46 results on '"Laure Champ-Rigot"'
Search Results
2. Insight into contact force local impedance technology for predicting effective pulmonary vein isolation
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Antoine Lepillier, Ruggero Maggio, Valerio De Sanctis, Maurizio Malacrida, Giuseppe Stabile, Cyril Zakine, Laure Champ-Rigot, Matteo Anselmino, Luca Segreti, Gabriele Dell’Era, Fabien Garnier, Giuseppe Mascia, Claudio Pandozi, Antonio Dello Russo, Marco Scaglione, Giuseppe Cosaro, Anna Ferraro, Olivier Paziaud, Giampiero Maglia, and Francesco Solimene
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atrial fibrillation ,catheter ablation ,local impedance ,contact force ,lesion formation ,pulmonary vein isolation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundHighly localized impedance (LI) measurements during atrial fibrillation (AF) ablation have the potential to act as a reliable predictor of the durability of the lesions created.ObjectiveWe aimed to collect data on the procedural parameters affecting LI-guided ablation in a large multicenter registry.MethodsA total of 212 consecutive patients enrolled in the CHARISMA registry and undergoing their first pulmonary vein (PV) isolation for paroxysmal and persistent AF were included.ResultsIn all, 13,891 radiofrequency (RF) applications of ≥3 s duration were assessed. The first-pass PV isolation rate was 93.3%. A total of 80 PV gaps were detected. At successful ablation spots, baseline LI and absolute LI drop were larger than at PV gap spots (161.4 ± 19 Ω vs. 153.0 ± 13 Ω, p 21 Ω at anterior sites and >18 Ω at posterior sites. There was a non-linear association between the magnitude of LI drop and contact-force (CF) (r = 0.14, 95% CI: 0.13–0.16, p 21 Ω at anterior sites and >18 Ω at posterior sites predicts successful ablation. A higher CF was associated with an increased likelihood of ideal LI drop. The combination of good CF and adequate LI drop allows a significant reduction in RF DT.Clinical trial registrationhttp://clinicaltrials.gov/, identifier: NCT03793998.
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- 2023
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3. Recurrent acute myocarditis: An under-recognized clinical entity associated with the later diagnosis of a genetic arrhythmogenic cardiomyopathy
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Pierre Ollitrault, Mayane Al Khoury, Yann Troadec, Yoann Calcagno, Laure Champ-Rigot, Virginie Ferchaud, Arnaud Pellissier, Damien Legallois, Paul Milliez, and Fabien Labombarda
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recurrent acute myocarditis ,arrhythmogenic cardiomyopathy ,myocardial inflammation ,ventricular arrhythmia ,sudden cardiac death ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
BackgroundMyocardial inflammation has been consistently associated with genetic arrhythmogenic cardiomyopathy (ACM) and it has been hypothesized that episodes mimicking acute myocarditis (AM) could represent early inflammatory phases of the disease.ObjectiveWe evaluated the temporal association between recurrent acute myocarditis (RAM) episodes and the later diagnosis of a genetic ACM.Materials and methodsBetween January 2012 and December 2021, patients with RAM and no previous cardiomyopathy were included (Recurrent Acute Myocarditis Registry, NCT04589156). A follow-up visit including clinical evaluation, resting and stress electrocardiogram, cardiac magnetic resonance imaging, and genetic testing was carried out. Endpoints of the study was the incidence of both ACM diagnosis criteria and ACM genetic mutation at the end of follow-up.ResultsTwenty-one patients with RAM were included and follow-up was completed in 19/21 patients (90%). At the end of follow-up, 3.3 ± 2.9 years after the last AM episode, 14/21 (67%) patients with an ACM phenotype (biventricular: 10/14, 71%; left ventricular: 4/14, 29%) underwent genetic testing. A pathogenic or likely pathogenic mutation was found in 8/14 patients (57%), 5/8 in the Desmoplakin gene, 2/8 in the Plakophillin-2 gene, and 1/8 in the Titin gene. Family history of cardiomyopathy or early sudden cardiac death had a positive predictive value of 88% for the presence of an underlying genetic mutation in patients with RAM.ConclusionRAM is a rare entity associated with the latter diagnosis of an ACM genetic mutation in more than a third of the cases. In those patients, RAM episodes represent early inflammatory phases of the disease. Including RAM episodes in ACM diagnosis criteria might allow early diagnosis and potential therapeutic interventions.
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- 2022
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4. Clinical outcomes after primary prevention defibrillator implantation are better predicted when the left ventricular ejection fraction is assessed by cardiovascular magnetic resonance
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Laure Champ-Rigot, Pauline Gay, Frédéric Seita, Leila Benouda, Remy Morello, Arnaud Pellissier, Joachim Alexandre, Eric Saloux, and Paul Milliez
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Cardiovascular magnetic resonance imaging ,Echocardiography ,Left ventricular ejection fraction ,Late gadolinium enhancement ,Implantable cardioverter defibrillator ,Primary prevention ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background The left ventricular ejection fraction (LVEF) is the key selection criterion for an implanted cardioverter defibrillator (ICD) in primary prevention of sudden cardiac death. LVEF is usually assessed by two-dimensional echocardiography, but cardiovascular magnetic resonance (CMR) imaging is increasingly used. The aim of our study was to evaluate whether LVEF assessment using CMR imaging (CMR-LVEF) or two-dimensional echocardiography (2D echo-LVEF) may predict differently the occurrence of clinical outcomes. Methods In this retrospective study, we reviewed patients referred for primary prevention ICD implantation to Caen University Hospital from 2005 to 2014. We included 173 patients with either ischemic (n = 120) or dilated cardiomyopathy (n = 53) and who had undergone pre-ICD CMR imaging. The primary composite end point was the time to death from any cause or first appropriate device therapy. Results The mean CMR-LVEF was significantly lower than the mean 2D echo-LVEF (24% ± 6 vs 28% ± 6, respectively; p
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- 2020
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5. Predictors of clinical outcomes after cardiac resynchronization therapy in patients ≥75 years of age: a retrospective cohort study
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Laure Champ-Rigot, Anne-Laure Cornille, Pierre Ollitrault, Arnaud Pellissier, Mathieu Chequel, Damien Legallois, and Paul Milliez
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Resynchronization therapy ,Heart failure ,Aged ,Treatment outcome ,Geriatrics ,RC952-954.6 - Abstract
Abstract Background Cardiac resynchronization therapy has been shown to benefit selected patients with heart failure and reduced ejection fraction. Older patients have been underrepresented in randomized trials. This study was conducted to determine whether predictive factors for cardiac resynchronization therapy outcomes differ in patients older and younger than 75 years of age. Methods Consecutive patients who received a cardiac resynchronization device cardiac resynchronization therapy between 2013 and 2016 in our center were retrospectively included in this cohort study. The primary endpoint was cardiac resynchronization therapy effectiveness, which was defined as survival for one year with both no heart failure hospitalization and improvement by one or more NYHA class. The secondary endpoints were mortality, complications, and device therapies. Results Among the 243 patients included, 102 were ≥ 75 years old. Cardiac resynchronization therapy effectiveness was observed in 70 patients (50%)
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- 2019
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6. Effects of Mineralocorticoid Receptor Antagonists on Atrial Fibrillation Occurrence: A Systematic Review, Meta‐Analysis, and Meta‐Regression to Identify Modifying Factors
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Joachim Alexandre, Charles Dolladille, Laurent Douesnel, Jonaz Font, Rafal Dabrowski, Linda Shavit, Damien Legallois, Christian Funck‐Brentano, Laure Champ‐Rigot, Pierre Ollitrault, Farzin Beygui, Theodora Bejan‐Angoulvant, Jean‐Jacques Parienti, and Paul Milliez
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aldosterone, mineralocorticoids ,atrial fibrillation ,meta‐analysis ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Mineralocorticoid receptor antagonists (MRAs) have emerged as potential atrial fibrillation (AF) preventive therapy, but inconsistent results have been reported. We aimed to examine the effects of MRAs on AF occurrence and explore factors that could influence the magnitude of the effect size. Methods and Results PubMed, Embase, and Cochrane Central databases were used to search for randomized clinical trials and observational studies addressing the effect of MRAs on AF occurrence from database inception through April 03, 2018. We performed a systematic review and random effects meta‐analyses to compute odds ratios with 95% CIs. Meta‐regression was then applied to explore the sources of between‐study heterogeneity. We included 24 studies, 11 randomized clinical trials and 13 observational cohorts, representing a total number of 7914 patients (median age: 64.2 years; median left ventricular ejection fraction: 49.7%; median follow‐up: 12.0 months), 2843 (35.9%) of whom received MRA therapy. Meta‐analyses showed a significant overall reduction in AF occurrence in the MRA‐treated patients versus the control groups (15.0% versus 32.2%; odds ratio, 0.55; 95% CI, 0.44–0.70 [P
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- 2019
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7. Rationale and Design for a Monocentric Prospective Study: Sleep Apnea Diagnosis Using a Novel Pacemaker Algorithm and Link With Aldosterone Plasma Level in Patients Presenting With Diastolic Dysfunction (SAPAAD Study)
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Laure Champ-Rigot, Virginie Ferchaud, Jean-Noël Prévost, Pierre Moirot, Arnaud Pellissier, Damien Legallois, Joachim Alexandre, Patrice Scanu, Remy Morello, Eric Saloux, and Paul Ursmar Milliez
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Previous studies showed good agreement between pacemaker respiratory disturbance index (RDI) and polysomnography for diagnosis of severe sleep apnea (SA). The aim of this study is to investigate the diagnostic accuracy of RDI compared with apnea-hypopnea index (AHI) from a cardiorespiratory sleep study for the diagnosis of severe SA within patients requiring a pacemaker and meeting diastolic dysfunction criteria. Secondary objectives are as follows: correlation between plasma aldosterone level and SA severity, diagnostic accuracy of RDI for moderate SA, prevalence of SA among patients with diastolic dysfunction, occurrence of arrhythmias, and improvement of RDI with continuous positive airway pressure therapy. We designed a monocentric prospective nonrandomized study of prevalent cases to include 68 patients with a 6-month follow-up. Both RDI and AHI will be compared 2 months after implantation and after 1 month of continuous positive airway pressure treatment in patients with severe SA. This is the first study that examines diagnostic accuracy of pacemaker algorithm for the diagnosis of SA and correlation with plasma aldosterone levels in patients with diastolic dysfunction. Protocol version: V04. 04/04/2017 Trial registration: ClinicalTrials.gov NCT02751021
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- 2018
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8. Conduction system pacing in France in 2022: A snapshot survey from the Working Group of Pacing and Electrophysiology of the French Society of Cardiology
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Pierre Ollitrault, Corentin Chaumont, Jonaz Font, Mathieu Amelot, Célia Brejoux, Laure Champ-Rigot, Virginie Ferchaud, Rodrigue Garcia, Sophie Gomes, Alain Lebon, Philippe Loiselet, Raphaël Martins, Denis Metais, Arnaud Pellissier, Pascal Defaye, Paul Milliez, and Frédéric Anselme
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
9. Recurrent syncope in a pacemaker recipient: What is the mechanism?
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Pierre Ollitrault, Arnaud Pellissier, Virginie Ferchaud, Célia Brejoux, Denis Metais, Mayane Al khoury, Laure Champ‐Rigot, and Paul Milliez
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General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
10. Recurrences of Atrial Fibrillation Despite Durable Pulmonary Vein Isolation: The PARTY-PVI Study
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Karim Benali, Valentin Barré, Alexis Hermida, Vincent Galand, Antoine Milhem, Séverine Philibert, Serge Boveda, Clément Bars, Frédéric Anselme, Baptiste Maille, Clémentine André, Albin Behaghel, Ghassan Moubarak, Nicolas Clémenty, Antoine Da Costa, Marine Arnaud, Sandrine Venier, Frédéric Sebag, Laurence Jésel-Morel, Audrey Sagnard, Laure Champ-Rigot, Duc Dang, Benoit Guy-Moyat, Selim Abbey, Rodrigue Garcia, Olivier Césari, Nicolas Badenco, Antoine Lepillier, Sandro Ninni, Stéphane Boulé, Philippe Maury, Vincent Algalarrondo, Babé Bakouboula, Jacques Mansourati, François Lesaffre, Philippe Lagrange, Abdeslam Bouzeman, Lucian Muresan, Raoul Bacquelin, Agustin Bortone, Sok-Sithikun Bun, Dominique Pavin, Laurent Macle, Raphaël P. Martins, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], CHU Amiens-Picardie, HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666 (HEMATIM), and Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie-Institut National de la Santé et de la Recherche Médicale (INSERM)
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pulmonary vein ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Physiology (medical) ,atrial fibrillation ,freedom ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,dilatation ,Cardiology and Cardiovascular Medicine ,ablation - Abstract
Background: Recurrences of atrial fibrillation (AF) after pulmonary vein isolation (PVI) are mainly due to pulmonary vein reconnection. However, a growing number of patients have AF recurrences despite durable PVI. The optimal ablative strategy for these patients is unknown. We analyzed the impact of current ablation strategies in a large multicenter study. Methods: Patients undergoing a redo ablation for AF and presenting durable PVI were included. The freedom from atrial arrhythmia after pulmonary vein-based, linear-based, electrogram-based, and trigger-based ablation strategies were compared. Results: Between 2010 and 2020, 367 patients (67% men, 63±10 years, 44% paroxysmal) underwent a redo ablation for AF recurrences despite durable PVI at 39 centers. After durable PVI was confirmed, linear-based ablation was performed in 219 (60%) patients, electrogram-based ablation in 168 (45%) patients, trigger-based ablation in 101 (27%) patients, and pulmonary vein-based ablation in 56 (15%) patients. Seven patients (2%) did not undergo any additional ablation during the redo procedure. After 22±19 months of follow-up, 122 (33%) and 159 (43%) patients had a recurrence of atrial arrhythmia at 12 and 24 months, respectively. No significant difference in arrhythmia-free survival was observed between the different ablation strategies. Left atrial dilatation was the only independent factor associated with arrhythmia-free survival (HR, 1.59 [95% CI, 1.13–2.23]; P =0.006). Conclusions: In patients with recurrent AF despite durable PVI, no ablation strategy used alone or in combination during the redo procedure appears to be superior in improving arrhythmia-free survival. Left atrial size is a significant predictor of ablation outcome in this population.
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- 2023
11. PO-02-070 COMBINED LOCAL IMPEDANCE AND CONTACT FORCE FOR SUCCESSFUL RADIOFREQUENCY ABLATION OF ATRIAL FIBRILLATION
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Giuseppe Stabile, Antoine Lepillier, Matteo Anselmino, Ruggero Maggio, Valerio DeSanctis, Cyril ZAKINE, Laure CHAMP RIGOT, Gabriele Dell'Era, Fabien Garnier, Giuseppe Mascia, Luca Segreti, William Escande, Giuseppe Cosaro, Maurizio Malacrida, Giampiero Maglia, and Francesco Solimene
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Published
- 2023
12. Usefulness of sleep apnea monitoring by pacemaker sensor in elderly patients with diastolic dysfunction
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Laure Champ-Rigot, Anne-Laure Cornille, Virginie Ferchaud, Rémy Morello, Arnaud Pellissier, Pierre Ollitrault, Eric Saloux, Pierre Moirot, and Paul Milliez
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Pulmonary and Respiratory Medicine - Published
- 2023
13. Clinical outcomes after catheter ablation of atrial arrhythmias guided by ultra-high density mapping system in heart failure patients
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LAURE CHAMP-RIGOT, Emilie Marminia, Pierre Ollitrault, Anne Rollin, ARNAUD PELLISSIER, Virginie Ferchaud, Philippe Maury, and Paul Milliez
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Introduction: Catheter ablation of atrial fibrillation (AF) and/or atrial tachycardia (AT) in heart failure (HF) patients provides improvement in symptoms cardiac function and survival. However, these procedures remain challenging with higher recurrence and complication rates compared to patients with normal cardiac function. We aimed to compare outcomes of AF/AT ablations guided by an ultra-high density mapping system between HF patients and controls. Methods and results: Primary endpoint was the one-year recurrence rate of AF/AT. We retrospectively examined all Rhythmia™-guided procedures performed in Caen and Toulouse University Hospitals between 2015 and 2018 for AF/AT. Patients with reduced left ventricular ejection fraction (LVEF) (i.e. Conclusion: Clinical outcomes of AF/AT ablations guided by UHD mapping system appear similar in HF and non-HF patients. During the follow-up period, patients with HF exhibit improvement of NYHA status and LVEF.
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- 2022
14. Sex Differences in Outcomes of Tetralogy of Fallot Patients With Implantable Cardioverter-Defibrillators
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Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessière, Fabien Labombarda, Christelle Marquié, Jean-Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Alain Al Arnaout, Frédéric Anselme, Caroline Audinet, Yvette Bernard, Serge Boveda, Sok Sithikun Bun, Morgane Chassignolle, Gaël Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphaël Martins, Jean-Luc Pasquié, Jean-Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Chrystelle Akret, Jean-Paul Albenque, Vincent Algalarrondo, Christine Alonso, Denis Amet, Frédéric Ansselme, Anouk Asselin, Nicolas Badenco, Hugues Bader, Marc Badoz, Pierre Baudinaud, Nathalie Behar, Mouna Ben Kilani, Géraldine Bertaux, Cathy Bertrand, Francis Bessiere, Hughes Blangy, Damien Bonnet, Pierre Bordchar, Paul Bru, Adrien Carabelli, Christèle Cardin, Bruno Cauchemez, Tej Chalbia, Laure Champ-Rigot, Thomas Chastre, Philippe Chevallier, Nicolas Clementy, Stéphane Combes, Christian De Chillou, Maxime De Guillebon, Bruno Degand, Jean-Claude Deharo, Nicolas Derval, Sylvie Di Filippo, Guillaume Domain, Antoine Dompnier, Arnaud Dulac, Alexandre Duparc, D Cécile Duplantier, Rim El Bouazzaoui, Bogdan Enache, Fabrice Extramiana, Pierre Fiorello, Pierre Frey, Luc Freysz, Vincent Galand, Estelle Gandjbakhch, Kevin Gardey, Olivier Geoffroy, Bénédicte Godin, Samuel Goussot, Caroline Grimard, Jean-Baptiste Guichard, Michel Haissaguerre, David Hamon, Sébastien Hascoet, Karim Hasni, Jean-Sylvain Hermida, Françoise Hidden-Lucet, Mélèze Hocini, Jérome Hourdain, Peggy Jacon, Gaël Jauvert, Frédéric Jean, Nicolas Johnson, Pierre Khattar, Ziad Khoueiry, Rita Koutbi, Guillaume Laborie, Gabriel Lactu, Pierre-Marc Lallemand, Gabriel Laurent, Thomas Lavergne, Arnaud Lazarus, Laurianne Le Gloan, Christophe Leclercq, Antoine Leenhardt, Nicolas Lellouche, Christophe Loose, Philippe Mabo, Alice Maltret, Franck Mandel, Christelle Marquie, Carole Maupain, Antoine Milhelm, Paul Milliez, Adrian Mirolo, Ghassan Moubarak, Stéphane Mourot, Jacky Ollitrault, Pierre Ollitrault, Akli Otmani, Jean-Luc Pasquie, Dominique Pavin, Séverinne Philibert, Damien Poindron, Charlotte Potelle, Vincent Probst, Paul Puie, Anne Rollin, Cécile Romeyer-Bouchard, Nicolas Sadoul, Audrey Sagnard, Arnaud Savoure, Didier Scarlatti, Fabien Squara, Nikita Tanese, Jean Benoit Thambo, Olivier Thomas, Emie Varlet, Sandrine Venier, Quentin Voglimacci Stephanopoli, Xavier Waintraub, Françoise Wiart, Alexandre Zhao, Amir Zouaghi, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Clinique Pasteur, Clinique Pasteur [Toulouse], and This work was supported by the French Institute of Health and Medical Research, Fédération Française de Cardiologie, and Société Française de Cardiologie. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
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Male ,Adult ,Heart Defects, Congenital ,Sex Characteristics ,sudden death ,Middle Aged ,congenital heart disease ,Defibrillators, Implantable ,Cohort Studies ,implantable cardioverter-defibrillator ,Death, Sudden, Cardiac ,Tetralogy of Fallot ,sex ,Humans ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,women ,ventricular arrhythmia - Abstract
International audience; Background: Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.Objectives: The aim of this study was to assess sex-related differences in patients with tetralogy of Fallot (TOF) and implantable cardioverter-defibrillators (ICDs).Methods: Data were analyzed from the DAI-T4F (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator) cohort study, which has prospectively enrolled all patients with TOF with ICDs in France since 2010. Clinical events were centrally adjudicated by a blinded committee.Results: A total of 165 patients (mean age 42.2 ± 13.3 years) were enrolled from 40 centers, including 49 women (29.7%). Among the 9,692 patients with TOF recorded in the national database, the proportion of women with ICDs was estimated to be 1.1% (95% CI: 0.8%-1.5%) vs 2.2% (95% CI: 1.8%-2.6%) in men (P < 0.001). The clinical profiles of patients at implantation, including the number of risk factors for ventricular arrhythmias, were similar between women and men. During a median follow-up period of 6.8 years (IQR: 2.5-11.4 years), 78 patients (47.3%) received at least 1 appropriate ICD therapy, without significant difference in annual incidences between women (12.1%) and men (9.9%) (HR: 1.22; 95% CI: 0.76-1.97; P = 0.40). The risk for overall ICD-related complications was similar in women and men (HR: 1.33; 95% CI: 0.81-2.19; P = 0.30), with 24 women (49.0%) experiencing at least 1 complication.Conclusions: Our findings suggest that women with TOF at high risk for sudden cardiac death have similar benefit/risk balance from ICD therapy compared with men. Whether ICD therapy is equally offered to at-risk women vs men warrants further evaluation in TOF as well as in other congenital heart disease populations. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574)
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- 2022
15. Long-Term Follow-Up of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator
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Victor Waldmann, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Francis Bessiere, Fabien Labombarda, Christelle Marquié, Jean Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Frédéric Anselme, Anouk Asselin, Caroline Audinet, Yvette Bernard, Serge Boveda, Paul Bru, Sok Sithikun Bun, Gael Clerici, Antoine Da Costa, Maxime de Guillebon, Pascal Defaye, Nathalie Elbaz, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Franck Halimi, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Anne Messali, Kumar Narayanan, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Penelope Pujadas, Frédéric Sacher, Pascal Sagnol, Ardalan Sharifzadehgan, Camille Walton, Pierre Winum, Cyril Zakine, Laurent Fauchier, Raphael Martins, Jean Luc Pasquié, Jean Benoit Thambo, Xavier Jouven, Nicolas Combes, Eloi Marijon, Fabien Squara, Guillaume Theodore, Didier Scarlatti, Jérome Hourdain, Jean-Claude Deharo, Pierre Ollitrault, Paul Milliez, Laure Champ-Rigot, Hugues Bader, Cécile Duplantier, Antoine Milhem, Audrey Sagnard, Géraldine Bertaux, Gabriel Laurent, Marc Badoz, Agustin Bortone, Guillaume Laborie, Anne Rollin, Quentin Voglimacci Stephanopoli, Franck Mandel, Alexandre Duparc, Guillaume Domain, Jean-Paul Albenque, Christèle Cardin, Stéphane Combes, Nikita Tanese, Karim Hasni, Christophe Leclercq, Vincent Galand, Dominique Pavin, Philippe Mabo, Nathalie Behar, Nicolas Clementy, Christophe Loose, Akli Otmani, Sandrine Venier, Adrien Carabelli, Peggy Jacon, Mouna Ben Kilani, Jean Bapstist Guichard, Cécile Romeyer-Bouchard, Laurianne Le Gloan, Vincent Probst, Luc Freysz, Hugues Blangy, Christian De Chillou, Nicolas Sadoul, Pierre Khattar, Charlotte Potelle, Frederic Jean, Paul Puie, Ziad Khoueiry, Philippe Chevallier, Arnaud Dulac, Sylvie Di Filippo, Kevin Gardey, Pierre Frey, Chrystelle Akret, Antoine Dompnier, Carole Maupain, Xavier Waintraub, Françoise Hidden-Lucet, Thomas Chastre, Estelle Gandjbakhch, Nicolas Badenco, Fabrice Extramiana, Antoine Leenhardt, Amir Zouaghi, Vincent Algalarrondo, Denis Amet, Emilie Varlet, Tej Chalbia, Séverine Philibert, Jacky Ollitrault, Thomas Lavergne, Pierre Baudinaud, Adrian Mirolo, Arnaud Savouré, Bénédicte Godin, Cathy Bertrand, Pierre Fiorello, Nicolas Johnson, Pierre-Marc Lallemand, Alexis Herminda, Jean-Sylvain Hermida, Bruno Degand, Rim El Bouazzaou, Stéphane Mourot, Samuel Goussot, Gaël Jauvert, Arnaud Lazarus, Caroline Grimard, Christine Alonso, Alexandre Zhao, Olivier Thomas, Bruno Cauchemez, Ghassan Moubarak, Nicolas Lellouche, David Hamon, Bogdan Enache, Gabriel Lactu, Françoise Wiart, Olivier Geoffroy, Damien Poindron, Alice Maltret, Cristine Raimondo, Damien Bonnet, Sébastien Hascoët, Nicolas Derval, Michel Haïssaguerre, Mélèze Hocini, and Clinical sciences
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Adult ,Male ,medicine.medical_specialty ,Long term follow up ,Cyanotic congenital heart disease ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Sudden death ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Defibrillators, Implantable/trends ,Registries ,030212 general & internal medicine ,Tetralogy of Fallot ,business.industry ,medicine.disease ,Implantable cardioverter-defibrillator ,Tetralogy of Fallot/epidemiology ,Defibrillators, Implantable ,3. Good health ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, and sudden cardiac death represents an important mode of death in these patients. Data evaluating the implantable cardioverter defibrillator (ICD) in this patient population remain scarce. Methods: A Nationwide French Registry including all patients with tetralogy of Fallot with an ICD was initiated in 2010 by the French Institute of Health and Medical Research. The primary time to event end point was the time from ICD implantation to first appropriate ICD therapy. Secondary outcomes included ICD-related complications, heart transplantation, and death. Clinical events were centrally adjudicated by a blinded committee. Results: A total of 165 patients (mean age, 42.2±13.3 years, 70.1% males) were included from 40 centers, including 104 (63.0%) in secondary prevention. During a median (interquartile range) follow-up of 6.8 (2.5–11.4) years, 78 (47.3%) patients received at least 1 appropriate ICD therapy. The annual incidence of the primary outcome was 10.5% (7.1% and 12.5% in primary and secondary prevention, respectively; P =0.03). Overall, 71 (43.0%) patients presented with at least 1 ICD complication, including inappropriate shocks in 42 (25.5%) patients and lead dysfunction in 36 (21.8%) patients. Among 61 (37.0%) patients in primary prevention, the annual rate of appropriate ICD therapies was 4.1%, 5.3%, 9.5%, and 13.3% in patients with, respectively, 0, 1, 2, or ≥3 guidelines-recommended risk factors. QRS fragmentation was the only independent predictor of appropriate ICD therapies (hazard ratio, 3.47 [95% CI, 1.19–10.11]), and its integration in a model with current criteria increased the 5-year time-dependent area under the curve from 0.68 to 0.81 ( P =0.006). Patients with congestive heart failure or reduced left ventricular ejection fraction had a higher risk of nonarrhythmic death or heart transplantation (hazard ratio, 11.01 [95% CI, 2.96–40.95]). Conclusions: Patients with tetralogy of Fallot and an ICD experience high rates of appropriate therapies, including those implanted in primary prevention. The considerable long-term burden of ICD-related complications, however, underlines the need for careful candidate selection. A combination of easy-to-use criteria including QRS fragmentation might improve risk stratification. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03837574.
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- 2020
16. Atrial fibrillation detection by the subcutaneous defibrillator: real-world clinical performances and implications from a multicentre study
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Peggy Jacon, Virginie Ferchaud, Laure Champ-Rigot, Paul Milliez, N. Auquier, Arnaud Pellissier, Pascal Defaye, Frédéric Anselme, Damien Legallois, Pierre Ollitrault, Mouna Ben Kilani, and Florence Vandevelde
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medicine.medical_specialty ,business.industry ,Premature atrial contraction ,Incidence (epidemiology) ,Atrial fibrillation ,Rhythm control ,Ventricular tachycardia ,medicine.disease ,Predictive value ,Defibrillators, Implantable ,Electrocardiography ,Predictive Value of Tests ,Physiology (medical) ,Internal medicine ,Atrial Fibrillation ,medicine ,Cardiology ,Humans ,Cardiology and Cardiovascular Medicine ,business ,Lead (electronics) ,Paroxysmal AF - Abstract
AimsNo data exist concerning the clinical performances of the subcutaneous implantable cardioverter-defibrillator (S-ICD) atrial fibrillation (AF) detection algorithm. We aimed to study the performances and implications of the latter in a ‘real-world’ setting.Methods and resultsBetween July 2017 and August 2019, 155 consecutive S-ICD recipients were included. Endpoint of the study was the incidence of de novo or recurrent AF using a combined on-site and remote-monitoring follow-up approach. After a mean follow-up of 13 ± 8 months, 2531 AF alerts were generated for 55 patients. A blinded analysis of the 1950 subcutaneous electrocardiograms available was performed. Among them 47% were true AF, 23% were premature atrial contractions or non-sustained AF, 29% were premature ventricular contractions or non-sustained ventricular tachycardia, and 1% were misdetection. Fourteen percent (21/155) patients had at least one correct diagnosis of AF by the S-ICD algorithm. One patient presented symptomatic paroxysmal AF not diagnosed by the S-ICD algorithm (false negative patient). Patient-based sensitivity, specificity, positive, and negative predictive values were respectively 95%, 74%, 38%, and 99%. Among patients with at least one correct diagnosis of AF, 38% (8/21) had subsequent clinical implications (anticoagulation initiation or rhythm control therapies).ConclusionThe S-ICD AF detection algorithm yields a high sensitivity for AF diagnosis. Low specificity and positive predictive value contribute to a high remote monitoring-notification workload and underline the necessity of a manual analysis. Atrial fibrillation diagnosis by the S-ICD AF detection algorithm might lead to significant therapeutic adjustments.
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- 2020
17. Prevalence and significance of fragmented QRS complex in lead V1 on the surface electrocardiogram of healthy athletes
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Emmanuel Reboursière, Amir Hodzic, Nicolas Junqua, Eric Saloux, Pierre Ollitrault, Mathieu Chequel, Paul Milliez, Laure Champ-Rigot, and Arnaud Pellissier
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medicine.medical_specialty ,Multivariate analysis ,biology ,business.industry ,Athletes ,Heart Ventricles ,Fragmented qrs ,Odds ratio ,biology.organism_classification ,Confidence interval ,Surface electrocardiogram ,Electrocardiography ,QRS complex ,Echocardiography ,Physiology (medical) ,Internal medicine ,Prevalence ,medicine ,Cardiology ,Humans ,Cardiology and Cardiovascular Medicine ,Lead (electronics) ,business - Abstract
Aims Limited data exist concerning fragmented QRS complexes (fQRSs) on the surface electrocardiogram (ECG) of apparently healthy athletes. We aimed to study the prevalence and significance of fQRS in lead V1 (fQRSV1), representing right ventricular (RV) activation, regarding training-induced RV morphological remodelling. Methods and results Between January 2017 and August 2019, 434 consecutive non-sedentary subjects underwent preparticipation cardiovascular screening, including a 12-lead ECG. Three hundred and ninety-three apparently healthy subjects were included, 119 of them were athletes (defined as performing ≥8 h/week for the last 6 months) and 274 were non-athletes. All athletes underwent two-dimensional transthoracic echocardiography. Fragmented QRS complex in lead V1 pattern was defined as a narrow ( Conclusion Fragmented QRS complex in lead V1 is a newly described, frequent, ECG pattern in young and apparently healthy athletes and is associated with training-induced RV remodelling.
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- 2020
18. Effects of highest dose of sacubitril/valsartan association compared to lower doses on mortality and ventricular arrhythmias
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Laure Champ-Rigot, Arnaud Pellissier, Damien Legallois, Alain Lebon, Olivier Citerne, Katrien Blanchart, Florent Allain, Pierre Ollitrault, Farzin Beygui, Paul Milliez, Mathieu Chequel, Sophie Gomes, and Rémi Sabatier
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medicine.medical_specialty ,business.industry ,Internal medicine ,Cardiology ,Pharmaceutical Science ,Medicine ,business ,Sacubitril, Valsartan - Published
- 2020
19. Vitamin K antagonist vs direct oral anticoagulants with antiplatelet therapy in dual or triple therapy after percutaneous coronary intervention or acute coronary syndrome in atrial fibrillation: Meta‐analysis of randomized controlled trials
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Paul Milliez, Clément Briet, Rémi Sabatier, Katrien Blanchart, Adrien Lemaitre, Farzin Beygui, Mathieu Bignon, Laure Champ-Rigot, Pierre Ardouin, and Vincent Roule
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medicine.medical_specialty ,Acute coronary syndrome ,medicine.drug_class ,medicine.medical_treatment ,Reviews ,direct oral anticoagulant ,Review ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,atrial fibrillation ,030212 general & internal medicine ,business.industry ,percutaneous coronary intervention ,Percutaneous coronary intervention ,Atrial fibrillation ,dual therapy ,General Medicine ,Vitamin K antagonist ,medicine.disease ,Clopidogrel ,Clinical trial ,triple therapy ,Conventional PCI ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background The combination of vitamin K antagonists (VKA) for atrial fibrillation (AF) and antiplatelet agents following percutaneous coronary intervention (PCI) is associated with an increased bleeding risk. Hypothesis Direct oral anticoagulants (DOAC) are associated with a greater safety profile but the optimal antithrombotic treatment strategy, especially when considering ischemic events, is unclear. Methods We performed a meta‐analysis of randomized controlled trials comparing outcomes in AF patients following PCI and/or acute coronary syndrome (ACS) when treated with DOAC vs VKA, both in combination with one (dual) or two (triple) antiplatelet regimens. A systematic review was performed by searches of electronic databases MEDLINE (source PubMed) and the Cochrane Controlled Clinical Trials Register Database as well as Cardiology annual meetings. Three studies were finally included. Results Compared to VKA triple therapy, the use of DOAC was associated with a decreased risk of any bleeding (relative risk [RR] 0.68 [0.62; 0.74]), major bleeding (RR 0.61 [0.51; 0.75]) and intracranial bleeding (RR 0.33 [0.17; 0.66]) and similar rates of the composite efficacy endpoint (RR 1.0 [0.87; 1.14]) and its components. Similar and consistent results were observed with both dual and triple therapy including a DOAC compared to VKA. Conclusion Our meta‐analysis supports the use of dual therapy combining a DOAC and clopidogrel as the default regimen in most AF patients after PCI and/or ACS.
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- 2019
20. Comparison between novel and standard high-density 3D electro-anatomical mapping systems for ablation of atrial tachycardia
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Laure Champ-Rigot, Didier Carrié, Vanina Bongard, Anne Rollin, Lilian Marty, Stefano Capellino, Michel Galinier, Emilie Marminia, Pierre Mondoly, Philippe Maury, and Paul Milliez
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,High density ,030204 cardiovascular system & hematology ,Radiography, Interventional ,Multimodal Imaging ,03 medical and health sciences ,0302 clinical medicine ,3d mapping ,Heart Conduction System ,Recurrence ,Internal medicine ,Tachycardia, Supraventricular ,medicine ,Humans ,030212 general & internal medicine ,Atrial tachycardia ,Aged ,Retrospective Studies ,business.industry ,Body Surface Potential Mapping ,Middle Aged ,Ablation ,Cardiac surgery ,Logistic Models ,Treatment Outcome ,Mapping system ,Catheter Ablation ,Cardiology ,Female ,medicine.symptom ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business - Abstract
Ultra-high-density mapping allows very accurate characterization of circuits/mechanisms in atrial tachycardia (AT). Whether these advantages will translate into a better procedural or long-term clinical outcome is unknown. Sixty consecutive AT ablation procedures using ultra-high-density mapping (Rhythmia™, group 1) were retrospectively compared to 60 consecutive procedures using standard high-density mapping (Carto/NavX™, group 2) (total 209 AT, 79% left AT). A higher number of maps were performed in group 1 (4.8 ± 2.5 vs 3.2 ± 1.7, p = 0.0001) with similar acquisition duration (12 ± 5 vs 13 ± 6 min per map, p = ns), although with a greater number of activation points (10,543 ± 5854 vs 689 ± 1827 per map, p
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- 2018
21. Efficacy of deep sedation for patients with intractable electrical storm refractory to anti-arrhythmic drugs
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Charles Guenancia, Nicolas Clementy, David Hamon, Jean-Marie Urien, Josselin Duchateau, Nicolas Barbarot, C. De Chillou, Laure Champ-Rigot, Jean-Marc Sellal, Vincent Galand, R Martins, Eloi Marijon, Rodrigue Garcia, Estelle Gandjbakhch, and F. Sacher
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business.industry ,Sedation ,medicine.medical_treatment ,Hospital mortality ,Sedation procedure ,Refractory ,Anesthesia ,Extracorporeal membrane oxygenation ,Medicine ,Anti arrhythmic ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents - Abstract
Background Sympathetic overactivity is implicated in the initiation and maintenance of electrical storm (ES). Deep sedation has empirically been considered as an efficient therapeutic option to blunt sympathetic tone and control ES. Purpose The aim of this multicenter study was to determine the efficacy of deep sedation in patients presenting intractable ES refractory to anti-arrhythmic drugs. Methods Patients requiring deep sedation for refractory ES from January 1st 2007 to July 31st 2018 were retrospectively included in 13 centers. The primary endpoint was the rate of acute response to sedation, defined as ES termination within 15 minutes after deep sedation. Results Among the 116 patients, 55 (47.4%) had ES termination within 15 minutes and were considered “acute responders” to deep sedation. Clinical signs of congestive heart failure before deep sedation (OR=3.31, 95% CI:1.001–10.97, p=0.049) was the only independent predictor of non-acute response. Twenty-one non-acute responders (34.4%) had an extracorporeal membrane oxygenation (ECMO) implanted. Non-acute responders had a significantly lower in-hospital survival (Log-rank, p=0.010). ECMO implantation did not influence survival in non-acute responders to sedation. Acute response to deep sedation was an independent protector of in-hospital mortality, decreasing by 73% the risk of death (OR 0.27; 95% CI:0.10–0.70, p=0.008). Conclusion To the best of our knowledge, this multicenter study is the first analysis of the efficacy of deep sedation in patients with intractable ES refractory to anti-arrhythmic drugs, and demonstrating the positive impact of “acute response” on in-hospital survival. Funding Acknowledgement Type of funding source: None
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- 2020
22. Effectiveness of Deep Sedation for Patients With Intractable Electrical Storm Refractory to Antiarrhythmic Drugs
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Nicolas Barbarot, Charles Guenancia, Christophe Leclercq, Audrey Sagnard, Arnaud Bisson, David Hamon, Laure Champ-Rigot, Paul Milliez, Estelle Gandjbakhch, Lionel Borella, D. Pavin, Bruno Degand, Nathalie Behar, Frederic Sacher, Nicolas Lellouche, Pierre Bouju, Rodrigue Garcia, Vincent Galand, Jean-Marc Sellal, Philippe Mabo, Raphaël P. Martins, Angélique Goepp, Josselin Duchateau, E. Varlet, Romain Tixier, Nicolas Clementy, Guillaume Rieul, Jean-Marie Urien, Christian de Chillou, Stéphane Schumacher, Eloi Marijon, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital de St Brieuc, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de cardiologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de Cardiologie [Bordeaux], CHU Bordeaux [Bordeaux], Centre hospitalier de Vannes, Service de Cardiologie [Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de cardiologie et de pathologie vasculaire [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de cardiologie [CHU de Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre hospitalier de Lorient, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de Saint-Brieuc, CHU Trousseau [Tours], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CH Vannes, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CH de Lorient, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
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cardiac ,[SDV]Life Sciences [q-bio] ,Sedation ,Hospital mortality ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,Physiology (medical) ,Medicine ,Humans ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Aged ,hospital mortality ,business.industry ,Storm ,3. Good health ,Anesthesia ,Tachycardia, Ventricular ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,medicine.symptom ,Deep Sedation ,Cardiology and Cardiovascular Medicine ,business ,arrhythmias ,Anti-Arrhythmia Agents - Abstract
International audience
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- 2020
23. Ventricular fibrillation in acute myocardial infarction: 20-year trends in the FAST-MI study
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Rodrigue Garcia, Eloi Marijon, Nicole Karam, Kumar Narayanan, Frédéric Anselme, Olivier Césari, Laure Champ-Rigot, Vladimir Manenti, Raphael Martins, Etienne Puymirat, Jean Ferrières, François Schiele, Tabassome Simon, and Nicolas Danchin
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Cardiology and Cardiovascular Medicine - Abstract
Aims Sudden cardiac arrest remains a major complication of acute myocardial infarction (AMI) and is frequently related to ventricular fibrillation (VF). Incidence and impact of VF among patients hospitalized for AMI were evaluated. Methods and results Data from the FAST-MI programme consisting of 5 French nationwide prospective cohort studies between 1995 and 2015 were analysed, totally including 14 423 patients with AMI (66 ± 14 years, 72% males, 59% ST-elevation myocardial infarction). Overall, proportion of patients presenting in-hospital VF decreased from 3.9% in 1995 to 1.8% in 2015 (P < 0.001). One-year mortality decreased from 60.7% to 24.6% (P < 0.001). However, compared with patients who did not develop VF, the over-risk of 1-year mortality associated with VF was stable over time [hazard ratio (HR) 6.78, 95% confidence interval (CI) 5.03–9.14 in 1995 and HR 6.64, 95% CI 4.20–10.49 in 2015, P = 0.52]. This increased mortality in the VF group was mainly related to fatal events occurring prior to hospital discharge, representing 86.2% of 1-year mortality, despite the very low rate of implantable cardioverter defibrillator in the VF group (2.6%). Conclusion This study demonstrates that in-hospital VF incidence and mortality in the setting of AMI have significantly decreased over the past 20 years. Nevertheless, VF remained steadily associated with approximately a 10-fold increased relative risk of in-hospital mortality, without an impact on post-discharge mortality. Beyond long-term cardiac defibrillation strategy, these results emphasize the need to identify in-hospital interventions to further reduce mortality in VF patients. Study registration ClinicalTrials.gov Identifier: NCT00673036, NCT01237418, NCT02566200
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- 2020
24. Identification of anticancer drugs associated with atrial fibrillation: analysis of the WHO pharmacovigilance database
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Jennifer Cautela, Paul Milliez, Stéphane Ederhy, Jean-Pierre Vilque, Ariel Cohen, Ghandi Damaj, Camille Ropert, Damien Legallois, Javid Moslehi, Christian Funck-Brentano, Charles Dolladille, Joachim Alexandre, Marion Sassier, Laure Champ-Rigot, Anne-Flore Plane, Franck Thuny, Joe-Elie Salem, Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique (SEILIRM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC Paris Est, Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], Département de Pharmacologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de cardiologie et de pathologie vasculaire [CHU Caen], Hôpital Nord [CHU - APHM], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie cellulaire des régulations hormonale, nutritionnelles et pharmacologiques (UMR-S-530), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire d'Hématologie Biologique [CHU Caen], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière] (CIC Paris-Est), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)
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pharmacovigilance database ,[SDV]Life Sciences [q-bio] ,Antineoplastic Agents ,030204 cardiovascular system & hematology ,World Health Organization ,computer.software_genre ,Pharmacovigilance ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Obinutuzumab ,medicine ,Adverse Drug Reaction Reporting Systems ,Humans ,Pharmacology (medical) ,Prospective Studies ,030212 general & internal medicine ,Midostaurin ,Lenalidomide ,Database ,business.industry ,Ponatinib ,Pomalidomide ,Atrial fibrillation ,United States ,3. Good health ,Clinical trial ,anticancer drugs ,chemistry ,Docetaxel ,Cardiology and Cardiovascular Medicine ,business ,computer ,medicine.drug - Abstract
Aims The explosion of novel anticancer therapies has meant emergence of cardiotoxicity signals including atrial fibrillation (AF). Reliable data concerning the liability of anticancer drugs in inducing AF are scarce. Using the World Health Organization individual case safety report database, VigiBase®, we aimed to determine the association between anticancer drugs and AF. Methods and results A disproportionality analysis evaluating the multivariable-adjusted reporting odds ratios for AF with their 99.97% confidence intervals was performed for 176 U.S. Food and Drug Administration (FDA)- or European Medicines Agency (EMA)-labelled anticancer drugs in VigiBase®, followed by a descriptive analysis of AF cases for the anticancer drugs identified in VigiBase®. ClinicalTrial registration number: NCT03530215. A total of 11 757 AF cases associated with at least one anticancer drug were identified in VigiBase® of which 95.8% were deemed serious. Nineteen anticancer drugs were significantly associated with AF of which 14 (74%) are used in haematologic malignancies and 9 (45%) represented new AF associations not previously confirmed in literature including immunomodulating agents (lenalidomide, pomalidomide), several kinase inhibitors (nilotinib, ponatinib, midostaurin), antimetabolites (azacytidine, clofarabine), docetaxel (taxane), and obinutuzumab, an anti-CD20 monoclonal antibody. Conclusion Although cancer malignancy itself may generate AF, we identified 19 anticancer drugs significantly associated with a significant increase in AF over-reporting. This pharmacovigilance study provides evidence that anticancer drugs themselves could represent independent risk factors for AF development. Dedicated prospective clinical trials are now required to confirm these 19 associations. This list of suspected anticancer drugs should be known by physicians when confronted to AF in cancer patients, particularly in case of haematologic malignancies.
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- 2020
25. Predictors of clinical outcomes after cardiac resynchronization therapy in patients ≥75 years of age: a retrospective cohort study
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Damien Legallois, Laure Champ-Rigot, Anne-Laure Cornille, Mathieu Chequel, Paul Milliez, Arnaud Pellissier, and Pierre Ollitrault
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Cardiac resynchronization therapy ,Heart failure ,lcsh:Geriatrics ,030204 cardiovascular system & hematology ,Cardiac Resynchronization Therapy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,medicine ,Clinical endpoint ,Humans ,030212 general & internal medicine ,Treatment outcome ,Retrospective Studies ,Aged ,Aged, 80 and over ,Ejection fraction ,business.industry ,Patient Selection ,Mortality rate ,Age Factors ,Retrospective cohort study ,Atrial fibrillation ,medicine.disease ,Defibrillators, Implantable ,Survival Rate ,lcsh:RC952-954.6 ,Resynchronization therapy ,cardiovascular system ,Cardiology ,Female ,Geriatrics and Gerontology ,business ,Research Article ,Cohort study - Abstract
Background Cardiac resynchronization therapy has been shown to benefit selected patients with heart failure and reduced ejection fraction. Older patients have been underrepresented in randomized trials. This study was conducted to determine whether predictive factors for cardiac resynchronization therapy outcomes differ in patients older and younger than 75 years of age. Methods Consecutive patients who received a cardiac resynchronization device cardiac resynchronization therapy between 2013 and 2016 in our center were retrospectively included in this cohort study. The primary endpoint was cardiac resynchronization therapy effectiveness, which was defined as survival for one year with both no heart failure hospitalization and improvement by one or more NYHA class. The secondary endpoints were mortality, complications, and device therapies. Results Among the 243 patients included, 102 were ≥ 75 years old. Cardiac resynchronization therapy effectiveness was observed in 70 patients (50%) p = 0.69). NYHA class ≥III (OR = 6.02; CI95% [1.33–18.77], p = 0.002) was a predictive factor for cardiac resynchronization therapy effectiveness only in the ≥75-year-old group, while atrial fibrillation was independently negatively associated with the primary endpoint in the p = 0.001). The one-year mortality rate was 14%, with no difference between age groups. Rescue cardiac resynchronization therapy and atrial fibrillation were independent predictive factors for mortality in both age groups. Eighty-two complications occurred in 45 patients (19%), with no difference between groups. Defibrillator use and QRS duration were independent predictive factors for complications in both age groups. There was no difference between groups considering device therapies. Conclusion At one year, cardiac resynchronization therapy response is not compromised by patient age. In older patients, highly symptomatic individuals with NYHA class ≥III have better outcomes after cardiac resynchronization therapy.
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- 2019
26. Effects of Mineralocorticoid Receptor Antagonists on Atrial Fibrillation Occurrence: A Systematic Review, Meta‐Analysis, and Meta‐Regression to Identify Modifying Factors
- Author
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Jonaz Font, Pierre Ollitrault, Paul Milliez, Charles Dolladille, Linda Shavit, Rafal Dabrowski, Christian Funck-Brentano, Jean-Jacques Parienti, Theodora Bejan-Angoulvant, Laure Champ-Rigot, Joachim Alexandre, Damien Legallois, Laurent Douesnel, Farzin Beygui, Signalisation, électrophysiologie et imagerie des lésions d’ischémie-reperfusion myocardique (SEILIRM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Université de Caen Normandie - UFR Santé (UNICAEN Santé), Institute of Cardiology (WARSAW - Cardiology), Institute of Cardiology, Shaare Zedek Medical Center, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Groupe de Recherche sur l'Adaptation Microbienne (GRAM 2.0), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), HAL-SU, Gestionnaire, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN)
- Subjects
030204 cardiovascular system & hematology ,Bioinformatics ,ACE/Angiotension Receptors/Renin Angiotensin System ,aldosterone, mineralocorticoids ,03 medical and health sciences ,0302 clinical medicine ,Mineralocorticoid receptor ,Recurrence ,Odds Ratio ,medicine ,Humans ,atrial fibrillation ,Meta-regression ,030212 general & internal medicine ,Mineralocorticoid Receptor Antagonists ,Randomized Controlled Trials as Topic ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,aldosterone ,Systematic Review and Meta‐analysis ,business.industry ,Incidence ,Atrial fibrillation ,Protective Factors ,medicine.disease ,3. Good health ,Observational Studies as Topic ,Preventive therapy ,Logistic Models ,meta‐analysis ,Meta-analysis ,Linear Models ,mineralocorticoids ,Cardiology and Cardiovascular Medicine ,business ,MRAS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Background Mineralocorticoid receptor antagonists ( MRA s) have emerged as potential atrial fibrillation ( AF ) preventive therapy, but inconsistent results have been reported. We aimed to examine the effects of MRA s on AF occurrence and explore factors that could influence the magnitude of the effect size. Methods and Results PubMed, Embase, and Cochrane Central databases were used to search for randomized clinical trials and observational studies addressing the effect of MRA s on AF occurrence from database inception through April 03, 2018. We performed a systematic review and random effects meta‐analyses to compute odds ratios with 95% CI s. Meta‐regression was then applied to explore the sources of between‐study heterogeneity. We included 24 studies, 11 randomized clinical trials and 13 observational cohorts, representing a total number of 7914 patients (median age: 64.2 years; median left ventricular ejection fraction: 49.7%; median follow‐up: 12.0 months), 2843 (35.9%) of whom received MRA therapy. Meta‐analyses showed a significant overall reduction in AF occurrence in the MRA ‐treated patients versus the control groups (15.0% versus 32.2%; odds ratio, 0.55; 95% CI , 0.44–0.70 [ P AF episodes ( odds ratio , 0.42; 95% CI , 0.31–0.59 [ P I 2 =54%; P =0.0008). Meta‐regression analyses showed that effect size was significantly associated with older studies and higher AF occurrence rate in the control groups. Conclusions MRA s seem to be effective in AF prevention, especially regarding recurrent AF episodes.
- Published
- 2019
27. Recurrent ventricular tachycardia in a dual‐chamber ICD recipient: What is the mechanism?
- Author
-
Mathieu Chequel, Laure Champ-Rigot, Paul Milliez, Arnaud Pellissier, and Pierre Ollitrault
- Subjects
Male ,medicine.medical_specialty ,business.industry ,Mechanism (biology) ,Recurrent ventricular tachycardia ,General Medicine ,Cardiomyopathy, Hypertrophic ,Middle Aged ,DUAL (cognitive architecture) ,Ventricular tachycardia ,medicine.disease ,Defibrillators, Implantable ,Equipment Failure Analysis ,Electrocardiography ,Recurrence ,Internal medicine ,Tachycardia, Ventricular ,Cardiology ,Humans ,Medicine ,Atrioventricular Block ,Cardiology and Cardiovascular Medicine ,business ,Algorithms - Published
- 2019
28. Heart rate and risk of death among patients with Pulmonary Hypertension: A 12-lead ECG analysis
- Author
-
Paul Milliez, Eric Saloux, Helene Bouchery-Bardet, Damien Legallois, Vincent Roule, Christian Creveuil, Fabien Labombarda, Laure Champ-Rigot, Gérard Zalcman, Emmanuel Bergot, Farzin Beygui, Fabrice Bauer, and Rémi Sabatier
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Multivariate analysis ,Hypertension, Pulmonary ,Population ,Hemodynamics ,030204 cardiovascular system & hematology ,World Health Organization ,QT interval ,Electrocardiography ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Heart Rate ,Cause of Death ,Internal medicine ,Heart rate ,medicine ,Humans ,Sinus rhythm ,Registries ,Mortality ,education ,Aged ,education.field_of_study ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Pulmonary hypertension ,030228 respiratory system ,Multivariate Analysis ,Cardiology ,Female ,Risk of death ,business - Abstract
Background Despite the emergence of new therapies, Pulmonary Hypertension (PH) still has a high mortality. Several clinical, echocardiographic, biological or hemodynamic prognostic factors have been identified but are of limited predictive value for survival. We aimed to assess whether heart rate (HR) and all ECG abnormalities measured on a 12-lead ECG may help to better identify patients at high risk of death in this population. Methods and results 296 patients followed in a registry were included with all types of PH, except group 2 of the WHO clinical classification. After a median follow-up of 10 years, age, male sex, NYHA III/IV status and, among all ECG parameters, HR and corrected QT interval were associated with mortality. In multivariate analysis, HR, age and male sex remained significant independent predictors of mortality. HR has a higher predictive value in the 238 patients in sinus rhythm. In addition, only HR was significantly correlated with clinical and hemodynamic PH prognostic factors. Conclusion HR measured on a 12-lead ECG at the time of the diagnosis is a strong independent predictor of mortality in PH patients.
- Published
- 2017
29. Zero-fluoroscopy trans-septal puncture and catheter ablation of a left atrial tachycardia in a pregnant woman with a prosthetic mitral valve
- Author
-
Virginie Ferchaud, Pierre Ollitrault, Laure Champ-Rigot, Arnaud Pellissier, Paul Milliez, and Justine Havard
- Subjects
Tachycardia ,medicine.medical_specialty ,medicine.medical_treatment ,Catheter ablation ,Punctures ,Pregnancy ,Left atrial ,PROSTHETIC MITRAL VALVE ,Physiology (medical) ,Internal medicine ,Tachycardia, Supraventricular ,medicine ,Humans ,Fluoroscopy ,medicine.diagnostic_test ,business.industry ,Treatment Outcome ,Catheter Ablation ,Cardiology ,Mitral Valve ,Female ,Pregnant Women ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Published
- 2021
30. Vascular entrapment of a multipolar basket catheter (Orion TM ) during catheter ablation
- Author
-
Laure Champ-Rigot, Arnaud Pellissier, Olivier Coffin, Pierre Ollitrault, Virginie Ferchaud, and Paul Milliez
- Subjects
medicine.medical_specialty ,animal structures ,business.industry ,medicine.medical_treatment ,Catheter ablation ,030204 cardiovascular system & hematology ,Vascular entrapment ,Surgery ,body regions ,03 medical and health sciences ,0302 clinical medicine ,nervous system ,Physiology (medical) ,Surgical removal ,embryonic structures ,cardiovascular system ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,Basket catheter ,business - Abstract
The IntellaMap OrionTM (Boston Scientific) is a 64-electrode basket catheter allowing for ultrahigh-density mapping of complex cardiac arrhythmias. We report the case of a basket catheter vascular entrapment, requiring surgical removal.
- Published
- 2020
31. Safety of uninterrupted direct oral anticoagulants for ambulatory common atrial flutter catheter ablation: A propensity score-matched cohort study
- Author
-
Patrick Bittar, Arnaud Pellissier, Laure Champ-Rigot, Pierre Ollitrault, Damien Legallois, Mathieu Chequel, Paul Milliez, and Joachim Alexandre
- Subjects
Male ,medicine.drug_class ,medicine.medical_treatment ,Administration, Oral ,Catheter ablation ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Clinical endpoint ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Propensity Score ,Aged ,business.industry ,Anticoagulant ,Anticoagulants ,medicine.disease ,Stroke ,Treatment Outcome ,Ambulatory Surgical Procedures ,Atrial Flutter ,Anesthesia ,Ambulatory ,Propensity score matching ,Catheter Ablation ,Feasibility Studies ,Female ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Atrial flutter ,Kidney disease ,Follow-Up Studies - Abstract
Background Same-day home discharge after common atrial flutter catheter ablation (CAFCA) is a feasible, safe, and cost-effective practice, but there are currently no data for patients treated with direct oral anticoagulants (DOAs). Objective We evaluated the safety, efficacy, and feasibility of ambulatory CAFCA in patients treated with DOAs compared with those treated with vitamin K antagonists (VKAs). Methods Patients scheduled for isolated and elective ambulatory CAFCA in our tertiary university center between 2009 and 2019 were included. Propensity score for anticoagulant type was calculated from age, sex, body mass index, HAS-BLED and CHA2DS2-VASc scores, chronic kidney disease, associated antiplatelet treatment, procedure duration, and number of femoral venipunctures. Results Propensity score matching yielded 820 patients (mean age 67 ± 11 years). Catheter ablation was performed under uninterrupted VKA (n = 410; international normalized ratio 2.5 ± 0.6) or uninterrupted DOA (n = 410). The procedural success rate was 91%, and the effective same-day discharge rate was 93%. The occurrence of the primary end point, defined as any early and clinically significant bleeding (Bleeding Academic Research Consortium classification ≥ 2) at 1 week, was similar between patients treated with DOAs and those treated with VKAs (2.9% vs 3.7%; P = .70). Female sex, high HAS-BLED score, and prolonged procedure duration were independently associated with the primary end point. Conclusion Uninterrupted DOA regimens are safe for patients undergoing ambulatory CAFCA in a high-volume center with a dedicated ambulatory unit and standardized procedural and postoperative management.
- Published
- 2019
32. Rationale and Design for a Monocentric Prospective Study: Sleep Apnea Diagnosis Using a Novel Pacemaker Algorithm and Link With Aldosterone Plasma Level in Patients Presenting With Diastolic Dysfunction (SAPAAD Study)
- Author
-
Eric Saloux, Arnaud Pellissier, Pierre Moirot, Laure Champ-Rigot, Damien Legallois, Jean-Noël Prévost, Patrice Scanu, Rémy Morello, Virginie Ferchaud, Paul Milliez, and Joachim Alexandre
- Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system ,diagnosis ,medicine.medical_treatment ,Diastole ,Polysomnography ,chemistry.chemical_compound ,Respiratory disturbance index ,Research Proposal ,medicine ,Sleep study ,Continuous positive airway pressure ,Prospective cohort study ,aldosterone ,Aldosterone ,medicine.diagnostic_test ,business.industry ,Sleep apnea ,sleep apnea ,medicine.disease ,chemistry ,lcsh:RC666-701 ,diastolic dysfunction ,attended cardiorespiratory sleep study ,Cardiology and Cardiovascular Medicine ,business ,Algorithm - Abstract
Previous studies showed good agreement between pacemaker respiratory disturbance index (RDI) and polysomnography for diagnosis of severe sleep apnea (SA). The aim of this study is to investigate the diagnostic accuracy of RDI compared with apnea-hypopnea index (AHI) from a cardiorespiratory sleep study for the diagnosis of severe SA within patients requiring a pacemaker and meeting diastolic dysfunction criteria. Secondary objectives are as follows: correlation between plasma aldosterone level and SA severity, diagnostic accuracy of RDI for moderate SA, prevalence of SA among patients with diastolic dysfunction, occurrence of arrhythmias, and improvement of RDI with continuous positive airway pressure therapy. We designed a monocentric prospective nonrandomized study of prevalent cases to include 68 patients with a 6-month follow-up. Both RDI and AHI will be compared 2 months after implantation and after 1 month of continuous positive airway pressure treatment in patients with severe SA. This is the first study that examines diagnostic accuracy of pacemaker algorithm for the diagnosis of SA and correlation with plasma aldosterone levels in patients with diastolic dysfunction. Protocol version: V04. 04/04/2017 Trial registration: ClinicalTrials.gov NCT02751021
- Published
- 2018
33. Ultra-high density electroanatomic mapping of left atrial local macro-reentry occurring twenty-three years after orthotopic heart transplantation
- Author
-
Arnaud Pellissier, Pierre Breguiboul, Laure Champ-Rigot, Mathieu Chequel, Paul Milliez, and Pierre Ollitrault
- Subjects
Heart transplantation ,medicine.medical_specialty ,Ultra high density ,Electroanatomic mapping ,business.industry ,medicine.medical_treatment ,Left atrium ,Reentry ,medicine.anatomical_structure ,Left atrial ,Physiology (medical) ,Internal medicine ,Cardiology ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2019
34. Scar extent as a predictive factor of ventricular tachycardia cycle length after myocardial infarction: implications for implantable cardioverter-defibrillator programming optimization
- Author
-
Paul Milliez, Sophie Gomes, Alain Lebon, Laure Champ-Rigot, Patrice Scanu, Arnaud Pellissier, Eric Saloux, Adrien Lemaitre, Audrey Emmanuelle Dugué, Fabien Labombarda, Joachim Alexandre, and Vincent Roule
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Electric Countershock ,Myocardial Infarction ,Contrast Media ,Amiodarone ,Ventricular tachycardia ,Risk Assessment ,Cicatrix ,Meglumine ,Predictive Value of Tests ,Risk Factors ,Physiology (medical) ,Internal medicine ,Organometallic Compounds ,Humans ,Medicine ,cardiovascular diseases ,Myocardial infarction ,Prospective cohort study ,Cycle length ,Aged ,Retrospective Studies ,business.industry ,Myocardium ,Patient Selection ,Area under the curve ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Implantable cardioverter-defibrillator ,Magnetic Resonance Imaging ,Defibrillators, Implantable ,Treatment Outcome ,ROC Curve ,Area Under Curve ,Tachycardia, Ventricular ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Aims After an old myocardial infarction (MI), patients are at risk for reentrant ventricular tachycardia (VT) due to scar tissue that can be accurately identified by late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Although the ability of LGE-CMR to predict sustained VT in implantable cardioverter-defibrillator (ICD) recipients has been well established, its use to predict monomorphic VT (sustained or not) cycle length (CL) and so, optimize ICD programming has never been investigated. Methods and results We included retrospectively 49 consecutive patients with an old MI who had undergone LGE-CMR before ICD implantation over a 4-year period (2006–09). Patients with amiodarone used were excluded. Scar extent was assessed by measuring scar mass, percent scar, and transmural scar extent. The endpoint was the occurrence of monomorphic VT, requiring an ICD therapy or not. The endpoint occurred in 26 patients. The median follow-up duration was 31 months. Scar extent parameters were significantly correlated with the study endpoint. With univariate regression analysis, the scar mass had the highest correlation with the VT CL ( R = 0.671, P = 0.0002). Receiver-operating characteristic curve showed that scar mass can predict VT CL (area under the curve = 0.977, P < 0.0001). For a cut-off value of scar mass at 17.6 g, there is 100% specificity and 94.4% sensitivity. Conclusion In this observational and retrospective study, scar mass studied by LGE-CMR was specific and sensitive to predict VT CL and so could be a promising option to improve ICD post-implantation programming and decrease appropriate and inappropriate shocks. These conclusions must now be confirmed in a large and prospective study.
- Published
- 2013
35. Primary prevention with a defibrillator: are therapies always really optimized before implantation?
- Author
-
Fabien Labombarda, Eric Saloux, Laure Champ-Rigot, Arnaud Pellissier, Anthony Foucault, Patrice Scanu, Paul Milliez, Sophie Gomes, Mathieu Amelot, Cardioprotection, Remodelage et Thrombose (CRT), and Université d'Angers (UA)
- Subjects
Male ,Time Factors ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Cardiomyopathy ,Angiotensin-Converting Enzyme Inhibitors ,030204 cardiovascular system & hematology ,Ventricular Function, Left ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Risk Factors ,030212 general & internal medicine ,Ejection fraction ,Middle Aged ,Defibrillators, Implantable ,3. Good health ,Primary Prevention ,Treatment Outcome ,medicine.anatomical_structure ,cardiovascular system ,Cardiology ,Female ,France ,Cardiomyopathies ,Cardiology and Cardiovascular Medicine ,Adult ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Electric Countershock ,Revascularization ,Sudden death ,03 medical and health sciences ,Physiology (medical) ,Internal medicine ,Primary prevention ,medicine ,Humans ,In patient ,Medical prescription ,Aged ,Retrospective Studies ,Chi-Square Distribution ,business.industry ,Cardiovascular Agents ,Stroke Volume ,Recovery of Function ,medicine.disease ,Death, Sudden, Cardiac ,Ventricle ,business ,Angiotensin II Type 1 Receptor Blockers - Abstract
International audience; AIMS:Left ventricle ejection fraction (LVEF) ≤ 30-35% is widely accepted as a cut-off for primary prevention with an implantable cardiac defibrillator (ICD) in patients with both ischaemic and non-ischaemic cardiomyopathy supposedly on optimal medical therapy. This study reports evolutions of LVEF and treatments of patients implanted in our institution with an ICD for primary prevention of sudden death, after 2 years of follow-up. METHODS AND RESULTS: Among 84 patients with LVEF under 35% implanted between 2005 and 2007, 28 (33%) had improved their LVEF >35% after the 2 years of follow-up. During this period, even if Beta-blockers (98%) and renin-angiotensin system (RAS) blockers (95%) were already initially prescribed, treatments were significantly optimized with improvement of maximal doses of beta-blockers and RAS blockers at 2 year follow-up compared with initial prescription (62 vs. 37% and 68 vs. 45%, respectively). In patients with improved LVEF, a trend toward a better treatment optimization and revascularization procedures (in the sub-group of ischaemic patients) were observed compared with non-improved LVEF patients. CONCLUSIONS: In our study of patients with prophylactic ICD, one-third of them have improved their LVEF after a 2 year follow-up. Despite an optimal medical therapy at the time of implantation, we were able to further improve the maximal treatment doses after implantation. This study highlights the issue of what should be considered as 'optimal' therapy and the possibility of improvement of LVEF related to a real optimized treatment before implantation.
- Published
- 2012
36. Comparison of outcomes in patients with abandoned versus extracted implantable cardioverter defibrillator leads
- Author
-
Arnaud Pellissier, Laure Champ-Rigot, Patrice Scanu, Paul Milliez, Anthony Foucault, Sophie Gomes, Mathieu Amelot, Cardioprotection, Remodelage et Thrombose (CRT), and Université d'Angers (UA)
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Complications ,Leads ,Defibrillation ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Electric Countershock ,030204 cardiovascular system & hematology ,Prosthesis Design ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Implantable cardioverter defibrillator ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Lead (electronics) ,Shocks ,Device Removal ,Chocs ,Aged ,Retrospective Studies ,Heart Failure ,Sondes ,Chi-Square Distribution ,business.industry ,Medical record ,Défibrillateur automatique implantable ,Retrospective cohort study ,General Medicine ,Middle Aged ,Implantable cardioverter-defibrillator ,humanities ,Defibrillators, Implantable ,Prosthesis Failure ,3. Good health ,Surgery ,Treatment Outcome ,extraction ,France ,Cardiology and Cardiovascular Medicine ,business ,Risk assessment ,Chi-squared distribution - Abstract
International audience; SummaryBackgroundDespite the increased number of implantable cardioverter defibrillator (ICD) recipients and the frequent need for device upgrading and/or occurrence of lead malfunction, the optimal approach to managing abandoned leads remains debated. Aims To determine the rate and type of complications related to either abandoned or extracted ICD leads. Methods Patients with abandoned or extracted leads were identified retrospectively. Patient medical records were reviewed to assess long-term lead or device malfunction, defibrillation test values before and after lead abandonment or extraction, and appropriateness of delivered shocks and subsequent surgical procedures related to devices or leads. Results A total of 58 ICD patients with 47 extracted and 34 abandoned leads were identified. After a mean follow-up of 3.2 ± 2.6 years, the defibrillation test was not affected by either abandoned or extracted leads (23.4 ± 6.6 J vs 25.4 ± 4.9 J, respectively; P = 0.24). There were no differences in the number of ICD-related surgical procedures after extracting versus abandoning leads (22% vs 12%, respectively; P = 0.3) or in the thromboembolic event rate (7.7% vs 6.3%; P = 0.83). During follow-up, no differences in the occurrence of major complications or appropriate/inappropriate shocks were observed between patients with or without abandoned leads. Conclusion We observed no difference in rates of immediate or medium-term complications between extracting versus abandoning leads. Lead abandonment remains an alternative and safe option when extraction does not appear mandatory according to the age of the leads or experience of the operating centre.
- Published
- 2011
37. Ultra-high density electroanatomic mapping through transbaffle approach of re-entrant tachycardia after Senning operation
- Author
-
Arnaud Pellissier, Fabien Labombarda, Marc-Olivier Fischer, Paul Milliez, Laure Champ-Rigot, and Guillaume Gibert
- Subjects
Tachycardia ,Electroanatomic mapping ,Ultra high density ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Treatment outcome ,Catheter ablation ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Re entrant ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Senning operation - Published
- 2018
38. Que faire devant un premier passage récent en fibrillation atriale ?
- Author
-
Paul Milliez, Sophie Gomes, Arnaud Pellissier, Clémentine Dufay-Bougon, Laure Champ-Rigot, Patrice Scanu, Jean-Michel Hurpe, and Anthony Foucault
- Subjects
Supraventricular arrhythmia ,education.field_of_study ,medicine.medical_specialty ,Heart disease ,business.industry ,Population ,Rate control ,Atrial fibrillation ,General Medicine ,medicine.disease ,Emergency medicine ,Medicine ,Medical prescription ,business ,education ,Stroke ,Paroxysmal AF - Abstract
Atrial fibrillation (AF) is the most frequent supraventricular arrhythmias with an approximative prevalence of 1 % in the general population and above 6 % in the elderly. Management of a first AF episode is different depending on the clinical status of patients. Practice guidelines developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society are available for the management of these patients. A four-step decisional scheme must be followed in the management of a first recent AF episode: need for a short- and long-term anticoagulation, define a rythmologic strategy (rhythm or rate control), select the weapon (drug, device or ablation) and reconsider the strategy if needed. After a first uncomplicated paroxysmal AF episode, guidelines recommend that prescription of antiarrhythmics must be avoided and anticoagulation is optional. After a first persistent AF episode, guidelines recommend to either respect or reduce the arrhythmia. Prescription of antiarrhythmics and anticoagulation is also optional depending on the patients condition. In case of the AF reduction decision, anticoagulation must be tailored preliminary to this reduction. AF recurrence rate varies depending on the patients condition, and the risk of stroke assessed by the CHADS(2) score might be similarly considered for both paroxysmal and persistent AF.
- Published
- 2010
39. Ventricular arrhythmia originating from scar border tissue during dobutamine myocardial perfusion gated SPECT on CZT camera
- Author
-
Laure Champ-Rigot, Denis Agostini, Damien Legallois, Alain Manrique, and Benjamin Houdu
- Subjects
Male ,medicine.medical_specialty ,Gated SPECT ,030204 cardiovascular system & hematology ,Cicatrix ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Text mining ,Dobutamine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Aged ,Tomography, Emission-Computed, Single-Photon ,medicine.diagnostic_test ,business.industry ,Myocardial Perfusion Imaging ,Arrhythmias, Cardiac ,Zinc ,Cardiology ,Tellurium ,Cardiology and Cardiovascular Medicine ,business ,Perfusion ,medicine.drug - Published
- 2015
40. P1473Long-term efficiency of a novel high density mapping system for ablation of atrial tachycardia
- Author
-
Benjam Monteil, Philippe Maury, L. Marty, Paul Milliez, Anne Rollin, Laure Champ-Rigot, C. Cardin, Marie Sadron, Pierre Mondoly, Stefano Capellino, and Alexandre Duparc
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,High density ,Ablation ,Term (time) ,Physiology (medical) ,Mapping system ,Internal medicine ,medicine ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Atrial tachycardia - Published
- 2017
41. Apical aneurism and myocardial bridging in a patient with hypertrophic cardiomyopathy: Association or consequence of the myocardial bridging?
- Author
-
Laure Champ-Rigot, Eric Saloux, Arnaud Pellissier, Loic Hilpert, Anthony Foucault, Patrice Scanu, Francois Hédoire, Paul Milliez, Sophie Gomes, Cardioprotection, Remodelage et Thrombose (CRT), and Université d'Angers (UA)
- Subjects
medicine.medical_specialty ,Myocardial bridging ,Myocardial Bridging ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Primary prevention ,medicine ,Humans ,030212 general & internal medicine ,Risk factor ,Heart Aneurysm ,Apical aneurysm ,business.industry ,Hypertrophic cardiomyopathy ,General Medicine ,Cardiomyopathy, Hypertrophic ,Middle Aged ,medicine.disease ,3. Good health ,Surgery ,Defibrillators, Implantable ,Death, Sudden, Cardiac ,Treatment Outcome ,Sustained ventricular tachycardia ,Cardiology ,Tachycardia, Ventricular ,Female ,Implant ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
International audience; The identification of high-risk patients with hypertrophic cardiomyopathy (HC) for primary prevention of sudden cardiac death (SCD) remains a challenging issue, since major risk factors sometimes lack specificity. We report the case of a patient with HC and association of apical aneurysm and myocardial bridging who had been initially not implanted because she had only one major risk factor. She subsequently experienced a sustained ventricular tachycardia that finally motivated the implantation. We conclude that it is never an easy decision to implant a preventive implantable cardioverter-defibrillator (ICD). Nevertheless, additional criteria for a better selection of patients who would benefit from an ICD implant are certainly useful.
- Published
- 2012
42. Takotsubo cardiomyopathy triggered by alcohol withdrawal
- Author
-
Joakim, Alexandre, Leila, Benouda, Laure, Champ-Rigot, and Fabien, Labombarda
- Subjects
Male ,Ethanol ,Takotsubo Cardiomyopathy ,Alcohols ,Humans ,Middle Aged ,Substance Withdrawal Syndrome - Abstract
Takotsubo cardiomyopathy is a reversible cardiomyopathy frequently precipitated by a sudden emotional or physical stress. The exact physiopathology is still debated and may involve catecholamine-induced myocardial stunning. Alcohol withdrawal is associated with an hyperadrenergic state and may be a period at risk of cardiac events. We report a 56-year-old man with Takotsubo cardiomyopathy triggered by alcohol withdrawal.
- Published
- 2011
43. [Management of a first recent episode of atrial fibrillation in clinical practice]
- Author
-
Sophie, Gomes, Laure, Champ-Rigot, Anthony, Foucault, Clémentine, Dufay-Bougon, Arnaud, Pellissier, Jean-Michel, Hurpé, Patrice, Scanu, and Paul, Milliez
- Subjects
Atrial Fibrillation ,Decision Trees ,Practice Guidelines as Topic ,Humans - Abstract
Atrial fibrillation (AF) is the most frequent supraventricular arrhythmias with an approximative prevalence of 1 % in the general population and above 6 % in the elderly. Management of a first AF episode is different depending on the clinical status of patients. Practice guidelines developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society are available for the management of these patients. A four-step decisional scheme must be followed in the management of a first recent AF episode: need for a short- and long-term anticoagulation, define a rythmologic strategy (rhythm or rate control), select the weapon (drug, device or ablation) and reconsider the strategy if needed. After a first uncomplicated paroxysmal AF episode, guidelines recommend that prescription of antiarrhythmics must be avoided and anticoagulation is optional. After a first persistent AF episode, guidelines recommend to either respect or reduce the arrhythmia. Prescription of antiarrhythmics and anticoagulation is also optional depending on the patients condition. In case of the AF reduction decision, anticoagulation must be tailored preliminary to this reduction. AF recurrence rate varies depending on the patients condition, and the risk of stroke assessed by the CHADS(2) score might be similarly considered for both paroxysmal and persistent AF.
- Published
- 2010
44. Diagnostic accuracy of in-stent coronary restenosis detection with multislice spiral computed tomography: a meta-analysis
- Author
-
Laure Champ-Rigot, Rémy Morello, Michèle Hamon, John W. Riddell, and Martial Hamon
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Coronary Angiography ,Sensitivity and Specificity ,Coronary Restenosis ,Restenosis ,Predictive Value of Tests ,Coronary stent ,medicine ,Odds Ratio ,Humans ,Radiology, Nuclear Medicine and imaging ,Multislice ,Neuroradiology ,business.industry ,Stent ,Reproducibility of Results ,General Medicine ,medicine.disease ,Confidence interval ,Spiral computed tomography ,Diagnostic odds ratio ,Stents ,Radiology ,business ,Tomography, Spiral Computed - Abstract
This study was designed to define the current role of multislice spiral computed tomography (MSCT) for the diagnosis of coronary in-stent restenosis using a meta-analytic process. Restenosis remains a limitation after coronary stent implantation and contributes to a substantial number of coronary re-assessments by conventional invasive coronary angiography (CA). We identified 15 studies (807 patients) evaluating in-stent restenosis by means of both MSCT (>or=16 slices) and conventional CA until February 2007. After data extraction the analysis was performed according to a random-effects model. The analysis pooled the results from 15 studies with a total of 1,175 stents. A substantial number of unassessable stents (13%) were excluded from the analysis underscoring the shortcomings of MSCT. With this major limitation the diagnostic performance of MSCT for in-stent restenosis detection can be summarized as follows: the sensitivity and specificity were 84% [95% confidence interval (CI) 77-89%] and 91% (95% CI 89-93%), respectively, with positive and negative likelihood ratios of 12.2 (95% CI 6.6-22.6) and 0.23 (95% CI 0.17-0.31), respectively, and with a diagnostic odds ratio of 67.9 (95% CI 34.4-134.1). MSCT has shortcomings difficult to overcome in daily practice for in-stent restenosis detection and continues to have moderately high sensitivity and specificity. The diagnostic role of this emerging technology as an alternative to CA for in-stent restenosis detection remains limited.
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- 2007
45. 250 AngiotensinII induced atrial remodelling is worsened in mice overexpressing aldosterone synthase in cardiomyocyte
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Claude Delcayre, Laure Champ-Rigot, Jane-Lise Samuel, Ludovic Bénard, Paul Milliez, Sophie Gomes, and Camille Rodroguez
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Genetically modified mouse ,Aldosterone synthase ,medicine.medical_specialty ,Aldosterone ,biology ,business.industry ,Wild type ,Connexin ,medicine.disease ,Muscle hypertrophy ,chemistry.chemical_compound ,Endocrinology ,Blood pressure ,chemistry ,Fibrosis ,Internal medicine ,medicine ,biology.protein ,cardiovascular system ,business ,Cardiology and Cardiovascular Medicine - Abstract
The aim Of this work was to check the hypothesis that increased cardiac aldosterone level combined with arterial hypertension may enhance the deleterious effects at the heart level. Transgenic mice overexpressing Aldo Synthase (AS) in cardiomyocytes and wild type (WT) littermates were submitted to AngII-induced hypertension by osmotic pump (1mg/kg/day) during 3 or 8 weeks.Results1) Physiological analysis indicated that the arterial pressure increased similarly (+50 mmHg) in AngII-perfused groups whatever the genotype. At the ventricular level, the hypertrophy and the fibrosis (×3, p
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46. Prévention de la mort subite rythmique par un système entièrement sous-cutané comparé au défibrillateur trans-veineux : étude rétrospective au CHU de Caen
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Cloix, Camille, Université de Caen Normandie - UFR Santé (UNICAEN Santé), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), and Laure Champ Rigot
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[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Mort subite cardiaque -- Prévention ,Arythmie ,Défibrillateurs implantables ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Introduction. Implantable cardioverter-defibrillator (ICD) prevents from sudden cardiac death but it requires the use of intra-cardiac leads which are associated with the majority of the ICD’s complications. Recently, a new type of subcutaneous ICD (S-ICD) with no intravascular lead was developed and constitutes an alternative to the standard transvenous ICD (TV-ICD). Aim. We studied the safety and efficacy of the S-ICD device compared to (TV-ICD) in Caen University Hospital. Methods. One-hundred-and-seven patients were retrospectively included from April 2015 and October 2017: 28 in the S-ICD group and 79 in the TV-ICD group. The primary safety end-point was the rate of complications (local, infectious, electronic or lead failure inappropriate device therapy). The secondary end-points were the effectiveness of the device and the mortality rate. Results. There were significantly more inappropriate therapies in the S-ICD group (14% versus 3%, p = 0,039), and more local discomfort (p = 0,05). There was neither difference between the two groups regarding the remaining local complications, especially hemorrhagic complications, nor difference in lead or electronic failure. None of our patients experienced device infection. No difference was observedin appropriate device therapies and in mortality rates between the S-ICD and the TV-ICD groups. Conclusion. In our population, complications are different between TV-ICD and S-ICD patients. Latter experienced more inappropriate device therapies. However, Our study confirms safety and effectiveness of S-ICD compared to Tv-ICD with no difference regarding efficacy of the device and mortality.; Introduction. Le défibrillateur implantable a montré son efficacité et sa sûreté dans la prévention de la mort subite rythmique. Néanmoins les complications liées au matériel, pour la plupart liées aux électrodes endocavitaires, sont responsables d’une morbi-mortalité non négligeables et d’une dégradation de la qualité de vie. Depuis les années 2000, un nouveau système de défibrillation entièrement sous-cutané a été développé, et constitue une alternative fiable au système endocavitaire désormais intégrée aux recommandations. Objectif. Nous avons comparé les résultats du défibrillateur sous-cutané (S-DAI) au défibrillateur trans-veineux (TV-DAI) en termes de sécurité et d’efficacité à court et long terme, au Centre Hospitalo-Universitaire de Caen. Méthodes. Cent-sept patients ont été inclus rétrospectivement entre le 30 Avril 2015 et le 30 Octobre 2017 : 28 patients dans le groupe S-DAI et 79 dans le groupe TV-DAI. Le critère primaire était l’apparition d’une complication locale, infectieuse, de matériel ou la survenue d’une thérapie inappropriée. Le critère secondaire était l’évaluation de l’efficacité du dispositif en terme de thérapies appropriées, et de la mortalité toute cause. Résultats. Au terme d’un suivi moyen de 14 mois , les patients implantés d’un S-DAI ont présenté plus de thérapies inappropriées que les patients implantés d’un TV-DAI (14% contre 3%, p = 0,039) et plus de gênes fonctionnelles (p = 0,05). Il n’y a pas eu de différence entre les deux groupes concernant les autres complications locales notamment hémorragiques ni les complications électroniques. Aucun patient n’a présenté de complication infectieuse au cours du suivi. Il n’y a pas eu de différence significative en termes d’efficacité et de mortalité entre les deux types de défibrillateurs. Conclusion. Les complications secondaires aux deux types de défibrillateurs sont différentes avec dans notre série plus de thérapies inappropriées chez les porteurs de S-DAI. Néanmoins nos résultats confirment que le S-DAI est sûr et aussi efficace en prévention de la mort subite cardiaque que le TV-DAI.
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- 2018
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