithhypertension.However,thepathogenesisremains unclearandthislimitstheabilitytopreventandtreatthispathology.Thebeneficialeffectsofandrogens for vascular system are associated with their ability to cause vasorelaxation. Inhuman vessels, this non genomiceffectofandrogensappeartobeduetoactivationoflargeconductancecalcium-activatedpotassiumchannels(BKCa)andvoltagegatedpotassiumchannels(KV)whichisinducedbycGMPincrease andaconsequentactivationofcGMP-dependentproteinkinase(PKG).Ontheotherhand,thegenomic effects of androgens concerning ionic channels are almost unknown. Our previous studies suggested that androgens increase the expression of BKCa channels and decrease expression of L-type calcium channels (LTCC). The aim of this work was to analyze the genomic effects of androgens on theexpressionofotherproteinsinvolvedintheregulationofvascularcontractility,suchassolubleguanylate cyclase (sGC), the natriuretic peptide receptor-A (NPRA) and PKG. This study also aimed to compare the expression levels of these proteins in human umbilical artery (HUA) from normotensive andhypertensivepregnantwomen.ToachievethesegoalsrealtimePCRwasperformedusingsmooth

Published
2011
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17. Poster Session 3

Author

G. M. T. Fabbri, S. Baldasseroni, D. Panuccio, M. Zoni Berisso, M. Scherillo, D. Lucci, G. Di Pasquale, G. Mathieu, I. Burazor, M. Burazor, Z. Perisic, V. Atanaskovic, V. Erakovic, A. Stojkovic, T. Vogtmann, C. Schoebel, S. Sogorski, M. Sebert, J. Schaarschmidt, I. Fietze, G. Baumann, T. Penzel, C. Mornos, A. Ionac, D. Cozma, D. Dragulescu, A. Mornos, L. Petrescu, L. Pescariu, B. Brembilla-Perrot, H. Khachab, F. Lamberti, C. Bellini, R. Remoli, T. Cogliandro, R. Nardo, F. Bellusci, V. Mazzuca, A. Gaspardone, L. E. Aguinaga Arrascue, A. Bravo, P. Garcia Freire, P. Gallardo, E. Hasbani, R. Quintana, J. Dantur, K. Inoue, A. Ueoka, Y. Tsubakimoto, T. Sakatani, A. Matsuo, H. Fujita, M. Kitamura, M. Wegrzynowska, E. Konduracka, A. Z. Pietrucha, D. Mroczek-Czernecka, A. Paradowski, I. Bzukala, J. Nessler, O. Igawa, M. Adachi, H. Atarashi, Y. Kusama, E. Kodani, R. Okazaki, A. Nakagomi, Y. Endoh, J. L. Baez-Escudero, A. S. Dave, C. M. Sasaridis, M. Valderrabano, R. Tilz, R. Bai, L. Di Biase, G. J. Gallinghouse, D. Gibson, A. Pisapia, O. Wazni, A. Natale, A. Arujuna, R. Karim, A. Rinaldi, M. Cooklin, K. Rhode, R. Razavi, M. O'neill, J. Gill, S. Kusa, Y. Komatsu, K. Kakita, K. Takayama, H. Taniguchi, K. Otomo, Y. Iesaka, S. Ammar, T. Reents, S. Fichtner, J. Wu, P. Zhu, C. Kolb, G. Hessling, I. Deisenhofer, G. Gilbert, P. Mohanty, J. Cunningham, T. Metz, R. Horton, S. Tao, Y. Yamauchi, H. Okada, S. Maeda, T. Obayashi, M. Isobe, J. Chan, S. Johar, T. Wong, V. Markides, W. Hussain, M. Konstantinidou, E. Wissner, A. Fuernkranz, Y. Yoshiga, A. Metzner, K.- H. Kuck, F. Ouyang, K. Kettering, F. Gramley, H. Mollnau, C. Weiss, S. Bardeleben, L. Biasco, M. Scaglione, D. Caponi, P. Di Donna, D. Sergi, N. Cerrato, A. Blandino, F. Gaita, M. Fiala, D. Wichterle, L. Sknouril, V. Bulkova, J. Chovancik, R. Nevralova, J. Pindor, J. Januska, J. I. Choi, J. E. Ban, N. Yasutsugu, J. S. Park, J. S. Jung, H. E. Lim, S. W. Park, Y. H. Kim, M. Kuhne, T. Reichlin, P. Ammann, B. Schaer, S. Osswald, C. Sticherling, M. Ohe, M. Goya, K. Hiroshima, K. Hayashi, Y. Makihara, M. Nagashima, M. Fukunaga, Y. An, U. Dorwarth, M. Schmidt, M. Wankerl, J. Krieg, F. Straube, E. Hoffmann, S. Kathan, P. Defaye, A. Mbaye, R. Cassagneau, V. Gagniere, P. Jacon, E. Pokushalov, A. Romanov, S. Artemenko, V. Shabanov, D. Elesin, I. Stenin, A. Turov, D. Losik, K. Kondo, J. Miake, A. Yano, K. Ogura, M. Kato, C. Shigemasa, Y. Sekiguchi, H. Tada, K. Yoshida, Y. Naruse, H. Yamasaki, M. Igarashi, T. Machino, K. Aonuma, S. Chen, S. Liu, G. Chen, W. Meng, F. Zhang, Y. Yan, L. Sciarra, S. Dottori, C. Lanzillo, E. De Ruvo, L. De Luca, M. Minati, E. Lioy, L. Calo', J. Lin, Z. Nie, M. Zhu, X. Wang, J. Zhao, W. Hu, H. Tao, J. Ge, B. Johansson, B. Houltz, N. Edvardsson, H. Schersten, T. Karlsson, B. Wandt, E. Berglin, R. H. Hoyt, B. P. Jenson, S. A. I. P. Trines, J. Braun, A. Tjon Joek Tjien, K. Zeppenfeld, G. Tavilla, R. J. M. Klautz, M. J. Schalij, R. Krausova, R. Cihak, P. Peichl, J. Kautzner, J. Pirk, I. Skalsky, J. Maly, K. Imai, T. Sueda, K. Orihashi, B. C. Picarra, A. R. Santos, P. Dionisio, P. Semedo, R. Matos, M. Leitao, M. Banha, M. Trinca, D. H. J. Elder, J. George, R. Jain, C. C. Lang, A. M. Choy, M. Konert, S. Loescher, A. Hartmann, E. Aversa, R. Chirife, E. Sztyglic, H. Mazzetti, O. Mascheroni, M. C. Tentori, R. M. Pop, A. D. Margulescu, R. Dulgheru, O. Enescu, C. Siliste, D. Vinereanu, A. Menezes Junior, A. R. Castro Carneiro, B. L. De Oliveira, A. N. Shah, B. Kantharia, R. De Lucia, E. Soldati, L. Segreti, A. Di Cori, G. Zucchelli, S. Viani, L. Paperini, M. G. Bongiorni, A. Kutarski, M. Czajkowski, R. Pietura, B. Malecka, J. Heintze, L. Eckardt, A. Bauer, M. Meine, L. Van Erven, P. E. Bloch Thomsen, M. P. Lopez Chicharro, O. Merhi, Y. Soga, K. Andou, M. Nobuyoshi, A. Gonzalez-Mansilla, R. Martin-Asenjo, L. Unzue, J. Torres, E. Garralda, R. R. Coma, J. E. Rodriguez Garcia, T. Yaegashi, H. Furusho, T. Kato, A. Chikata, S. Takashima, S. Usui, M. Takamura, S. Kaneko, M. Chudzik, P. Mitkowski, A. Przybylski, J. Lewek, T. Smukowski, A. Maciag, S. Castrejon Castrejon, A. Perez-Silva, A. Estrada, D. Doiny, M. Ortega, J. L. Lopez-Sendon, J. L. Merino, C. O'mahony, C. Coats, M. Cardona, A. Garcia, M. Calcagnino, R. Lachmann, D. Hughes, P. M. Elliott, S. Conti, G. P. Pruiti, E. Puzzangara, S. A. Romano, A. Di Grazia, G. P. Ussia, C. Tamburino, V. Calvi, A. Radinovic, S. Sala, A. Latib, M. Mussardo, S. Sora, G. Paglino, M. Gullace, A. Colombo, M.- A. G. Ohlow, B. Lauer, A. Wagner, M. Schreiber, B. Buchter, A. Farah, J. T. Fuhrmann, J. C. Geller, R. M. Nascimento Cardoso, L. A. Batista Sa, L. F. C. Campos Filho, S. V. Rodrigues, M. V. F. Dutra, T. R. S. A. Borges, D. R. Portilho, T. Deering, A. Bernardes, A. Veiga, O. Gartenlaub, A. Goncalves, A. Jimenez, A. Rousseauplasse, J. C. Deharo, H. Striekwold, G. Gosselin, H. Sitbon, V. Martins, G. Molon, F. Ayala-Paredes, M. J. Sancho-Tello, I. A. Fazal, S. Brady, J. Cronin, S. Mcnally, M. Tynan, C. J. Plummer, J. M. Mccomb, J. E. Val-Mejias, R. M. Oliveira, R. Costa, M. Martinelli Filho, K. R. Silva, L. M. Menezes, W. T. Tamaki, W. Mathias, N. A. G. Stolf, T. Misawa, I. Ohta, T. Shishido, T. Miyasita, T. Miyamoto, J. Nitobe, T. Watanabe, I. Kubota, B. Thibault, A. Ducharme, C. Simpson, C. Stuglin, C. E. Gagne, R. Williams, S. Mcnicoll, M. S. Silvetti, F. Drago, D. Penela, B. Bijnens, A. Doltra, E. Silva, A. Berruezo, L. Mont, M. Sitges, R. Mcintosh, O. Baumann, P. Raju, S. Gurunathan, S. Furniss, N. Patel, N. Sulke, G. Lloyd, M. Mor, S. Dror, Y. Tsadok, N. Bachner-Hinenzon, A. Katz, N. Liel-Cohen, Y. Etzion, R. Mlynarski, A. Mlynarska, J. Wilczek, M. Sosnowski, A. M. Sinha, D. Sinha, G. Noelker, J. Brachmann, F. Weidemann, G. Ertl, M. Jones, N. Searle, M. Cocker, E. Ilsley, P. Foley, R. Khiani, K. E. Nelson, A. J. Turley, W. A. Owens, S. A. James, N. J. Linker, V. Velagic, M. Cikes, B. Pezo Nikolic, D. Puljevic, J. Separovic-Hanzevacki, M. Lovric-Bencic, B. Biocina, D. Milicic, H. Kawata, L. Chen, H. Phan, K. Anand, G. Feld, U. Birgesdotter-Green, I. Fernandez Lozano, C. Mitroi, J. Toquero Ramos, V. Castro Urda, V. Monivas Palomero, A. Corona Figueroa, L. Hernandez Reina, L. Alonso Pulpon, A. Gate-Martinet, A. Da Costa, P. Rouffiange, A. Cerisier, L. Bisch, C. Romeyer-Bouchard, K. Isaaz, M.- A. Morales, E. Bianchini, U. Startari, F. Faita, T. Bombardini, V. Gemignani, M. Piacenti, S. Adhya, R. H. Kamdar, L. M. Millar, C. Burchardt, F. D. Murgatroyd, D. Klug, C. Kouakam, L. Guedon-Moreau, C. Marquie, S. Benard, S. Kacet, N. Cortez-Dias, P. Carrilho-Ferreira, D. Silva, S. Goncalves, M. Valente, P. Marques, L. Carpinteiro, J. Sousa, T. Keida, T. Nishikido, M. Fujita, T. Chinen, T. Kikuchi, K. Nakamura, H. Ohira, M. Takami, D. Anjo, A. Meireles, C. Gomes, C. Roque, A. Pinheiro Vieira, V. Lagarto, H. Reis, S. Torres, D. F. Ortega, L. D. Barja, J. P. Montes, E. Logarzo, P. Bonomini, N. Mangani, C. Paladino, T. Chwyczko, E. Smolis-Bak, M. Sterlinski, M. Pytkowski, B. Firek, A. Jankowska, H. Szwed, I. Nakajima, T. Noda, H. Okamura, K. Satomi, T. Aiba, W. Shimizu, N. Aihara, S. Kamakura, W. Brzozowski, A. Tomaszewski, A. Wysokinski, E. G. Bertoldi, L. E. Rohde, L. I. Zimerman, M. Pimentel, C. A. Polanczyk, G. Boriani, M. Lunati, M. Gasparini, M. Landolina, G. Lonardi, D. Pecora, M. Santini, S. Valsecchi, B. J. Rubinstein, D. Y. Wang, S. E. Cabreriza, M. E. Richmond, A. Rusanov, T. A. Quinn, B. Cheng, H. M. Spotnitz, H. M. Kristiansen, G. Vollan, T. Hovstad, H. Keilegavlen, S. Faerestrand, U. Brigesdotter-Green, A. M. R. Nawar, D. A. L. I. A. Ragab, R. A. N. I. A. Eluhsseiny, A. H. M. E. D. Abdelaziz, E. Nof, R. Abu Shama, J. Buber, R. Kuperstein, M. S. Feinberg, D. Barlev, M. Eldar, M. Glikson, H. Badran, R. Samir, M. Tawfik, M. Amin, H. Eldamnhoury, S. Khaled, J. M. Tolosana, A. M. Martin, A. Hernandez-Madrid, A. Macias, I. Fernandez-Lozano, J. Osca, A. Quesada, L. Padeletti, G. L. Botto, T. De Santo, A. Szwed, J. G. Martinez, B. Degand, G. Q. Villani, C. Leclercq, P. Ritter, I. Watanabe, K. Nagashima, Y. Okumura, M. Kofune, K. Ohkubo, T. Nakai, A. Hirayama, E. Mikhaylov, M. Vander, D. Lebedev, M. Zarse, H. Suleimann, H. Bogossian, J. Stegelmeyer, I. Ninios, Z. Karosienne, A. Kloppe, B. Lemke, S. John, T. Gaspar, S. Rolf, P. Sommer, G. Hindricks, C. Piorkowski, J. Fernandez-Armenta, L. L. Mont, H. Zeljko, D. Andreu, C. Herzcku, T. Boussy, J. Brugada, T. Obayahi, J. Hegrenes, E. Lim, V. Mediratta, R. Bautista, L. Teplitsky, C. F. B. Van Huls Van Taxis, A. P. Wijnmaalen, M. Gawrysiak, J. D. Schuijf, J. J. Bax, Y. Huo, S. Richter, A. Arya, A. Bollmann, F. Akca, T. Bauernfeind, B. Schwagten, N. M. S. De Groot, L. Jordaens, T. Szili-Torok, S. Miller, G. Kastner, P. Maury, P. Della Bella, E. Delacretaz, F. Sacher, G. Maccabelli, R. Brenner, A. Rollin, P. Jais, P. Vergara, N. Trevisi, A. Ricco, F. Petracca, C. Bisceglia, F. Baratto, R. Salguero Bodes, A. Fontenla Cerezuela, M. De Riva Silva, M. Lopez Gil, E. Mejia Martinez, A. Jurado Roman, M. Montero Alvarez, F. Arribas Ynsaurriaga, A. Baszko, K. Krzyzanowski, W. Bobkowski, R. Surmacz, E. Zinka, A. Siwinska, A. Szyszka, A. Perez Silva, A. Estrada Mucci, M. Ortega Molina, J. L. Lopez Sendon, J. L. Merino Llorens, K. Kaitani, K. Hanazawa, C. Izumi, Y. Nakagawa, I. Yamanaka, T. Hirahara, Y. Sugawara, C. Suga, J. Ako, S. Momomura, N. Galizio, J. Gonzalez, F. Robles, A. Palazzo, L. Favaloro, M. Diez, E. Guevara, A. Fernandez, S. Greenberg, A. Epstein, D. S. Goldman, C. Sangli, J. A. Keeney, K. Lee, S. R. D. Piers, J. B. Van Rees, J. Thijssen, C. J. W. Borleffs, E. T. Van Der Velde, C. H. Leclercq, M. Hero, M. Mizobuchi, Y. Enjoji, Y. Yazaki, K. Shibata, A. Funatsu, T. Kobayashi, S. Nakamura, G. Amit, B. Pertzov, D. Zahger, L. Medesani, R. Rana, F. Albano, H. Fraguas, S. S. Pedersen, M. T. Hoogwegt, D. A. M. J. Theuns, K. C. Van Den Broek, F. B. Tekle, M. Habibovic, M. Alings, P. Van Der Voort, J. Denollet, H. Vrazic, C. Jilek, H. Lesevic, S. Tzeis, V. Semmler, M. R. Gold, M. C. Burke, G. H. Bardy, N. Varma, B. Pavri, B. Stambler, J. Michalski, T. R. U. S. T. Investigators, E. Safak, D. Schmitz, T. Konorza, C. Wende, A. Schirdewan, J. Neuzner, T. Simmers, A. Erglis, R. Gradaus, J. Goetzke, L. Coutrot, K. Goehl, V. Bazan Gelizo, N. Grau, E. Valles, M. Felez, C. Sanjuas, J. Bruguera, J. Marti-Almor, S. Y. Chu, P. W. Li, W. H. Ding, C. Schukro, L. Leitner, J. Siebermair, G. Stix, T. Pezawas, J. Kastner, M. Wolzt, H. Schmidinger, N. A. T. H. A. L. I. E. Behar, G. Kervio, B. Petit, P. Maison-Balnche, S. Bodi, P. Mabo, P. W. X. Foley, E. Mutch, J. Brashaw-Smith, L. Ball, F. Leyva, D. H. Kim, M. J. Lee, W. S. Lee, S. D. Park, S. H. Shin, S. I. Woo, J. Kwan, K. S. Park, Y. Munetsugu, K. Tanno, M. Kikuchi, H. Ito, F. Miyoshi, M. Kawamura, Y. Kobayashi, S. Man, A. M. Algra, C. A. Schreurs, E. E. Van Der Wall, S. C. Cannegieter, C. A. Swenne, K. Iitsuka, T. Kondo, K. Goebbert, Z. Karossiene, D. Goldman, B. Kallen, E. Kerpi, J. Sardo, P. Arsenos, K. Gatzoulis, G. Manis, P. Dilaveris, D. Tsiachris, D. Mytas, S. Asimakopoulos, C. Stefanadis, S. Sideris, E. Kartsagoulis, O. Barbosa, M. Marocolo Junior, R. Silva Cortes, R. A. Moraes Brandolis, L. F. Oliveira, L. A. Pertili Rodrigues De Resende, M. A. Vieira Da Silva, V. J. Dias Da Silva, R. A. Hegazy, I. A. Sharaf, F. Fadel, H. Bazaraa, R. Esam, M. S. Deshko, V. A. Snezhitsky, T. P. Stempen, K. Kuroki, M. Igawa, K. Kuga, L. Ferreira Santos, T. Dionisio, L. Nunes, J. Machado, S. Castedo, C. Henriques, A. Matos, J. Oliveira Santos, K. Kraaier, M. A. G. M. Olimulder, M. A. Galjee, P. F. H. M. Van Dessel, J. Van Der Palen, A. A. M. Wilde, M. F. Scholten, F. Chouchou, L. Poupard, C. Philippe, I. Court-Fortune, J.- C. Barthelemy, F. Roche, T. S. Dolgoshey, G. A. Madekina, S. Sugiura, E. Fujii, M. Senga, K. Dohi, E. Sugiura, M. Nakamura, M. Ito, C. Eitel, J. Mendell, K. Lasseter, M. Shi, L. Urban, R. Hatala, P. Hlivak, M. De Melis, C. Garutti, G. Corbucci, H. Mlcochova, R. Maxian, E. Arbelo, A. Dogac, C. Luepkes, M. Ploessnig, C. Chronaki, L. Hinterbuchner, A. Guillen, S. S. Bun, D. G. Latcu, F. Franceschi, S. Prevot, L. Koutbi, P. Ricard, N. Saoudi, N. Nazari, A. Alizadeh, S. Sayah, M. Hekmat, M. Assadian, A. Ahmadzadeh, M. Wnuk, J. Jedrzejczyk-Spaho, O. Kruszelnicka, W. Piwowarska, A. Fedorowski, P. Burri, S. Juul-Moller, O. Melander, P. Mitro, P. Murin, P. Kirsch, V. Habalova, E. Slaba, E. Matyasova, M. A. Barlow, R. J. Blake, P. Rostoff, E. Wojewodka Zak, L. Froidevaux, F. P. Sarasin, M. Louis-Simonet, O. Hugli, B. Yersin, J. Schlaepfer, C. Mischler, E. Pruvot, E. Occhetta, F. Frascarelli, A. Burali, and E. Dovellini

Subjects
Oncology, medicine.medical_specialty, business.industry, nutritional and metabolic diseases, medicine.disease, Logistic regression, Breast cancer, Physiology (medical), Internal medicine, medicine, lipids (amino acids, peptides, and proteins), skin and connective tissue diseases, Cardiology and Cardiovascular Medicine, business
Abstract

Results: Out of 664159 women there were 22938 patients with hyperlipidaemia (3.5%) and 9312 patients with breast cancer. Out of the hyperlipidaemia patients, 530 patients developed breast cancer (2.3%) compared with 8782 patients developing breast cancer without hyperlipidaemia (1.4%). A logistic regression model accounting for time from first presentation to development of breast cancer showed that the presence of hyperlipidaemia increases the outcome of breast cancer by 1.64 times (95% C.I. 1.50-1.79). Conclusions: Whilst we appreciate numerous limitations of our methods, coupled with the main findings of the recent basic science research, our analysis further augments the case for the role of cholesterol in the development of breast cancer. Our data from a large clinical relevant sample further strengthens the argument to prospectively trial statins in the management of breast cancer.

Published
2011
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18. Essential Ventricular Arrhythmias: An Early Step Toward Cardiomyopathy?

Author

Marcello Piacenti, L. Paperini, C. Contini, A. Pozzolini, M. G. Bongiorni, A. Biagini, S. Berti, D. Levorato, M. T. Baratto, C. Arlotta, and G. Kraft

Subjects
medicine.medical_specialty, business.industry, Internal medicine, Healthy subjects, Cardiomyopathy, Cardiology, Medicine, cardiovascular diseases, business, medicine.disease, Ventricular tachycardia, Endomyocardial biopsy, Arrhythmogenic right ventricular dysplasia
Abstract

Severe ventricular arrhythmias in apparently healthy subjects have recently been shown to be associated with regional or global myocardial contractile abnormalities. In this study we have assumed, as a working hypothesis, that this association in such subjects may represent an early step toward cardiomyopathy [1–5].

Published
1990
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19. Role of Radionuclide Angiography in the Diagnosis of Early Ventricular Dysfunction in Patients with Complex Ventricular Arrhythmias

Author

A. Biagini, L. Paperini, D. Levorato, C. Contini, M. G. Bongiorni, A. L’Abbate, Oberdan Parodi, M. Piacenti, G. Kraft, C. Arlotta, S. Berti, Danilo Neglia, and M. T. Baratto

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Dilated cardiomyopathy, medicine.disease, Arrhythmogenic right ventricular dysplasia, Heart muscle disorder, Both ventricles, Radionuclide angiography, Internal medicine, Etiology, Cardiology, Medicine, In patient, business, Medical attention
Abstract

Dilated cardiomyopathy is defined as a heart muscle disorder of unknown etiology in which there is impaired contractile function and dilatation of one or both ventricles [1, 2]. It is known that, once clinical evidence of impaired ventricular performance is apparent, the prognosis is poor [3–5]. Hence, we should attempt to diagnose the disorder earlier in its latency period. Much evidence suggests that subjects who come to medical attention only because of ventricular arrhythmias may represent the tip of the iceberg of patients with primitive myocardial disease.

Published
1990
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20. 8.2 Therapy optimization in pacemaker patients with atrial fibrillation

Author

E. Manfredini, G.C. Bini, M. Pauletti, E. Pardini, R. Bini, L. Paperini, and G. Corbucci

Subjects
medicine.medical_specialty, business.industry, P wave, Atrial fibrillation, medicine.disease, law.invention, law, Physiology (medical), Internal medicine, medicine, Cardiology, Artificial cardiac pacemaker, Cardiology and Cardiovascular Medicine, business
Published
2003
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22. 333 Relationship between stress echo results and angiographically assessed coronary artery disease severity

Author

G.C. Bini, L. Paperini, Frank Lloyd Dini, M. Pauletti, Baldini U, G. Magini, and Raugi M

Subjects
Coronary artery disease, medicine.medical_specialty, Stress Echo, business.industry, Internal medicine, medicine, Cardiology, Radiology, Nuclear Medicine and imaging, General Medicine, Cardiology and Cardiovascular Medicine, business, medicine.disease
Published
1999
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23. [Ambulatory electrocardiography in the screening of patients with palpitations]

Author

C, Contini, C, Arlotta, M T, Baratto, S, Berti, M G, Bongiorni, D, Levorato, L, Paperini, M, Piacenti, and A, Pozzolini

Subjects
Electrocardiography, Terminology as Topic, Humans, Arrhythmias, Cardiac, Prognosis, Circadian Rhythm, Monitoring, Physiologic
Abstract

The role of 24 hour Holter monitoring in the screening of patients complaining of palpitations is reviewed. The term "palpitations", although not always unequivocally used, implies the presence of an arrhythmia. The clinical-instrumental correlation of an intermittent symptom is made possible by continuous electrocardiographic monitoring. Answers to be expected from a 24 hour Holter monitoring in order to achieve an early characterization of the arrhythmia are related to: site of origin, incidence, circadian distribution, prognostic stratification, events aggregation, presence of other asymptomatic abnormalities (rhythm, ST-T).

Published
1987

24. Long-term efficacy of oral encainide in frequent and repetitive ventricular arrhythmias

Author

Levorato D, Carlo Contini, L. Paperini, Bongiorni Mg, and C. Arlotta

Subjects
Tachycardia, Adult, Male, medicine.medical_specialty, Adolescent, Encainide, Heart Ventricles, Ventricular tachycardia, Electrocardiography, Internal medicine, medicine, Humans, Anilides, Adverse effect, Aged, Monitoring, Physiologic, Ventricular function, medicine.diagnostic_test, Dose-Response Relationship, Drug, business.industry, Arrhythmias, Cardiac, Fractional shortening, Middle Aged, medicine.disease, Echocardiography, Anesthesia, Chronic Disease, Cardiology, Exercise Test, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Anti-Arrhythmia Agents, medicine.drug, Follow-Up Studies
Abstract

The short- and long-term efficacy of oral encainide was studied in 14 patients with chronic high-frequency ventricular arrhythmias and in 14 patients with chronic frequent episodes of non-sustained ventricular tachycardia (NSVT). Encainide efficacy was assessed during a dose-titration period and in a 36-month follow-up also studying the drug effects on routine haematologic data and left ventricular function (LVF). During dose-titration, encainide caused a 78.3% decrease in the average hourly frequency of isolated PVC and a 96.1% reduction in NSVT episodes in the two groups of patients. On follow-up (11 patients in each group) the mean percentage reductions were 95.1% in isolated PVC and 99.7% in NSVT episodes. Encainide did not impair LVF as showed by the comparison of echocardiographic fractional shortening before and after 12 months of treatment. Minor adverse effects of encainide were dose-related visual disturbances in two patients. A major adverse effect was the appearance of sustained VT in one NYHA class IV patient. Oral encainide effectively reduces the frequency of PVC and NSVT, it does not impair left ventricular function and it is associated with infrequent minor side effects. Uncommon, but severe, side effects may appear in patients with marked impairment of left ventricular function.

Published
1988

25. Asymptomatic cardiac arrhythmias in periodic paralysis

Author

A Arrigo, Alberto Muratorio, Mg Bongiorni, Ubaldo Bonuccelli, Carlo Contini, Angelo Nuti, and L. Paperini

Subjects
medicine.medical_specialty, business.industry, Periodic paralysis, medicine.disease, Asymptomatic, Psychiatry and Mental health, Text mining, Internal medicine, medicine, Cardiology, Surgery, Neurology (clinical), medicine.symptom, business, Research Article
Published
1988

26. Transvenous lead extraction: Efficacy and safety of the procedure in female patients.

Author

Segreti L, Bongiorni MG, Barletta V, Parollo M, Di Cori A, Fiorentini F, Giannotti Santoro M, De Lucia R, Viani S, Grifoni G, Paperini L, Sodati E, Mazzocchetti L, Canu AM, and Zucchelli G

Abstract

Background: Existing data on the impact of sex differences on transvenous lead extraction (TLE) outcomes in cardiac device patients are limited., Objective: The purpose of this study was to evaluate the safety and efficacy of mechanical TLE in female patients., Methods: A retrospective evaluation was performed on 3051 TLE patients (group 1: female; group 2: male) from a single tertiary referral center. All individuals received treatment using single sheath mechanical dilation and various venous approaches as required., Results: Our analysis included 3051 patients (group 1: 750; group 2: 2301), with a total of 5515 leads handled with removal. Female patients were younger, had a higher left ventricular ejection fraction, and lower prevalences of coronary artery disease and diabetes mellitus. Infection was more common in male patients, whereas lead malfunction or abandonment were more frequent in female patients. Radiologic success was lower in female patients (95.8% vs 97.5%; P = .003), but there was no significant difference in clinical success between groups (97.2% vs 97.5%; P = .872). However, major complications (1.33% vs 0.60%; P <.001) and procedural mortality (0.4% vs 0.1%; P <.001) were higher in females compared to male patients. After multivariate analysis, female sex emerged as the only predictor of major complications, including deaths (odds ratio 3.96; 95% confidence interval 1.39-11.24)., Conclusion: TLE using unpowered simple mechanical sheaths in female patients is safe and effective, but is associated with lower radiologic success and higher complication rates and mortality than in males. This finding underscores the importance of recognizing sex differences in TLE outcomes., (© 2023 Heart Rhythm Society. Published by Elsevier Inc.)

Published
2023
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27. Feasibility and Accuracy of Noninvasive Continuous Arterial Pressure Monitoring during Transcatheter Atrial Fibrillation Ablation.

Author

Di Cori A, Parollo M, Fiorentini F, Della Volpe S, Mazzocchetti L, Barletta V, Segreti L, Viani S, De Lucia R, Paperini L, Canu A, Grifoni G, Soldati E, Bongiorni MG, and Zucchelli G

Abstract

Introduction: Transcatheter atrial fibrillation (AF) ablation is still carried out with continuous invasive radial arterial blood pressure (IBP) monitoring in many centers. Continuous noninvasive blood pressure (CNBP) measurement using the volume-clamp method is a noninvasive alternative method used in ICU. No data on CNBP reliability are available in the electrophysiology lab during AF ablation, where rhythm variations are common., Background: The objective of the present study was to compare continuous noninvasive arterial pressure measured with the ClearSight device (Edwards Lifesciences, Irvine, CA, USA) with invasive radial artery pressure used as the reference method during AF ablation., Methods: We prospectively enrolled 55 consecutive patients (age 62 ± 11 years, 80% male) undergoing transcatheter AF ablation (62% paroxysmal, 38% persistent) at our center. Standard of care IBP monitoring via a radial cannula and a contralateral noninvasive finger volume-clamp CNBP measurement device were positioned simultaneously in all patients for the entire procedure. Bland-Altman analysis was used to analyze the agreement between the two techniques., Results: A total of 1219 paired measurements for systolic, diastolic, and mean arterial pressure were obtained in 55 subjects, with a mean (SD) of 22 (9) measurements per patient. The mean bias (SD) was -12.97 (13.89) mmHg for systolic pressure (level of agreement -14.24-40.20; correlation coefficient 0.84), -1.85 (8.52) mmHg for diastolic pressure (level of agreement -18.54-14.84; correlation coefficient 0.77) and 2.31 (8.75) mmHg for mean pressure (level of agreement -14.84-19.46; correlation coefficient 0.85)., Conclusion: In patients undergoing AF ablation, CNBP monitoring with the ClearSight device showed acceptable agreement with IBP monitoring. Larger studies are needed to confirm the potential clinical implications of continuous noninvasive BP monitoring during AF ablation.

Published
2023
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28. His-bundle pacing to treat an unusual case of chest pain after pacemaker implant.

Author

Parollo M, Zucchelli G, Santoro MG, Barletta V, Paperini L, and Bongiorni MG

Abstract

A 63-year-old man with hypertension and 3-vessel coronary artery disease previously treated with coronary artery bypass graft was admitted to our emergency room complaining of chest pain. He had undergone pacemaker implant 5 months before due to paroxysmal advanced atrioventricular block. Electrocardiography and troponin testing were unremarkable. Echocardiography and chest X-ray ruled out lead displacement and perforation. Interrogation showed normal parameters [right atrium: impedance 550 Ohm bipolar, sensing 2.4 mV bipolar; threshold 0.50 V/0.4 ms bipolar; right ventricle (RV): impedance 580 Ohm bipolar, sensing > 25 mV bipolar; threshold 1.5 V/0.4 ms bipolar and 0.4 V/0.4 ms unipolar]. Pain was evoked only during RV pacing. An electrophysiology study demonstrated painful RV pacing from multiple sites. We hypothesized that pain was associated with pacing-induced dyssynchrony. His-bundle pacing (HBP) was considered as a solution. We achieved HBP with a bipolar fixed-screw catheter connected to a cardiac resynchronization therapy pacemaker generator. During HBP above threshold (4.00 V/1.00 ms) the patient did not complain of any pain. He was discharged 3 days later pain-free with His-bundle lead amplitude set at 5.00 V/1.00 ms. After 6 months the patient was asymptomatic, with the device showing normal functioning. This is the first clinical experience of painful RV pacing treated with HBP. < Learning objective: Painful right ventricular pacing in the absence of perforation is a rare but potentially underdiagnosed condition. Ventricular dyssynchrony could represent the underlying mechanism. Physiological electromechanical activation achieved via His-bundle pacing could represent an effective therapeutic option.>., Competing Interests: The authors declare no conflict of interest., (© 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Published
2021
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29. Comparison between leadless and transvenous single-chamber pacemaker therapy in a referral centre for lead extraction.

Author

Zucchelli G, Tolve S, Barletta V, Di Cori A, Parollo M, De Lucia R, Della Tommasina V, Giannotti Santoro M, Viani S, Cellamaro T, Segreti L, Paperini L, Soldati E, and Bongiorni MG

Subjects
Cardiac Pacing, Artificial, Equipment Design, Humans, Referral and Consultation, Treatment Outcome, Pacemaker, Artificial
Abstract

Purpose: The aim of the study was to compare the long-term clinical and electrical performance of Micra leadless pacemaker with transvenous single-chamber pacemaker (TV-VVI PM) in a high-volume centre for transvenous lead extraction (TLE)., Methods: One-hundred patients (group 1) undergoing Micra implant were matched with 100 patients undergoing TV-VVI PM implant (group 2) by age, sex, left ventricular systolic ejection fraction and previous TLE., Results: The implant procedure was successful in all patients. In group 1, the procedure duration was lower than in group 2 (43.86 ± 22.38 vs 58.38 ± 17.85 min, p < 0.001), while the fluoroscopy time was longer (12.25 ± 6.84 vs 5.32 ± 4.42 min, p < 0.001). There was no difference about the rate of septal implant at the right ventricle (76% vs 86%, p = 0.10). Patients were followed-up for a median of 12 months. No acute and chronic procedure-related complication was observed in group 1, while we reported acute complications in seven patients (7%, p = 0.02) and long-term complications in three patients (3%, p = 0.24), needing for a system revision in 6 cases (6%, p = 0.038), in group 2. One systemic infection occurred in TV-VVI PM group. Electrical measurements were stable during follow-up in both groups, with a longer estimated battery life in group 1 (mean delivered energy at threshold at discharge: 0.14 ± 0.21 vs 0.26 ± 0.22 μJ, p < 0.001)., Conclusion: Micra pacemaker implant is a safe and effective procedure, with a lower rate of acute complications and system revisions compared with TV-VVI PM, even in a real-life setting including patients who underwent TLE., (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)

Published
2021
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30. Role of pre-procedural CT imaging on catheter ablation in patients with atrial fibrillation: procedural outcomes and radiological exposure.

Author

Di Cori A, Zucchelli G, Faggioni L, Segreti L, De Lucia R, Barletta V, Viani S, Paperini L, Parollo M, Soldati E, Caramella D, and Bongiorni MG

Subjects
Female, Humans, Infant, Newborn, Male, Tomography, Tomography, X-Ray Computed, Treatment Outcome, Atrial Fibrillation diagnostic imaging, Atrial Fibrillation surgery, Catheter Ablation, Pulmonary Veins diagnostic imaging, Pulmonary Veins surgery
Abstract

Background: Cardiac computed tomography (CT) is commonly used to study left atrial (LA) and pulmonary veins (PVs) anatomy before atrial fibrillation (AF) ablation. The aim of the study was to determine the impact of pre-procedural cardiac CT with 3D reconstruction on procedural outcomes and radiological exposure in patients who underwent radiofrequency catheter ablation (RFA) of AF., Methods: In this registry, 493 consecutive patients (age 62 ± 8 years, 70% male) with paroxysmal (316) or persistent (177) AF who underwent first procedure of RFA were included. A pre-procedural CT scan was obtained in 324 patients (CT group). Antral pulmonary vein isolation was performed in all patients using an open-irrigation-tip catheter with a 3D electroanatomical navigation system. Procedural outcome, including radiological exposure, and clinical outcomes were compared among patients who underwent RFA with (CT group) and without (no CT group) pre-procedural cardiac CT., Results: Acute PV isolation was obtained in all patients, with a comparable overall complication rate between CT and no CT group (4.3% vs 3%, p = 0.7). No differences were observed about mean duration of the procedure (231 ± 60 vs 233 ± 58 min, p = 0.7) and fluoroscopy time (13 ± 10 vs 13 ± 8 min, p = 0.6) among groups. Cumulative radiation dose resulted significantly higher in the CT group compared with no CT group (8.9 ± 24 vs 4.8 ± 15 mSv, P = 0.02). At 1 year, freedom from AF/atrial tachycardia were comparable among groups (CT group, 227/324 (70%), vs no CT group,119/169 (70%), p = ns)., Conclusions: Pre-procedural CT does not improve safety and efficacy of AF ablation, increasing significantly the cumulative radiological exposure.

Published
2021
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31. The in-ear region as a novel anatomical site for ECG signal detection: validation study on healthy volunteers.

Author

De Lucia R, Zucchelli G, Barletta V, Di Cori A, Giannotti Santoro M, Parollo M, Segreti L, Viani S, Della Tommasina V, Paperini L, Soldati E, and Bongiorni MG

Subjects
Adult, Arrhythmias, Cardiac diagnosis, Heart Rate, Humans, Male, Middle Aged, Reproducibility of Results, Electrocardiography, Wearable Electronic Devices
Abstract

Purpose: Early detection of cardiac arrhythmias is a major opportunity for mobile health, as wearable devices nowadays available can detect single-lead electrocardiogram (ECG). The study aims to validate the in-ear region as a new anatomical site for ECG signal detection and looks towards designing innovative ECG wearable devices., Methods: We performed ECG using KardiaMobile device (AliveCor®) on 35 healthy volunteers. First, ECG was detected by standard modality using both hands. Then, ECG was detected using the left in-ear region instead of the right hand. All the recorded ECGs were analyzed by the device and by two cardiologists in blind testing., Results: We successfully collected 70 ECGs performed on 35 volunteers (male 54%, age 39.1 ± 10.7 years; BMI 22.9 ± 2.89 kg/m 2 ) with no differences observed by KardiaMobile in ECG reports detected in the two different modalities. All the ECGs were reported as normal by the device and the two cardiologists. Moreover, linear regression analysis showed good correlation between the amplitude (mV) of P (r = 0.76; r 2  = 0.57; p < 0.0001) and QRS waves (r = 0.81; r 2  = 0.65; p < 0.0001), the intervals (ms) of PR (r = 0.91; r 2  = 0.83; p < 0.0001; LOA - 0.60-0.41; CC = 0.91), QRS (r = 0.78; r 2  = 0.61; p < 0.0001; LOA - 0.49-0.43; CC = 0.78), QT (r = 0.85; r 2  = 0.71; p < 0.0001; LOA - 1.31-1.20; CC = 0.85), and heart rate (r = 0.94; r 2  = 0.89; p < 0.0001; LOA - 7.82-7.76; CC = 0.94) detected in two different modalities., Conclusion: The in-ear region is a reliable novel anatomical site for ECG signal detection in normal healthy subjects. Further studies are needed to validate this new ECG detection modality also in case of cardiac arrhythmias and to support the development of new wearable devices.

Published
2021
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32. Predictors of zero X ray procedures in supraventricular arrhythmias ablation.

Author

Di Cori A, Zucchelli G, Segreti L, Barletta V, Viani S, Paperini L, Della Tommasina V, Cellamaro T, Vecchi A, Soldati E, and Bongiorni MG

Subjects
Action Potentials, Adult, Aged, Atrial Flutter diagnostic imaging, Atrial Flutter physiopathology, Electrophysiologic Techniques, Cardiac, Female, Fluoroscopy, Heart Rate, Humans, Male, Middle Aged, Occupational Exposure adverse effects, Patient Safety, Radiation Exposure adverse effects, Retrospective Studies, Risk Assessment, Risk Factors, Tachycardia, Atrioventricular Nodal Reentry diagnostic imaging, Tachycardia, Atrioventricular Nodal Reentry physiopathology, Tachycardia, Supraventricular diagnostic imaging, Tachycardia, Supraventricular physiopathology, Time Factors, Treatment Outcome, Atrial Flutter surgery, Catheter Ablation adverse effects, Occupational Exposure prevention & control, Radiation Dosage, Radiation Exposure prevention & control, Tachycardia, Atrioventricular Nodal Reentry surgery, Tachycardia, Supraventricular surgery
Abstract

To evaluate predictors of zero-X ray procedures for supraventricular arrhythmias (SVT) using minimally fluoroscopic approach (MFA). Patients referred for RF catheter ablation of SVT were admitted for a MFA with an electro-anatomical navigation system or a conventional fluoroscopic approach (ConvA). Exclusion criterion was the need to perform a transseptal puncture. 206 patients (98 men, age 53 ± 19 years) underwent an EP study, 93 (45%) with an MFA and 113 (55%) with a ConvA. Fifty-five had no inducible arrhythmias (EPS). Fifty-four had AV nodal reentrant tachycardia (AVNRT), 49 patients had typical atrial flutter (AFL), 37 had AV reciprocating tachycardia (AVRT/WPW), 11 had focal atrial tachycardia (AT), and underwent a RF ablation. X-ray was not used at all in 51/93 (58%) procedures (zero X ray). MFA was associated with a significant reduction in total fluoroscopy time (5.5 ± 10 vs 13 ± 18 min, P = 0.01) and operator radiation dose (0.8 ± 2.5 vs 3 ± 8.2 mSV, P < 0.05). The greatest absolute dose reduction was observed in AVNRT (0.1 ± 0.3 vs 5.1 ± 10 mSV, P = 0.01, 98% relative dose reduction) and in AFL (1.3 ± 3.6 vs 11 ± 16 mSV, P = 0.003, 88% relative dose reduction) groups. Both AVNRT or AFL resulted the only statistically significant predictors of zero x ray at multivariate analysis (OR 4.5, 95% CI 1.5-13 and OR 5, 95% CI 1.7-15, P < 0.001, respectively). Success and complication rate was comparable between groups (P = NS). Using MFA for SVT ablation, radiological exposure is significantly reduced. Type of arrhythmia is the strongest predictor of zero X ray procedure.

Published
2020
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33. Safety and efficacy of transvenous mechanical lead extraction in patients with abandoned leads.

Author

Segreti L, Giannotti Santoro M, Di Cori A, Fiorentini F, Zucchelli G, Bernini G, De Lucia R, Viani S, Paperini L, Barletta V, Soldati E, and Bongiorni MG

Subjects
Equipment Failure, Humans, Odds Ratio, Retrospective Studies, Treatment Outcome, Defibrillators, Implantable, Device Removal, Pacemaker, Artificial
Abstract

Aims: Optimal management of redundant or malfunctioning leads is controversial. We aimed to assess safety and efficacy of mechanical transvenous lead extraction (TLE) in patients with abandoned leads., Methods and Results: Consecutive TLE procedures performed in our centre from January 2009 to December 2017 were considered. We evaluated the safety and efficacy of mechanical TLE in patients with abandoned (Group 1) compared to non-abandoned (Group 2) leads. We analysed 1210 consecutive patients that required transvenous removal of 2343 leads. Group 1 accounted for 250 patients (21%) with a total of 617 abandoned leads (26%). Group 2 comprised 960 patients (79%) with 1726 leads (74%). The total number of leads (3.0 vs. 2.0), dwelling time of the oldest lead (108.00 months vs. 60.00 months) and infectious indications for TLE were higher in Group 1. Clinical success was achieved in 1168 patients (96.5%) with a lower rate in Group 1 (90.4% vs. 98.1%; P < 0.001). Major complications occurred in only 9 patients (0.7%), without significant differences among the two groups. The presence of one or more abandoned leads [odds ratio (OR) 3.47; 95% confidence interval (CI) 1.07-11.19; P = 0.037] and dwelling time of the oldest lead (OR 1.01 for a month; 95% CI 1.01-1.02; P < 0.001) were associated with a higher risk of clinical failure., Conclusion: Transvenous mechanical lead extraction is a safe procedure also in high-risk settings, as patients with abandoned leads. Success rate resulted a bit lower, especially in the presence of abandoned leads with long implantation time., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Published
2020
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34. Micra pacemaker implant after cardiac implantable electronic device extraction: feasibility and long-term outcomes.

Author

Zucchelli G, Barletta V, Della Tommasina V, Viani S, Parollo M, Mazzocchetti L, Cellamaro T, Paperini L, Di Cori A, De Lucia R, Segreti L, Soldati E, and Bongiorni MG

Subjects
Aged, Cardiac Catheters adverse effects, Feasibility Studies, Female, Follow-Up Studies, Humans, Italy epidemiology, Male, Outcome and Process Assessment, Health Care, Prosthesis Implantation instrumentation, Prosthesis Implantation methods, Reoperation adverse effects, Reoperation methods, Time, Cardiac Pacing, Artificial methods, Cardiac Pacing, Artificial statistics & numerical data, Microelectrodes, Pacemaker, Artificial adverse effects, Pacemaker, Artificial statistics & numerical data, Prosthesis Implantation adverse effects, Prosthesis-Related Infections etiology, Prosthesis-Related Infections surgery
Abstract

Aims: We aimed at investigating the feasibility and outcome of Micra implant in patients who have previously undergone transvenous lead extraction (TLE), in comparison to naïve patients implanted with the same device., Methods and Results: Eighty-three patients (65 males, 78.31%; 77.27 ± 9.96 years) underwent Micra implant at our centre. The entire cohort was divided between 'post-extraction' (Group 1) and naïve patients (Group 2). In 23 of 83 patients (20 males, 86.96%; 73.83 ± 10.29 years), Micra was implanted after TLE. Indication to TLE was an infection in 15 patients (65.21%), leads malfunction in four (17.39%), superior vena cava syndrome in three (13.05%), and severe tricuspid regurgitation in one case (4.35%). The implant procedure was successful in all patients and no device-related events occurred at follow-up (median: 18 months; interquartile range: 1-24). No differences were observed between groups in fluoroscopy time (13.88 ± 10.98 min vs. 13.15 ± 6.64 min, P = 0.45), single device delivery (Group 1 vs. Group 2: 69.56% vs. 55%, P = 0.22), electrical performance at implant and at 12-month follow-up (Group 1 vs. Group 2: pacing threshold 0.48 ± 0.05 V/0.24 ms vs. 0.56 ± 0.25 V/0.24 ms, P = 0.70; impedance 640 ± 148.83 Ohm vs. 583.43 ± 99.7 Ohm, P = 0.27; and R wave amplitude 10.33 ± 2.88 mV vs. 12.62 ± 5.31 mV, P = 0.40). A non-apical site of implant was achievable in the majority of cases (72.3%) without differences among groups (78.26% vs. 70%; P = 0.42)., Conclusion: Micra implant is an effective and safe procedure in patients still requiring a ventricular pacing after TLE, with similar electrical performance and outcome compared with naïve patients at long-term follow-up., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.)

Published
2019
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35. Feasibility and long-term effectiveness of a non-apical Micra pacemaker implantation in a referral centre for lead extraction.

Author

Bongiorni MG, Della Tommasina V, Barletta V, Di Cori A, Rogani S, Viani S, Segreti L, Paperini L, Soldati E, De Lucia R, and Zucchelli G

Subjects
Action Potentials, Aged, Aged, 80 and over, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac physiopathology, Equipment Design, Feasibility Studies, Female, Heart Rate, Humans, Male, Middle Aged, Time Factors, Treatment Outcome, Arrhythmias, Cardiac therapy, Cardiac Pacing, Artificial, Pacemaker, Artificial
Abstract

Aims: To demonstrate the feasibility and long-term performances of a non-apical Micra pacemaker implantation., Methods and Results: Fifty-two consecutive patients underwent Micra implantation, targeting a non-apical site of delivery when feasible. Each patient received a regular follow-up (mean 13 ± 9 months). The first 17 patients were also enrolled in the Micra transcatheter pacing system trial (Group 1); the remaining ones presented broader indications and included post-extraction subjects (Group 2). In 19 of 52 patients (Group 1: 6%, Group 2: 51%; P = 0.002) Micra was implanted because of high-risk characteristics that discouraged the implantation of a traditional pacemaker. In 31 of 52 patients (60%) Micra was implanted in a non-apical location, with a lower rate of single delivery compared with apical sites (48% vs. 81%, P = 0.035), but without any impact on electrical performance. Pacing threshold remained optimal in the majority of patients (94%), regardless of the site of implantation (apical vs. non-apical location: 0.50 vs. 0.52 V/0.24 ms; P = 0.856) and group membership, with only 6% of the subjects showing elevated values (mean 1.92 ± 0.92 V/0.24 ms) at the last follow-up. No device-related adverse events were registered., Conclusion: Micra pacemaker implant is a safe and effective procedure even in a real life cohort of high-risk patients. A non-apical site of implantation is feasible in the majority of patients allowing stable electrical performance at long-term follow-up.

Published
2019
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36. Utility of risk scores to predict adverse events in cardiac lead extraction.

Author

Segreti L, Giannotti Santoro M, Di Cori A, Zucchelli G, Viani S, De Lucia R, Della Tommasina V, Barletta V, Paperini L, Soldati E, and Bongiorni MG

Subjects
Device Removal methods, Fibrosis, Humans, Reproducibility of Results, Risk Assessment, Defibrillators, Implantable adverse effects, Device Removal adverse effects, Pacemaker, Artificial adverse effects
Abstract

Introduction: Increasing device implantations, patient comorbidities, and longer life expectancy contribute to an increased need for lead extraction. Even if transvenous lead extraction (TLE) is a highly successful procedure, some serious procedural complications are reported. In order to identify those patients who are at higher risk, risk stratification scores were proposed. Areas covered: The major obstacles to lead extractions are represented by the body's response to the foreign implanted material and by the following development of fibrotic reaction between the lead and the vascular system. Several clinical factors and device features are associated with major complications and worse outcomes. Although different multiparametric scores predicting the safety and the efficacy of TLE procedures were reported, none of these scores were prospective evaluated. Expert commentary: A correct risk stratification is needed in order to refer complex patients to centers with proven experience and avoid futile procedures. Furthermore, the identification of high-risk patients allows to perform the extraction procedure in the operating room instead of electrophysiology lab. Albeit some risk scores able to predict adverse event in cardiac lead extraction were described, there are still several limitations to their use and reproducibility.

Published
2018
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37. Prevention of sudden cardiac death: from wearable to subcutaneous cardioverter defibrillator.

Author

Viani S, Soldati E, DI Cori A, Segreti L, Paperini L, DE Lucia R, Zucchelli G, and Bongiorni MG

Subjects
Defibrillators, Electric Countershock instrumentation, Electric Countershock methods, Humans, Practice Guidelines as Topic, Primary Prevention methods, Secondary Prevention methods, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable, Wearable Electronic Devices
Abstract

The implantable cardioverter defibrillator (ICD) is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention. However many clinical conditions that would represent an indication to ICD implantation, according to guidelines, may be potentially reversible or may be accompanied by temporary contraindications to the implant. Moreover transvenous cardioverter defibrillator implantation still carries a not negligible risk of complications both acutely and at follow-up. The Wearable Cardioverter Defibrillator and the Subcutaneous Defibrillator are two recently developed technologies that can potentially overcome the aforementioned limitations of traditional transvenous ICDs. This review will discuss the main aspects of these 2 technologies, the data coming from clinical experiences and future perspectives.

Published
2018
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38. Overcoming the current issues surrounding device leads: reducing the complications during extraction.

Author

Bongiorni MG, Segreti L, Di Cori A, Zucchelli G, Paperini L, Viani S, and Soldati E

Subjects
Device Removal methods, Fibrosis, Humans, Treatment Outcome, Defibrillators, Implantable, Device Removal adverse effects, Pacemaker, Artificial, Postoperative Complications prevention & control
Abstract

Introduction: The implantation rate of cardiac implantable electronic devices has consistently increased in the last 20 years, as have the related complication rates. The most relevant issue is the removal of pacing and implantable cardioverter defibrillator (ICD) leads, which a few months after implantation tend to develop intravascular fibrosis, often making extraction a challenging and risky procedure. Areas covered: The transvenous lead extraction (TLE) scenario is constantly evolving. TLE is a key procedure in lead management strategies. Many efforts have been made to develop new TLE approaches and techniques allowing a safe and effective procedure for patients. The increasing rate of cardiac implantable electronic device (CIED) implantations and of CIED related complications highlight the importance of TLE. Lead related- and patient-related factors may change the future of extractions. We review the current status of TLE, focusing on the strategies available to perform the optimal procedure in the right patient and reducing procedure related complications. Expert commentary: Understanding the importance of an accurate TLE risk stratification is mandatory to optimize the procedural risk-to-benefits ratio. The use of adequate tools, techniques and approaches, and appropriate training are cornerstones for the achievement of safer procedures.

Published
2017
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39. Leadless cardiac pacemaker implant in a patient with two deep brain stimulators: A peaceful cohabitation beyond prejudices.

Author

Bongiorni MG, Zucchelli G, Coluccia G, Soldati E, Barletta V, Paperini L, Menichetti F, Di Cori A, Segreti L, Del Prete E, and Ceravolo R

Subjects
Aftercare, Aged, Electrocardiography methods, Female, Humans, Pacemaker, Artificial, Treatment Outcome, Atrioventricular Block complications, Atrioventricular Block diagnosis, Atrioventricular Block physiopathology, Atrioventricular Block therapy, Cardiac Pacing, Artificial methods, Deep Brain Stimulation methods, Parkinson Disease complications, Parkinson Disease surgery, Prosthesis Fitting methods
Published
2016
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40. Subcutaneous Implantable Defibrillator in an acromegalic pregnant woman for secondary prevention of sudden cardiac death: When (2) technologies save (2) lives.

Author

Viani S, Zucchelli G, Paperini L, Soldati E, Segreti L, Di Cori A, Menichetti F, Coluccia G, Andreini D, Branchitta G, and Bongiorni MG

Subjects
Acromegaly complications, Acromegaly diagnostic imaging, Adult, Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Cardiovascular diagnostic imaging, Secondary Prevention trends, Acromegaly therapy, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable trends, Human Growth Hormone metabolism, Pregnancy Complications, Cardiovascular prevention & control, Secondary Prevention methods
Published
2016
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41. Where is the future of cardiac lead extraction heading?

Author

Bongiorni MG, Di Cori A, Segreti L, Zucchelli G, Viani S, Paperini L, Menichetti F, Coluccia G, and Soldati E

Subjects
Cardiac Resynchronization Therapy Devices adverse effects, Defibrillators, Implantable adverse effects, Humans, Needs Assessment, Treatment Outcome, Catheterization, Peripheral methods, Device Removal methods
Abstract

Introduction: Transvenous lead extraction (TLE) is the gold standard for lead removal. The increasing rate of cardiac implantable electronic device (CIED) implantations and of CIED related complications highlight the importance of transvenous lead extraction ., Areas Covered: The TLE scenario is constantly changing. Optimizing lead related technology and improving TLE practice across the world are the cornerstones to improving safety and efficacy. We review the state of the art in TLE, focusing on potential future implications and improvements in terms of skills and technologies. Expert commentary: The increased number of extractions will increase the necessity of safe and effective TLE. New technologies, techniques and appropriate training is warranted across the world.

Published
2016
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42. A Questionable Indication For ICD Extraction After Successful VT Ablation.

Author

Segreti L, Di Cori A, Zucchelli G, Soldati E, Coluccia G, Viani S, Paperini L, and Bongiorni MG

Abstract

Sustained ventricular tachyarrhythmias represent a kind of complication shared by a number of clinical presentations of heart disease, sometimes leading to sudden cardiac death. Many efforts have been made in the fight against such a complication, mainly being represented by the implantable cardioverter defibrillator (ICD). In recent years, catheter ablation has grown as a means to effectively treat patients with sustained ventricular arrhythmias, in the contest of different cardiac substrates. Since carrying an ICD is associated with a potential risk deriving from its possible infective or malfunctioning complications, and given the current effectiveness of lead extraction procedures, it has been thought not to be unreasonable to ask ourselves about how to deal with ICD patients who have been successfully treated by means of ablation of their ventricular arrhythmias. To date, no control data have been published on transvenous lead extraction in the setting of VT ablation. In this paper we will review the current evidence about ICD therapy, catheter ablation of ventricular arrhythmias and lead extraction, trying to outline some considerations about how to face this new clinical issue.

Published
2015
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43. Transvenous extraction profile of Riata leads: procedural outcomes and technical complexity of mechanical removal.

Author

Bongiorni MG, Di Cori A, Segreti L, Zucchelli G, Viani S, Paperini L, De Lucia R, Levorato D, Boem A, and Soldati E

Subjects
Aged, Equipment Design instrumentation, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, United States, Defibrillators, Implantable adverse effects, Device Removal statistics & numerical data, Electrodes, Implanted adverse effects, Equipment Design adverse effects, Equipment Failure statistics & numerical data, Medical Device Recalls
Abstract

Background: Riata (RT) and Sprint Fidelis (SF) leads were recalled by the United States Food and Drug Administration because of an increased rate of failure mainly due to conductor fracture or insulation abrasion. According to lead design and type of failure, extraction complexity may be different, potentially affecting procedural outcomes and indications., Objective: The purpose of this study was to assess the extraction profile of RT leads with and without cable externalization in comparison to SF leads., Methods: From January 1997 to April 2014, all consecutive RT and SF leads extracted transvenously were analyzed. Among 661 consecutive patients with 705 ventricular implantable cardioverter-defibrillator (ICD) leads extracted, 194 patients with 134 RT leads (RT group) and 61 SF leads (SF group) were identified. Removal indications often were infective (64%), and extracted leads had a prevalence of dual-coil design (89%). Baseline patients and lead characteristics were comparable between groups., Results: Success rate was high in both groups (97.8% RT vs 100% SF) without major complications. Mechanical dilation was comparable between groups, but RT leads often required larger sheaths (11.7 ± 1.4 vs 11.3 ± 1.4), a more frequent crossover to the internal transjugular approach (14% vs 3%), and a longer procedural time (23 ± 33 minutes vs 12 ± 16 minutes). Implantation time (odds ratio 4.84, 95% confidence interval 1.05-22.2, P = .042) and RT leads (odds ratio 1.04, 95% confidence interval 1.02-1.06, P <.001) were independent predictors of the internal transjugular approach., Conclusion: Extraction of RT leads is feasible and effective. However, extraction of RT leads is more complex than that of SF leads. Lack of coil backfilling and cable externalization in RT group may account for these differences., (Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Published
2015
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44. Subcutaneous implantable cardiac defibrillators: indications and limitations.

Author

Bongiorni MG, Viani S, Zucchelli G, Di Cori A, Segreti L, Paperini L, Levorato D, Boem A, Branchitta G, Andreini D, and Soldati E

Subjects
Arrhythmias, Cardiac complications, Arrhythmias, Cardiac therapy, Clinical Trials as Topic, Death, Sudden, Cardiac etiology, Heart Failure complications, Heart Failure therapy, Humans, Prosthesis Design, Prosthesis Failure, Death, Sudden, Cardiac prevention & control, Defibrillators, Implantable adverse effects
Abstract

The implantable cardioverter defibrillator is today an indisputable evidence-based treatment for cardiac sudden death both in primary and secondary prevention. However, trans-venous cardioverter defibrillator implantation still carries a not negligible risk of complications both acutely and during follow-up. Trans-venous endocardial lead is the weak link of implantable cardioverter defibrillator (ICD) technology being the source of most mechanical complications on vessels and heart structures and exposed to infection, malfunction and recalls. A totally subcutaneous defibrillation lead has recently been introduced in clinical practice. With the subcutaneous pulse generator forms a defibrillation system that leaves the vessels and the heart completely "untouched." Subcutaneous ICD has proven to be safe and effective in many clinical trials. Patients without pacing indications and at higher risk of complications from trans-venous lead implantation represent the perfect candidates to S-ICD technology. However, with technical improvement, it is reasonable to expect a further expansion of indications.

Published
2015
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45. Major predictors of fibrous adherences in transvenous implantable cardioverter-defibrillator lead extraction.

Author

Segreti L, Di Cori A, Soldati E, Zucchelli G, Viani S, Paperini L, De Lucia R, Coluccia G, Valsecchi S, and Bongiorni MG

Subjects
Aged, Aged, 80 and over, Analysis of Variance, Cohort Studies, Device Removal statistics & numerical data, Electrodes, Implanted adverse effects, Female, Follow-Up Studies, Heart Failure diagnosis, Heart Failure mortality, Heart Failure therapy, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Survival Rate, Tissue Adhesions, Treatment Outcome, Defibrillators, Implantable adverse effects, Device Removal methods, Fibrosis pathology, Jugular Veins
Abstract

Background: Percutaneous removal of implantable cardioverter-defibrillator (ICD) leads is a difficult procedure because of the consequence of massive fibrous tissue growth along the lead., Objective: The purpose of this study was to describe the occurrence and location of fibrous adherences in ICD lead extraction and to identify potential predictors among patient and lead characteristics., Methods: We studied 637 consecutive patients who underwent transvenous extraction of 678 ICD leads from 1997 to 2013., Results: Procedural success rate was 99%, without major complications. Areas of adherence were found in the subclavian vein (78%), innominate vein (65%), superior vena cava (66%), and heart (73%). Dwell-time, passive fixation, and dual-coil lead design were independently associated with adherences. Dual-coil lead design was associated with adherences in the innominate vein and superior vena cava, whereas coil treatment (eg, expandable polytetrafluoroethylene-coated or medical adhesive back-filled strategies) prevented adherences. Passive fixation mechanism was associated with adherences in the heart., Conclusion: ICD leads, after long dwell-time, are affected by fibrous adherences uniformly distributed along the lead course. Lead features represent major predictors of the phenomenon. Careful lead selection is recommended at the time of implantation to prevent adherences. In addition, lead-related risk stratification is mandatory before a transvenous extraction procedure., (Copyright © 2014 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)

Published
2014
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46. Safety and efficacy of internal transjugular approach for transvenous extraction of implantable cardioverter defibrillator leads.

Author

Bongiorni MG, Segreti L, Di Cori A, Zucchelli G, Viani S, Paperini L, De Lucia R, Boem A, Levorato D, and Soldati E

Subjects
Cohort Studies, Female, Humans, Italy epidemiology, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Defibrillators, Implantable statistics & numerical data, Device Removal methods, Device Removal statistics & numerical data, Electrodes, Implanted statistics & numerical data, Jugular Veins
Abstract

Aims: We report our 15 years experience of a mechanical single-sheath technique with a multiple venous entry-site approach. We evaluated the effectiveness and safety of this technique in implantable defibrillator (ICD) lead extraction and investigated the potential association between clinical and lead-related factors and procedural complexity., Methods and Results: The proposed technique consists of an initial attempt at manual traction, followed by mechanical dilatation performed through the venous entry-site and, if necessary, by crossover to the internal transjugular approach. The study cohort comprised 545 consecutive patients referred to our institution for transvenous lead extraction from January 1997 to December 2012. Initial manual traction resulted in the effective removal of 6% of leads. Mechanical dilatation increased the success rate to 89% when performed through the venous entry-site, and to 99% when subsequently attempted via the internal jugular vein. No major complications were associated with lead extraction. Dwell-time, a passive fixation mechanism and dual-coil lead design were independently associated with the need for mechanical dilatation. However, dwell-time was the only variable associated with crossover to the internal transjugular approach. Specifically, a dwell-time of 20 months best predicted the need for venous entry-site mechanical dilatation, while a value of 55 months predicted crossover to the internal transjugular approach., Conclusion: Mechanical transvenous extraction of ICD leads is a complex but safe and effective procedure. A longer lead dwell-time is associated with the need for mechanical dilatation and for crossover to the internal transjugular approach; this should be considered when planning the removal procedure. Moreover, passive lead fixation and dual-coil lead design predict a more challenging extraction procedure., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)

Published
2014
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48. [Does a woman's heart beat faster?].

Author

Bongiorni MG, Paperini L, Viani S, Di Cori A, Zucchelli G, and Soldati E

Subjects
Arrhythmias, Cardiac epidemiology, Atrial Fibrillation physiopathology, Evidence-Based Medicine, Female, Humans, Incidence, Italy epidemiology, Long QT Syndrome physiopathology, Male, Prevalence, Risk Factors, Sex Distribution, Survival Rate, Arrhythmias, Cardiac physiopathology, Heart Rate
Abstract

Recent publications have identified a different epidemiological prevalence related to sex in some of the most common supraventricular and ventricular arrhythmias. This fact is attributed to the effect of sex hormones on myocardial cell electrophysiology. Women, in particular, have a higher prevalence than males with regard to intranodal reentrant tachycardia, idiopathic monomorphic ventricular tachycardia and ventricular arrhythmias in congenital or acquired long QT syndrome. A higher incidence in females with regard to complications during atrial fibrillation has also been reported. This paper examines data from the literature regarding gender differences in the prevalence of the most common arrhythmias, the causes of these differences, and some discriminating aspects related to female sex in the architecture of published clinical studies.

Published
2012
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49. Cardiac resynchronization therapy after coronary sinus lead extraction: feasibility and mid-term outcome of transvenous reimplantation in a tertiary referral centre.

Author

Zucchelli G, Bongiorni MG, Di Cori A, Soldati E, Solarino G, Fabiani I, Segreti L, De Lucia R, Viani S, Coluccia G, and Paperini L

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Industry statistics & numerical data, Italy epidemiology, Longitudinal Studies, Male, Middle Aged, Prevalence, Referral and Consultation statistics & numerical data, Reoperation statistics & numerical data, Risk Assessment, Risk Factors, Survival Analysis, Survival Rate, Treatment Outcome, Arrhythmias, Cardiac mortality, Arrhythmias, Cardiac prevention & control, Cardiac Resynchronization Therapy statistics & numerical data, Coronary Sinus surgery, Electrodes, Implanted statistics & numerical data, Prosthesis Implantation statistics & numerical data
Abstract

Aims: Few data are available on cardiac resynchronization therapy (CRT) after coronary sinus (CS) lead extraction. We aimed to evaluate the feasibility and mid-term outcome of transvenous CS lead reimplantation in a tertiary referral centre., Methods and Results: We enrolled all patients who were referred to our hospital for CS lead removal from December 2000 through to May 2009 and were transvenously reimplanted with a CRT system before June 2009. One-year follow-up was performed to evaluate the incidence of infections, malfunctions, and mortality. We studied 113 consecutive patients undergoing successful CS lead extraction; 90 patients (75 male, mean age 69.2, range 35-84) underwent CS lead reimplantation (success rate: 95.6%; right-sided approach: 64.4%). In these patients, cardiac device infection was the usual indication for extraction (74.4%) and the subsequent reimplantation was performed after a median time of 3 days. The coronary sinus lead was usually positioned in the left ventricular (LV) postero-lateral region (62.2%); two procedures were required in two cases (2.2%). Balloon angioplasty was necessary for two patients (failure in one), whereas for the others we used a conventional implant technique. During follow-up, we observed four cases (4.4%) of local infection and six cases (6.7%) of system malfunction, requiring reintervention (two cases during the same hospitalization). One-year mortality was 5.5%., Conclusion: Left ventricular lead reimplantation is in our experience an effective and safe procedure, also in the case of right-sided approach. During follow-up, 1-year mortality was particularly low, whereas overall infection rate was higher than first implant procedures.

Published
2012
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50. Large, single-center experience in transvenous coronary sinus lead extraction: procedural outcomes and predictors for mechanical dilatation.

Author

di Cori A, Bongiorni MG, Zucchelli G, Segreti L, Viani S, de Lucia R, Paperini L, and Soldati E

Subjects
Aged, Cardiovascular Surgical Procedures methods, Device Removal methods, Female, Humans, Italy epidemiology, Male, Prevalence, Survival Analysis, Survival Rate, Treatment Outcome, Cardiovascular Surgical Procedures mortality, Coronary Sinus surgery, Device Removal mortality, Electrodes, Implanted statistics & numerical data, Pacemaker, Artificial statistics & numerical data
Abstract

Background: The aim of this study was to evaluate procedural outcomes of coronary sinus (CS) lead extraction, focusing on predictors and need for mechanical dilatation (MD) in the event that manual traction (MT) is ineffective., Methods: The study assessed results in 145 consecutive patients (age 69 ± 10 years; 121 men)--a total of 147 CS pacing leads--who underwent transvenous CS lead removal between January 2000 and March 2010., Results: All leads but one (99%) (implantation time 29 ± 25 months) were successfully removed. MT was effective in 103 (70%), and MD was necessary in the remaining 44 (30%) procedures. In multivariate analyses, unipolar design (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43-7.7; P = 0.005) and noninfective indication (OR 4.8, 95% CI 1.8-13, P = 0.002) were independent predictors for MD (P < 0.0001), with a predictive trend for prior cardiac surgery (OR 2.2, 95% CI 0.98-5.26; P = 0.06). Five (3.4%) complex procedures required a transfemoral vein approach (TFA) or repeat procedure. No deaths occurred, and there was one major complication (0.7%), cardiac tamponade, after MT. No complication predictors were identified., Conclusions: CS leads were safely and effectively removed in nearly all patients, and 70% were removed with MT alone; 30% required MD. Preoperative predictors suggesting the need for MD or TFA were noninfective indication and unipolar lead design. Complications were rare, and there was no predictable pattern among MT or MD removal techniques., (©2011, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.)

Published
2012
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